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

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

• 0:00
  Speaker 1: Emily, when you pitch the idea of talking about colostrum
• 0:06
  Speaker 1: to me, I thought of the human substance that comes
• 0:11
  Speaker 1: from that comes from breasts, yep, after a mother has
• 0:16
  Speaker 1: a baby. And you were like, no, no, no, it's
• 0:18
  Speaker 1: huge in the endurance athlete space. And I have like
• 0:22
  Speaker 1: these horrifying visions of like human women in factories, this
• 0:29
  Speaker 1: totally dystopian view. And then I learned that this is
• 0:33
  Speaker 1: not humans where this colostrum is coming from, Thank you God.
• 0:39
  Speaker 2: It is still a little dystopian, and we can get
• 0:41
  Speaker 2: into the baby cows. But I will tell you that
• 0:46
  Speaker 2: when people first started asking me about should I take colostrum?
• 0:48
  Speaker 3: I assumed that they were talking about their.
• 0:51
  Speaker 2: Own colostrum, And often this question was phrased like should
• 0:55
  Speaker 2: my husband take colostrum? And it's like, well, there's only
• 0:58
  Speaker 2: a tiny amount of it, Like you know, if you
• 1:00
  Speaker 2: have a baby, that colostrum, it's like the first milk
• 1:04
  Speaker 2: that comes in. It's thicker, it's more yellow, but it's
• 1:06
  Speaker 2: like so little, and it's like you're desperately trying to
• 1:10
  Speaker 2: get some of it out for your baby.
• 1:11
  Speaker 3: It's like, fuck you, what do you mean? Your husband's like.
• 1:13
  Speaker 1: This guy's got a marathon tomorrow.
• 1:15
  Speaker 3: So what are you going to go?
• 1:16
  Speaker 1: Cycle? Like? Are you kidding me?
• 1:18
  Speaker 2: And So we are talking about bovine colostrum in this episode,
• 1:24
  Speaker 2: not human colostrum, which is a great food for babies,
• 1:27
  Speaker 2: but should not be shared with your spouse even if
• 1:30
  Speaker 2: they have a large endurance event.
• 1:32
  Speaker 3: Coming up shortly.
• 1:34
  Speaker 1: Cal colostrum coming right up.
• 1:38
  Speaker 2: I'm Emily Oster. I'm an economist and a data expert.
• 1:42
  Speaker 1: And I'm Perry Wilson, I'm a medical doctor.
• 1:44
  Speaker 2: It's Thursday, May seventh, twenty twenty six. And this is
• 1:48
  Speaker 2: wellness actually.
• 1:50
  Speaker 1: Because you're getting a staggering amount of health and wellness
• 1:53
  Speaker 1: information nowadays from every source imaginable, and some of it
• 1:57
  Speaker 1: is awesome and some.
• 1:59
  Speaker 3: Of it is well actually both.
• 2:03
  Speaker 2: Fortunately we are both people who know how to read studies,
• 2:06
  Speaker 2: how to parse the data, and can tell you what's
• 2:08
  Speaker 2: worth thinking about and what you can safely ignore.
• 2:11
  Speaker 1: But before we dig in, a note that this podcast
• 2:14
  Speaker 1: is for educational purposes and should not be construed as
• 2:16
  Speaker 1: medical advice. We don't know your unique situation, so talk
• 2:20
  Speaker 1: to your doctor for personal health decisions.
• 2:23
  Speaker 2: This week we're asking what's the deal with colostrum? Perry
• 2:26
  Speaker 2: and I will give the official Smasher pass and then
• 2:29
  Speaker 2: we'll get to your question of the week. But first
• 2:32
  Speaker 2: let's do the health news roundup after the break, and
• 2:47
  Speaker 2: now for the health news of the week, Perry, I
• 2:50
  Speaker 2: want to start with a new trial in alcohol use
• 2:55
  Speaker 2: disorder about ozembic, which I thought was really exciting.
• 2:59
  Speaker 3: Did you think this was exciting?
• 3:01
  Speaker 1: This is super exciting. The context here is that since
• 3:05
  Speaker 1: ozepic has been a thing and been in diabetes and
• 3:09
  Speaker 1: weight loss trials, there has been this, I don't know
• 3:11
  Speaker 1: if you even want to call it a side effect,
• 3:13
  Speaker 1: like an additional effect, which has been reported, which is
• 3:16
  Speaker 1: people saying I'm not drinking as much alcohol and other
• 3:19
  Speaker 1: things like not smoking as much, other sort of compulsive behaviors.
• 3:22
  Speaker 1: But it hadn't really been formally tested, like let's do
• 3:26
  Speaker 1: a trial specifically with this as the outcome. It was
• 3:29
  Speaker 1: always just sort of icing on the cake. But this
• 3:31
  Speaker 1: week we have a new randomized trial appearing in the Lancet,
• 3:35
  Speaker 1: which randomized one hundred and eight participants about half men,
• 3:38
  Speaker 1: half women. They all had alcohol use disorder. They all
• 3:43
  Speaker 1: also had obesity, so they did have a like an
• 3:47
  Speaker 1: FDA indication for ozempic. But the purpose of this trial
• 3:51
  Speaker 1: was to see if the people that got ozepic versus
• 3:54
  Speaker 1: placebo would have a reduction in days with heavy drinking,
• 3:58
  Speaker 1: and indeed, they did a forty one percent reduction in
• 4:01
  Speaker 1: the ozepic group compared to a twenty six percent reduction
• 4:05
  Speaker 1: in the placebo group. That was statistically significant, and there
• 4:08
  Speaker 1: was a bunch of other secondary effects that also suggested
• 4:13
  Speaker 1: significantly less drinking. So, I mean, it's good news.
• 4:17
  Speaker 3: It's really good news.
• 4:18
  Speaker 2: I mean, we have relatively little treatment for alcohol use disorder.
• 4:22
  Speaker 3: There are some.
• 4:23
  Speaker 2: Medications, but they have pretty substantial side effects that make
• 4:27
  Speaker 2: people not want to use them. They basically work by
• 4:30
  Speaker 2: making drinking very unpleasant, and so this obviously works in
• 4:34
  Speaker 2: a different way, and people describe it, at least anecdotally,
• 4:38
  Speaker 2: it's more like you just don't want to drink, which
• 4:41
  Speaker 2: is obviously much better than wanting to drink but then
• 4:43
  Speaker 2: feeling bad when you do. So I thought this was
• 4:46
  Speaker 2: really exciting. I think we'll be seeing more like this.
• 4:48
  Speaker 2: I'd like to see some work on narcotics also, but
• 4:50
  Speaker 2: I think that's probably down the line.
• 4:52
  Speaker 1: Yeah, one hundred percent. I mean the big caveat here
• 4:55
  Speaker 1: is that it does make you lose weight, and so
• 4:57
  Speaker 1: this is not necessarily a therapy for people who are
• 5:00
  Speaker 1: of normal weight to begin with, or you know, at
• 5:02
  Speaker 1: some people with severe alcohol and drug use to sort
• 5:04
  Speaker 1: of have are quite a bit underweight, so that'll sort
• 5:06
  Speaker 1: of take this out of the picture for them. But
• 5:10
  Speaker 1: really interesting to see some corroboration of the observational data
• 5:14
  Speaker 1: on ozepic and alcohol use disorder. We need to close
• 5:20
  Speaker 1: the book on perennial Surgeon General candidate doctor Casey Means, Emily,
• 5:26
  Speaker 1: we the saga is over. I like to think we played,
• 5:30
  Speaker 1: you know, perhaps a small part in the saga. So
• 5:34
  Speaker 1: talk to me about no longer surgeon General candidate Casey Means,
• 5:38
  Speaker 1: and where we are with this position that has been
• 5:40
  Speaker 1: vacant for a long for a very long time.
• 5:43
  Speaker 3: Yeah.
• 5:44
  Speaker 2: So, so the surgeon general position has been vacant for
• 5:47
  Speaker 2: a long time. I think it's an interesting question of
• 5:49
  Speaker 2: kind of is that something we should be concerned about
• 5:52
  Speaker 2: the surgeon general is it's some ways a largely symbolic
• 5:56
  Speaker 2: role and so we're not exactly missing a lot of
• 5:59
  Speaker 2: things milestones, let's say, but it is a role that
• 6:04
  Speaker 2: needs to be filled. Casey Means has been on the
• 6:07
  Speaker 2: ropes in terms of approval. For many months now, it's
• 6:12
  Speaker 2: been she I think was caught up in this in
• 6:16
  Speaker 2: the backlash wave to some of the anti vax activities
• 6:20
  Speaker 2: of the RFK administration.
• 6:22
  Speaker 3: You know, people have lost patients. Some people have lost
• 6:27
  Speaker 3: patients with the resistance to vaccines.
• 6:30
  Speaker 1: As more and more, Senator.
• 6:32
  Speaker 2: Cassidy noticed a lot of piece people got measles. And
• 6:35
  Speaker 2: he noticed that whatever deal he had made with Kennedy
• 6:37
  Speaker 2: was not followed through on. And he's had enough and
• 6:42
  Speaker 2: that has tanked the nomination. The White House was not
• 6:44
  Speaker 2: interested in getting losing further capital on this, and they
• 6:49
  Speaker 2: have now nominated someone named Nicole Safire Leaves how you
• 6:52
  Speaker 2: say her name? Who seems like a very standard up
• 6:56
  Speaker 2: the middle of candidate.
• 6:57
  Speaker 1: Yeah, up the middle for this administration. I would say,
• 7:00
  Speaker 1: doctor Perry. She's an actual I'll take it. I will
• 7:02
  Speaker 1: tell she's a doctor. She's a real doctor. She's a
• 7:05
  Speaker 1: breast radiologist at Memorial Sloan kettering.
• 7:08
  Speaker 3: As a reasonable she's a Fox News contributor. But she's
• 7:11
  Speaker 3: a real doctor.
• 7:11
  Speaker 2: And I feel like that's my that's my bark's doctor.
• 7:14
  Speaker 1: Great go, and I imagine she will get confirmed unless
• 7:18
  Speaker 1: the position is truly cursed, as we have speculated on
• 7:22
  Speaker 1: earlier episodes of this podcast.
• 7:24
  Speaker 3: Thanks for be confirmed.
• 7:25
  Speaker 2: We have to say, all right, last question, there is
• 7:28
  Speaker 2: an outbreak of a haunt of virus on a cruise ship.
• 7:31
  Speaker 2: People are stuck on this cruise ship off the coast
• 7:35
  Speaker 2: of I believe West Africa, and a lot of them
• 7:40
  Speaker 2: have haunted virus. Please tell us what is that and
• 7:44
  Speaker 2: should people be concerned about it?
• 7:47
  Speaker 1: Yeah, let's let's do the haunt of virus primer. So.
• 7:51
  Speaker 1: Hantavirus is an RNA virus that exists all over the world.
• 7:55
  Speaker 1: It is carried by rodents. The rodents generally are asymptomatic,
• 7:59
  Speaker 1: so they just kind of carried around and they leave
• 8:01
  Speaker 1: it in their feces and urine, and then when you
• 8:04
  Speaker 1: go to clean up feces and urine, that virus gets aerosolized.
• 8:08
  Speaker 1: You inhale it and it can cause very severe disease
• 8:12
  Speaker 1: in the New World. There are two main forms of hantavirus,
• 8:17
  Speaker 1: two species. The one that we would worry about here
• 8:20
  Speaker 1: is called Andy's virus, which is common in Argentina where
• 8:23
  Speaker 1: the cruise ship left from. Andy's virus has two notable features.
• 8:29
  Speaker 1: One is that it is the most lethal of the
• 8:31
  Speaker 1: Haunt of viruses, with about a thirty to fifty percent
• 8:34
  Speaker 1: case mortality rate. Also, it's the only Hanta virus that
• 8:37
  Speaker 1: has been shown to be capable of transmission person to
• 8:40
  Speaker 1: person as opposed to mause to person. Okay, that all
• 8:43
  Speaker 1: sounds scary, but to turn this down, I'm going to
• 8:46
  Speaker 1: turn this down just a little bit. You know, so far,
• 8:49
  Speaker 1: I think there are only five people with conf that
• 8:53
  Speaker 1: have symptoms. Now, three people have died from this, so
• 8:57
  Speaker 1: I mean this is severe on the cruise ship, but
• 9:00
  Speaker 1: it's not like the whole cruise ship was infected. I
• 9:02
  Speaker 1: think that's important. Also, two of the people that died
• 9:05
  Speaker 1: were husband and wife, So if there was person to
• 9:08
  Speaker 1: person transmission, which is suspected in Andy's virus, it does
• 9:11
  Speaker 1: require very close contact and like exchange of bodily fluids
• 9:15
  Speaker 1: and things like that. This is not an airborne virus,
• 9:18
  Speaker 1: so you know, the public health risk is quite low
• 9:22
  Speaker 1: unless you're interacting extremely closely with someone who's infected. The
• 9:26
  Speaker 1: argument to quarantine this ship is actually not strong. I
• 9:30
  Speaker 1: don't think because of that. The risk really comes from
• 9:33
  Speaker 1: the droppings, not from the people who are infected who
• 9:37
  Speaker 1: need to be in hospitals and getting very close supportive care.
• 9:40
  Speaker 1: There's no treatment, but you know they need to be
• 9:42
  Speaker 1: an intensive care unit.
• 9:44
  Speaker 3: Yeah.
• 9:44
  Speaker 2: But on the other hand, people, We're hundreds of years
• 9:49
  Speaker 2: into people being concerned about diseases on boats being spread
• 9:52
  Speaker 2: to the population, and so I'm not that surprised that
• 9:55
  Speaker 2: we are quarantining this ship. I do want to say
• 9:59
  Speaker 2: that a lot of people do get sick on cruise ships,
• 10:02
  Speaker 2: but this is not like a major risk factor on
• 10:05
  Speaker 2: cruise ships. The main disease you get on the cruise
• 10:07
  Speaker 2: ship is a neural virus, which is almost one hundred
• 10:09
  Speaker 2: percent chance of getting Yeah.
• 10:10
  Speaker 1: Oh yeah, Once nora virus breaks out, it's it is
• 10:13
  Speaker 1: all over.
• 10:14
  Speaker 3: You're getting it. But this is rare, Although obviously scary,
• 10:19
  Speaker 3: it does.
• 10:19
  Speaker 1: Add to my ever growing list of reasons I never
• 10:22
  Speaker 1: want to go on a cruise. But this is the
• 10:24
  Speaker 1: first case I've seen of hantavirus.
• 10:26
  Speaker 3: Don't I don't go on boats due to stomach issues.
• 10:31
  Speaker 1: We should just say people, if you're cleaning up your
• 10:34
  Speaker 1: house and you're worried about mouse or rat droppings, you
• 10:37
  Speaker 1: want to spray those with a bleach containing solution before
• 10:41
  Speaker 1: you clean them up, and ideally not vacuum because that
• 10:43
  Speaker 1: can really aerosolize things. There is hantavirus in the US.
• 10:46
  Speaker 1: Gene Hackman's wife died of hantavirus, although apparently there were
• 10:50
  Speaker 1: a lot of There was a pretty bad roadent infestation
• 10:53
  Speaker 1: in the house. So you know, be careful, but there'sn't
• 10:56
  Speaker 1: something to panic about quite yet.
• 10:58
  Speaker 2: Be careful, but don't panic. Yep, all right, that's it
• 11:00
  Speaker 2: for the health news of the week. After the break.
• 11:03
  Speaker 3: What's the deal with colostrum?
• 11:10
  Speaker 4: This is raw colostrum so powerful it's actually banned in
• 11:14
  Speaker 4: NC DOUBLEA. Yes, college sports banned colostrum because it contains
• 11:18
  Speaker 4: IGF one, insulin like growth factor one. It's associated with
• 11:20
  Speaker 4: increased muscle growth and vitality, increased levels of HDL and humans.
• 11:24
  Speaker 4: Colostrum muscle contains a ton of different immune globulins which
• 11:27
  Speaker 4: support the health of the gut. Also proleine rich peptides
• 11:30
  Speaker 4: like colosterrne and that support the immune system and the thymus.
• 11:33
  Speaker 1: This stuff is liquid gold.
• 11:34
  Speaker 4: It's the first milk cows give to their calves and
• 11:37
  Speaker 4: it helps program their gut and across species, mammalian milk
• 11:40
  Speaker 4: is very healthy for humans. So if you can find
• 11:42
  Speaker 4: somewhere to get a colostrum, probably a raw colostrum. This
• 11:46
  Speaker 4: stuff is incredible for your gut, for your immune system,
• 11:48
  Speaker 4: incredible for muscle growth and recovery.
• 11:50
  Speaker 1: I love this stuff. However you can get it.
• 11:51
  Speaker 4: Colossrum is a super food banned by the NC DOUBLEA
• 11:53
  Speaker 4: good for me, good for you. This stuff is amazing.
• 11:55
  Speaker 4: I'm going to go home and drink a bunch of
• 11:57
  Speaker 4: colostrum right now.
• 11:58
  Speaker 2: I love that clip, Perry, because I think I think
• 12:00
  Speaker 2: it illustrates a very common wellness influencer talking point, which is,
• 12:05
  Speaker 2: you know this is like why would they ban this
• 12:07
  Speaker 2: if it wasn't great?
• 12:09
  Speaker 1: I mean we've made that talking point several timetally.
• 12:12
  Speaker 2: Yes, I'm always making that point, like, you know, this
• 12:14
  Speaker 2: must be good for performance if they ban it in
• 12:16
  Speaker 2: professional cycling. So I'm convinced. But before we talk about
• 12:20
  Speaker 2: how we should all be consuming the milk of that
• 12:24
  Speaker 2: is intended for baby cows, I think we should talk
• 12:26
  Speaker 2: about what this is and why it might be helpful.
• 12:32
  Speaker 2: So let me start with the what it is, and
• 12:33
  Speaker 2: then I'm going to pass to you for like what
• 12:36
  Speaker 2: might possibly be going on, which is, you know, so
• 12:39
  Speaker 2: bovine colostrum is the colostrum from cows literally, so it's
• 12:42
  Speaker 2: the first milk that is produced by the female lady
• 12:46
  Speaker 2: cow after she calves, and it has like human colostrum
• 12:51
  Speaker 2: has a different composition than more mature human breast milk.
• 12:54
  Speaker 2: Bovine colostrum has a different concentration of various features than
• 13:01
  Speaker 2: mature milk. And the idea is that somehow this would
• 13:04
  Speaker 2: be helpful for something. And I actually, relative to some
• 13:09
  Speaker 2: of the things we talk about, those fill ins are
• 13:13
  Speaker 2: to me very vague. This is a lot of it
• 13:17
  Speaker 2: feels like that influencer clip where it's just a list
• 13:20
  Speaker 2: of things that one might be interested in and how
• 13:23
  Speaker 2: they might be good here, but with no real connection. Yeah,
• 13:26
  Speaker 2: so is there something biologically behind anything here?
• 13:31
  Speaker 1: Yeah, it's always so complicated when we're talking about like
• 13:34
  Speaker 1: a natural substance instead of a chemical or a single chemical. Right,
• 13:40
  Speaker 1: even when we talk about something like as simple as
• 13:41
  Speaker 1: coffee and like, oh, this study showed that you know,
• 13:43
  Speaker 1: coffee was beneficial for X, Y or Z, And it's like, okay,
• 13:46
  Speaker 1: well coffee is eight million different things, right, Yes, there's caffeine,
• 13:49
  Speaker 1: but there's also all this other stuff, and it's very
• 13:51
  Speaker 1: hard to untangle, and colossrum is no different. It is
• 13:55
  Speaker 1: clearly a biologically very important substance. All mammals produce colostrum
• 14:01
  Speaker 1: before they produce milk, and as you pointed out, it
• 14:03
  Speaker 1: is quite a bit different from like, you know, the
• 14:05
  Speaker 1: milk that comes in later, and animals that don't get
• 14:09
  Speaker 1: colostrum from their mother early certainly do worse in a
• 14:14
  Speaker 1: variety of ways. So it is something important. I think
• 14:18
  Speaker 1: when I was kind of listening to you know, what
• 14:20
  Speaker 1: influencers are talking about and people who support colostrum a lot,
• 14:24
  Speaker 1: there's a few substances in there that kind of keep
• 14:27
  Speaker 1: getting mentioned, and I think we'll probably want to focus
• 14:29
  Speaker 1: on those as like the biologically relevant ones. The first
• 14:33
  Speaker 1: is probably IGF one or insulin like growth factor one.
• 14:37
  Speaker 1: There are anywhere between fifty and two thousand micrograms per
• 14:42
  Speaker 1: leader of IGF one in col colostrum compared to like
• 14:47
  Speaker 1: less than ten micrograms basically undetectable in mature cow milk.
• 14:51
  Speaker 1: This is from the Bulgarian Journal of Veterinary Science, you know,
• 14:55
  Speaker 1: not maybe the number one veterinary journal in.
• 14:58
  Speaker 3: The world, not impact factor of it, okay.
• 15:01
  Speaker 1: But actually the best study unlike the content, the actual
• 15:04
  Speaker 1: measurements of what's in this stuff that I could find.
• 15:07
  Speaker 1: So and I think let's if can we talk about
• 15:10
  Speaker 1: IGF one is like, because I think this will give
• 15:12
  Speaker 1: a framework for how to think about stuff that you eat. So,
• 15:16
  Speaker 1: what IGF one is is the molecule that mediates the
• 15:19
  Speaker 1: effects of growth hormone. So your pituitary gland releases growth hormone,
• 15:24
  Speaker 1: particularly when you're growing, and downstream that tells your body
• 15:28
  Speaker 1: to grow, tells your bones and your muscles to grow,
• 15:30
  Speaker 1: and for you to get taller. That's what growth hormone does.
• 15:32
  Speaker 1: But it doesn't do it itself. It doesn't act itself.
• 15:34
  Speaker 1: It acts on the liver to release IGF one, and
• 15:37
  Speaker 1: then igf one is the thing that tells your muscles
• 15:39
  Speaker 1: and stuff to grow. So it's just a two step process. Okay,
• 15:41
  Speaker 1: that's IGF one. Kids who are born with like genetic
• 15:44
  Speaker 1: deficiencies of IGF one or growth hormone have congenital short
• 15:48
  Speaker 1: stature syndromes, so you know, little people types of syndromes.
• 15:54
  Speaker 1: IGF one is banned by the nc double A and
• 15:58
  Speaker 1: the World Antidoping Association, And you can inject IGF one
• 16:03
  Speaker 1: because it does grow muscles. It is a growth factor.
• 16:07
  Speaker 1: In fact, there is concern about some people who are
• 16:10
  Speaker 1: concerned about our intake of dairy point to IGF one
• 16:13
  Speaker 1: and they're like, dairy causes cancer because of IGF one, right,
• 16:16
  Speaker 1: because of the growth signals from IGF one. So you
• 16:18
  Speaker 1: always get these millions of sides. But there's a couple
• 16:20
  Speaker 1: of things we need to think about when it comes
• 16:22
  Speaker 1: to a cow product. Number One, are we pasteurizing it.
• 16:26
  Speaker 1: If we're pasteurizing it, some proteins lose their functionality, some don't.
• 16:31
  Speaker 1: Number Two, can it get absorbed intact through your GI tract?
• 16:35
  Speaker 1: And this is the big one where kind of a
• 16:38
  Speaker 1: lot of the biological plausibility falls apart when it comes
• 16:44
  Speaker 1: to IGF one, And this will be the case for
• 16:46
  Speaker 1: multiple things. That's in cow colostrum. You can give it
• 16:50
  Speaker 1: to people. In fact, it's heat stable IGF one, So
• 16:52
  Speaker 1: you can even pasteurize this stuff and it still has
• 16:54
  Speaker 1: IGF one in it, but it does not get into
• 16:57
  Speaker 1: the blood. Some studies that suggest it does get into
• 17:00
  Speaker 1: the blood see fragments of IGF one, But that's just
• 17:02
  Speaker 1: digested stuff, it's not the actual molecule.
• 17:05
  Speaker 2: Yeah, I think that this point comes up actually a
• 17:08
  Speaker 2: lot in this space of linking. You know, this is
• 17:12
  Speaker 2: a substance in this food to this is going to
• 17:14
  Speaker 2: have this impact where we know the substance is something
• 17:18
  Speaker 2: where like if you injected it ad mice, right, Really,
• 17:21
  Speaker 2: what you're saying here is like if you take IGF
• 17:22
  Speaker 2: one and you inject it in a mouse or even
• 17:24
  Speaker 2: in a person, Yeah, like that's good.
• 17:26
  Speaker 3: You know, That's why they don't let you go.
• 17:28
  Speaker 1: It's not necessarily good for you, but it'll make your
• 17:30
  Speaker 1: muscles grow a bit. It'll make your.
• 17:31
  Speaker 2: Muscles grow, and so you can get a super muscular
• 17:34
  Speaker 2: mouse by injecting them with igf one. But our digestive
• 17:38
  Speaker 2: system is not the same as injecting things.
• 17:40
  Speaker 1: Not at all.
• 17:41
  Speaker 2: Right, Like when you when you consume something, it goes
• 17:44
  Speaker 2: through your stomach, and your stomach is full of acids
• 17:46
  Speaker 2: and other stuff, and it breaks it down in all
• 17:49
  Speaker 2: kinds of ways. And so there are many things, for example,
• 17:53
  Speaker 2: even GLP ones, where there is a reason it's taken
• 17:55
  Speaker 2: a long time to get to an oral GLP one
• 17:57
  Speaker 2: because the injected version is just so much more accessible
• 18:02
  Speaker 2: to our body.
• 18:03
  Speaker 3: And so I actually believe if.
• 18:05
  Speaker 2: We looked into it, there's many things in this space
• 18:08
  Speaker 2: where that that is the link that kind of breaks
• 18:11
  Speaker 2: when people go from here is something where we know
• 18:14
  Speaker 2: if we injected it in a mouse, it would matter
• 18:16
  Speaker 2: to you know, here is something you can take by mouth,
• 18:18
  Speaker 2: because the amount that you have accessible after you consume
• 18:22
  Speaker 2: it through your stomach is like nothing.
• 18:24
  Speaker 1: Yeah, yeah, it's it's really hard, and pharmacologists spend a
• 18:27
  Speaker 1: lot of time trying to figure out how to get
• 18:29
  Speaker 1: your body to absorb something without digesting. It's it's just
• 18:32
  Speaker 1: a tricky problem and it's not solved in colostrum. So
• 18:36
  Speaker 1: I'm actually I think that like a colostrum if you
• 18:39
  Speaker 1: dig into the NC double A rules on this. The
• 18:42
  Speaker 1: reason they ban colostrum is actually they say that it's
• 18:46
  Speaker 1: risky because potentially of false positives in your blood. It's
• 18:50
  Speaker 1: like similar to how like you might not want to
• 18:52
  Speaker 1: eat a lot of poppy seeds if you're getting like
• 18:54
  Speaker 1: an opioid test, right, It's not because the poppy seeds
• 18:57
  Speaker 1: make you high. It's because they have kind of similar
• 18:59
  Speaker 1: chemical structure. You get little pieces of IGF one in
• 19:02
  Speaker 1: your bloodstream after it's digested, But then the test that
• 19:04
  Speaker 1: they give you is like, oh, he's using IGF one.
• 19:07
  Speaker 2: So, in fact, perry a lot of people when they
• 19:09
  Speaker 2: get popped for doping, the excuse is I ate a
• 19:13
  Speaker 2: food where the animal was fed growth hormone.
• 19:16
  Speaker 1: Okay, there you go, Yes, you know. That is why
• 19:20
  Speaker 1: I exclusively drink milk that has been extensively treated with
• 19:25
  Speaker 1: bovine growth growth hormone.
• 19:28
  Speaker 2: When they test you at the end of the five
• 19:29
  Speaker 2: K so I'm not getting tested.
• 19:30
  Speaker 3: I just trying.
• 19:31
  Speaker 1: I'm just trying to hit the golf ball further. That's
• 19:34
  Speaker 1: all I care about, just trying.
• 19:35
  Speaker 3: Okay.
• 19:36
  Speaker 2: So when we look at the particular items in colostrum,
• 19:40
  Speaker 2: and I think this is important to set the stage
• 19:42
  Speaker 2: for like looking at the at the data on it,
• 19:46
  Speaker 2: there's the growth hormones. There are a bunch of other things, immunoglobulins.
• 19:52
  Speaker 1: Yeah, we should definitely talk about that.
• 19:53
  Speaker 3: I will say big we should talk about all these things.
• 19:55
  Speaker 2: But big picture, one of the issues with biological plausibility
• 19:59
  Speaker 2: for this substance at all is that almost all these
• 20:02
  Speaker 2: things are not really available once you eat them.
• 20:06
  Speaker 1: Yes, that's correct, most things are digested. I'm going to
• 20:09
  Speaker 1: like put one coin on the other side of the
• 20:11
  Speaker 1: scale though. Let's give colostrum it's due not everything that
• 20:16
  Speaker 1: affects your body has to get into your body, true,
• 20:20
  Speaker 1: and so for example, immunoglobulins. Immunoglobulins are little those are antibodies,
• 20:26
  Speaker 1: and your body makes them against certain antigens like bacteria, viruses,
• 20:33
  Speaker 1: stuff like that. The antibodies sticky, they're each specific to
• 20:37
  Speaker 1: one of those antigens. They stick to it, and it's
• 20:39
  Speaker 1: sort of a signal to your body like this is
• 20:40
  Speaker 1: a bad thing. It's marked for death, like take care
• 20:42
  Speaker 1: of it, and the whole cascade immune cascade follows. There
• 20:45
  Speaker 1: are different types of immunoglobulins, but one that's very relevant
• 20:49
  Speaker 1: here is called IgA immunoglobulin A, which is the immunoglobulin
• 20:54
  Speaker 1: that lives in your mucosal system, so in your nose, mouth, throat,
• 20:59
  Speaker 1: and GI tract. This is the frontline immunoglobulin. It's actually
• 21:03
  Speaker 1: secreted into the mucosa by your body and it's directed
• 21:08
  Speaker 1: against antigens. The many different bacterian pathogens and stuff that
• 21:12
  Speaker 1: you will get, you know, just by breathing air in
• 21:15
  Speaker 1: a non sterile environment, by eating food that hasn't been
• 21:17
  Speaker 1: sterilized like we always do et cetera. And colostrum contains IgA,
• 21:22
  Speaker 1: and so that IgA can actually stick and mark some
• 21:26
  Speaker 1: of those antigens potentially while they're sitting there in the
• 21:29
  Speaker 1: GI tract, and it's conceivable that that would promote an
• 21:33
  Speaker 1: immune response to some antigens. Some scientists also point out
• 21:37
  Speaker 1: that some of these molecules, including even things like IGF one. Yes,
• 21:42
  Speaker 1: they don't get into the blood, but they can potentially
• 21:44
  Speaker 1: signal to the gut epithelium because those are cells, right,
• 21:49
  Speaker 1: and like they're just half of them are sitting out there,
• 21:51
  Speaker 1: you know, in the lumen of the GI tract, and
• 21:54
  Speaker 1: the IGF one can kind of float by and at
• 21:56
  Speaker 1: least act on them, And you get people saying like
• 21:59
  Speaker 1: this promotes gut health and stuff like that. So, yeah,
• 22:03
  Speaker 1: the idea that you're getting, like, you know, a secret
• 22:06
  Speaker 1: way to take anabolic steroids by drinking the stuff definitely
• 22:10
  Speaker 1: not true, but there may well be some physiologic effects.
• 22:13
  Speaker 3: Here, Okay.
• 22:14
  Speaker 2: So I think that that is a good place to
• 22:18
  Speaker 2: turn to the question of what we see in the data,
• 22:22
  Speaker 2: because I mean, always with stuff like this you can
• 22:24
  Speaker 2: sort of start with, like, is there a biological plausibility?
• 22:27
  Speaker 3: I think in this case, it's like a little bit maybe.
• 22:32
  Speaker 2: But then the question is when you look into people,
• 22:36
  Speaker 2: are we actually seeing any any impacts and the outcomes
• 22:41
  Speaker 2: here that there are actually two groups we can talk
• 22:44
  Speaker 2: about them in turn. The first is there's actually a
• 22:46
  Speaker 2: lot of work on this in athletes.
• 22:47
  Speaker 3: Yeah, yeah, my favorite. And then you're about to work
• 22:50
  Speaker 3: on people.
• 22:52
  Speaker 1: To actual people. Okay, I like that, there's athletes.
• 22:55
  Speaker 3: People, not elite maile cyclists.
• 22:58
  Speaker 2: And then and sort of we're looking at like something
• 23:02
  Speaker 2: about inflammation the gut, maybe performance, maybe respiratory viruses. Part
• 23:08
  Speaker 2: of what's hard here is the range of outcomes that
• 23:11
  Speaker 2: we're looking at are so broad that it feels like
• 23:14
  Speaker 2: like how could it possibly how could this thing possibly
• 23:16
  Speaker 2: matter for all of these Yeah, it's a problem.
• 23:19
  Speaker 1: And of course, because there's so much stuff in colostrum,
• 23:22
  Speaker 1: there's always going to be a biologically plausible route, right,
• 23:25
  Speaker 1: Like you're given all these lego pieces and you can
• 23:27
  Speaker 1: be like, oh, I can make a car, and I
• 23:28
  Speaker 1: can make a boat and so on and so forth.
• 23:30
  Speaker 2: So just so it's always a just so story. You
• 23:32
  Speaker 2: can sort of say, Okay, I'm going to look for
• 23:33
  Speaker 2: this in the data. Maybe I'm going to like pee
• 23:35
  Speaker 2: haack a little bit through a bunch of different outcomes
• 23:37
  Speaker 2: and then I'm going to make up a story for
• 23:38
  Speaker 2: why the particular peptide that's in this matters for that.
• 23:42
  Speaker 3: So I think that's a that is a caution with
• 23:45
  Speaker 3: everything we will say here.
• 23:47
  Speaker 1: Absolutely, But you know, I as I was looking through this,
• 23:50
  Speaker 1: I definitely saw, you know, a number of trials in
• 23:52
  Speaker 1: these athletes, and all I could think reading them was like,
• 23:55
  Speaker 1: I've got to get Emily's take on this, So can
• 23:57
  Speaker 1: you can you walk me through how you, as an
• 24:00
  Speaker 1: athlete can talk to me as a human about the
• 24:05
  Speaker 1: data here.
• 24:07
  Speaker 2: So what I really like about studying athletes, and what
• 24:10
  Speaker 2: I think researchers like, is that you know the outcome
• 24:14
  Speaker 2: you are looking for and it's very easy to measure.
• 24:17
  Speaker 2: So like an example of a study, it's like a study.
• 24:19
  Speaker 2: It's a pretty old study from the British Journal of
• 24:22
  Speaker 2: Sports Medicine, but it's like very consistent with this whole
• 24:25
  Speaker 2: research space.
• 24:27
  Speaker 1: And we love the British Journal of Sports Medicine.
• 24:29
  Speaker 3: That's actually very good journal, Yes it is.
• 24:31
  Speaker 2: So this is like we take they take twenty nine
• 24:34
  Speaker 2: highly trained mail road cyclist.
• 24:36
  Speaker 3: That's everybody's favorite.
• 24:37
  Speaker 2: Everybody loves a highly trained mail road cyclist and then
• 24:41
  Speaker 2: you stick them on the bike and you have them
• 24:45
  Speaker 2: do time trials, and then you give them some colostrum
• 24:48
  Speaker 2: and some not colostrum, and or in this case, I
• 24:53
  Speaker 2: think it was some of the time they had the
• 24:54
  Speaker 2: colostrum and sometime they didn't. There's all kinds of like
• 24:57
  Speaker 2: detailed ways you can control this, and then they look
• 25:00
  Speaker 2: at whether their time trial VO two max performs. It's
• 25:03
  Speaker 2: just like there's a lot of outcomes you can very
• 25:06
  Speaker 2: clearly measure, and so in a set of studies like this,
• 25:09
  Speaker 2: you do see you know, some impacts on performance, maybe
• 25:13
  Speaker 2: some impacts on respiratory illness. In some of this we
• 25:16
  Speaker 2: see a little bit in like recovery for runners, you know,
• 25:23
  Speaker 2: a lot of it's a lot of cyclists.
• 25:25
  Speaker 1: Yeah, I want to put numbers on this, and I
• 25:28
  Speaker 1: don't know how good this is, but I'm hoping you do.
• 25:30
  Speaker 4: So.
• 25:31
  Speaker 1: I'm looking at the British Jurnal Sports Medicine study. They
• 25:34
  Speaker 1: did a forty kilometer time trial either on colostrum or
• 25:38
  Speaker 1: on like way, protein was the control, I think, and
• 25:40
  Speaker 1: their performance improved by two percent versus baseline. Like to
• 25:47
  Speaker 1: me as a human that is not an athlete, two percent.
• 25:51
  Speaker 1: I'm like, that doesn't sound like great at all, But
• 25:53
  Speaker 1: is that actually something where it's like, dude, like, if
• 25:56
  Speaker 1: you're an elite male cyclist, this is the difference between
• 26:00
  Speaker 1: first and second place, Like, like, what are you talking
• 26:02
  Speaker 1: about here?
• 26:02
  Speaker 3: Yeah?
• 26:02
  Speaker 2: I mean so look, two percent is there's two ways
• 26:05
  Speaker 2: to think about two percent. One is to say, like,
• 26:07
  Speaker 2: if you're at the end of the Tour de France
• 26:12
  Speaker 2: and you're trying you're like Yones Vanago and you're trying
• 26:15
  Speaker 2: to get toddy pigatcha at the top of the you
• 26:18
  Speaker 2: know called the blob andy blah, like, you would take
• 26:21
  Speaker 2: a point. Those are people need to go and ty
• 26:25
  Speaker 2: pigacha people. I don't know which call the call is,
• 26:28
  Speaker 2: you know, Okay, anyway, you would take like a half.
• 26:31
  Speaker 3: I mean that's that's the difference.
• 26:32
  Speaker 2: These guys are are biking for one hundreds and hundreds
• 26:35
  Speaker 2: of miles and winning by four seconds.
• 26:37
  Speaker 1: All right.
• 26:38
  Speaker 2: For more regular people, I think two percent is pretty good.
• 26:43
  Speaker 2: It's like not as good as it's not as much
• 26:45
  Speaker 2: as the benefit you'd get from really like ramping up
• 26:48
  Speaker 2: your fueling, which is like a sort of core element
• 26:51
  Speaker 2: of improving your your performance. But it's like that's like
• 26:54
  Speaker 2: a solid like people would take is people who love,
• 26:58
  Speaker 2: people who are highly.
• 26:59
  Speaker 3: Trained mail Roadsnichles, but definitely take two percent.
• 27:02
  Speaker 1: Okay, So that sort of confirms my impression, which you know,
• 27:07
  Speaker 1: there are several studies like this where you see, you know,
• 27:10
  Speaker 1: relatively small studies, relatively small effects sizes, and I think
• 27:14
  Speaker 1: we do need to say to people that that raises
• 27:18
  Speaker 1: your eyebrows a little bit from a data science perspective.
• 27:24
  Speaker 1: In part that's because of publication bias, So just as
• 27:28
  Speaker 1: worth saying that, Like, if you conduct a study in
• 27:30
  Speaker 1: twenty people and the results are negative, it's just hard
• 27:33
  Speaker 1: to get it published, like I've been there, by the way,
• 27:37
  Speaker 1: And you submit it to a journal and they're like this,
• 27:39
  Speaker 1: like why we don't care, Like nothing happened. You only
• 27:42
  Speaker 1: enroll twenty people. Like if you enrolled one thousand and
• 27:44
  Speaker 1: nothing happened, then you know, sure we'll publish that because
• 27:47
  Speaker 1: that's a big study. But for twenty no, not really.
• 27:49
  Speaker 1: But if you enroll twenty people and you do see
• 27:52
  Speaker 1: a modest effect, or even a tiny effect, but you
• 27:54
  Speaker 1: know that passes statistical significant special you're much more likely
• 27:57
  Speaker 1: to get it published. So we do kind of want
• 27:59
  Speaker 1: to the meta analytic things we think about here is
• 28:03
  Speaker 1: like if we're seeing all if we're seeing several studies
• 28:06
  Speaker 1: but they're all very small, we worry a little bit
• 28:09
  Speaker 1: about this, about this issue of publication bias. Yeah, but
• 28:15
  Speaker 1: you know, hey, if you're an elite mail cyclist and
• 28:18
  Speaker 1: this is how you make your living, you know, seems
• 28:22
  Speaker 1: like you can give it a shot. I suppose.
• 28:24
  Speaker 2: Yeah, I mean I find yeah, maybe, I mean I
• 28:27
  Speaker 2: think I think the publication bias piece here is pretty
• 28:31
  Speaker 2: pretty important.
• 28:33
  Speaker 1: And yeah, yeah, you got to say it right, Yes,
• 28:35
  Speaker 1: the literature is not perfect.
• 28:37
  Speaker 2: This is a place where you know, we like, I
• 28:39
  Speaker 2: think the really great next step if one was really
• 28:42
  Speaker 2: interested in this is to say, okay, let's take these theories,
• 28:45
  Speaker 2: like we've got a bunch of data that would suggest
• 28:47
  Speaker 2: particular outcomes that have been seen before. Let's redo with
• 28:51
  Speaker 2: a larger sample looking at those outcomes, which would get
• 28:55
  Speaker 2: away from p hacking, like you're just choosing your outcomes
• 28:57
  Speaker 2: based on which one's work and would get away from
• 29:00
  Speaker 2: some of the publication bias if you could kind of
• 29:02
  Speaker 2: pre register.
• 29:02
  Speaker 3: But I don't know, I think what's we can get
• 29:05
  Speaker 3: into the people thing.
• 29:06
  Speaker 2: What's hard here is like, I have no idea why
• 29:08
  Speaker 2: this would matter, Like, nothing in the biology of this
• 29:12
  Speaker 2: substance would suggest that it connects to It's not like
• 29:16
  Speaker 2: protein or creatine or something where you could say, okay,
• 29:18
  Speaker 2: I can see mechanistically why this matters for a performance.
• 29:22
  Speaker 3: Is just sort of like it's just like a really good
• 29:24
  Speaker 3: protein shake.
• 29:26
  Speaker 1: Yeah. Yeah, there's just kind of like good humors in it.
• 29:29
  Speaker 1: And you know, these dudies were controlled for protein and
• 29:31
  Speaker 1: take by giving way protein. So so yeah, we like
• 29:34
  Speaker 1: some plausibility, and I think actually the place that has
• 29:39
  Speaker 1: more plausibility is in the data looking at like respiratory infection. Yeah, rates,
• 29:47
  Speaker 1: so this is a place where we actually have some
• 29:50
  Speaker 1: larger trials also kind of relatively on the on the
• 29:54
  Speaker 1: old side. But the reason I think there's some biologic
• 29:58
  Speaker 1: plausibility goes back to that immunoglobulin A phenomenon. So again,
• 30:04
  Speaker 1: you know, if you're putting something in your in your
• 30:06
  Speaker 1: GI tract that has a lot of immiglobulin A in it,
• 30:11
  Speaker 1: and presumably these cows are making immunoglobulins against at least
• 30:14
  Speaker 1: some of the same pathogens that you know humans are
• 30:17
  Speaker 1: exposed to, maybe that can rev up your immune system.
• 30:21
  Speaker 1: So I'll highlight one study because it was relatively large,
• 30:26
  Speaker 1: from the European Journal of Nutrition, also old two thousand
• 30:29
  Speaker 1: and three. They took one hundred and seventy four adult men.
• 30:34
  Speaker 1: This actually it was a little bit a little bit
• 30:38
  Speaker 1: of a weird design. They created this study out of
• 30:41
  Speaker 1: other randomized trials of colostrum versus WAY and just look
• 30:46
  Speaker 1: to see who reported as an adverse effect upper respiratory symptom.
• 30:50
  Speaker 1: So this wasn't the primary outcome, so it like it
• 30:53
  Speaker 1: is randomized, but they're kind of like they're they're like
• 30:56
  Speaker 1: convenience looking at the outcome. And over the seven weeks
• 31:00
  Speaker 1: that they looked at, thirty two percent of the colosstrum
• 31:05
  Speaker 1: subjects reported some upper respiratory tract symptoms could be anything
• 31:08
  Speaker 1: from a running nose to a sore throat versus forty
• 31:11
  Speaker 1: eight percent in those who are getting WAY protein. So
• 31:16
  Speaker 1: and that was a significant decline, you know, And there
• 31:20
  Speaker 1: are sort of other studies that go along this line.
• 31:24
  Speaker 1: There's even been some studies in medical people like who
• 31:27
  Speaker 1: are exposed you know, presumably exposed to there's the.
• 31:31
  Speaker 2: Study in preschool children who are exposed to talk to
• 31:35
  Speaker 2: me about even more oh my god.
• 31:37
  Speaker 3: Yeah, yeah, yeah, yeah.
• 31:38
  Speaker 2: So there is a like six week long study of
• 31:42
  Speaker 2: colostrum in preschool children. It's relatively small, it's like sixty kids,
• 31:48
  Speaker 2: fifty seven kids, and they randomized kids into colossum versus
• 31:53
  Speaker 2: not and there was a reduction in days with upper
• 31:57
  Speaker 2: respiratory symptoms thirty one percent, which is large.
• 32:02
  Speaker 1: Yeah, that's not parents.
• 32:05
  Speaker 2: Parents would definitely take that when they are parenting preschool children.
• 32:09
  Speaker 2: So so, yeah, we do see this in a number
• 32:11
  Speaker 2: of different settings. I will say I am still worried
• 32:14
  Speaker 2: about the pe hacking and the small samples and the
• 32:19
  Speaker 2: publication bias.
• 32:21
  Speaker 3: I think I just I'm still worried about that here.
• 32:25
  Speaker 1: It's always going to be the case when we have
• 32:27
  Speaker 1: multiple small studies. That preschool study also had parental reported outcomes,
• 32:32
  Speaker 1: which I don't know. You're not going to ask the
• 32:33
  Speaker 1: kids obviously, but that does open the door. You know.
• 32:36
  Speaker 1: This isn't like they were tested in some way for
• 32:39
  Speaker 1: you know, viral carriage in their nose or something that
• 32:41
  Speaker 1: was objective. This is a subjective perception of if the
• 32:44
  Speaker 1: kid is doing better, and if blinding is inadequate, like
• 32:48
  Speaker 1: if there's if the parents had any way to tell like, oh,
• 32:51
  Speaker 1: this is my kid's getting colostrum versus my kids getting
• 32:53
  Speaker 1: way protein, then that can kind of bias the results.
• 32:56
  Speaker 1: So there's just you know, this is this is medium
• 32:58
  Speaker 1: to load to medium quality d pointing in a direction,
• 33:01
  Speaker 1: and there is some biologic plausibility here, but we do
• 33:05
  Speaker 1: have to be really careful in interpretation.
• 33:07
  Speaker 2: Why can I ask you before we get to the
• 33:08
  Speaker 2: second piece of this, which is the like gut health,
• 33:12
  Speaker 2: leaky gut my favorite topic, why do you think we
• 33:17
  Speaker 2: do not have larger scale trials here? I mean, I
• 33:20
  Speaker 2: understand why maybe we don't have larger scale trials in
• 33:22
  Speaker 2: sports because people don't.
• 33:23
  Speaker 3: Care that much.
• 33:24
  Speaker 2: But you know, let's say there was something that you
• 33:27
  Speaker 2: could give your kid that would cause a thirty one
• 33:29
  Speaker 2: percent decrease in upper respiratory infections. Like that seems pretty important.
• 33:34
  Speaker 2: And so I'm a little bit confused. And it's not
• 33:37
  Speaker 2: like the studies were published in twenty twenty five. It's like, oh,
• 33:39
  Speaker 2: somebody is doing that, Like, what do you think is
• 33:41
  Speaker 2: in the way of what we'd really want here, large
• 33:44
  Speaker 2: scale randomized control trial really evaluating this?
• 33:48
  Speaker 1: Yeah, in money is the is the answer. So you know,
• 33:51
  Speaker 1: colostrum is recognized by the FDA's a dietary supplement. So
• 33:56
  Speaker 1: that has two implications. Number one, it doesn't have to
• 33:59
  Speaker 1: be vetted. They have to adhere to certain good manufacturing practices.
• 34:03
  Speaker 1: But it's not like tested by the FDA. There's no
• 34:06
  Speaker 1: they don't need to prove that it's efficacious or that
• 34:11
  Speaker 1: it is safe. It's generally recognized as safe. It's like
• 34:14
  Speaker 1: a food product, which means there's really no moat, like
• 34:17
  Speaker 1: anyone can sell colostrum. And so you know, in theory,
• 34:21
  Speaker 1: if you you know, if you're a big pharmaceutical company
• 34:24
  Speaker 1: that's going to fund a multimillion dollar trial, you want
• 34:26
  Speaker 1: to be able to sell your thing for more money
• 34:28
  Speaker 1: at least into your patent runs out, and that's not
• 34:30
  Speaker 1: possible here. What can happen and the way this often
• 34:33
  Speaker 1: works when there are signals from natural substances is that
• 34:37
  Speaker 1: pharmaceutical companies will go in and like try to pull
• 34:40
  Speaker 1: out what molecules might be meeting this effect, and then
• 34:44
  Speaker 1: you know patent and do a trial on that molecule.
• 34:47
  Speaker 1: That often doesn't work because you know, and it's not
• 34:53
  Speaker 1: because there's like a magical combination of things, and you
• 34:56
  Speaker 1: need the magical combination to work like a LAH original
• 34:59
  Speaker 1: Michael and Batman, Hello, gen X, how are you today?
• 35:02
  Speaker 3: Good?
• 35:02
  Speaker 1: Good? It's that you are often wrong about the substance
• 35:08
  Speaker 1: that you've like put your nickel down on. So I
• 35:11
  Speaker 1: think that's the that's the main problem.
• 35:13
  Speaker 3: Yeah, I mean I think I totally agree that's the
• 35:15
  Speaker 3: main problem.
• 35:15
  Speaker 2: This is one of my frustrations with like the ANIH
• 35:20
  Speaker 2: and other like government funders, because.
• 35:22
  Speaker 3: I feel like, yeah, they could do this, they could
• 35:24
  Speaker 3: do this.
• 35:24
  Speaker 2: They could just be like, you know what, Farma is
• 35:26
  Speaker 2: not going to do this, you know, fharmas it's not
• 35:27
  Speaker 2: a hill to make your penis grow faster or whatever,
• 35:30
  Speaker 2: which presumably Pharma is into. It is something that couldn't
• 35:33
  Speaker 2: potentially improve a lot of people's lives, and we could
• 35:38
  Speaker 2: we the NIH could fund someone to run this child,
• 35:40
  Speaker 2: which wouldn't, actually, by the way, be that expensive. It's
• 35:43
  Speaker 2: like how I feel about breast milk storage, and I
• 35:45
  Speaker 2: have a lot of feelings about the things the NIH.
• 35:47
  Speaker 1: And this actually feels kind of aligned with the MAHA agenda, right,
• 35:50
  Speaker 1: It's like this is a natural thing. And you could
• 35:53
  Speaker 1: even imagine a whole NIH institute who's like, Okay, we're
• 35:56
  Speaker 1: going to test the stuff that like no one else
• 35:59
  Speaker 1: you know, that's that's widely available, that's not patented. And
• 36:03
  Speaker 1: if it doesn't work, fine, great, we learned something. And
• 36:06
  Speaker 1: if it does work, we have this great new public
• 36:07
  Speaker 1: health intervention that is widely accessible. To totally agree, it
• 36:10
  Speaker 1: seems like a great use of that.
• 36:11
  Speaker 3: I agree, Jay Boudicharia.
• 36:13
  Speaker 2: Jay, if you're still talking to me after the interview
• 36:16
  Speaker 2: I did with you last week, I have some This
• 36:19
  Speaker 2: is my suggestion.
• 36:21
  Speaker 1: Make it happen, Jay, doctor Jay.
• 36:23
  Speaker 3: Jay, let's do it.
• 36:24
  Speaker 2: Okay, all right, So let's talk about the last sort
• 36:27
  Speaker 2: of set of big things that come up in colostrum,
• 36:30
  Speaker 2: which is leeky gut intestinal permeability.
• 36:34
  Speaker 3: H lee, hey gut. It's so popular with the wellness influencers.
• 36:38
  Speaker 3: Nobody wants it. Where is it leaking? To Perry, where's
• 36:41
  Speaker 3: it going?
• 36:43
  Speaker 1: It's god, the wellness influencer marketing is so much better
• 36:47
  Speaker 1: than like everyone else. Leaky gut sounds terrible. Talked about
• 36:51
  Speaker 1: glucose spikes before, like it's really good. It's no one
• 36:55
  Speaker 1: wants a leaky gut. Okay. First of all, it's very
• 36:58
  Speaker 1: important that your gut is leaky, because if nothing got
• 37:00
  Speaker 1: through your gut, you would die. So let's set the
• 37:05
  Speaker 1: table here. Intestinal permeability is the medical term for what's
• 37:13
  Speaker 1: going on, and your intestine is supposed to be permeable
• 37:16
  Speaker 1: to a wide variety of things amano acids, proteins, glucose,
• 37:20
  Speaker 1: other substances, et cetera. That's what your gut is for.
• 37:22
  Speaker 2: This is because as the food moves through your small intestine,
• 37:25
  Speaker 2: that's when the stuff comes out of it. It goes
• 37:26
  Speaker 2: through your small intestine and stuff comes out and goes
• 37:28
  Speaker 2: into your bloodstream, and that's how you get nutrients.
• 37:31
  Speaker 1: That's correct, and you want that. Now you can measure
• 37:34
  Speaker 1: intestinal permeability in the lab. What you do is you
• 37:37
  Speaker 1: give someone a dose of some substance that should not
• 37:40
  Speaker 1: be absorbed very well, like something like mannitol for example.
• 37:43
  Speaker 1: It's like a poorly absorbed sugar type of thing, and
• 37:46
  Speaker 1: then you measure it in their blood. And you can
• 37:47
  Speaker 1: certainly show that there's variation across people, like some people
• 37:52
  Speaker 1: they take the manson like there's more in their blood
• 37:54
  Speaker 1: and some people there's less. And scientists have shown that
• 37:58
  Speaker 1: people with comorbid condition like people who are sicker, often
• 38:02
  Speaker 1: have a leak your gut.
• 38:03
  Speaker 2: By that definition, it means more stuff that should not
• 38:06
  Speaker 2: be getting through is getting through.
• 38:09
  Speaker 1: It's not even necessarily that should not be getting through.
• 38:12
  Speaker 1: It's just like that usually doesn't get through, if you
• 38:14
  Speaker 1: appreciate sort of where I'm going with that. But there's
• 38:19
  Speaker 1: this real causality problem here, right, Like a lot of
• 38:23
  Speaker 1: wellness people be like, oh, no, it's your leaky gut
• 38:26
  Speaker 1: that causes the diabetes or the cancer or the dementia
• 38:30
  Speaker 1: or like whatever it is, as opposed to it's the
• 38:33
  Speaker 1: diabetes or the cancer or the dementia that causes the
• 38:37
  Speaker 1: leaky gut, and we don't know the difference there.
• 38:40
  Speaker 2: Yeah, yeah, it's sort of I mean, another way to
• 38:42
  Speaker 2: say this is like, even if colassroom were to fix
• 38:44
  Speaker 2: your leaky gut, it isn't really obvious that the leaky
• 38:46
  Speaker 2: gut itself is really a particular issue. It is just
• 38:50
  Speaker 2: a thing we see rising that is higher among people
• 38:55
  Speaker 2: with certain conditions, but also in other like this is
• 38:58
  Speaker 2: like a problem and that athletes have, like you stress,
• 39:02
  Speaker 2: your body.
• 39:02
  Speaker 1: Stuff gets absolutely Now in the medical space, there is
• 39:06
  Speaker 1: this phenomenon called bacterial translocation, where someone comes in with
• 39:10
  Speaker 1: a bloodstream infection with bacteria. This is bad. I shouldn't
• 39:13
  Speaker 1: want this, this is sepsis sepsis, And when someone comes
• 39:17
  Speaker 1: in with that, we zoom around and we look for
• 39:20
  Speaker 1: what the source of the infection is and we identify
• 39:23
  Speaker 1: the infection. We're like, Okay, is there a skin lesion
• 39:26
  Speaker 1: that spread to the blood? Is do they have pneumonia
• 39:28
  Speaker 1: that spread to the blood? Like where did it come from?
• 39:30
  Speaker 1: And every once in a while you cannot find the source.
• 39:34
  Speaker 1: And if it's a gut organism like E. Coli that's
• 39:37
  Speaker 1: in the blood, all you're left with is like did
• 39:39
  Speaker 1: the E. Coal I like escape from the gut? And
• 39:42
  Speaker 1: you know, bacteria are a lot bigger than glucose molecules, right,
• 39:45
  Speaker 1: so like they should bacteria should not be translocating the gut,
• 39:49
  Speaker 1: but in very stressful situations it can. And the reason
• 39:53
  Speaker 1: I'm mentioning this is because of one study looking at
• 39:58
  Speaker 1: this phenomenon actually in sixty two children who had newly
• 40:03
  Speaker 1: diagnosed leukemia, all leukemia. And one of the problems when
• 40:08
  Speaker 1: you're getting chemotherapy, you know, pretty intense chemotherapy like this,
• 40:11
  Speaker 1: is that you can affect the intestinal lining and you
• 40:16
  Speaker 1: can get bacterial translocation. And if these kids get sepsis,
• 40:20
  Speaker 1: they're in big trouble. We don't want that to happen.
• 40:23
  Speaker 1: So anything you could put in there to like prevent
• 40:25
  Speaker 1: bacteria from getting out would be great. So they randomize
• 40:28
  Speaker 1: these kids to or bovine colostrum while they were getting
• 40:34
  Speaker 1: that induction chemotherapy versus a control, and they were looking
• 40:38
  Speaker 1: at fever as well as bacteremia, and there was no
• 40:45
  Speaker 1: difference in fever or infection rates. They look at fever,
• 40:49
  Speaker 1: by the way, as a marker of like maybe the
• 40:50
  Speaker 1: bacteria got in, but then you thought it off before
• 40:52
  Speaker 1: we detected it and like caused a fever response. So
• 40:54
  Speaker 1: no difference in fever or infection rates, but there was
• 40:58
  Speaker 1: a secondary outcome that was positive. Here some called mucusitis,
• 41:01
  Speaker 1: which are like these ulcers that develop in the mouth
• 41:02
  Speaker 1: with intensive chemotherapy. It's incredible painful. That was improved by
• 41:05
  Speaker 1: the colostrum. And so I'm setting this in terms of,
• 41:09
  Speaker 1: like this is the leakiest gut you can have where
• 41:13
  Speaker 1: you're actually worried about bacterial translocation causing you know, sepsis
• 41:17
  Speaker 1: and death. Colostrum is not preventing that phenomenon. That's our
• 41:22
  Speaker 1: starting point. Now we can kind of walk this back
• 41:26
  Speaker 1: to maybe your average everyday person who's worried about, you know,
• 41:30
  Speaker 1: their own gut health.
• 41:32
  Speaker 2: And when we walk it back there, I would say
• 41:34
  Speaker 2: there is a bit of evidence. Again, the evidence probably
• 41:38
  Speaker 2: stronger in sports than in nonsports. You know, the to
• 41:45
  Speaker 2: the extent that the stress of like intense exercise increases
• 41:49
  Speaker 2: the permeability of the gut, which we know that it does.
• 41:53
  Speaker 2: This seems to some extent truncate that that rise and
• 41:59
  Speaker 2: so kind of I don't know, seal off the gut
• 42:01
  Speaker 2: a little bit, I guess, which is interesting, and I
• 42:05
  Speaker 2: guess is potentially some of the mechanism for some of
• 42:08
  Speaker 2: the performance effects, although I'm not sure why that would
• 42:10
  Speaker 2: why that would be.
• 42:11
  Speaker 1: I don't either. I just I don't know why leaky
• 42:14
  Speaker 1: gut is is bad.
• 42:16
  Speaker 2: Right, I mean, I think there's a fundamental thing which
• 42:18
  Speaker 2: is outside of this kind of setting that you're talking
• 42:21
  Speaker 2: about with with you know, kids who are very sick,
• 42:23
  Speaker 2: where this could potentially lead, Like it's not really clear
• 42:25
  Speaker 2: why you would care about fixing this, why you would
• 42:27
  Speaker 2: care if you had it, why you would care about
• 42:28
  Speaker 2: fixing it if you were an otherwise healthy person. So
• 42:31
  Speaker 2: observing that this fixes that, Okay.
• 42:34
  Speaker 1: It's not enough you've got it. You've gone from A
• 42:36
  Speaker 1: to B. That's great. Now go from B to scene.
• 42:39
  Speaker 1: Now show me that you have improved, you know, exercise performance,
• 42:43
  Speaker 1: and then hey, there's there's a little bit of that.
• 42:46
  Speaker 1: This is a potential mechanism, but again, small effects sizes
• 42:50
  Speaker 1: in small studies they do.
• 42:52
  Speaker 2: You know, they look at like diarrhea in some ill patients,
• 42:56
  Speaker 2: which were kind of interesting, and they saw some reduction
• 43:00
  Speaker 2: actually quite a large, small study of quite a large
• 43:03
  Speaker 2: reduction in diarrheal events among HIV patients in Uganda. So
• 43:08
  Speaker 2: there's a few pieces here of kind of yeah, potentially
• 43:12
  Speaker 2: interesting outcomes, but.
• 43:16
  Speaker 3: I wouldn't say it's overwhelming.
• 43:19
  Speaker 1: Yeah it is, it's definitely not. And there's studies that
• 43:22
  Speaker 1: don't show improvements in diarrhea. They did a study of
• 43:25
  Speaker 1: kids with shigella infection, which is an unpleasant bacterial diarrhea illness,
• 43:30
  Speaker 1: and no difference with the colostrum. We need to talk
• 43:36
  Speaker 1: about safety because upfront, that guy was holding if you're
• 43:41
  Speaker 1: watching this on a video, this big jar of bovine colostrum,
• 43:46
  Speaker 1: raw and unpasteurized.
• 43:49
  Speaker 2: I will say the reason the influencers like the unpasteurized
• 43:51
  Speaker 2: colostrum is that there are some elements of glossrum that
• 43:54
  Speaker 2: would be killed by pastor is it like some of
• 43:56
  Speaker 2: these elements that might be killed by pasteurization. So if
• 43:59
  Speaker 2: you're a true and wellness influencer here, you are into
• 44:02
  Speaker 2: the raw colostrum. Although I will say all of these
• 44:04
  Speaker 2: studies would be using pasteurized colostrum powder, which is in
• 44:09
  Speaker 2: the study okay, correct.
• 44:13
  Speaker 1: And moreover, even the things that are heard by pasteurization,
• 44:19
  Speaker 1: even the things that are in activated by pasturization, still
• 44:21
  Speaker 1: don't make it into your blood in the right in
• 44:24
  Speaker 1: the raw form. So okay, and what Emily, what else
• 44:29
  Speaker 1: is killed by pasteurization?
• 44:31
  Speaker 2: Yeah, it's it's it's ecoli and other bacteria that make
• 44:34
  Speaker 2: you really sick. And the reason that we don't recommend
• 44:38
  Speaker 2: people drink raw milk or raw colostrum is that it
• 44:41
  Speaker 2: can be and often is tremendously full of bacteria that
• 44:45
  Speaker 2: will make you very sick. And if you are taking
• 44:48
  Speaker 2: this colostrum so you don't have a lot of diarrhea,
• 44:52
  Speaker 2: you are also putting yourself at risk for quite a
• 44:54
  Speaker 2: lot of diarrhea from the ecolib it may be lurking
• 44:57
  Speaker 2: in your colostrum and also other things.
• 45:00
  Speaker 3: It's not just eqaly other things.
• 45:02
  Speaker 1: Yep, I'll put some numbers on it for you. Journal
• 45:04
  Speaker 1: of Dairy Science twenty twenty one. They looked at twelve
• 45:08
  Speaker 1: one hundred and forty one colostrum samples from thirty nine
• 45:11
  Speaker 1: Czech dairy farms. The average count of bacteria per plate
• 45:17
  Speaker 1: that they put the colostrum on was four hundred and
• 45:20
  Speaker 1: eight thousand colony forming units per milli liter, and only
• 45:24
  Speaker 1: twenty eight point four percent met the recommended threshold for
• 45:29
  Speaker 1: bacteria levels, which is less than one hundred thousand colony
• 45:32
  Speaker 1: farming units per milliliter. A study in Northern Ireland a
• 45:36
  Speaker 1: few years earlier than that found that eighty one percent
• 45:39
  Speaker 1: of raw colostrum samples exceeded industry bacterial contamination guidelines. So
• 45:45
  Speaker 1: chances are there's quite a bit of ecali and other
• 45:50
  Speaker 1: nasties in the colostrum if it hasn't been pasteurized.
• 45:54
  Speaker 2: Yeah, there's some evidence we also have some of these
• 45:57
  Speaker 2: in the dried commercial products as well, so it's not
• 46:00
  Speaker 2: it's not only the raw milk colostrums that are impacted anyway.
• 46:05
  Speaker 3: This is you should be careful about your colostrum.
• 46:08
  Speaker 1: Definitely. Do you want to touch briefly Emily on like
• 46:13
  Speaker 1: this might be the bleeding heart in me here, but like,
• 46:17
  Speaker 1: what about these baby cows, Like, isn't it for them?
• 46:21
  Speaker 3: It is for them?
• 46:23
  Speaker 2: I mean, I think what the people who produce both
• 46:26
  Speaker 2: my colostrum will say is that an individual cow produces
• 46:29
  Speaker 2: far more colosterrum than a calf needs. I think the
• 46:34
  Speaker 2: counter point is like, but why, that's not how evolution works?
• 46:38
  Speaker 2: You know, why are they producing all this extra colostrum?
• 46:41
  Speaker 2: So I get this definitely comes up in people's concerns. Again,
• 46:48
  Speaker 2: I think you make the same complaint about milk.
• 46:50
  Speaker 1: I wouldn't, though, because milk, as long as you keep
• 46:53
  Speaker 1: milking a cow, they'll keep making milk even after the
• 46:55
  Speaker 1: calf doesn't.
• 46:56
  Speaker 3: The colossrum is more limited, right, yeah.
• 46:58
  Speaker 1: Colostrum is like time limited, and think of how cute
• 47:01
  Speaker 1: the baby cows are. Are you considering that aspect from
• 47:05
  Speaker 1: a data point of.
• 47:06
  Speaker 3: View, I'm considering it people.
• 47:10
  Speaker 2: Probably the people whore eating the raw colostrum are also
• 47:12
  Speaker 2: eating veal, you.
• 47:14
  Speaker 1: Think, so I feel like that ven diagram does not
• 47:17
  Speaker 1: overlap for I think you're wrong.
• 47:18
  Speaker 2: I think you are wrong. I guess we could look
• 47:21
  Speaker 2: at the data listeners.
• 47:23
  Speaker 1: Are you both veal and raw colostrum.
• 47:26
  Speaker 2: Okay, all right, Perry, smash your pass on colostrum.
• 47:33
  Speaker 1: I am a pass on colostrum. I think, you know,
• 47:37
  Speaker 1: if this is not the way I want to spend
• 47:39
  Speaker 1: my fifty bucks some month and what I want to be,
• 47:43
  Speaker 1: you know, mixing into my shakes in the morning, there's
• 47:45
  Speaker 1: other better stuff. I'm a pass. How about you, Emily
• 47:47
  Speaker 1: smash pass Okay, I.
• 47:49
  Speaker 2: Am actually a soft smash, And I will say I
• 47:52
  Speaker 2: do have this. I do call after all of this,
• 47:56
  Speaker 2: after all of this, this is an example of some
• 48:00
  Speaker 2: thing where I think, if you are an athlete who
• 48:04
  Speaker 2: has GI problems, I believe this might be worth a
• 48:09
  Speaker 2: self experimentation because I think some of the evidence is
• 48:15
  Speaker 2: a little suggestive. I wouldn't recommend it is a general rule,
• 48:20
  Speaker 2: but I'm I guess I'm a soft soft smash.
• 48:23
  Speaker 1: Okay, I'll give it to you. Are you an athlete
• 48:26
  Speaker 1: with GI problems? And do you feel like it's helped
• 48:28
  Speaker 1: your athleticism or GI problem?
• 48:32
  Speaker 2: Yes, I am an athlete with GI problems, and no
• 48:35
  Speaker 2: I don't think that it helps me.
• 48:37
  Speaker 3: But I am not sorry that I tried it.
• 48:40
  Speaker 2: Okay, it turns out what helps is not eating too
• 48:43
  Speaker 2: much salad for dinner. We can get into that another
• 48:48
  Speaker 2: at another time, or perhaps never, Perhaps we can never
• 48:51
  Speaker 2: get into that.
• 48:52
  Speaker 1: Well, not eating salad is cheaper than buying colostrum.
• 48:57
  Speaker 3: Totally, totally. Salad has too much fiber. That's the problem. Anyway,
• 49:02
  Speaker 3: there we go.
• 49:03
  Speaker 2: All right, that is it for colostrum. Your mail back
• 49:06
  Speaker 2: question of the week after the break.
• 49:13
  Speaker 3: Hi dad at all? This is a liar.
• 49:15
  Speaker 2: Why do people sneeze when they look at the sun?
• 49:18
  Speaker 1: This is a question from my own home. That's my
• 49:21
  Speaker 1: daughter writing the question. This happens to her, Emily. Are
• 49:24
  Speaker 1: you a photic sneezer?
• 49:27
  Speaker 3: The I'm not a photo sneezer? Are you? Is it genetic?
• 49:31
  Speaker 1: I am not, but my wife is. And there is
• 49:36
  Speaker 1: in fact a genetic condition called autosomal dominant compelling helio
• 49:43
  Speaker 1: ophthalmic outburst or the ACHU syndrome, which you made that up.
• 49:50
  Speaker 1: I did not. I mean that it is a It
• 49:53
  Speaker 1: is a real genetic syndrome, maybe a bit more dramatic
• 49:57
  Speaker 1: than what people are thinking about. These are people who
• 49:59
  Speaker 1: will have a series of like ten sneezes in response
• 50:02
  Speaker 1: to bright light, which is not what like my daughter
• 50:05
  Speaker 1: or my wife has. You know what most people I've
• 50:08
  Speaker 1: experienced is going into bright light and you have like
• 50:10
  Speaker 1: a sneeze or two. This has been recognized for centuries
• 50:15
  Speaker 1: and centuries. I think like I think like Aristotle or
• 50:18
  Speaker 1: something like this wrote about it, and it's not fully understood.
• 50:22
  Speaker 1: People think that it is a little cross talk between
• 50:26
  Speaker 1: your optic nerve and your ophthalmic nerve. So the nerves
• 50:29
  Speaker 1: from your eyes and the nerve coming from your nose,
• 50:32
  Speaker 1: and like the bright light kind of like goes your
• 50:35
  Speaker 1: optic nerve a little bit, and that kind of jazz
• 50:37
  Speaker 1: is your ophthalmic nerve in some people, and you just
• 50:39
  Speaker 1: like sneeze out of confusion.
• 50:43
  Speaker 3: That is totally fascinating.
• 50:45
  Speaker 2: And so it's autosomal dominant, which means that it is strong.
• 50:49
  Speaker 3: That would be a strong genetically.
• 50:50
  Speaker 1: Yeah, it would mean that if one of your parents
• 50:52
  Speaker 1: has it, you have a fifty percent chance of inheriting it.
• 50:57
  Speaker 2: That is totally fascinating. And I had no idea. The
• 50:59
  Speaker 2: only thing makes me sneeze is pollen.
• 51:01
  Speaker 1: Oh well, it's been it's been rough this year.
• 51:04
  Speaker 2: It's been a bad year for sneezing. I choose syndrome fantastic,
• 51:10
  Speaker 2: all right, that is it for us today? Stick with
• 51:13
  Speaker 2: us next week when we will ask what's the deal
• 51:15
  Speaker 2: with psychedelics? I'm excited, but I will say I don't
• 51:19
  Speaker 2: have these in my cabinet, Perry, so I won't have
• 51:22
  Speaker 2: as much personal experience. Wellness Actually is produced in association
• 51:30
  Speaker 2: with iHeartMedia. Our senior producer is Tamar Avisheik. Our executive
• 51:35
  Speaker 2: producer at iHeart is Jennifer Bassett. Our theme music is
• 51:38
  Speaker 2: by Eric Deutsch, and our content is for educational purposes only.
• 51:43
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• 51:45
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• 51:48
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• 51:54
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• 51:58
  Speaker 1: Head over to Wellness Actually dot fm and leave us
• 52:00
  Speaker 1: a question for our mailbag or suggest a topic for
• 52:03
  Speaker 1: a future show.
• 52:04
  Speaker 3: We'll let the influencers have the last word. To know
• 52:07
  Speaker 3: if you have a leaky gut.
• 52:08
  Speaker 1: There's no such thing one chronic fatigue. I have chronic fatigue,
• 52:11
  Speaker 1: frequent headaches and brain falls. I have frequent headaches and
• 52:14
  Speaker 1: brain thoughts.
• 52:14
  Speaker 3: Armor clossum is.
• 52:15
  Speaker 1: A pure oh come on man strengthens your.
• 52:18
  Speaker 3: Gut burial replenishes from my biome.
• 52:21
  Speaker 1: Comeback tooth