Timothy Ferriss's Blog

Nick Kokonas and Richard Thaler, Nobel Prize Laureate — Realistic Economics, Avoiding The Winner’s Curse, Using Temptation Bundling, and Going Against the Establishment (#830)

Richard H. Thaler (@r_thaler) is the 2017 recipient of the Nobel Memorial Prize in Economic Sciences for his contributions to behavioral economics and the Charles R. Walgreen Distinguished Service Professor of Behavioral Science and Economics at the University of Chicago Booth School of Business. He is also a founding principal at FullerThaler Asset Management, which uses behavioral finance to manage over $30 billion in small-cap US equities. 

Thaler has been a professional disrupter. He helped create the fields of behavioral economics and finance that lie in the gap between economics and psychology. He investigates the implications of relaxing the standard economic assumption that everyone in the economy is rational and selfish, instead entertaining the possibility that some of the agents in the economy are sometimes human. 

Thaler is the New York Times bestselling coauthor of Nudge: Improving Decisions About Health, Wealth, and Happiness (with Cass R. Sunstein) and the author of Misbehaving: The Making of Behavioral Economics. His new book is The Winner’s Curse: Behavioral Economics Anomalies, Then and Now, co-authored with economist Alex O. Imas. 

My co-host is Nick Kokonas (@nickkokonas), an entrepreneur, investor, and author best known as the co-founder of The Alinea Group (sold, 2024) and the reservation platform Tock (now owned by American Express). After revolutionizing how restaurants and experiences are crafted, booked, and managed, he’s now focused on creative ventures that blend business, technology, and art—from immersive theater projects to Napa Valley winemaking. A philosophy graduate of Colgate University, he is as interested in ideas and first principles as he is in building things that last. He lives in Chicago and Napa Valley with his wife and two sons.

Please enjoy!

This episode is brought to you by:

ExpressVPN  high-speed, secure, and anonymous VPN serviceSeed’s DS-01® Daily Synbiotic broad spectrum 24-strain probiotic + prebioticAG1 all-in-one nutritional supplement[image error]Listen onSpotify Listen onApple Podcasts[image error]Listen onOvercastNick Kokonas and Richard Thaler, Nobel Prize Laureate — Realistic Economics, Avoiding The Winner’s Curse, Using Temptation Bundling, and Going Against the EstablishmentAdditional podcast platforms

Listen to this episode on Apple Podcasts, Spotify, Overcast, Podcast Addict, Pocket Casts, Castbox, YouTube Music, Amazon Music, Audible, or on your favorite podcast platform.

SHOW NOTES & LINKSTranscriptsThis episodeAll episodesSHOW NOTES

Books and Articles:

The Winner’s Curse: Behavioral Economics and Anomalies Then and Now by Richard H. Thaler and Alex Imas Misbehaving: The Making of Behavioral Economics by Richard H. Thaler Nudge: Improving Decisions About Health, Wealth, and Happiness  by by Richard H. Thaler and Cass R. Sunstein Thinking, Fast and Slow by Daniel Kahneman The Undoing Project by Michael Lewis“The Last Decision by the World’s Leading Thinker on Decisions” (Wall Street Journal)

Additional Resources:

Richard H. Thaler — X Profile Richard H. Thaler — Chicago Booth ProfileInterview with Richard H. Thaler — NobelPrize.orgRead These Five Papers to Understand Thaler’s Nobel-Winning Work (Bloomberg)The Making of Richard Thaler’s Economics Nobel (The New Yorker)Richard Thaler Wins the Nobel in Economics for Killing Homo Economicus (The Atlantic)Nick Kokonas — WikipediaNick Kokonas — How to Apply World-Class Creativity to Business, Art, and Life (#341) — The Tim Ferriss ShowNick Kokonas on Resurrecting Restaurants, Skin in the Game, and Investing (#429) — The Tim Ferriss ShowTock — Official SiteThe Alinea GroupAlex Imas — Chicago Booth ProfileDaniel KahnemanAmos TverskyProspect Theory (Kahneman & Tversky, 1979)Judgment under Uncertainty: Heuristics and Biases (1974)Availability Heuristic (Tversky & Kahneman, 1973)Endowment Effect & Coase Theorem (Kahneman, Knetsch & Thaler, 1990)Fairness as a Constraint on Profit Seeking (Kahneman, Knetsch & Thaler, 1986)Save More Tomorrow (Thaler & Benartzi, 2004)Default Effects in 401(k)s (Madrian & Shea, 2001)Choice Architecture (Thaler, Sunstein & Balz, 2013)Schiphol’s “Fly in the Urinal” NudgeSunk Cost Fallacy (Arkes & Blumer, 1985)Gambling with the House Money and Trying to Break Even (Thaler & Johnson, 1990)Golden Eggs and Hyperbolic Discounting (Laibson, 1997)The CFO Survey (Duke/Fuqua)Libertarian Paternalism (Thaler & Sunstein, 2003)Journal of Economic Perspectives (open access)Anomalies: The Winner’s Curse (Thaler, JEP)Estimating the Reproducibility of Psychological Science (Open Science Collaboration, 2015)Evaluating Replicability of Laboratory Experiments in Economics (Camerer et al., 2016)Temptation Bundling (Milkman, Minson & Volpp, 2014)Paying Not to Go to the Gym (DellaVigna & Malmendier, 2006)

Note from the editor: An expanded list of links & resources will be added.

This episode is brought to you by Seed’s DS-01 Daily Synbiotic! Seed’s DS-01 was recommended to me months ago by a PhD microbiologist, so I started using it well before their team ever reached out to me. After incorporating two capsules of Seed’s DS-01 into my morning routine, I have noticed improved digestion, skin tone, and overall health. It’s a 2-in-1 probiotic and prebiotic formulated with 24 clinically and scientifically studied strains that have systemic benefits in and beyond the gut. And now, you can get 25% off your first month of DS-01 with code 25TIM.

This episode is brought to you by AG1! I get asked all the time, “If you could use only one supplement, what would it be?” My answer is usually AG1, my all-in-one nutritional insurance. I recommended it in The 4-Hour Body in 2010 and did not get paid to do so. Right now, you’ll get a 1-year supply of Vitamin D free with your first subscription purchase—a vital nutrient for a strong immune system and strong bones. Visit DrinkAG1.com/Tim to claim this special offer today and receive your 1-year supply of Vitamin D (and 5 free AG1 travel packs) with your first subscription purchase! 

This episode is brought to you by ExpressVPN. I’ve been using ExpressVPN to make sure that my data is secure and encrypted without slowing my Internet speed. All you need to do is download the ExpressVPN app on your computer or smartphone and then use the Internet just as you normally would. Use my link ExpressVPN.com/Tim today and get an extra three months free on a one-year package!

The post Nick Kokonas and Richard Thaler, Nobel Prize Laureate — Realistic Economics, Avoiding The Winner’s Curse, Using Temptation Bundling, and Going Against the Establishment (#830) appeared first on The Blog of Author Tim Ferriss.

James Nestor — Breathing Protocols to Reboot Your Health, Fix Your Sleep, and Boost Performance (#829)

James Nestor (@MrJamesNestor) is a science journalist and the author of the international bestseller Breath: The New Science of a Lost Art, with more than three million copies sold in 44 languages. Breath was named the Best General Nonfiction Book by the American Society of Journalists and Authors and was a finalist for Science Book of the Year at the Royal Society.

He is also the author of Deep: Free Diving, Renegade Science, and What the Ocean Tells Us About Ourselves and Get High Now (Without Drugs).

Please enjoy!

This episode is brought to you by:

Helix Sleep  premium mattresses Momentous  high-quality creatine for cognitive and muscular support AG1 all-in-one nutritional supplement[image error]Listen onSpotify Listen onApple Podcasts[image error]Listen onOvercastJames Nestor — Breathing Protocols to Reboot Your Health, Fix Your Sleep, and Boost PerformanceAdditional podcast platforms

Listen to this episode on Apple Podcasts, Spotify, Overcast, Podcast Addict, Pocket Casts, Castbox, YouTube Music, Amazon Music, Audible, or on your favorite podcast platform. Watch the interview on YouTube here.

SHOW NOTES & LINKSConnect with James Nestor:

Website | Instagram

TranscriptsThis episodeAll episodesBooks Breath: The New Science of a Lost Art Deep: Free Diving, Renegade Science, and What the Ocean Tells Us About Ourselves   The Body Electric Heart, Breath, Mind: Train Your Heart to Conquer Stress and Achieve Success Products, Apps, & ToolsSnoreLab (app)SnoreClock (app)Hostage Tape MyoTapeAranet4 (CO₂ monitor)Relaxator (breathing retrainer)HeartMath (HRV monitor)O2Trainer

This episode is brought to you by Helix Sleep! Helix was selected as the best overall mattress of 2024 by Forbes, Fortune, and Wired magazines and many others. With Helix, there’s a specific mattress to meet each and every body’s unique comfort needs. Just take their quiz—only two minutes to complete—that matches your body type and sleep preferences to the perfect mattress for you. They have a 10-year warranty, and you get to try it out for a hundred nights, risk-free. They’ll even pick it up from you if you don’t love it. And now, Helix is offering 27% off all mattress orders at HelixSleep.com/Tim.

This episode is brought to you by AG1! I get asked all the time, “If you could use only one supplement, what would it be?” My answer is usually AG1, my all-in-one nutritional insurance. I recommended it in The 4-Hour Body in 2010 and did not get paid to do so. Right now, you’ll get a 1-year supply of Vitamin D free with your first subscription purchase—a vital nutrient for a strong immune system and strong bones. Visit DrinkAG1.com/Tim to claim this special offer today and receive your 1-year supply of Vitamin D (and 5 free AG1 travel packs) with your first subscription purchase! 

This episode is brought to you by Momentous high-quality creatine and more! Momentous offers high-quality supplements and products across a broad spectrum of categories, and I’ve been testing their products for months now. I’ve been using their magnesium threonate, apigenin, and L-theanine daily, all of which have helped me improve the onset, quality, and duration of my sleep. I’ve also been using Momentous creatine, and while it certainly helps physical performance, including poundage or wattage in sports, I use it primarily for mental performance (short-term memory, etc.). Use code TIM at checkout and enjoy 35% off your first subscription order or 14% off your first one-time purchase! 

The post James Nestor — Breathing Protocols to Reboot Your Health, Fix Your Sleep, and Boost Performance (#829) appeared first on The Blog of Author Tim Ferriss.

David Senra — How Extreme Winners Think and Win: Lessons from 400+ of History’s Greatest Founders and Investors (Including Buffett, Munger, Rockefeller, Jobs, Ovitz, Zell, and Names You Don’t Know But Should) (#828)

“If you could summarize nine years, 400 biographies, into one word of what I’ve learned, it’s ‘focus.'”
— David Senra

David Senra (@FoundersPodcast) is the host of the Founders podcast. For the past nine years, David has intensely studied the life and work of hundreds of history’s greatest entrepreneurs. Every week he reads another biography and shares lessons on his podcast. David has been invited to lecture at Harvard Business School, Columbia Business School, and Notre Dame. Founders is one of the top business podcasts in the world, with hundreds of thousands of founders, investors, and executives listening every week. 

His new podcast, David Senra, showcases conversations with the best-of-the-best living founders and extreme winners. Its goal is to share timeless lessons with current and future generations of entrepreneurs and leaders.

Please enjoy!

This episode is brought to you by:

Cresset family office services for CEOs, founders, and entrepreneurs Our Place’s Titanium Always Pan® Pro , using nonstick technology that’s coating-free and made without PFAS, otherwise known as “forever chemicals”AG1 all-in-one nutritional supplement[image error]Listen onSpotify Listen onApple Podcasts[image error]Listen onOvercastDavid Senra — How Extreme Winners Think and WinAdditional podcast platforms

Listen to this episode on Apple Podcasts, Spotify, Overcast, Podcast Addict, Pocket Casts, Castbox, YouTube Music, Amazon Music, Audible, or on your favorite podcast platform.

SHOW NOTES & LINKSConnect with David Senra:

Website | Founders Podcast | Founders Newsletter | LinkedIn | Twitter | Instagram

Podcasts Founders David Senra All the Hacks Breaking Bread with Tom Papa David Senra: The Obsession That Creates Enduring Companies | Invest Like The BestElon Musk: Childhood and Work Philosophy | The Kevin Rose Show Hardcore History How I Built The Tim Ferriss Show to 700+ Million Downloads — An Immersive Explanation of All Aspects and Key Decisions (Featuring Chris Hutchins) | The Tim Ferriss Show #538 Invest Like the Best Musashi: Warrior Code and Life | Jocko Podcast 100 with Tim FerrissBooks & Articles Am I Being Too Subtle?: Straight Talk From a Business Rebel by Sam Zell Blood Meridian: Or the Evening Redness in the West by Cormac McCarthyThe Border Trilogy: All the Pretty Horses, The Crossing, Cities of the Plain by Cormac McCarthy Buffett: The Making of an American Capitalist by Roger Lowenstein Deep Future: Creating Technology That Matters by Pablos Holman The Dream of Solomeo: My Life and the Idea of Humanistic Capitalism by Brunello Cucinelli Dune by Frank Herbert Extreme Ownership: How US Navy SEALs Lead and Win by Jocko Willink and Leif Babin The 4-Hour Workweek: Escape 9-5, Live Anywhere, and Join the New Rich by Timothy Ferriss Getting Things Done: The Art of Stress-Free Productivity by David Allen Hard Drive: Bill Gates and the Making of the Microsoft Empire by James Wallace and Jim Erickson How to Make a Few Billion Dollars by Brad Jacobs Idea Man: A Memoir by the Cofounder of Microsoft by Paul Allen Insisting On the Impossible: The Life of Edwin Land by Victor K. McElhenyInterview: Steven Jobs | Playboy Invention: A Life of Learning Through Failure by James Dyson Inventor of the Future: The Visionary Life of Buckminster Fuller by Alec Nevala-Lee John D.: The Founding Father of the Rockefellers by David Freeman Hawke Land’s Polaroid: A Company and the Man Who Invented It by Peter C. Wensberg Let My People Go Surfing: The Education of a Reluctant Businessman-Including 10 More Years of Business Unusual by Yvon Chouinard Losing My Virginity: How I’ve Survived, Had Fun, and Made a Fortune Doing Business My Way by Richard Branson The Marginalian by Maria Popova Michael Jordan: The Life by Roland Lazenby Musashi (New Edition): A Novel by Eiji Yoshikawa No Country for Old Men by Cormac McCarthy Overdrive: Bill Gates and the Race to Control Cyberspace by James Wallace Play Nice But Win: A CEO’s Journey from Founder to Leader by Michael Dell and James Kaplan The Power Broker: Robert Moses and the Fall of New York by Robert Caro The Psychology of Money: Timeless Lessons on Wealth, Greed, and Happiness by Morgan Housel Psychopathy Prevalence Facts & Figures | Psychopathy Is The Red Bull Story: The Unbelievable Success of Dietrich Mateschitz and His Energy Drink Empire by Wolfgang Fürweger The Road by Cormac McCarthy Scientific Advertising by Claude Hopkins The Score Takes Care of Itself: My Philosophy of Leadership by Bill Walsh, Steve Jamison, and Craig Walsh The Snowball: Warren Buffett and the Business of Life by Alice Schroeder Source Code: My Beginnings by Bill Gates Stranger in a Strange Land by Robert A. Heinlein The Tao of Seneca: Letters from a Stoic Master by Seneca the Younger The Thinking Machine: Jensen Huang, Nvidia, and the World’s Most Coveted Microchip by Stephen Witt Titan: The Life of John D. Rockefeller, Sr. by Ron Chernow Vagabonding: An Uncommon Guide to the Art of Long-Term World Travel by Rolf Potts Who Is Michael Ovitz? by Michael OvitzPeopleDavid AllenPaul AllenMarc AndreessenKarim AtiyehPeter AttiaAlexander Graham BellJeff BezosUsain BoltRichard BransonIsambard Kingdom BrunelKobe BryantSusan BuffettWarren BuffettJulius CaesarDan CarlinRobert CaroJim CaseyRon ChernowYvon ChouinardWinston ChurchillBill ClintonHillary ClintonBrunello CucinelliLeonardo Del VecchioMichael DellW. Edwards DemingDr. DreAriel DurantWill DurantJames DysonThomas EdisonDaniel EkLarry EllisonEnzo FerrariHenry FordBenjamin FranklinJeremy FryR. Buckminster FullerJeremy Giffon Larry GagosianBill GatesDavid GeffenRick GersonShane GillisTodd GravesAlexander the GreatDavid Freeman HawkeJames J. HillSam HinkieBenny HinnPablos HolmanClaude HopkinsMorgan HouselJensen HuangAndrew HubermanChris HutchinsCarl IcahnJimmy IovineAlec IssigonisBrad JacobsLeBron JamesJesusSteve JobsLyndon B. JohnsonMichael JordanThe JudgeHenry KaiserTravis KalanickKevin KellyJamal KhashoggiDara KhosrowshahiStephen KingJared KushnerEddie LampertEdwin LandAlbert LaskerEstée LauderRoland LazenbyAbraham LincolnBlake LivelyTobias LütkePhilip II of MacedonCormac McCarthyRob MohrRobert MosesMrBeastCharlie MungerMiyamoto MusashiElon MuskAlex NorströmRockwood NotesPatrick O’ShaughnessyDavid OgilvyJiro OnoMichael OvitzTom PapaMichael PhelpsMaria PopovaRolf PottsSol PriceJay PritzkerVladimir PutinRichard RainwaterNaval RavikantRyan ReynoldsJoe RoganKevin RoseRick RubinLes SchwabArnold SchwarzeneggerJerry SeinfeldSeneca the YoungerIsadore SharpJim SinegalHenry SingletonDerek SiversFred SmithGustav SöderströmEd ThorpDonald TrumpCornelius VanderbiltLuis von AhnJosh WaitzkinLee WalkerBill WalshSam WaltonJocko WillinkWilliam ZeckendorfSam ZellMark ZuckerbergVisual Media The Defiant Ones Dune Inside Bill’s Brain: Decoding Bill Gates Jiro Dreams of Sushi Mad Men No Country for Old Men The Road The Tim Ferriss Experiment Companiesa16zAmazonAppleAudibleBlackstoneBlinkistBrunello CucinelliCAAColossusCostcoDellDenny’sDysonEvernoteFacebookFedExFour SeasonsGoldman SachsGraphtreonIBMInstagramKodakLuxotticaMySpaceNetflixNVIDIAOraclePatagoniaPatreonPlayboyPolaroidRaising Cane’sReadwiseSam’s ClubSchlitz BeerSciCommSee’s CandySpotifyTikTokTwitter (X)UberUFCUPSWMAYouTubeMiscellaneous MentionsThe Fountainhead YachtThe Hawaiian TechniqueThe Hoover DamIkigaiMoons Over My HammyOmakaseToyota Way 2020Timestamps[00:00:00] Start.[00:01:11] Brad Jacobs: Roll-up king and positive-driven billionaire founder.[00:02:26] Rare positive archetypes: Ed Thorp, Sol Price, Brunello Cucinelli.[00:06:04] Michael Dell as another exception; fear of failure and motivation.[00:06:47] Negative self-talk, excellence, and its ripple effects.[00:08:26] Jensen Huang story: “Why do you suck so much?”[00:08:54] Inspiration from Dan Carlin’s Hardcore History.[00:10:00] Derek Sivers: unconventional, philosophical entrepreneur.[00:11:04] Learning equals behavior change, not memorization.[00:11:48] Jeremy Gafan insight: biographies as substitute mentors.[00:12:37] Reading biographies as one-sided conversations.[00:13:16] The chain of influence.[00:14:09] Podcasting as “relationships at scale.”[00:14:28] Coping with trauma and breaking cycles.[00:20:18] Note-taking process: books, Post-its, ruler, Readwise.[00:29:27] OCD tendencies and love of doing things the hard way.[00:31:04] Comparing our reading/re-reading workflows.[00:35:04] A family falling out and the randomness of student housing.[00:38:58] David’s introduction to my work during his MySpace-era college years.[00:40:07] Podcasting influences: Jocko Willink, Kevin Rose’s Elon Musk interview.[00:44:14] Five-and-a-half years of obscurity before breakthrough.[00:46:50] Graphtreon and experiments with subscription models.[00:49:25] Patrick O’Shaughnessy’s endorsement sparks growth.[00:51:23] Sam Hinkie and Patrick connections fuel momentum.[00:52:19] Transition to ads and joining Patrick’s network.[00:55:17] Edwin Land: patron saint of founders and Steve Jobs’ influence.[00:57:02] Lessons from Sam Zell, Jay Pritzker, and William Zeckendorf.[00:58:48] Need a generous, well-connected person? You can’t go wrong with Rick Gerson.[01:03:04] Edwin Land’s philosophies: Differentiation and doing to excess.[01:04:30] Entrepreneurial archetypes and conflicting advice.[01:06:00] Daniel Ek as an alternative founder archetype and mentor.[01:10:59] Further founder archetypes and contrasts.[01:13:41] What is an anti-business billionaire?[01:19:55] Advice from “shark” Michael Ovitz about the value of truth in one’s inner circle.[01:22:30] The hands-on approach of practical founders who live for the love of their business.[01:23:28] Doing one thing relentlessly.[01:23:51] “This can’t be my life” as a powerful motivator.[01:26:57] Low introspection as a common trait among founders — and its implications about human nature.[01:30:15] Robert Caro: The only writer David believes should be allowed to write thousand-page biographies.[01:32:40] James Dyson’s persistence vs. the risk of blind stubbornness.[01:34:22] Todd Graves (Raising Cane’s) as an example of relentless focus on one idea.[01:35:41] Separating fact from fiction in biographies/histories.[01:41:55] Considering trainable vs. non-trainable attributes in potential role models.[01:46:11] Perusing Charlie Munger’s library.[01:49:35] Dealmaking lessons on Eddie Lampert’s superyacht.[01:55:34] The smartest person David knows.[01:56:55] David’s obsessive craftsman approach to podcast creation.[01:58:51] Why David decided to begin a second podcast.[02:01:21] The economics of trust.[02:03:40] The benefits of cultivating a purposeful aloofness about current events.[02:07:11] Using the pulpit of publicity for good, not evil.[02:09:57] New show frequency/dynamic and how David plans to balance the burden of running two shows.[02:13:30] Teamwork with essence of turtle.[02:15:40] Adapting the Rockefeller “secret allies” strategy to podcasting.[02:17:56] Chris Hutchins: The mad scientist of podcasting?[02:18:30] Working with Rob Mohr and Andrew Huberman of SciComm.[02:20:54] Why David focuses on 24-hour cycles over long-term planning.[02:24:54] Does David worry the extra workload will disrupt his lifestyle?[02:30:18] What makes one potential guest more interesting to David than another?[02:34:34] Making an impact vs. happiness.[02:36:32] Playing the status game when your heart’s not in it is for suckers.[02:44:23] Travel observations and the rarity of truly unique experiences.[02:46:26] Books as philosophical operating systems.[02:48:39] Parting thoughts.MORE DAVID SENRA QUOTES FROM THE INTERVIEW

“I’m not building a media company. I’m building relationships at scale.”
— David Senra

“You should be copying the what, not the how. You don’t copy what they did; you copy how they did it, and then you just take the little ideas that make sense to you.”
— David Senra

“The maxim I’ve made for myself on this is learning is not memorizing information. Learning is changing your behavior.”
— David Senra

“If you could summarize nine years, 400 biographies, into one word of what I’ve learned, it’s focus.”
— David Senra

“My whole thing is just very simple. I want to do one thing relentlessly.”
— David Senra

“I just love when people take what they do very seriously, and I like the craft of it. And I want to dedicate my life to making a product that makes somebody else’s life better. That is what drives me.”
— David Senra

“I love the climb. I don’t care where the summit is.”
— David Senra

“All a great life is, is a string of great days. And so the furthest I plan out is 24 hours.”
— David Senra

Want to hear another episode with someone who deeply appreciates business history? Listen to my conversation with Doug McMillon, CEO of Walmart, as he shares stories from Sam Walton’s office (which he still works in), discusses the founder’s legendary Saturday morning meetings, the “Go for it” keychain philosophy, and much more.

This episode is brought to you by Cresset Family Office! Cresset offer family office services for CEOs, founders, and entrepreneurs. They handle the complex financial planning, uncertain tax strategies, timely exit planning, bill pay and wires, and all the other parts of wealth management that would otherwise pull me away from doing what I love most: making things, mastering skills, and spending time with the people I care about.  Schedule a call today at cressetcapital.com/Tim to see how Cresset can help streamline your financial plans and grow your wealth.

I’m a client of Cresset. There are no material conflicts other than this paid testimonial. All investing involves risk, including loss of principal.

This episode is brought to you by AG1! I get asked all the time, “If you could use only one supplement, what would it be?” My answer is usually AG1, my all-in-one nutritional insurance. I recommended it in The 4-Hour Body in 2010 and did not get paid to do so. Right now, you’ll get a 1-year supply of Vitamin D free with your first subscription purchase—a vital nutrient for a strong immune system and strong bones. Visit DrinkAG1.com/Tim to claim this special offer today and receive your 1-year supply of Vitamin D (and 5 free AG1 travel packs) with your first subscription purchase! 

This episode is brought to you by Our Place’s Titanium Always Pan® Pro! Many nonstick pans can release harmful “forever chemicals”—PFAS—into your food, your home, and, ultimately, your body. Exposure to PFAS has been linked to major health issues like gut microbiome disruption, testosterone dysregulation, and more, which have been correlated to chronic disease in the long term. This is why I use the Titanium Always Pan Pro from today’s sponsor, Our Place.  It’s the first nonstick pan with zero coating. This means zero “forever chemicals” and durability that will last a lifetime. Visit FromOurPlace.com/Tim and use code TIM at checkout for 10% off your entire order. With a 100-day, risk-free trial, free shipping, and free returns, there’s zero risk in test-driving a great upgrade to your kitchen.

The post David Senra — How Extreme Winners Think and Win: Lessons from 400+ of History’s Greatest Founders and Investors (Including Buffett, Munger, Rockefeller, Jobs, Ovitz, Zell, and Names You Don’t Know But Should) (#828) appeared first on The Blog of Author Tim Ferriss.

Pablos Holman — One of the Scariest Hackers I’ve Ever Met (#827)

Pablos Holman (@pablos) is a hacker and inventor and the bestselling author of Deep Future: Creating Technology that Matters, the indispensable guide to deep tech. Previously, Pablos worked on spaceships at Blue Origin and helped build The Intellectual Ventures Lab to invent a wide variety of breakthroughs, including a brain surgery tool, a machine to suppress hurricanes, 3D food printers, and a laser that can shoot down mosquitos, part of an impact invention effort to eradicate malaria with Bill Gates.

Pablos hosts the Deep Future Podcast, and his TED talks have been viewed more than 30 million times. He is also managing partner at Deep Future, investing in technologies to solve the world’s biggest problems. 

Please enjoy!

Transcript of this episode.Transcripts of all episodes.

This episode is brought to you by:

Cresset prestigious family office for CEOs, founders, and entrepreneurs Maui Nui Venison​ delicious, nutrient-dense, and responsible red meatAG1 all-in-one nutritional supplement[image error]Listen onSpotify Listen onApple Podcasts[image error]Listen onOvercastPablos Holman — One of The Scariest Hackers I’ve Ever MetAdditional podcast platforms

Listen to this episode on Apple Podcasts, Spotify, Overcast, Podcast Addict, Pocket Casts, Castbox, YouTube Music, Amazon Music, Audible, or on your favorite podcast platform.

SHOW NOTES & LINKSConnect with Pablos Holman:

Deepfuture.Tech | Twitter | LinkedIn

TranscriptsThis episode.All episodes.Media Deep Future: Creating Technology That Matters by Pablos HolmanThe Deep Future PodcastPablos Propaganda WhatsApp GroupETech: Hacker Shows How Your TV, Front Door, and iPhone are Vulnerable | WIREDPablos Holman: Nuclear Reactors Can Solve Inequality | TED TalkPablos Holman: Better Ancestors | TED TalkPablos Holman: How to Become Relevant When a Robot Takes Your Job | TED TalkPablos Holman: Inventing for the World’s Largest Problems | TED Talk The Art of Deception by Kevin Mitnick Back to the Future starring Michael J. Fox and Christopher Lloyd Breakneck: China’s Quest to Engineer the Future by Dan Wang Cryptonomicon by Neal Stephenson DodgeBall: A True Underdog Story starring Ben Stiller and Vince Vaughn Elysium starring Matt Damon and Jodie Foster The 4-Hour Chef: The Simple Path to Cooking Like a Pro, Learning Anything, and Living the Good Life by Timothy Ferriss Scent of a Woman starring Al Pacino Snow Crash by Neal Stephenson True Lies starring Arnold Schwarzenegger and Jamie Lee Curtis WarGames starring Matthew Broderick Zero Effect starring Bill Pullman and Ben StillerPeopleJeff BezosJeremy BornsteinTyler CowenBrady ForrestBill GatesSherlock Holmes3ric JohansonSamy KamkarStephen KeyElan LeePalmer LuckeyMajor MalfunctionKevin MitnickRodney MullenElon MuskNathan MyhrvoldKeith RosemaNeal StephensonBen StillerDonald TrumpChris YoungCompanies & Concepts in Technology & InnovationAbu Dhabi’s AI-Native GovernmentThe ADVANCE Act of 2024AirSnortAndurilApple IIAutonomous ShipsBlue OriginCommonwealth Fusion SystemsDeep FissionDeep IsolationDodgeballEmpire State BuildingEverett Massacre (Wobblies vs. Snohomish County Sheriff)HackerbotHolobiomeIntellectual VenturesLinuxMaerskNewlabNuclear Fusion PowerNuclear Power in ChinaNuclear Regulatory Commission (NRC)NvidiaOakley X-Metal (Pablos’ indestructible glasses)ONE CampaignPerpetual MotionPSYOPRecycling in EuropeRecycling in the USRFID (Radio Frequency Identification)Ladon RoboticsSchlage LocksSock Puppet AttackTerraPowerUber vs. TaxisZero-Click ExploitsConferencesChaos Computer Congress (CCC)DEF CONMars (Jeff Bezos’ private conference)O’Reilly Emerging Technology ConferenceShmooConToorConMiscellaneous MotionAikidoBartitsu: The Gentleman’s Martial ArtSalsaTangoTimestamps[00:00:00] Start.[00:02:12] The first time I witnessed Pablos’ digital sleight of hand.[00:04:33] How did Pablos become what he considers to be a hacker?[00:08:04] The off-label mindset that makes a good hacker (like Samy Kamkar) great.[00:17:07] The magic of Rodney Mullen.[00:20:28] How Eric Johanson and Pablos gave life to adorable password thief Hackerbot.[00:23:44] Hacker self-defense and the zero-click exploit market.[00:27:11] International pockets of hacker density.[00:30:13] Conventions where modern hackers congregate.[00:30:48] Why, in geopolitics, technology is a game lost by the non-players.[00:33:05] The case to rally behind new nuclear power.[00:36:54] Sequencing priorities so the US can remain technologically competitive.[00:44:49] Evaluating risk and reward in deep tech investment.[00:50:40] Shoring up the shape of shipping.[00:56:59] How Pablos gained his name and famous frames.[00:58:48] Pablos is a possible-ist.[00:59:45] What makes Pablos an attractive hire for the world’s richest people?[01:02:06] From Silicon Valley to Seattle: the Blue Origin origin story.[01:08:55] Why Pablos prevails over his M-dash peers.[01:11:41] Zero Effect and WarGames: The only movies that matter?[01:15:58] A major security malfunction exploited by Major Malfunction.[01:18:30] The enigmatic Neal Stephenson.[01:19:38] Long-form lessons gleaned from Jeff Bezos and the Blue Origin mission.[01:27:15] For solving the world’s problems, communities are crucial.[01:31:03] Newlab PSYOPS.[01:34:44] AI and the ripple effects of China’s engineering-minded vs. America’s attorney-heavy leadership.[01:48:20] Unearthing like-minded inventors and innovators.[01:50:42] How Pablos learned salsa dancing via aikido vs. my own tango experience.[02:08:27] Why you should invest or get involved in deep tech.[02:14:45] Clearing up fusion confusion.[02:21:17] Making progress happen is a team effort.[02:24:19] Parting thoughts.MORE PABLOS HOLMAN QUOTES FROM THE INTERVIEW

“I think a future that’s awesome is absolutely possible. A shitty future is also possible, but the balance is up to us.”

— Pablos Holman

“I tried to do tango first for a month, but it takes advantage of none of my natural talents. You can’t do reverse engineering in tango. It’s too structured and disciplined and minute, and salsa, you can just wiggle your way through it.”

— Pablos Holman

“Most people, if you get a new gadget, like your phone, and give it to your mom, she’ll ask you, ‘What does this do?’ That’s a totally normal question. ‘iPhone, Mom. Says on the box.’ If you give a new gadget to a hacker, then the question is, ‘What can I make this do?'”

— Pablos Holman

“You can’t invent a new technology by reading the directions. That’s just never happened, ever.”

— Pablos Holman

“I had a computer in the cold, in the dark, in the basement, in Alaska, and nobody to show me anything about how it worked. So I had to learn by reverse engineering.”

— Pablos Holman

I do have a kind of extreme risk tolerance. My whole career, I’ve only worked on things that I thought were cool or interesting. I’ll optimize for that over everything else.

— Pablos Holman

“Pablos is a totally fake name because all hackers have fake names.”

— Pablos Holman

Want to hear another episode with someone who asks “What can I make this do?” Listen to my conversation with legendary hacker Samy Kamkar, in which we discussed creating the fastest-spreading computer virus of all time, accidentally taking down MySpace, getting raided by the Secret Service, hijacking drones with custom hardware, optimizing online dating through reverse engineering, opening locked cars, manipulating Google Maps traffic data, and much more.

This episode is brought to you by Cresset Family Office! Cresset is a prestigious family office for CEOs, founders, and entrepreneurs. They handle the complex financial planning, uncertain tax strategies, timely exit planning, bill pay and wires, and all the other parts of wealth management that would otherwise pull me away from doing what I love most: making things, mastering skills, and spending time with the people I care about.  Schedule a call today at cressetcapital.com/Tim to see how Cresset can help streamline your financial plans and grow your wealth.

I’m a client of Cresset. There are no material conflicts other than this paid testimonial. All investing involves risk, including loss of principal.

This episode is brought to you by AG1! I get asked all the time, “If you could use only one supplement, what would it be?” My answer is usually AG1, my all-in-one nutritional insurance. I recommended it in The 4-Hour Body in 2010 and did not get paid to do so. Right now, you’ll get a 1-year supply of Vitamin D free with your first subscription purchase—a vital nutrient for a strong immune system and strong bones. Visit DrinkAG1.com/Tim to claim this special offer today and receive your 1-year supply of Vitamin D (and 5 free AG1 travel packs) with your first subscription purchase! 

This episode is also brought to you by Maui Nui Venison. I’ve been eating ​Maui Nui Venison​ for more than five years, and I eat it practically every week. It’s the cleanest and most nutrient-dense red meat you can buy.

Maui Nui has just released its most important innovation to date: the ʻOhana Reserve Aged Cuts. It is the only wild-harvested Axis deer that’s been naturally aged for 14 days to enhance tenderness, consistency, and depth of flavor. The result is a delicious, nutrient-dense protein that’s easy to cook and rivals the choicest cuts of meat I’ve ever had. ​ Reserve Aged Cuts are only available by subscription through the ‘Ohana Reserve Box. And for a limited time, Maui Nui is giving my readers a free Stick Starter Pack—two of their most popular venison sticks—when you subscribe and spend $79 or more. If you’ve been curious about trying truly wild, aged, red meat, this is the best way in. Click here to subscribe and claim your complimentary Starter Pack.

The post Pablos Holman — One of the Scariest Hackers I’ve Ever Met (#827) appeared first on The Blog of Author Tim Ferriss.

Pablos Holman — One of The Scariest Hackers I’ve Ever Met (#827)

Pablos Holman (@pablos) is a hacker and inventor and the bestselling author of Deep Future: Creating Technology that Matters, the indispensable guide to deep tech. Previously, Pablos worked on spaceships at Blue Origin and helped build The Intellectual Ventures Lab to invent a wide variety of breakthroughs, including a brain surgery tool, a machine to suppress hurricanes, 3D food printers, and a laser that can shoot down mosquitos, part of an impact invention effort to eradicate malaria with Bill Gates.

Pablos hosts the Deep Future Podcast, and his TED talks have been viewed more than 30 million times. He is also managing partner at Deep Future, investing in technologies to solve the world’s biggest problems. 

Please enjoy!

This episode is brought to you by:

Cresset prestigious family office for CEOs, founders, and entrepreneurs Maui Nui Venison​ delicious, nutrient-dense, and responsible red meatAG1 all-in-one nutritional supplement[image error]Listen onSpotify Listen onApple Podcasts[image error]Listen onOvercastPablos Holman — One of The Scariest Hackers I’ve Ever MetAdditional podcast platforms

Listen to this episode on Apple Podcasts, Spotify, Overcast, Podcast Addict, Pocket Casts, Castbox, YouTube Music, Amazon Music, Audible, or on your favorite podcast platform.

SHOW NOTESPablos Holman

Pablos on X: @pablos | Deep Future | Deep Future Podcast | Pablos on LinkedIn

Books & Movies & Articles Deep Future: Creating Technology That Matters  ETech: Hacker Shows How Your TV, Front Door, and Iphone are Vulnerable Zero Effect  WarGames  Cryptonomicon   Snow Crash   Breakneck: China’s Quest to Engineer the Future The Art of Deception  PeopleSamy KamkarRodney MullenNeal StephensonNathan Myhrvold Eric Johanson Chris Young Palmer Luckey Brady Forrest Companies, Labs, ProductsSchlage LocksIntellectual VenturesDeep Isolation TerraPowerAnduril Commonwealth Fusion Systems Holobiome Newlab AirSnort Dodgeball Blue OriginConferences & OrganizationsNuclear Regulatory Commission (NRC)DEF CONChaos Computer Congress (CCC)ToorConShmooConMars (Jeff Bezos’s private conference)The ONE Campaign

This episode is brought to you by Cresset Family Office! Cresset is a prestigious family office for CEOs, founders, and entrepreneurs. They handle the complex financial planning, uncertain tax strategies, timely exit planning, bill pay and wires, and all the other parts of wealth management that would otherwise pull me away from doing what I love most: making things, mastering skills, and spending time with the people I care about.  Schedule a call today at cressetcapital.com/Tim to see how Cresset can help streamline your financial plans and grow your wealth.

I’m a client of Cresset. There are no material conflicts other than this paid testimonial. All investing involves risk, including loss of principal.

This episode is brought to you by AG1! I get asked all the time, “If you could use only one supplement, what would it be?” My answer is usually AG1, my all-in-one nutritional insurance. I recommended it in The 4-Hour Body in 2010 and did not get paid to do so. Right now, you’ll get a 1-year supply of Vitamin D free with your first subscription purchase—a vital nutrient for a strong immune system and strong bones. Visit DrinkAG1.com/Tim to claim this special offer today and receive your 1-year supply of Vitamin D (and 5 free AG1 travel packs) with your first subscription purchase! 

This episode is also brought to you by Maui Nui Venison. I’ve been eating ​Maui Nui Venison​ for more than five years, and I eat it practically every week. It’s the cleanest and most nutrient-dense red meat you can buy.

Maui Nui has just released its most important innovation to date: the ʻOhana Reserve Aged Cuts. It is the only wild-harvested Axis deer that’s been naturally aged for 14 days to enhance tenderness, consistency, and depth of flavor. The result is a delicious, nutrient-dense protein that’s easy to cook and rivals the choicest cuts of meat I’ve ever had. ​ Reserve Aged Cuts are only available by subscription through the ‘Ohana Reserve Box. And for a limited time, Maui Nui is giving my readers a free Stick Starter Pack—two of their most popular venison sticks—when you subscribe and spend $79 or more. If you’ve been curious about trying truly wild, aged, red meat, this is the best way in. Click here to subscribe and claim your complimentary Starter Pack.

The post Pablos Holman — One of The Scariest Hackers I’ve Ever Met (#827) appeared first on The Blog of Author Tim Ferriss.

Q&A with Tim — Supplements I’m Taking, Austin vs. SF, Training for Mental Performance, Current Go-To AI Tools, Recovering from Surgery, Intermittent Fasting, and More (#826)

Welcome back to another in-between-isode, with one of my favorite formats: the good old-fashioned Q&A.

I answer questions submitted by the small-but-elite group of test readers of my upcoming THE NO BOOK. The community is closed for new members, as we have the right number of people now, but I hope to potentially expand it, once the book comes out. 

See below for show notes, links to everything discussed, and more!

Please enjoy!

Listen to the episode on Apple Podcasts, Spotify, Overcast, Podcast Addict, Pocket Casts, Castbox, YouTube Music, Amazon Music, Audible, or on your favorite podcast platform.

This episode is brought to you by:

Monarch Money  track, budget, plan, and do more with your money Eight Sleep Pod Cover 5  sleeping solution for dynamic cooling and heating Shopify  global commerce platform, providing tools to start, grow, market, and manage a retail businessListen onApple Podcasts[image error]Listen onSpotify[image error]Listen onOvercastQ&A with Tim — Supplements I’m Taking, Austin vs. SF, Training for Mental Performance, Current Go-To AI Tools, Recovering from Surgery, Intermittent Fasting, and More

This episode is brought to you by Monarch Money! Traditional budgeting apps can help, but they don’t compare to the complete financial command center you get with this episode’s sponsor, Monarch Money. Monarch was named The Wall Street Journal’s Best Budgeting App of 2025, and it’s the top-recommended personal finance app by users and experts, with more than 30,000 5-star reviews. Get control of your overall finances with Monarch Money. Use code TIM at monarchmoney.com/Tim for half off your first year.

This episode is brought to you by Eight Sleep. Temperature is one of the main causes of poor sleep, and heat is my personal nemesis. But a few years ago, I started using the Pod Cover, and it has transformed my sleep. Eight Sleep has launched their newest generation of the Pod: Pod 5 Ultra. It cools, it heats, and now it elevates, automatically. With the best temperature performance to date, Pod 5 Ultra ensures you and your partner stay cool in the heat and cozy warm in the cold. And now, listeners of The Tim Ferriss Show can get $350 off of the Pod 5 Ultra for a limited time! Click here to claim this deal and unlock your full potential through optimal sleep.

This episode is brought to you by Shopify! Shopify is one of my favorite platforms and one of my favorite companies. Shopify is designed for anyone to sell anywhere, giving entrepreneurs the resources once reserved for big business. In no time flat, you can have a great-looking online store that brings your ideas to life, and you can have the tools to manage your day-to-day and drive sales. Go to shopify.com/Tim to sign up for a one-dollar-per-month trial period. It’s a great deal for a great service, so I encourage you to check it out. Take your business to the next level today by visiting shopify.com/Tim.

SELECTED LINKS FROM THE EPISODEBooks & MediaThe 4-Hour Body: An Uncommon Guide to Rapid Fat-Loss, Incredible Sex, and Becoming Superhuman by Timothy Ferriss: My book on health and the human body, which I reference when discussing the PAGG supplement protocol.The 4-Hour Chef: The Simple Path to Cooking Like a Pro, Learning Anything, and Living the Good Life by Timothy Ferriss: My book about accelerated learning. I mention it in the context of sequencing and as a key resource for adapting in the AI era.The 4-Hour Workweek: Escape 9-5, Live Anywhere, and Join the New Rich by Timothy Ferriss: My first book on lifestyle design, mentioned in the context of needing a phase of openness in your career.How to Stop Worrying and Start Living by Dale Carnegie: A book I reference for its advice on gathering more information to address fears and challenges.Sin City (Collector’s Edition) by Frank Miller: A coffee table book that I use for creative inspiration, noting how it shows the artist’s process. Hyde : An upcoming gothic horror graphic novel series starring Johnny Depp and created in collaboration with Ridley Scott, reimagining the classic Dr. Jekyll and Mr. Hyde story as a sequel where Hyde has triumphed over his alter ego.Charlie and the Chocolate Factory by Roald Dahl: A book I recently finished listening to. The Wonderful Story of Henry Sugar : A Wes Anderson short film on Netflix, adapted from a Roald Dahl story that was recommended to me.Fast Like a Girl: A Woman’s Guide to Using the Healing Power of Fasting to Burn Fat, Boost Energy, and Balance Hormones by Dr. Mindy Pelz: A book recommended by a listener for its focus on fasting for women.Eat Like a Girl: 100+ Delicious Recipes to Balance Hormones, Boost Energy, and Burn Fat by Dr. Mindy Pelz: Another book recommended by a listener for its focus on nutrition for women. The Resetter Podcast : Dr. Mindy Pelz’s podcast, also recommended by a listener. Fall of Civilizations Podcast : A podcast I mention to illustrate that most legacies, even of great empires, fade over time.“The Art of Letting Bad Things Happen (And Weapons of Mass Distraction)”: One of my older blog posts that I say is very relevant to how I live my life.“The Karmic Capitalist: Should I Wait Until I’m Rich to Give Back?”: Another of my older blog posts, which I reference when discussing my philosophy on philanthropy.Batman: Year One by Frank Miller and David Mazzucchelli: Originally released in 1988 in four parts, these stories give us more insight into Batman’s origin. The Four Seasons : A modern, eight-part series adapted from the 1981 Alan Alda film The Four Seasons . Dirty Dancing : A 1987 romantic drama film starring Patrick Swayze and Jennifer Grey about a young woman who falls in love with a dance instructor during a family vacation.Health & Wellness SupplementsAGG Stack (PAGG minus the P): A supplement combination consisting of:Alpha-Lipoic Acid (ALA)Green Tea ExtractGarlic Allicin ExtractBPC-157: A peptide used to aid in elbow surgery recovery.Collagen & Vitamin C: Taken together prior to physical therapy or stretching to support tissue repair.N-acetylcysteine (NAC): A supplement taken for liver health, often between meals.Fish Oil (Pure Encapsulations ONE): Tested for purity by Kevin Rose and Dr. Rhonda Patrick.Magnesium L-threonate: A form of magnesium for cognitive support.Maca Root Extract: Taken for potential androgenic and reproductive health benefits.AREDS 2: A Bausch & Lomb supplement for ocular health being used experimentally for presbyopia.THC & CBN: A combination used at night for pain management post-surgery.Whey Protein: Used to supplement protein intake, especially within intermittent fasting windows.MCT Oil: A budget-friendly alternative to exogenous ketones for cognitive benefits.Ketone Ester (Monoester)/Keto Start (Ketone Salts): Expensive ketone monoesters vs. the more affordable Keto Start (a ketone salt product from Dominic D’Agostino).Prescription & Over-the-Counter Drugs

(Disclaimer: I emphasize multiple times not to copy my protocol and to consult a doctor.)

Uloric (Febuxostat): A prescription for managing uric acid to prevent future gout.Nexlizet (Ezetimibe and Bempedoic Acid): A prescription for managing my lipid profile.Famotidine (Pepcid): An over-the-counter medication I’m taking for its potential anti-COVID applications and as a mild vagal tone improver.DORA Class Sleep Medications: A class of prescription sleep medication I am researching for its potential to help clear amyloid plaque associated with Alzheimer’s.Diets & Training MethodsIntermittent Fasting: I have changed my mind on this and now practice it regularly, typically in a 16/8 format (eating within an eight-hour window).Ketogenic Diet: A diet I used to kickstart my intermittent fasting journey, which resulted in my best blood work in over a decade.Blood Flow Restriction (BFR) Training: A technique recommended by Kelly Starrett that I’m using to maintain muscle mass and flush tissue during rehab.Marc Pro Device: An electrical stimulation device used for decongestion and lymphatic drainage to aid healing.Apps, Tools, & TechnologyConsensus.app: An AI-powered search engine specifically designed to find and summarize findings from peer-reviewed scientific papers.ChatGPT, Claude, Perplexity: General large language models (LLMs) I use for initial research, which I then cross-reference.Zero: Kevin Rose’s app for tracking fasting periods.Discord: I mention using a Discord server to gather feedback from fans of Exploding Kittens games.Reddit: I note that subreddits can be a great place to cross-reference information and find very smart people (with the caveat that it is not medical advice).Ancestry.com: Mentioned as a tool for tracing family lineage for a potential family trip.Games & EntertainmentCoyote: The card game I created with Exploding Kittens, which is a central topic of discussion.Monopoly Deal: A fast-paced card game mentioned by a listener as a family favorite alongside Coyote.Dungeons & Dragons: I mention I still have all my old hardcover books, modules, and dice from when I was a kid.CØCKPUNCH/Legends of Varlata: My foray into fantasy fiction.Companies, Organizations, & BrandsExploding Kittens: The game company that published Coyote.Saisei Foundation: My own foundation, which funds research into mental health therapeutics.Maui Nui Venison: A company I am a large investor in, which I describe as providing highly nutritious red meat.PeopleRoald Dahl: Author of Charlie and the Chocolate Factory and The Wonderful Story of Henry Sugar and Six More .Wes Anderson: American filmmaker who directed the short-film adaptation of The Wonderful Story of Henry Sugar .Dale Carnegie: Author of How to Stop Worrying and Start Living .Pablos Holman: Hacker and inventor known for talks on proper problem sequencing.Keith Baar: UC Davis researcher whose work informs collagen and vitamin C usage.Kelly Starrett: Performance coach and PT who recommended BFR training.Kevin Rose & Rhonda Patrick: Friends who have discussed testing the purity of fish oil supplements.Kevin Tracey: Neurosurgeon known for research on vagus nerve stimulation.Seth Godin: Author and entrepreneur quoted on the idea that “money is a story.”Naval Ravikant: Investor and thinker referenced with the question, “How many Sumerians do you know?”Charles Babbage: English mathematician, philosopher, inventor and mechanical engineer considered by many to be the “father of the computer.”Valter Longo: Director of the USC Longevity Institute and biogerontologist known for his research on fasting-mimicking diets, cellular protection, aging, and longevity mechanisms across species.Dominic D’Agostino: Researcher focused on ketogenic diets, metabolic therapies, and nutritional strategies for neurological disorders and human performance optimization.Henry Shukman: Zen teacher at Mountain Cloud Zen Center.Frank Miller: Legendary comics creator of Sin City: The Hard Goodbye  and 300 .Elan Lee: Game designer and co-creator of Exploding Kittens; partner on the Coyote project.Johnny Depp: American actor and producer known for transformative film roles.Ridley Scott: British filmmaker behind Alien , Blade Runner , and Gladiator .Tom Hardy: British actor known for The Dark Knight Rises and Mad Max: Fury Road .Timothée Chalamet: American actor known for Call Me by Your Name and Dune (2021).Josh Waitzkin: Chess prodigy and author of The Art of Learning .Andrew Huberman & Peter Attia: Neuroscientist and physician who have discussed nicotine and health tradeoffs.Albert Hofmann: Swiss chemist best known for first synthesizing LSD.Javier Milei: President of Argentina since 2023, known for his libertarian economic policies and efforts to combat hyperinflation through drastic austerity measures and deregulation.Michael Phelps: Widely regarded as one of the greatest athletes of all time, he captured 28 Olympic medals and set 39 world records over the course of his swimming career.Mindy Pelz: Author and podcaster focused on fasting, particularly for women.Robert Rodriguez: American filmmaker known for El Mariachi , Desperado , and Sin City .Key Concepts & IdeasSequencing: The crucial importance of breaking a problem down and solving its pieces in the right order.80/20 Analysis: The principle of identifying the 20 percent of inputs that will yield 80 percent of the results.Saying “No”: The theme of turning down good opportunities to make space for “Hell, yes” moments.Vagus Nerve Stimulation: A topic I’m very interested in and would add a chapter about to The 4-Hour Body if I were to revisit it.Treating Philanthropy Like For-Profit Investing: My approach of applying rigorous, impact-driven analysis to my non-profit work.Extended Human Fasting: A neglected area of scientific research that I believe holds immense potential as a therapeutic tool.Fun as Recovery: The idea that delight, play, and laughter are not distractions but essential forms of recovery needed for high performance.PlacesAustin, Texas: Capital city of Texas and the “Live Music Capital of the World,” known for its vibrant music scene, breakfast tacos, technology industry, and the slogan “Keep Austin Weird.”Silicon Valley, California: California’s tech-centric region stretching from Belmont to San Jose around the south end of San Francisco Bay, home to major technology corporations like Google, Apple, Meta, and Stanford University.Glacier National Park: Montana national park showcasing melting glaciers, alpine meadows, carved valleys, and spectacular lakes with over 700 miles of trails, featuring the famous Going-to-the-Sun Road and historic lodges.Mountain Cloud Zen Center: A Zen meditation retreat in Santa Fe, New Mexico, run by Henry Shukman, which I describe as a magical experience.Taiwan: Island nation situated in the West Pacific between Japan and the Philippines, renowned for its democratic government, advanced technology sector, and semiconductor industry.Estonia: Baltic state and EU member known as one of the world’s most digitally advanced countries, offering innovative e-governance services, e-residency programs, and serving as the birthplace of technologies like Skype.Lithuania: Baltic state and EU/NATO member in Northern Europe, known for its medieval capital Vilnius, strong digital innovation sector, commitment to regional security and defense cooperation, and fascinating basketball-Grateful Dead connection.Mohonk Mountain House: A resort in Upstate New York I recommend for large, extended family outings.SHOW NOTES[00:00:00] Start[00:06:00] Coyote retail distribution challenges and data gathering.[00:09:12] Elbow surgery recovery: sequencing, decongestion, Marc Pro device, peptides, BFR training.[00:16:14] California vs. Austin for builders, mechanical engineers, and tech startups.[00:19:06] Using AI for medical advice workflow (and cross-referencing with professionals).[00:23:51] Current supplement regimen and PAGG/AGG status.[00:31:54] California vs. Texas considerations for aspiring parents.[00:32:48] Saying “No” to good things for “Hell, yes” moments.[00:34:34] Philanthropy lessons learned since starting Saisei Foundation.[00:37:45] Something I’ve changed my mind about recently: intermittent fasting.[00:42:44] Precious items from childhood I still keep: D&D relics and marine biology books.[00:43:03] Bucket list hike: Glacier National Park.[00:43:42] How the catalytic chaos of publishing The 4-Hour Chef led to launching this podcast.[00:45:52] Bringing delight vs. sixth-gear, high-performance focus.[00:49:05] Thoughts on extended human fasting research from the Soviet era.[00:52:58] Most magical New Mexico experience: Mountain Cloud Zen Center meditation retreat.[00:53:22] Meta skills for the AI era: Hyper-adaptability and world-class learning.[00:54:01] The (real and ideal) future of CØCKPUNCH/Legends of Varlata.[00:59:47] Competitive chess training enhancement: glucose management, intermittent fasting, MCT oil.[01:06:31] Behind-the-scenes projects: Fusion, algae feed additives, meat alternatives.[01:08:32] Countries I wish I had visited earlier, and places I’d still like to see.[01:11:06] “Not yet” vs. “No” in early growth phases.[01:14:14] Post Coyote, do I have any future games in the works?[01:14:46] Over-ear vs. in-ear headphones for podcasting.[01:15:16] What’s the uncrowded channel right now?[01:16:17] Recommendations for Dr. Mindy Pelz.[01:16:58] Robert Rodriguez and project juggling.[01:17:24] Fast neutron reactors and the Bugatti of ketones.[01:19:05] Extended family outings and Mahonk Mountain House.[01:20:31] NO BOOK meetup plans?[01:20:54] Parting thoughts.

Want to hear another episode where I answer questions directly from listeners? Have a gander at my recent Q&A session in which I discussed changing my mind about parenthood, identity diversification, how to find joy and live with urgency, career reinvention in the age of AI, avoiding complacency, getting unstuck, and much more.

The post Q&A with Tim — Supplements I’m Taking, Austin vs. SF, Training for Mental Performance, Current Go-To AI Tools, Recovering from Surgery, Intermittent Fasting, and More (#826) appeared first on The Blog of Author Tim Ferriss.

Dr. Dominic D’Agostino — All Things Ketones, How to Protect the Brain and Boost Cognition, Sardine Fasting, Diet Rules, Revisiting Metformin and Melatonin, and More (#825)

Dr. Dominic D’Agostino (@DominicDAgosti2) is a tenured associate professor in the Department of Molecular Pharmacology and Physiology at the University of South Florida Morsani College of Medicine and a Visiting Senior Research Scientist at the Institute for Human and Machine Cognition.

He teaches medical neuroscience, physiology, nutrition, and neuropharmacology, and his research focuses on the development and testing of nutritional strategies and metabolic-based therapies for neurological disorders, cancer, and human performance optimization. His work spans both basic science and human clinical trials.

He has a strong personal interest in environmental medicine and enhancing the safety and resilience of military personnel and astronauts. In this capacity, he served as a research investigator and crew member on NASA’s Extreme Environment Mission Operations. His research has been supported by the Office of Naval Research, the Department of Defense, the National Institutes of Health, private organizations, and nonprofit foundations.

He earned his B.S. in Nutritional Science and Biological Sciences from Rutgers University in 1998, followed by a predoctoral fellowship in Neuroscience and Physiology at Rutgers and the University of Medicine and Dentistry of New Jersey. He then completed postdoctoral training in Neuroscience at Wright State University’s Boonshoft School of Medicine in 2004 and at University of South Florida Morsani College of Medicine in 2006.

Please enjoy!

Listen to the episode on Apple Podcasts, Spotify, Overcast, Podcast Addict, Pocket Casts, Castbox, YouTube Music, Amazon Music, Audible, or on your favorite podcast platform. Watch the conversation on YouTube.

This episode is brought to you by:

AG1  all-in-one nutritional supplement Helix Sleep  premium mattresses Momentous  high-quality creatineListen onApple Podcasts[image error]Listen onSpotify[image error]Listen onOvercastDr. Dominic D’Agostino — All Things Ketones, How to Protect the Brain and Boost Cognition, Sardine Fasting, Diet Rules, Revisiting Metformin and Melatonin, and More

This episode is brought to you by AG1! I get asked all the time, “If you could use only one supplement, what would it be?” My answer is usually AG1, my all-in-one nutritional insurance. I recommended it in The 4-Hour Body in 2010 and did not get paid to do so. Right now, you’ll get a 1-year supply of Vitamin D free with your first subscription purchase—a vital nutrient for a strong immune system and strong bones. Visit DrinkAG1.com/Tim to claim this special offer today and receive your 1-year supply of Vitamin D (and 5 free AG1 travel packs) with your first subscription purchase! 

This episode is brought to you by Momentous high-quality creatine and more! Momentous offers high-quality supplements and products across a broad spectrum of categories, and I’ve been testing their products for months now. I’ve been using their magnesium threonate, apigenin, and L-theanine daily, all of which have helped me improve the onset, quality, and duration of my sleep. I’ve also been using Momentous creatine, and while it certainly helps physical performance, including poundage or wattage in sports, I use it primarily for mental performance (short-term memory, etc.). Use code TIM at checkout and enjoy 35% off your first subscription order or 14% off your first one-time purchase! 

This episode is brought to you by Helix Sleep! Helix was selected as the best overall mattress of 2024 by Forbes, Fortune, and Wired magazines and many others. With Helix, there’s a specific mattress to meet each and every body’s unique comfort needs. Just take their quiz—only two minutes to complete—that matches your body type and sleep preferences to the perfect mattress for you. They have a 10-year warranty, and you get to try it out for a hundred nights, risk-free. They’ll even pick it up from you if you don’t love it. And now, Helix is offering 27% off all mattress orders at HelixSleep.com/Tim.

SELECTED LINKS FROM THE EPISODEConnect with Dr. Dominic D’Agostino:

KetoNutrition.org | Facebook | Twitter | University of South Florida

Dr. Dominic D’Agostino’s Past AppearancesDom D’Agostino on Fasting, Ketosis, and the End of Cancer | The Tim Ferriss Show #117Dom D’Agostino — The Power of the Ketogenic Diet | The Tim Ferriss Show #172Dom D’Agostino on Disease Prevention, Cancer, and Living Longer | The Tim Ferriss Show #188Concepts & IdeasAPOE3/4 Genotype: A genetic variant where individuals carry one copy each of the APOE3 and APOE4 alleles, associated with moderately increased risk of Alzheimer’s disease compared to APOE3/3 but lower risk than APOE4/4.Type 3 Diabetes: A term used to describe Alzheimer’s disease as a form of insulin resistance and insulin deficiency that occurs specifically in the brain, characterized by impaired neuronal glucose metabolism.The Four Horsemen of Chronic Disease: The four pillars of chronic disease, according to Dr. Peter Attia.Glucose Hypometabolism: A state where the brain’s ability to use glucose for energy is impaired, often occurring more than 10 years before the onset of Alzheimer’s disease symptoms and considered a key feature of neurodegeneration.Neuroinflammation: Inflammation of nervous tissue involving activation of microglia and astrocytes, considered a major driver of neurodegenerative diseases including Alzheimer’s, Parkinson’s, and multiple sclerosis.Ketogenic Diet: A very low-carbohydrate (typically under 50g per day), high-fat diet originally developed at Mayo Clinic in the 1920s to treat epilepsy, which forces the body to produce ketones for fuel instead of using glucose.Mediterranean-Style Low-Carb Diet: A modified version of the traditional Mediterranean diet that reduces carbohydrate intake while emphasizing vegetables, fish, olive oil, nuts, and healthy fats to support weight loss and blood sugar control.Exogenous Ketones: Ketone bodies (primarily beta-hydroxybutyrate) that are consumed through nutritional supplements in the form of ketone salts, esters, or precursor compounds, allowing for rapid elevation of blood ketones without dietary restriction.Ketone Monoester vs. Diester vs. Salts: Different forms of exogenous ketone supplements where monoesters provide the most efficient ketone elevation, diesters are bonds between two ketone molecules, and salts combine ketones with minerals like sodium or potassium.Glucose Ketone Index (GKI): A ratio calculated by dividing blood glucose levels by ketone levels, used as a biomarker for metabolic health and the depth of ketosis, with lower values indicating better metabolic flexibility.Fasting and “Sardine Fasting”: Abstaining from food for therapeutic benefits, with “sardine fasting” referring to a modified fasting approach where only sardines are consumed, providing protein while maintaining some benefits of fasting.Autophagy: The body’s cellular recycling process of cleaning out damaged organelles and proteins to regenerate newer, healthier cellular components, enhanced during periods of fasting and ketosis.Cancer Cachexia: A complex metabolic syndrome characterized by severe loss of muscle mass and body weight, often accompanied by anemia, weakness, and loss of appetite in cancer patients.Metabolic Psychiatry: An emerging field that uses metabolic interventions, particularly ketogenic diets and exogenous ketones, to treat mental health conditions by addressing underlying metabolic dysfunction in the brain.NLRP3 Inflammasome: A multiprotein complex in immune cells that acts as a cellular sensor and triggers inflammatory responses, playing a crucial role in innate immunity and implicated in various neurodegenerative diseases.Metabolic Control of Epigenetic Regulation: The concept that metabolites like beta-hydroxybutyrate can directly influence gene expression by acting as signaling molecules and histone deacetylase inhibitors, affecting cellular function and health.Redox Stress: An imbalance in the cellular ratio of NAD+ to NADH that can impair mitochondrial function and energy production, often associated with aging and metabolic dysfunction.Hyperbaric Oxygen Therapy (HBOT): A medical treatment involving breathing pure oxygen in a pressurized chamber at 1.5 to 3 times normal atmospheric pressure, used to enhance healing and treat various conditions including wound healing and carbon monoxide poisoning.Lipid Energy Model: A metabolic model explaining how LDL cholesterol and ApoB particles can be elevated on low-carbohydrate diets as they function as transport vehicles for mobilized fatty acids used for energy production.SARM (Selective Androgen Receptor Modulator): A class of therapeutic compounds designed to selectively bind to androgen receptors in specific tissues, potentially offering the muscle-building benefits of anabolic steroids with reduced androgenic side effects.Substances & DrugsBeta-Hydroxybutyrate (BHB): The primary ketone body produced during fat metabolism and ketosis, used as an alternative energy source for the brain and body.1,3-Butanediol: A ketone precursor and alcohol compound that is metabolized into beta-hydroxybutyrate (BHB) in the liver.MCT Oil (Medium-Chain Triglyceride): A type of saturated fat that is readily absorbed and converted into ketones, commonly used in ketogenic diets.Creatine Monohydrate: A supplement that helps regenerate ATP in muscles, known for improving exercise performance, strength, and potentially cognitive function.Lipopolysaccharide (LPS): A component of gram-negative bacterial cell walls used in research to induce systemic inflammation and study immune responses.Ezetimibe (Zetia): A prescription medication that lowers cholesterol by inhibiting its absorption in the small intestine.Rapamycin: An immunosuppressive drug originally used to prevent organ rejection that has gained attention for potential anti-aging and longevity effects.Metformin: A first-line medication for type 2 diabetes that lowers blood glucose levels and has potential benefits for longevity and metabolic health.Berberine/Dihydroberberine: Plant-derived alkaloid compounds with glucose-lowering effects similar to metformin, used for metabolic health support.GLP-1 Agonists: A class of diabetes medications that mimic incretin hormones to regulate blood sugar and promote weight loss, including drugs like semaglutide and tirzepatide.SGLT-2 Inhibitors: A class of diabetes medications that lower blood sugar by preventing glucose reabsorption in the kidneys, causing excess glucose to be excreted in urine.NAD Supplements: Supplements like nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) designed to boost cellular NAD+ levels for potential anti-aging benefits.Idebenone / CoQ10 / Ubiquinol: Antioxidant compounds that support mitochondrial energy production and cellular health, with CoQ10 being essential for ATP synthesis.GABA / Phenibut: Gamma-aminobutyric acid and related compounds that have calming, inhibitory effects on the central nervous system.Diphenhydramine (Benadryl): An over-the-counter antihistamine commonly used for allergies that causes drowsiness and is sometimes used as a sleep aid.Melatonin: A hormone naturally produced by the pineal gland that regulates the sleep-wake cycle and is commonly used as a sleep supplement.Ostarine: A selective androgen receptor modulator (SARM) that selectively targets muscle and bone tissue, mentioned for veterinary use in research contexts.Alpha GPC / Theanine: Nootropic compounds where Alpha-GPC supports acetylcholine production for cognitive function and L-theanine promotes relaxation without sedation.Products & BrandsKetoStart (Audacious Nutrition): A ketone electrolyte supplement company founded by Dr. Dominic D’Agostino’s wife, specializing in exogenous ketone products.Qitone: A brand that produces ketone diester powder supplements for enhancing ketosis and metabolic performance.Keto-Mojo: A company that manufactures portable blood glucose and ketone testing devices popular among those following ketogenic diets.Abbott Precision Xtra: A dual-purpose blood glucose and ketone monitoring system manufactured by Abbott for diabetes management and ketosis tracking.LMNT: An electrolyte supplement brand that provides sugar-free, keto-friendly hydration products with optimal sodium, potassium, and magnesium ratios.Levels: A metabolic health company that provides continuous glucose monitors (CGMs) paired with an app to help users optimize their blood sugar responses.Stelo: An over-the-counter continuous glucose monitor developed by Dexcom for people without diabetes to track their glucose patterns.GB HealthWatch: A genetic testing company that provides personalized reports for dyslipidemia and cardiovascular risk assessment based on DNA analysis.Dry Farm Wines: A wine company specializing in natural, low-sugar, additive-free wines that are lab-tested for purity and lower alcohol content.French Women Don’t Get Fat: The Secret of Eating for Pleasure by Mireille Guiliano: A bestselling lifestyle guide that reveals the “French paradox” of how French women stay slim while enjoying bread, wine, and three-course meals through principles of balance, quality over quantity, and eating for pleasure rather than restriction.Keto Brainz: A supplement brand that produces MCT powder enhanced with nootropic compounds to support both ketosis and cognitive function.Nutricost / Quest: Popular supplement brands that offer MCT powder products among their extensive product lines.Nordic Naturals: A premium omega-3 supplement brand known for high-quality fish oil products with third-party purity testing and sustainable sourcing.OmegaQuant: A testing company that measures omega-3 fatty acid levels in blood to help individuals optimize their omega-3 status and cardiovascular health.Metabolic Mind: An educational platform from the Baszucki Group that focuses on metabolic approaches to mental health and psychiatric conditions.MetPsy: An app currently in development designed to provide metabolic therapy coaching and support for mental health applications.InstitutionsNIH (National Institutes of Health): The primary agency of the United States government responsible for biomedical and public health research.USF (University of South Florida): Public research university in Tampa where Dr. D’Agostino is a professor.Byrd Alzheimer’s Center: Research institute at USF Health dedicated to Alzheimer’s disease prevention, treatment and cure where Dr. D’Agostino’s wife worked.Buck Institute for Research on Aging: Independent biomedical research institute in California focused on extending healthy years of life.Harvard University: Private Ivy League research university in Cambridge, Massachusetts where Chris Palmer and Georgia Ede are affiliated.Moffitt Cancer Center: National Cancer Institute-designated comprehensive cancer center in Tampa collaborating with Dr. D’Agostino.Stanford University: Private research university in California where Shebani Sethi is affiliated.Oxford University: Prestigious collegiate research university in England where Dr. Ally Houston is affiliated.Northwestern University: Private research university in Illinois where Dr. Nav Chandel conducts research.University of Edinburgh: Public research university in Scotland where Dr. Iain Campbell conducts research.Yale University: Private Ivy League research university in Connecticut where Dr. Deep Dixit is a researcher.Genentech: American biotechnology corporation and subsidiary of Roche, pioneering in recombinant DNA technology.Metro International Biotech: Clinical-stage pharmaceutical company developing NAD+ precursors and therapeutics like MIB-626.Relevant Resources & ResearchMeet Dr. Mary T. Newport — Neonatologist and Advocate for Treating Alzheimer’s with Ketones | Keto-MojoHyperbaric Oxygen Therapy Improves Post-Concussion Symptoms in Adults with Childhood Traumatic Brain Injury: A Retrospective Cohort Study | Frontiers in NeurologyEnantiomer-Specific Cardiovascular Effects of the Ketone Body 3-Hydroxybutyrate | Journal of the American Heart AssociationThe Many Faces of Beta-Hydroxybutyrate (BHB) | KetoNutritionWhy Do We Need Both D-BHB and L-BHB? | KetoNutritionStudy of the Ketogenic Agent AC-1202 in Mild to Moderate Alzheimer’s Disease | Nutrition & MetabolismA New Way to Produce Hyperketonemia: Use of Ketone Ester in a Case of Alzheimer’s Disease | Alzheimer’s & Dementia JournalThe Ketone Metabolite Beta-Hydroxybutyrate Blocks NLRP3 Inflammasome-Mediated Inflammatory Disease | Nature MedicineExogenous Ketone Supplements Reduce Anxiety-Related Behavior in Two Rodent Models | Scientific ReportsElevated Plus Maze Test Combined with Video Tracking to Investigate the Anxiolytic Effect of Exogenous Ketogenic Supplements | JoVEToxicological Evaluation of the Ketogenic Ester Bis-Hexanoyl (R)-1,3-Butanediol: Subchronic Toxicity in Sprague-Dawley Rats | ToxicologyA Dietary Ketone Ester Mitigates Histological Outcomes of Nafld and Markers of Fibrosis in High-Fat Diet Fed Mice | American Journal of Gastrointestinal and Liver PhysiologyTherapeutic Use of the Ketogenic Diet in Refractory Epilepsy: What We Know and What Still Needs to Be Learned | NutrientsMetabolic Therapy with Deanna Protocol Supplementation Delays Disease Progression and Extends Survival in Amyotrophic Lateral Sclerosis (ALS) Mouse Model | PLOS ONEPeopleMary Newport: Physician and author who pioneered the use of MCT oil for Alzheimer’s disease, founding medical director of newborn intensive care units in Florida.Steve Newport: Husband of Dr. Mary Newport, subject of a case report on using a ketone monoester for Alzheimer’s disease who experienced significant improvements.Sam Corcos: Co-founder and CEO of Levels, a health technology startup that uses continuous glucose monitors to help people understand how food affects their metabolic health.Richard Veech: NIH researcher who developed the beta-hydroxybutyrate monoester and studied ketones for cognitive decline and neurological disorders.Peter Attia: Physician and longevity expert, known for the “Four Horsemen” concept, host of The Drive podcast and author of the #1 New York Times bestseller Outlive .George F. Cahill Jr.: Scientist known for his historic fasting studies and research on metabolic physiology at Harvard Medical School.Thomas Seyfried: Professor and cancer researcher at Boston College, colleague of Dr. D’Agostino who studies metabolic approaches to cancer treatment.Fred Hatfield (“Dr. Squat”): Powerlifter and mentor to Dr. D’Agostino who used a ketogenic diet for metastatic prostate cancer treatment.Valter Longo: Researcher known for the Fasting Mimicking Diet and director of the USC Longevity Institute studying aging and disease prevention.Mike Dancer: Man whose experience with epilepsy and the ketogenic diet influenced Dr. D’Agostino’s research direction.Sam Henderson: Researcher who published early research on AC-1202 (MCT oil) for Alzheimer’s disease treatment.Jong Rho: Researcher who highlighted the importance of acetoacetate and acetone in seizure control mechanisms.Spencer Nadolsky: Physician who suggested Dr. D’Agostino might be a hyperabsorber of cholesterol based on his lipid profiles.Matt Kaeberlein: Aging researcher and professor at the University of Washington studying longevity and healthspan extension.Csilla Ari D’Agostino: Neuroscientist, Dom’s wife, and founder of Audacious Nutrition.Charles Poliquin: Late strength coach known for his innovative training methods and work with elite athletes worldwide.Dale Bredesen: Physician and researcher focused on Alzheimer’s disease treatment and prevention through the ReCODE protocol.Navdeep Chandel: Researcher at Northwestern University studying cellular metabolism and its role in health and disease.Andrew Huberman: Neuroscientist and professor at Stanford University, host of the popular Huberman Lab podcast on health and performance.Rhonda Patrick: Scientist and host of FoundMyFitness, specializing in nutrition, aging, and disease prevention through lifestyle interventions.Eric Verdin: President and CEO of the Buck Institute for Research on Aging, studying metabolism and aging processes.Vishwa Deep Dixit: Researcher at Yale University who studied the NLRP3 inflammasome and its role in metabolic health.Chris Palmer: Harvard psychiatrist and author of Brain Energy , advocate for metabolic psychiatry approaches to mental health treatment.Matt Baszucki: Son of David Baszucki, whose experience with bipolar disorder was treated with a ketogenic diet approach.Jan and David Baszucki: Founders of Roblox, philanthropists funding metabolic psychiatry research through the Baszucki Brain Research Fund.Shebani Sethi: Psychiatrist at Stanford University researching metabolic approaches to mental health treatment.Ally Houston: Researcher at Oxford University studying metabolism and brain function.Georgia Ede: Harvard-trained psychiatrist and author of Change Your Diet, Change Your Mind , specializing in nutritional psychiatry.Iain Campbell: Researcher at the University of Edinburgh studying bipolar disorder and metabolic interventions.Deanna Tedone: Individual with ALS who stabilized her condition using the “Deanna Protocol” nutritional approach.Angela Poff and Victoria Field: Colleagues of Dr. D’Agostino who run the Metabolic Health Initiative at the University of South Florida.SHOW NOTES[00:00:00] Start.[00:14:43] Why I’m interested in ketogenic strategies for neurodegenerative prevention.[00:16:18] Mary and Steve Newport’s ketone-linked temporary cognitive improvements.[00:18:18] A mechanisms overview for Alzheimer’s/dementia.[00:21:25] The immune system as longevity’s “fifth horseman” — and why metabolic control is key.[00:22:04] How to measure ketones and GKI.[00:23:00] Fasting vs. ketogenic diet.[00:24:18] There’s nothing fishy about sardine fasting.[00:28:32] My hiatal hernia discovery and increased cancer risk concerns.[00:30:04] HSCRP as a superior biomarker to LDL for cardiovascular risk.[00:31:57] Glucose tolerance testing revelations and CGM importance.[00:31:57] Upgrading the metabolic machinery through keto without getting bored.[00:42:07] What do do if you, like Dom and me, are among the 30% who suffer from cholesterol hyperabsorption.[00:43:42] Dom’s day-to-day diet regimen.[00:45:56] How Dom optimizes his aging dogs with ketones, SARMs, and supplements.[00:51:30] Supplementing for sleep disruption while fasting.[00:55:41] Why Dom doesn’t have misgivings about melatonin.[00:59:15] Shingles prevention through fasting protocols.[01:00:15] Immune system modulation: Innate vs. adaptive, vegan vs. ketogenic.[01:03:54] Dom at 50-something: Current meal timing and composition.[01:05:57] Blue zone observations: Greek and Sardinian longevity habits.[01:08:16] Ketogenic diet initiation tips: MCT, electrolytes, and fasted cardio.[01:15:18] Ketone metabolic therapy for cancer.[01:18:15] The metabolic psychiatry revolution.[01:22:10] The soothing effects of hyperbaric oxygen and ketosis on seizure sufferers.[01:28:27] Metformin vs. berberine.[01:31:43] The low-dose neuroprotective potential of GLP-1 drugs.[01:34:58] NAD research: MIB-626 and stabilized forms for mitochondrial health.[01:39:48] Idebenone, CoQ10, and the Deanna protocol for ALS.[01:42:05] Dom’s supplement short list: CoQ10, creatine, ketones, vitamin D, melatonin.[01:44:43] KetoNutrition.org, Metabolic Health Summit, Audacious Nutrition, veteran-focused research protocols, and other parting thoughts.DR. DOMINIC D’AGOSTINO QUOTES FROM THE INTERVIEW

“I think the beauty of ketogenic [therapy] is that it’s pleiotropic, right? Which means it’s many mechanisms working in synergy.”

— Dr. Dominic D’Agostino

“I think the best way to measure to suggest you’re in autophagy is a glucose ketone index after a period of fasting.”

— Dr. Dominic D’Agostino

“About 30 percent of the population hyperabsorbs cholesterol.”

— Dr. Dominic D’Agostino

“HSCRP is a better indicator of cardiovascular disease than LDL cholesterol. We know that now. [No one would believe it] If someone said that 10 years ago.”

— Dr. Dominic D’Agostino

“I wouldn’t go above three, probably 1.5 to 2 millimolar range. That seems to be a level of ketones that safely does not produce a metabolic acidosis.”

— Dr. Dominic D’Agostino

“When we published the NLRP3, I got requests from Genentech and various pharmaceutical companies to go there and give a talk on the mechanism so they could drugify. And I would throw up a big flow chart of all these mechanisms, and I think they would get frustrated. And it was like, ‘Well, tell us the mechanism so we can make a drug out of this.'”

— Dr. Dominic D’Agostino

“I went on a vacation where I forgot melatonin and I slept like a baby probably because I was up every morning. The sun is the ultimate circadian synchronizer. I got off of melatonin to check my endogenous melatonin, and there was no suppression.”

— Dr. Dominic D’Agostino

“So we went to these blue zones and they just, at night after their dinner, the males will do a shot of alcohol, usually wine, but sometimes ouzo and they’re all in their nineties and hundreds, they’re in the blue zone. So it’s a universal characteristic.”

— Dr. Dominic D’Agostino

Want to hear the last time Dom was on the show? Listen to our previous conversation in which we discussed disease prevention, longevity, cancer, ketogenic diet mastery, the detoxifying effects of ketosis on pre-cancerous cells, how to jumpstart daily ketogenic cycles, “cheat” meals, and much more.

The post Dr. Dominic D’Agostino — All Things Ketones, How to Protect the Brain and Boost Cognition, Sardine Fasting, Diet Rules, Revisiting Metformin and Melatonin, and More (#825) appeared first on The Blog of Author Tim Ferriss.

What Most Has My Attention Right Now — Credible (vs. Bogus) Vagus Nerve Stimulation (#824)

Kevin J. Tracey, MD (@KevinJTraceyMD), is president and CEO of the Feinstein Institutes for Medical Research at Northwell Health, a pioneer of vagus-nerve research, and author of the recent book The Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes. 

His contributions include identifying the therapeutic action of monoclonal anti-TNF antibodies and discovering the specific reflex control of immunity by the nervous system, called the “inflammatory reflex.” These discoveries launched the new scientific field called bioelectronic medicine, which investigates the therapeutic applications of vagus-nerve stimulation to cure disease.

Dr. Tracey, a neurosurgeon, pursued studies of inflammation after the mysterious death, from sepsis, of a toddler who was in his care. His lab has since revealed molecular mechanisms of inflammation and identified the use of vagus-nerve stimulation to treat it. An inventor on more than 120 US patents and the author of more than 450 scientific publications, he is among the most highly cited scientists in the world. He co-founded the Global Sepsis Alliance, is the author of Fatal Sequence, and is a national and international lecturer.

Please enjoy!

Listen to the episode on Apple Podcasts, Spotify, Overcast, Podcast Addict, Pocket Casts, Castbox, YouTube Music, Amazon Music, Audible, or on your favorite podcast platform. Watch the conversation on YouTube. The transcript of this episode can be found here. Transcripts of all episodes can be found here.

This episode is brought to you by:

AG1  all-in-one nutritional supplement Eight Sleep Pod Cover 5  sleeping solution for dynamic cooling and heating Wealthfront  high-yield cash accountListen onApple Podcasts[image error]Listen onSpotify[image error]Listen onOvercastWhat Most Has My Attention Right Now — Credible (vs. Bogus) Vagus Nerve Stimulation

This episode is brought to you by AG1! I get asked all the time, “If you could use only one supplement, what would it be?” My answer is usually AG1, my all-in-one nutritional insurance. I recommended it in The 4-Hour Body in 2010 and did not get paid to do so. Right now, you’ll get a 1-year supply of Vitamin D free with your first subscription purchase—a vital nutrient for a strong immune system and strong bones. Visit DrinkAG1.com/Tim to claim this special offer today and receive your 1-year supply of Vitamin D (and 5 free AG1 travel packs) with your first subscription purchase! 

This episode is brought to you by Eight Sleep. Temperature is one of the main causes of poor sleep, and heat is my personal nemesis. But a few years ago, I started using the Pod Cover, and it has transformed my sleep. Eight Sleep has launched their newest generation of the Pod: Pod 5 Ultra. It cools, it heats, and now it elevates, automatically. With the best temperature performance to date, Pod 5 Ultra ensures you and your partner stay cool in the heat and cozy warm in the cold. And now, listeners of The Tim Ferriss Show can get $350 off of the Pod 5 Ultra for a limited time! Click here to claim this deal and unlock your full potential through optimal sleep.

This episode is brought to you by Wealthfront! Wealthfront is a financial services platform that offers services to help you save and invest your money. Right now, you can earn 4.00% APY—that’s the Annual Percentage Yield—with the Wealthfront Brokerage Cash Account. That’s nearly 10x more interest than if you left your money in a savings account at the average bank, with savings rates at 0.42%, according to FDIC.gov, as of 05/19/2025. It takes just a few minutes to sign up, and then you’ll immediately start earning 4.00% APY from program banks on your uninvested cash. And when new clients open an account today, they’ll get an extra $50 bonus with a deposit of $500 or more. Terms and Conditions apply.  Visit Wealthfront.com/Tim to get started.

Cash Account offered by Wealthfront Brokerage LLC, member FINRA/SIPC. Wealthfront is not a bank. The APY on cash deposits, as of 04/30/2025, is representative, subject to change, and requires no minimum. Funds in the Cash Account are swept to program banks, where they earn a variable APY. Tim receives cash compensation from Wealthfront Brokerage for advertising and holds a non-controlling equity interest in the corporate parent of Wealthfront Brokerage. Tim and Wealthfront Brokerage have no other affiliation. Tim expresses his own opinions, and Wealthfront does not endorse, sponsor, or promote them. See full disclosures here.

SELECTED LINKS FROM THE EPISODEConnect with Dr. Kevin Tracey:

X | The Feinstein Institutes of Northwell Health | SetPoint Medical | LinkedIn

The transcript of this episode can be found here. Transcripts of all episodes can be found here.

Publications & MediaThe Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes by Kevin J. Tracey: A groundbreaking book exploring the potential of the vagus nerve to regulate the body’s vital systems and heal medical conditions without drugs.The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation by Stephen W. Porges: A comprehensive compilation of decades of research on the polyvagal theory and its implications for understanding the autonomic nervous system. STEM-Talk : A bi-weekly interview podcast produced by the Florida Institute for Human and Machine Cognition featuring conversations with groundbreaking scientists, engineers, and technologists. The New York Times : A major American daily newspaper that featured coverage on SetPoint Medical and other medical developments. HuffPost : An American progressive news and opinion website where Dr. Tracey was interviewed about his research. Cell : A prestigious peer-reviewed scientific journal that published research on topics including gut microbiota and the ketogenic diet.Explain Pain by David Butler and G. Lorimer Moseley: An evidence-based book designed for therapists, patients, and students that explains the science behind pain and recovery strategies.The Integrative Action of the Nervous System by Charles Sherrington: A classic 1906 work in neuroscience that established fundamental concepts about how the nervous system functions as an integrated whole.Medical ConditionsRheumatoid Arthritis: An autoimmune disease that causes inflammation in the joints.Crohn’s Disease: A type of inflammatory bowel disease that affects the digestive tract.PTSD (Post-Traumatic Stress Disorder): A mental health condition triggered by experiencing or witnessing a traumatic event.Chronic Fatigue Syndrome: A long-term illness characterized by extreme fatigue that doesn’t improve with rest and may worsen with physical or mental activity.Depression: A mood disorder that causes persistent feelings of sadness, hopelessness, and loss of interest in activities.Lyme Disease: An infectious disease caused by bacteria transmitted through the bite of infected ticks.Neurodegenerative Disease: A range of conditions that primarily affect the neurons in the human brain, leading to progressive deterioration of function.Anaphylaxis: A severe, potentially life-threatening allergic reaction that can occur rapidly after exposure to an allergen.Asthma: A respiratory condition in which airways become inflamed, narrow, and produce excess mucus, making breathing difficult.Sepsis: A life-threatening condition that arises when the body’s response to infection causes widespread inflammation and organ dysfunction.Psoriatic Arthritis: A form of inflammatory arthritis that affects some people who have the skin condition psoriasis.Autoimmune Conditions: Disorders in which the immune system mistakenly attacks the body’s own healthy tissues and organs.COVID-19: A contagious respiratory illness caused by the SARS-CoV-2 virus that can range from mild to severe symptoms.Alzheimer’s Disease: A progressive neurodegenerative disease that destroys memory and other important mental functions.Parkinson’s Disease: A progressive disorder of the central nervous system that affects movement, often causing tremors, stiffness, and difficulty with balance.Metabolic Syndrome: A cluster of conditions including high blood pressure, high blood sugar, excess abdominal fat, and abnormal cholesterol levels that increase the risk of heart disease, stroke, and diabetes.Diabetes: A chronic disease that occurs when the body cannot properly produce or use insulin, leading to elevated blood sugar levels.Cancer: A group of diseases characterized by the uncontrolled growth and spread of abnormal cells in the body.Malaria: A life-threatening disease caused by parasites transmitted through the bites of infected female Anopheles mosquitoes.Tuberculosis: A serious infectious bacterial disease that primarily affects the lungs but can spread to other parts of the body.Peptic Ulcer Disease: A condition characterized by painful sores or ulcers that develop in the lining of the stomach or the first part of the small intestine.Epilepsy: A neurological disorder in which brain activity becomes abnormal, causing seizures, unusual behavior, sensations, and sometimes loss of consciousness.Cluster Headaches: A series of extremely painful headaches that occur in cyclical patterns or clusters, often at the same time each day for weeks or months.Migraines: Intense headaches that cause severe throbbing or pulsing pain, typically on one side of the head, often accompanied by nausea and sensitivity to light and sound.Sciatica: Pain that radiates along the sciatic nerve pathway from the lower back through the hips and down one or both legs.Treatments & TherapiesVagus Nerve Stimulation (VNS): A medical treatment that involves delivering electrical impulses to the vagus nerve.Audio Chakra Cleanse Soundtracks: A type of alternative therapy mentioned as an example of “nonsense.”Biologics: Medications made from living organisms or their components.Ketogenic Diet: A very low-carb, high-fat diet.Exogenous Ketones: Ketones that are ingested through a nutritional supplement.GLP-1 Agonists (e.g., Ozempic, Mounjaro): A class of medications used to treat type 2 diabetes and obesity.Microbiome Transplants: The transfer of fecal matter from a healthy donor to a recipient to restore a healthy gut microbiome.TMS (Transcranial Magnetic Stimulation): A noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression.Focused Ultrasound: A non-invasive therapeutic technology that uses focused sound waves to target and treat a variety of medical conditions.Psychedelics (e.g., LSD, 2C-B, Ayahuasca): A class of hallucinogenic drugs whose primary effect is to trigger non-ordinary states of consciousness.TENS (Transcutaneous Electrical Nerve Stimulation) units: A non-invasive method of pain relief that uses a mild electrical current.Auricular Therapy: A form of alternative medicine based on the idea that the ear is a microsystem which reflects the entire body.Famotidine (Pepcid): An over-the-counter antacid that Dr. Tracey describes as a pharmacological vagus nerve stimulator.Antibiotics: Medications that fight bacterial infections.SSRIs (Selective Serotonin Reuptake Inhibitors): A class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions.Ibuprofen: A nonsteroidal anti-inflammatory drug (NSAID).Monoclonal Antibodies: Laboratory-made proteins that mimic the immune system’s ability to fight off harmful pathogens such as viruses.Optogenetics: A biological technique that involves the use of light to control cells in living tissue, typically neurons, that have been genetically modified to express light-sensitive ion channels.Key Concepts & TheoriesPolyvagal Theory: A theory that links the evolution of the autonomic nervous system to social behavior and emphasizes the importance of physiological state in the expression of behavioral problems and psychiatric disorders.Heart Rate Variability (HRV): The variation in the time interval between consecutive heartbeats.Sympathetic Overdrive: A condition where the sympathetic nervous system is overactive.Inflammatory Reflex: A physiological reflex that controls the inflammatory response.Bioelectronic Medicine: A field of medicine that uses electronic devices to treat diseases and injuries.Blood-Brain Barrier: A highly selective semipermeable border of endothelial cells that prevents solutes in the circulating blood from non-selectively crossing into the extracellular fluid of the central nervous system where neurons reside.Cytokines (e.g., TNF, IL-1, IL-6): A broad and loose category of small proteins that are important in cell signaling.Cytokine Storm: A severe immune reaction in which the body releases too many cytokines into the blood too quickly.Inflammaging: Chronic, low-grade inflammation that develops with advanced age.Neuroinflammation: Inflammation of the nervous tissue.Neuroplasticity: The ability of the brain to form and reorganize synaptic connections, especially in response to learning or experience or following injury.Interoception: The sense of the internal state of the body.Engram: A physical trace of memory in the brain.M1 and M2 Macrophages: Two different types of white blood cells with different functions in the inflammatory response.PeopleKelly Owens: A patient of Dr. Tracey’s who suffered from Crohn’s disease and rheumatoid arthritis and was successfully treated with a vagus nerve stimulation device.Murthy Simhambhatla: The CEO of SetPoint Medical, a bioelectronic medicine company developing vagus nerve stimulation therapies.Dave Chernoff: The Chief Medical Officer of SetPoint Medical, overseeing clinical development of bioelectronic therapies.Nolan Williams: A psychiatry professor and director of the Stanford Brain Stimulation Lab who pioneered Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT), an FDA-approved treatment for treatment-resistant depression using accelerated TMS.Nora Volkow: Director of the National Institute on Drug Abuse (NIDA) who pioneered the use of brain imaging to investigate addiction as a brain disorder and is researching focused ultrasound therapies for addiction treatment.Steve Liberles: A professor of cell biology at Harvard Medical School and Howard Hughes Medical Institute investigator who studies the molecular neuroscience of vagus nerve sensory systems and identified specific vagal neuron subtypes that control breathing and digestion in mice.K. Frank Austen: A leading expert on asthma research and respiratory medicine.Barry Jacobs: A researcher at Princeton University who studied the effects of LSD on cats and contributed to early psychedelic research.Andrew Weil: A physician and author with a background in ethnobotany who has written about his experiences with psychedelics including LSD and integrative medicine approaches.Ulf Andersson: A retired professor of pediatric rheumatology at the Karolinska Institute and friend of Dr. Tracey’s who used a TENS unit to treat his own inflammation-related depression.Paul Nogier: A French physician who created the first auricular acupuncture maps in 1957, pioneering modern ear acupuncture techniques.Kenneth M. Ford: Founder and CEO Emeritus of the Florida Institute for Human and Machine Cognition (IHMC), and co-host of the STEM-Talk podcast.Geoff Ling: Retired colonel who founded the biology technology office at DARPA.Richard Feynman: Nobel Prize-winning American theoretical physicist known for his work in quantum mechanics, quantum electrodynamics, and superfluidity.Charles Sherrington: One of the founders of modern neuroscience, known for his groundbreaking work on neural reflexes and The Integrative Action of the Nervous System, for which he won the Nobel Prize in Physiology or Medicine in 1932.Santiago Ramón y Cajal: The other founding father of modern neuroscience, known for his pioneering studies of the structure of the nervous system and the neuron doctrine, Nobel Prize winner in Physiology or Medicine in 1906.Asya Rolls: A professor who discovered that inflammation in the colon can form a neural network connection to the brain, advancing our understanding of the gut-brain axis.Sangeeta Chavan: A colleague of Dr. Tracey’s at the Feinstein Institute for Medical Research, contributing to bioelectronic medicine research.Stavros Zanos: A colleague of Dr. Tracey’s at the Feinstein Institute for Medical Research, specializing in neural engineering and bioelectronics.Okito Hashimoto: A colleague of Dr. Tracey’s at the Feinstein Institute for Medical Research, working in the field of bioelectronic medicine.Eric Chang: A colleague of Dr. Tracey’s at the Feinstein Institute for Medical Research, contributing to neuroscience and bioelectronics research.Martine Rothblatt: A friend of Dr. Tracey’s and CEO of United Therapeutics, she is a renowned polymath who founded SiriusXM satellite radio before entering biotechnology to develop treatments for her daughter’s pulmonary hypertension, becoming the highest-paid female CEO in America.Lorimer Moseley: Co-author with David Butler of the book Explain Pain and a leading researcher in pain neuroscience and clinical neurosciences at the University of South Australia.William Bushell: A scientist who works with the Dalai Lama on studies involving meditation, consciousness, and human potential.Elizabeth Blackburn: A scientist who won both the Lasker Prize and the Nobel Prize in Physiology or Medicine in 2009 for her work on telomeres and telomerase.Bob Thurman: Uma Thurman’s father and a professor of Tibetan studies at Columbia University, known for his scholarship on Buddhist philosophy.The Dalai Lama: The spiritual leader of Tibet and global advocate for compassion, peace, and interfaith dialogue.Bill Murray: Formidably funny man and serial-striking bowler.Kevin Rose: Probably not the Kevin you’re looking for, but Kevin, by any other name, would smell as sweet.Institutions & CompaniesSetPoint Medical: A commercial-stage medical technology company that developed the first FDA-approved neuroimmune modulation device to treat rheumatoid arthritis using vagus nerve stimulation.Feinstein Institutes for Medical Research: The research arm of Northwell Health and home to 50 research labs, 3,000 clinical research studies, and 5,000 researchers where Dr. Tracey and his colleagues work.Mayo Clinic: A world-renowned nonprofit American medical organization dedicated to integrated healthcare, education, and research.Stanford University: A prestigious private research university in California known for its groundbreaking research, including work on accelerated TMS and other medical innovations.Centers for Disease Control and Prevention (CDC): The national public health agency of the United States, responsible for protecting public health and safety through disease prevention and health promotion.Karolinska Institute: A prestigious medical research institute and university in Sweden, home to the Nobel Committee for Physiology or Medicine.Defense Advanced Research Projects Agency (DARPA): A research and development agency of the United States Department of Defense responsible for developing emerging technologies for military use.Defense Language Institute: A United States Department of Defense educational and research institution that provides language training to military personnel and federal employees.United Therapeutics: A biotechnology company focused on creating innovative products to address the medical needs of patients with chronic and life-threatening conditions, including pulmonary arterial hypertension and organ transplantation technologies.World Health Organization (WHO): A specialized agency of the United Nations responsible for international public health, setting global health standards, and coordinating international health responses.Columbia University: A prestigious private Ivy League research university in New York City, renowned for its contributions to medicine, science, and other fields of study.Pendulum: A science-backed biotechnology company founded by doctors and scientists that produces next-generation probiotics, including the only commercially available live Akkermansia supplement.WHOOP: 24/7 monitoring across sleep, strain, stress, and heart health.Oura Ring: A smart ring that monitors over 20 biometrics that directly impact how you feel.Fitbit: Wearables designed to “keep you close to your goals, boost your motivation, and show your progress throughout your health and fitness journey.”Relevant Research & ResourcesKevin Tracey on Neuro-Immunology and the Treatment of Inflammatory Diseases | STEM-TalkKevin Tracey, MD, Reveals Vagus Nerve’s Power in New Book | Northwell HealthSetPoint Medical Receives FDA Approval for Novel Neuroimmune Modulation Therapy for Rheumatoid Arthritis | SetPoint MedicalNew Implant Offers Hope for Easing Rheumatoid Arthritis | The New York TimesI Tried 22 Different Medications Before an Electrical Implant Healed My Crohn’s Disease | PreventionNolan Williams — A Glimpse of the Future: Electroceuticals for 70%–90% Remission of Depression, Brain Stimulation for Sports Performance, and De-Risking Ibogaine for TBI/PTSD | The Tim Ferriss ShowDr. Nora Volkow — Director of the National Institute on Drug Abuse (NIDA) | The Tim Ferriss ShowReappraising the Role of the Vagus Nerve in GLP-1-Mediated Regulation of Eating | British Journal of PharmacologyRole of Vagus Nerve Signaling in CNI-1493-Mediated Suppression of Acute Inflammation | Autonomic NeuroscienceGood-bye to Drugs? Kevin Tracey, MD on the Bioelectronics Revolution at the Dysautonomia International Conference | Health RisingNo Audible Wheezing: Nuggets and Conundrums from Mouse Asthma Models | Journal of Experimental MedicineHere’s What Happens When Animals Eat LSD | DoubleBlindSome Practical Thoughts on Suicide | Tim FerrissThe Evolution of Inflammation | PfizerFDA Black Box Warning Raises Awareness of Medication Risk | GoodRxEffects of Anti-Inflammatory Vagus Nerve Stimulation in Endotoxemic Rats on Blood and Spleen Lymphocyte Subsets | Inflammation ResearchVagus Nerve Stimulation for Epilepsy and Depression | NeurotherapeuticsVagus Nerve Active during Exercise, Research Finds | The University of AucklandJumping into the Ice Bath Trend! Mental Health Benefits of Cold Water Immersion | Stanford Lifestyle MedicineThe Thermoregulatory Theory of Yawning: What We Know from over Five Years of Research | Frontiers in NeurosciencePrevalence of Autoimmune Diseases Is Strongly Associated with Average Annual Temperatures: Systematic Review and Linear Regression Analysis | BMC RheumatologyNobel Prize Is Awarded to Doctors Who Discovered H Pylori | The British Medical JournalWhat Happens to Your Blood Sugar While You Sleep? | WebMDType A Personality Traits vs. Type B | Simply PsychologyFocused Ultrasound Neuromodulation of the Spleen Activates an Anti-Inflammatory Response in Humans | Brain StimulationHistory of Auriculotherapy: Additional Information and New Developments | Medical AcupunctureThe Medial Surface of the Auricle: Historical and Recent Maps. What Are the Possible Expectations of the “Thumb-Index Technique” | MedicinesOur Ears Share a Common Ancestry with Fish Gills | Scientific AmericanJP Errico Explains How Vagus-Nerve Stimulation Reduces Inflammation and Chronic Diseases | STEM-TalkVagus Nerve Stimulation May Enhance Language Learning, DoD Study Reports | Practical NeurologyGeoffrey Ling: From DARPA to Life | Twin GlobalVagus Nerve Stimulation (VNS) Therapy | Epilepsy SocietyThe Gut Microbiota Mediates the Anti-seizure Effects of the Ketogenic Diet | CellDr. Andrew Weil — Optimal Health, Plant Medicine, and More | The Tim Ferriss ShowThe Hidden Flaws of HRV Tracking | The Unlazy WayBreathe to Directly Control Heart Rate via Huberman Lab | InstagramFamotidine Activates the Vagus Nerve Inflammatory Reflex to Attenuate Cytokine Storm | Molecular MedicineWHOOP Adds Psychedelics Tracking | Fitt InsiderWhy Don’t We Know How Antidepressants Work Yet? | Chemistry WorldUlf’s Case Study: VAGUS Smartwatch ECG Test | VAGUS Health Ltd.Study of the Transcutaneous Auricular Vagus Nerve Stimulation May Advance Outcome in Chronic Pediatric Inflammatory Diseases | Medical Research ArchivesAcupuncture Enhances Chances of Pregnancy in Unexplained Infertile Patients Who Undergo a Blastocyst Transfer in a Fresh-Cycle | Chinese Journal of Integrative MedicineAcupuncture as Treatment for Female Infertility: A Systematic Review and Meta-Analysis of Randomized Controlled Trials | Evidence-Based Complementary and Alternative MedicineDr. Martine Rothblatt — A Masterclass on Asking Better Questions and Peering into the Future | The Tim Ferriss ShowImmunoception: The Insular Cortex Perspective | Cellular & Molecular ImmunologyNew Science Shows Immune “Memory” in the Brain | Quanta MagazineJennifer Aniston Strikes a Nerve | NatureQuantum Physics — His Holiness the Dalai Lama Participates in the 26th Mind & Life Meeting at Drepung | The Office of His Holiness The Dalai LamaSHOW NOTES[00:00:00] Start.[00:06:34] Factors alleviating my skepticism about vagus nerve stimulation.[00:11:12] SetPoint Medical receives FDA approval for vagus nerve stimulation device to treat rheumatoid arthritis.[00:13:24] How Crohn’s disease sufferer Kelly Owens went from a wheelchair to running up stairs in Amsterdam.[00:20:36] Placebo effect concerns and the conditions driving my interest in bioelectric medicine.[00:25:31] Vagus nerve anatomy 101.[00:32:53] Cytokines and inflammation: What happens when the vagus nerve is stimulated.[00:33:45] Discovery story: Accidental finding of brain-body inflammation connection.[00:35:39] Bioelectronic medicine approach vs. pharmaceutical approach.[00:38:18] Mice don’t wheeze.[00:40:13] Depression and inflammation connection: SSRIs may work through anti-inflammatory effects.[00:42:46] My personal experience with vagus nerve stimulation and mood stability.[00:44:22] The pros and cons of inflammation, and how controlling it may lead to even longer lifespans.[00:50:56] Weighing the safety of VNS vs. biologics in cytokine suppression.[00:56:27] Cold exposure, meditation, and breathing practices affecting the vagus nerve.[00:59:01] A population-level increase in chronic inflammatory diseases: Nature vs. nurture.[01:00:48] H. pylori: For when you can’t blame stress, God, or the patient for that nagging ulcer.[01:03:13] Stress, cortisol, and inflammation connections.[01:05:42] SetPoint device vs. non-invasive alternatives for different patient populations.[01:11:09] Auricular therapy’s curious French origins.[01:13:28] There’s something fishy about this vestigial vagus nerve pathway.[01:16:03] Overlapping activation patterns from brain imaging studies of ear stimulation.[01:19:01] DARPA support and Geoff Ling’s “What if it’s yes?” attitude.[01:21:58] Neurocognition and vagus nerve inputs.[01:27:20] How Ulf Andersson turned his depression around with a TENS unit.[01:31:55] Heart rate variability complexity and measurement challenges.[01:33:05] A breathing exercise for directly controlling heart rate.[01:35:30] Using a common antacid as a pharmacological vagus nerve stimulator during COVID.[01:36:23] A call for more inflammation-based depression research and patient stratification.[01:39:52] SSRIs and anti-inflammatory mechanisms in depression treatment.[01:42:20] Interoception: The body’s inflammatory signals reaching the brain via vagus nerve.[01:43:22] Ulf’s published protocol for TENS unit ear stimulation.[01:44:37] VNS, acupuncture, fertility, and Martine Rothblatt.[01:47:16] Chronic low back pain and an inflammatory overreaction analogy.[01:48:35] Implications of Asya Rolls’ engram research and inflammation memories in the brain.[02:02:35] Cervical TENS vs. true VNS.[02:07:12] Charles Sherrington’s reflex theory and nervous system integration.[02:12:15] Blue energy meditation and vagus nerve pathways with the Dalai Lama.[02:16:47] Parting thoughts: Serious medical conditions vs. self-help approaches.DR. KEVIN TRACEY QUOTES FROM THE INTERVIEW

“60 million people die on the planet Earth every year. And 40 million of them die from heart disease, stroke, neurodegeneration, Alzheimer’s, Parkinson’s, metabolic syndrome, diabetes, and cancer. So two thirds of the people that die every year on the planet Earth die of those conditions. And that’s according to the WHO. Those conditions all have one thing in common: they’re either caused by inflammation or made worse by inflammation.”

— Dr. Kevin Tracey

“It was just announced that the company SetPoint Medical, which will now be marketing a device to stimulate the vagus nerve to treat rheumatoid arthritis, has received FDA approval. So there’ll be a product launch underway for everything we’re about to talk about in the context of using a medical device that activates an evolutionarily conserved and ancient reflex through which the brain can suppress inflammation when it’s running out of control.”

— Dr. Kevin Tracey

“We’ve discovered that signals travel from the brain through the vagus nerve. … These signals traveling in the vagus nerve are like the brakes on your car. And when you tap those brakes to slow your car barreling down the hill, this device activates what we call the inflammatory reflex.”

— Dr. Kevin Tracey

“If we can find such nerves, then we can build devices to control the nerves, and the devices become the therapy. The bioelectronic medicine story works as long as you know the molecular mechanism, and that’s where people have to be really careful with vagus-nerve stimulation.”

— Dr. Kevin Tracey

“Almost everybody until a hundred years ago, 150 years ago, almost everybody died by the time they were 30. And what happened in the last 150 years can be summarized in a very simple sentence. The human race in the last 150 years removed infection as the leading cause of death. … I think something similar will happen maybe in the next 20 years if we can really understand how to modify inflammation.”

— Dr. Kevin Tracey

“My adage for this thing is, when you don’t understand a disease, think of epilepsy. You start off, you blame God. So they did exorcisms, and that doesn’t work. So if it’s not God’s fault, the next thing you do is you blame the patient. And when you realize it’s not the patient’s fault, in today’s era, oftentimes we find out it’s actually caused, there’s some infectious cause of this thing. And so autoimmune disease may have an infectious cause, it may have an environmental cause. People talk about genetic causes. You inherit some level of risk for autoimmune diseases, but in very few of these conditions do you actually inherit the condition.”

— Dr. Kevin Tracey

Want to hear another episode about the future of electroceuticals and brain stimulation? Listen to my conversation with Stanford’s Dr. Nolan Williams, in which we discussed 70%–90% remission rates for treatment-resistant depression, brain stimulation for sports performance, accelerated TMS protocols, de-risking ibogaine for TBI/PTSD, the future of “electroceuticals,” and much more.

The post What Most Has My Attention Right Now — Credible (vs. Bogus) Vagus Nerve Stimulation (#824) appeared first on The Blog of Author Tim Ferriss.

Dr. Kevin Tracey — Stimulating the Vagus Nerve to Tame Inflammation, Alleviate Depression, Treat Autoimmune Disorders (e.g., Rheumatoid Arthritis), and Much More (#824)

Kevin J. Tracey, MD (@KevinJTraceyMD), is president and CEO of the Feinstein Institutes for Medical Research at Northwell Health, a pioneer of vagus-nerve research, and author of the recent book The Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes. 

His contributions include identifying the therapeutic action of monoclonal anti-TNF antibodies and discovering the specific reflex control of immunity by the nervous system, called the “inflammatory reflex.” These discoveries launched the new scientific field called bioelectronic medicine, which investigates the therapeutic applications of vagus-nerve stimulation to cure disease.

Dr. Tracey, a neurosurgeon, pursued studies of inflammation after the mysterious death, from sepsis, of a toddler who was in his care. His lab has since revealed molecular mechanisms of inflammation and identified the use of vagus-nerve stimulation to treat it. An inventor on more than 120 US patents and the author of more than 450 scientific publications, he is among the most highly cited scientists in the world. He co-founded the Global Sepsis Alliance, is the author of Fatal Sequence, and is a national and international lecturer.

Please enjoy!

Listen to the episode on Apple Podcasts, Spotify, Overcast, Podcast Addict, Pocket Casts, Castbox, YouTube Music, Amazon Music, Audible, or on your favorite podcast platform. Watch the conversation on YouTube. The transcript of this episode can be found here. Transcripts of all episodes can be found here.

This episode is brought to you by:

AG1  all-in-one nutritional supplement Eight Sleep Pod Cover 5  sleeping solution for dynamic cooling and heating Wealthfront  high-yield cash accountListen onApple Podcasts[image error]Listen onSpotify[image error]Listen onOvercastDr. Kevin Tracey — Stimulating The Vagus Nerve to Tame Inflammation, Alleviate Depression, Treat Autoimmune Disorders (e.g., Rheumatoid Arthritis), and Much More

This episode is brought to you by AG1! I get asked all the time, “If you could use only one supplement, what would it be?” My answer is usually AG1, my all-in-one nutritional insurance. I recommended it in The 4-Hour Body in 2010 and did not get paid to do so. Right now, you’ll get a 1-year supply of Vitamin D free with your first subscription purchase—a vital nutrient for a strong immune system and strong bones. Visit DrinkAG1.com/Tim to claim this special offer today and receive your 1-year supply of Vitamin D (and 5 free AG1 travel packs) with your first subscription purchase! 

This episode is brought to you by Eight Sleep. Temperature is one of the main causes of poor sleep, and heat is my personal nemesis. But a few years ago, I started using the Pod Cover, and it has transformed my sleep. Eight Sleep has launched their newest generation of the Pod: Pod 5 Ultra. It cools, it heats, and now it elevates, automatically. With the best temperature performance to date, Pod 5 Ultra ensures you and your partner stay cool in the heat and cozy warm in the cold. And now, listeners of The Tim Ferriss Show can get $350 off of the Pod 5 Ultra for a limited time! Click here to claim this deal and unlock your full potential through optimal sleep.

This episode is brought to you by Wealthfront! Wealthfront is a financial services platform that offers services to help you save and invest your money. Right now, you can earn 4.00% APY—that’s the Annual Percentage Yield—with the Wealthfront Brokerage Cash Account. That’s nearly 10x more interest than if you left your money in a savings account at the average bank, with savings rates at 0.42%, according to FDIC.gov, as of 05/19/2025. It takes just a few minutes to sign up, and then you’ll immediately start earning 4.00% APY from program banks on your uninvested cash. And when new clients open an account today, they’ll get an extra $50 bonus with a deposit of $500 or more. Terms and Conditions apply.  Visit Wealthfront.com/Tim to get started.

Cash Account offered by Wealthfront Brokerage LLC, member FINRA/SIPC. Wealthfront is not a bank. The APY on cash deposits, as of 04/30/2025, is representative, subject to change, and requires no minimum. Funds in the Cash Account are swept to program banks, where they earn a variable APY. Tim receives cash compensation from Wealthfront Brokerage for advertising and holds a non-controlling equity interest in the corporate parent of Wealthfront Brokerage. Tim and Wealthfront Brokerage have no other affiliation. Tim expresses his own opinions, and Wealthfront does not endorse, sponsor, or promote them. See full disclosures here.

SELECTED LINKS FROM THE EPISODEConnect with Dr. Kevin Tracey:

X | The Feinstein Institutes of Northwell Health | SetPoint Medical | LinkedIn

The transcript of this episode can be found here. Transcripts of all episodes can be found here.

Publications & MediaThe Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes by Kevin J. Tracey: A groundbreaking book exploring the potential of the vagus nerve to regulate the body’s vital systems and heal medical conditions without drugs.The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation by Stephen W. Porges: A comprehensive compilation of decades of research on the polyvagal theory and its implications for understanding the autonomic nervous system. STEM-Talk : A bi-weekly interview podcast produced by the Florida Institute for Human and Machine Cognition featuring conversations with groundbreaking scientists, engineers, and technologists. The New York Times : A major American daily newspaper that featured coverage on SetPoint Medical and other medical developments. HuffPost : An American progressive news and opinion website where Dr. Tracey was interviewed about his research. Cell : A prestigious peer-reviewed scientific journal that published research on topics including gut microbiota and the ketogenic diet.Explain Pain by David Butler and G. Lorimer Moseley: An evidence-based book designed for therapists, patients, and students that explains the science behind pain and recovery strategies.The Integrative Action of the Nervous System by Charles Sherrington: A classic 1906 work in neuroscience that established fundamental concepts about how the nervous system functions as an integrated whole.Medical ConditionsRheumatoid Arthritis: An autoimmune disease that causes inflammation in the joints.Crohn’s Disease: A type of inflammatory bowel disease that affects the digestive tract.PTSD (Post-Traumatic Stress Disorder): A mental health condition triggered by experiencing or witnessing a traumatic event.Chronic Fatigue Syndrome: A long-term illness characterized by extreme fatigue that doesn’t improve with rest and may worsen with physical or mental activity.Depression: A mood disorder that causes persistent feelings of sadness, hopelessness, and loss of interest in activities.Lyme Disease: An infectious disease caused by bacteria transmitted through the bite of infected ticks.Neurodegenerative Disease: A range of conditions that primarily affect the neurons in the human brain, leading to progressive deterioration of function.Anaphylaxis: A severe, potentially life-threatening allergic reaction that can occur rapidly after exposure to an allergen.Asthma: A respiratory condition in which airways become inflamed, narrow, and produce excess mucus, making breathing difficult.Sepsis: A life-threatening condition that arises when the body’s response to infection causes widespread inflammation and organ dysfunction.Psoriatic Arthritis: A form of inflammatory arthritis that affects some people who have the skin condition psoriasis.Autoimmune Conditions: Disorders in which the immune system mistakenly attacks the body’s own healthy tissues and organs.COVID-19: A contagious respiratory illness caused by the SARS-CoV-2 virus that can range from mild to severe symptoms.Alzheimer’s Disease: A progressive neurodegenerative disease that destroys memory and other important mental functions.Parkinson’s Disease: A progressive disorder of the central nervous system that affects movement, often causing tremors, stiffness, and difficulty with balance.Metabolic Syndrome: A cluster of conditions including high blood pressure, high blood sugar, excess abdominal fat, and abnormal cholesterol levels that increase the risk of heart disease, stroke, and diabetes.Diabetes: A chronic disease that occurs when the body cannot properly produce or use insulin, leading to elevated blood sugar levels.Cancer: A group of diseases characterized by the uncontrolled growth and spread of abnormal cells in the body.Malaria: A life-threatening disease caused by parasites transmitted through the bites of infected female Anopheles mosquitoes.Tuberculosis: A serious infectious bacterial disease that primarily affects the lungs but can spread to other parts of the body.Peptic Ulcer Disease: A condition characterized by painful sores or ulcers that develop in the lining of the stomach or the first part of the small intestine.Epilepsy: A neurological disorder in which brain activity becomes abnormal, causing seizures, unusual behavior, sensations, and sometimes loss of consciousness.Cluster Headaches: A series of extremely painful headaches that occur in cyclical patterns or clusters, often at the same time each day for weeks or months.Migraines: Intense headaches that cause severe throbbing or pulsing pain, typically on one side of the head, often accompanied by nausea and sensitivity to light and sound.Sciatica: Pain that radiates along the sciatic nerve pathway from the lower back through the hips and down one or both legs.Treatments & TherapiesVagus Nerve Stimulation (VNS): A medical treatment that involves delivering electrical impulses to the vagus nerve.Audio Chakra Cleanse Soundtracks: A type of alternative therapy mentioned as an example of “nonsense.”Biologics: Medications made from living organisms or their components.Ketogenic Diet: A very low-carb, high-fat diet.Exogenous Ketones: Ketones that are ingested through a nutritional supplement.GLP-1 Agonists (e.g., Ozempic, Mounjaro): A class of medications used to treat type 2 diabetes and obesity.Microbiome Transplants: The transfer of fecal matter from a healthy donor to a recipient to restore a healthy gut microbiome.TMS (Transcranial Magnetic Stimulation): A noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression.Focused Ultrasound: A non-invasive therapeutic technology that uses focused sound waves to target and treat a variety of medical conditions.Psychedelics (e.g., LSD, 2C-B, Ayahuasca): A class of hallucinogenic drugs whose primary effect is to trigger non-ordinary states of consciousness.TENS (Transcutaneous Electrical Nerve Stimulation) units: A non-invasive method of pain relief that uses a mild electrical current.Auricular Therapy: A form of alternative medicine based on the idea that the ear is a microsystem which reflects the entire body.Famotidine (Pepcid): An over-the-counter antacid that Dr. Tracey describes as a pharmacological vagus nerve stimulator.Antibiotics: Medications that fight bacterial infections.SSRIs (Selective Serotonin Reuptake Inhibitors): A class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions.Ibuprofen: A nonsteroidal anti-inflammatory drug (NSAID).Monoclonal Antibodies: Laboratory-made proteins that mimic the immune system’s ability to fight off harmful pathogens such as viruses.Optogenetics: A biological technique that involves the use of light to control cells in living tissue, typically neurons, that have been genetically modified to express light-sensitive ion channels.Key Concepts & TheoriesPolyvagal Theory: A theory that links the evolution of the autonomic nervous system to social behavior and emphasizes the importance of physiological state in the expression of behavioral problems and psychiatric disorders.Heart Rate Variability (HRV): The variation in the time interval between consecutive heartbeats.Sympathetic Overdrive: A condition where the sympathetic nervous system is overactive.Inflammatory Reflex: A physiological reflex that controls the inflammatory response.Bioelectronic Medicine: A field of medicine that uses electronic devices to treat diseases and injuries.Blood-Brain Barrier: A highly selective semipermeable border of endothelial cells that prevents solutes in the circulating blood from non-selectively crossing into the extracellular fluid of the central nervous system where neurons reside.Cytokines (e.g., TNF, IL-1, IL-6): A broad and loose category of small proteins that are important in cell signaling.Cytokine Storm: A severe immune reaction in which the body releases too many cytokines into the blood too quickly.Inflammaging: Chronic, low-grade inflammation that develops with advanced age.Neuroinflammation: Inflammation of the nervous tissue.Neuroplasticity: The ability of the brain to form and reorganize synaptic connections, especially in response to learning or experience or following injury.Interoception: The sense of the internal state of the body.Engram: A physical trace of memory in the brain.M1 and M2 Macrophages: Two different types of white blood cells with different functions in the inflammatory response.PeopleKelly Owens: A patient of Dr. Tracey’s who suffered from Crohn’s disease and rheumatoid arthritis and was successfully treated with a vagus nerve stimulation device.Murthy Simhambhatla: The CEO of SetPoint Medical, a bioelectronic medicine company developing vagus nerve stimulation therapies.Dave Chernoff: The Chief Medical Officer of SetPoint Medical, overseeing clinical development of bioelectronic therapies.Nolan Williams: A psychiatry professor and director of the Stanford Brain Stimulation Lab who pioneered Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT), an FDA-approved treatment for treatment-resistant depression using accelerated TMS.Nora Volkow: Director of the National Institute on Drug Abuse (NIDA) who pioneered the use of brain imaging to investigate addiction as a brain disorder and is researching focused ultrasound therapies for addiction treatment.Steve Liberles: A professor of cell biology at Harvard Medical School and Howard Hughes Medical Institute investigator who studies the molecular neuroscience of vagus nerve sensory systems and identified specific vagal neuron subtypes that control breathing and digestion in mice.K. Frank Austen: A leading expert on asthma research and respiratory medicine.Barry Jacobs: A researcher at Princeton University who studied the effects of LSD on cats and contributed to early psychedelic research.Andrew Weil: A physician and author with a background in ethnobotany who has written about his experiences with psychedelics including LSD and integrative medicine approaches.Ulf Andersson: A retired professor of pediatric rheumatology at the Karolinska Institute and friend of Dr. Tracey’s who used a TENS unit to treat his own inflammation-related depression.Paul Nogier: A French physician who created the first auricular acupuncture maps in 1957, pioneering modern ear acupuncture techniques.Kenneth M. Ford: Founder and CEO Emeritus of the Florida Institute for Human and Machine Cognition (IHMC), and co-host of the STEM-Talk podcast.Geoff Ling: Retired colonel who founded the biology technology office at DARPA.Richard Feynman: Nobel Prize-winning American theoretical physicist known for his work in quantum mechanics, quantum electrodynamics, and superfluidity.Charles Sherrington: One of the founders of modern neuroscience, known for his groundbreaking work on neural reflexes and The Integrative Action of the Nervous System, for which he won the Nobel Prize in Physiology or Medicine in 1932.Santiago Ramón y Cajal: The other founding father of modern neuroscience, known for his pioneering studies of the structure of the nervous system and the neuron doctrine, Nobel Prize winner in Physiology or Medicine in 1906.Asya Rolls: A professor who discovered that inflammation in the colon can form a neural network connection to the brain, advancing our understanding of the gut-brain axis.Sangeeta Chavan: A colleague of Dr. Tracey’s at the Feinstein Institute for Medical Research, contributing to bioelectronic medicine research.Stavros Zanos: A colleague of Dr. Tracey’s at the Feinstein Institute for Medical Research, specializing in neural engineering and bioelectronics.Okito Hashimoto: A colleague of Dr. Tracey’s at the Feinstein Institute for Medical Research, working in the field of bioelectronic medicine.Eric Chang: A colleague of Dr. Tracey’s at the Feinstein Institute for Medical Research, contributing to neuroscience and bioelectronics research.Martine Rothblatt: A friend of Dr. Tracey’s and CEO of United Therapeutics, she is a renowned polymath who founded SiriusXM satellite radio before entering biotechnology to develop treatments for her daughter’s pulmonary hypertension, becoming the highest-paid female CEO in America.Lorimer Moseley: Co-author with David Butler of the book Explain Pain and a leading researcher in pain neuroscience and clinical neurosciences at the University of South Australia.William Bushell: A scientist who works with the Dalai Lama on studies involving meditation, consciousness, and human potential.Elizabeth Blackburn: A scientist who won both the Lasker Prize and the Nobel Prize in Physiology or Medicine in 2009 for her work on telomeres and telomerase.Bob Thurman: Uma Thurman’s father and a professor of Tibetan studies at Columbia University, known for his scholarship on Buddhist philosophy.The Dalai Lama: The spiritual leader of Tibet and global advocate for compassion, peace, and interfaith dialogue.Bill Murray: Formidably funny man and serial-striking bowler.Kevin Rose: Probably not the Kevin you’re looking for, but Kevin, by any other name, would smell as sweet.Institutions & CompaniesSetPoint Medical: A commercial-stage medical technology company that developed the first FDA-approved neuroimmune modulation device to treat rheumatoid arthritis using vagus nerve stimulation.Feinstein Institutes for Medical Research: The research arm of Northwell Health and home to 50 research labs, 3,000 clinical research studies, and 5,000 researchers where Dr. Tracey and his colleagues work.Mayo Clinic: A world-renowned nonprofit American medical organization dedicated to integrated healthcare, education, and research.Stanford University: A prestigious private research university in California known for its groundbreaking research, including work on accelerated TMS and other medical innovations.Centers for Disease Control and Prevention (CDC): The national public health agency of the United States, responsible for protecting public health and safety through disease prevention and health promotion.Karolinska Institute: A prestigious medical research institute and university in Sweden, home to the Nobel Committee for Physiology or Medicine.Defense Advanced Research Projects Agency (DARPA): A research and development agency of the United States Department of Defense responsible for developing emerging technologies for military use.Defense Language Institute: A United States Department of Defense educational and research institution that provides language training to military personnel and federal employees.United Therapeutics: A biotechnology company focused on creating innovative products to address the medical needs of patients with chronic and life-threatening conditions, including pulmonary arterial hypertension and organ transplantation technologies.World Health Organization (WHO): A specialized agency of the United Nations responsible for international public health, setting global health standards, and coordinating international health responses.Columbia University: A prestigious private Ivy League research university in New York City, renowned for its contributions to medicine, science, and other fields of study.Pendulum: A science-backed biotechnology company founded by doctors and scientists that produces next-generation probiotics, including the only commercially available live Akkermansia supplement.WHOOP: 24/7 monitoring across sleep, strain, stress, and heart health.Oura Ring: A smart ring that monitors over 20 biometrics that directly impact how you feel.Fitbit: Wearables designed to “keep you close to your goals, boost your motivation, and show your progress throughout your health and fitness journey.”Relevant Research & ResourcesKevin Tracey on Neuro-Immunology and the Treatment of Inflammatory Diseases | STEM-TalkKevin Tracey, MD, Reveals Vagus Nerve’s Power in New Book | Northwell HealthSetPoint Medical Receives FDA Approval for Novel Neuroimmune Modulation Therapy for Rheumatoid Arthritis | SetPoint MedicalNew Implant Offers Hope for Easing Rheumatoid Arthritis | The New York TimesI Tried 22 Different Medications Before an Electrical Implant Healed My Crohn’s Disease | PreventionNolan Williams — A Glimpse of the Future: Electroceuticals for 70%–90% Remission of Depression, Brain Stimulation for Sports Performance, and De-Risking Ibogaine for TBI/PTSD | The Tim Ferriss ShowDr. Nora Volkow — Director of the National Institute on Drug Abuse (NIDA) | The Tim Ferriss ShowReappraising the Role of the Vagus Nerve in GLP-1-Mediated Regulation of Eating | British Journal of PharmacologyRole of Vagus Nerve Signaling in CNI-1493-Mediated Suppression of Acute Inflammation | Autonomic NeuroscienceGood-bye to Drugs? Kevin Tracey, MD on the Bioelectronics Revolution at the Dysautonomia International Conference | Health RisingNo Audible Wheezing: Nuggets and Conundrums from Mouse Asthma Models | Journal of Experimental MedicineHere’s What Happens When Animals Eat LSD | DoubleBlindSome Practical Thoughts on Suicide | Tim FerrissThe Evolution of Inflammation | PfizerFDA Black Box Warning Raises Awareness of Medication Risk | GoodRxEffects of Anti-Inflammatory Vagus Nerve Stimulation in Endotoxemic Rats on Blood and Spleen Lymphocyte Subsets | Inflammation ResearchVagus Nerve Stimulation for Epilepsy and Depression | NeurotherapeuticsVagus Nerve Active during Exercise, Research Finds | The University of AucklandJumping into the Ice Bath Trend! Mental Health Benefits of Cold Water Immersion | Stanford Lifestyle MedicineThe Thermoregulatory Theory of Yawning: What We Know from over Five Years of Research | Frontiers in NeurosciencePrevalence of Autoimmune Diseases Is Strongly Associated with Average Annual Temperatures: Systematic Review and Linear Regression Analysis | BMC RheumatologyNobel Prize Is Awarded to Doctors Who Discovered H Pylori | The British Medical JournalWhat Happens to Your Blood Sugar While You Sleep? | WebMDType A Personality Traits vs. Type B | Simply PsychologyFocused Ultrasound Neuromodulation of the Spleen Activates an Anti-Inflammatory Response in Humans | Brain StimulationHistory of Auriculotherapy: Additional Information and New Developments | Medical AcupunctureThe Medial Surface of the Auricle: Historical and Recent Maps. What Are the Possible Expectations of the “Thumb-Index Technique” | MedicinesOur Ears Share a Common Ancestry with Fish Gills | Scientific AmericanJP Errico Explains How Vagus-Nerve Stimulation Reduces Inflammation and Chronic Diseases | STEM-TalkVagus Nerve Stimulation May Enhance Language Learning, DoD Study Reports | Practical NeurologyGeoffrey Ling: From DARPA to Life | Twin GlobalVagus Nerve Stimulation (VNS) Therapy | Epilepsy SocietyThe Gut Microbiota Mediates the Anti-seizure Effects of the Ketogenic Diet | CellDr. Andrew Weil — Optimal Health, Plant Medicine, and More | The Tim Ferriss ShowThe Hidden Flaws of HRV Tracking | The Unlazy WayBreathe to Directly Control Heart Rate via Huberman Lab | InstagramFamotidine Activates the Vagus Nerve Inflammatory Reflex to Attenuate Cytokine Storm | Molecular MedicineWHOOP Adds Psychedelics Tracking | Fitt InsiderWhy Don’t We Know How Antidepressants Work Yet? | Chemistry WorldUlf’s Case Study: VAGUS Smartwatch ECG Test | VAGUS Health Ltd.Study of the Transcutaneous Auricular Vagus Nerve Stimulation May Advance Outcome in Chronic Pediatric Inflammatory Diseases | Medical Research ArchivesAcupuncture Enhances Chances of Pregnancy in Unexplained Infertile Patients Who Undergo a Blastocyst Transfer in a Fresh-Cycle | Chinese Journal of Integrative MedicineAcupuncture as Treatment for Female Infertility: A Systematic Review and Meta-Analysis of Randomized Controlled Trials | Evidence-Based Complementary and Alternative MedicineDr. Martine Rothblatt — A Masterclass on Asking Better Questions and Peering into the Future | The Tim Ferriss ShowImmunoception: The Insular Cortex Perspective | Cellular & Molecular ImmunologyNew Science Shows Immune “Memory” in the Brain | Quanta MagazineJennifer Aniston Strikes a Nerve | NatureQuantum Physics — His Holiness the Dalai Lama Participates in the 26th Mind & Life Meeting at Drepung | The Office of His Holiness The Dalai LamaSHOW NOTES[00:00:00] Start.[00:06:34] Factors alleviating my skepticism about vagus nerve stimulation.[00:11:12] SetPoint Medical receives FDA approval for vagus nerve stimulation device to treat rheumatoid arthritis.[00:13:24] How Crohn’s disease sufferer Kelly Owens went from a wheelchair to running up stairs in Amsterdam.[00:20:36] Placebo effect concerns and the conditions driving my interest in bioelectric medicine.[00:25:31] Vagus nerve anatomy 101.[00:32:53] Cytokines and inflammation: What happens when the vagus nerve is stimulated.[00:33:45] Discovery story: Accidental finding of brain-body inflammation connection.[00:35:39] Bioelectronic medicine approach vs. pharmaceutical approach.[00:38:18] Mice don’t wheeze.[00:40:13] Depression and inflammation connection: SSRIs may work through anti-inflammatory effects.[00:42:46] My personal experience with vagus nerve stimulation and mood stability.[00:44:22] The pros and cons of inflammation, and how controlling it may lead to even longer lifespans.[00:50:56] Weighing the safety of VNS vs. biologics in cytokine suppression.[00:56:27] Cold exposure, meditation, and breathing practices affecting the vagus nerve.[00:59:01] A population-level increase in chronic inflammatory diseases: Nature vs. nurture.[01:00:48] H. pylori: For when you can’t blame stress, God, or the patient for that nagging ulcer.[01:03:13] Stress, cortisol, and inflammation connections.[01:05:42] SetPoint device vs. non-invasive alternatives for different patient populations.[01:11:09] Auricular therapy’s curious French origins.[01:13:28] There’s something fishy about this vestigial vagus nerve pathway.[01:16:03] Overlapping activation patterns from brain imaging studies of ear stimulation.[01:19:01] DARPA support and Geoff Ling’s “What if it’s yes?” attitude.[01:21:58] Neurocognition and vagus nerve inputs.[01:27:20] How Ulf Andersson turned his depression around with a TENS unit.[01:31:55] Heart rate variability complexity and measurement challenges.[01:33:05] A breathing exercise for directly controlling heart rate.[01:35:30] Using a common antacid as a pharmacological vagus nerve stimulator during COVID.[01:36:23] A call for more inflammation-based depression research and patient stratification.[01:39:52] SSRIs and anti-inflammatory mechanisms in depression treatment.[01:42:20] Interoception: The body’s inflammatory signals reaching the brain via vagus nerve.[01:43:22] Ulf’s published protocol for TENS unit ear stimulation.[01:44:37] VNS, acupuncture, fertility, and Martine Rothblatt.[01:47:16] Chronic low back pain and an inflammatory overreaction analogy.[01:48:35] Implications of Asya Rolls’ engram research and inflammation memories in the brain.[02:02:35] Cervical TENS vs. true VNS.[02:07:12] Charles Sherrington’s reflex theory and nervous system integration.[02:12:15] Blue energy meditation and vagus nerve pathways with the Dalai Lama.[02:16:47] Parting thoughts: Serious medical conditions vs. self-help approaches.DR. KEVIN TRACEY QUOTES FROM THE INTERVIEW

“60 million people die on the planet Earth every year. And 40 million of them die from heart disease, stroke, neurodegeneration, Alzheimer’s, Parkinson’s, metabolic syndrome, diabetes, and cancer. So two thirds of the people that die every year on the planet Earth die of those conditions. And that’s according to the WHO. Those conditions all have one thing in common: they’re either caused by inflammation or made worse by inflammation.”

— Dr. Kevin Tracey

“It was just announced that the company SetPoint Medical, which will now be marketing a device to stimulate the vagus nerve to treat rheumatoid arthritis, has received FDA approval. So there’ll be a product launch underway for everything we’re about to talk about in the context of using a medical device that activates an evolutionarily conserved and ancient reflex through which the brain can suppress inflammation when it’s running out of control.”

— Dr. Kevin Tracey

“We’ve discovered that signals travel from the brain through the vagus nerve. … These signals traveling in the vagus nerve are like the brakes on your car. And when you tap those brakes to slow your car barreling down the hill, this device activates what we call the inflammatory reflex.”

— Dr. Kevin Tracey

“If we can find such nerves, then we can build devices to control the nerves, and the devices become the therapy. The bioelectronic medicine story works as long as you know the molecular mechanism, and that’s where people have to be really careful with vagus-nerve stimulation.”

— Dr. Kevin Tracey

“Almost everybody until a hundred years ago, 150 years ago, almost everybody died by the time they were 30. And what happened in the last 150 years can be summarized in a very simple sentence. The human race in the last 150 years removed infection as the leading cause of death. … I think something similar will happen maybe in the next 20 years if we can really understand how to modify inflammation.”

— Dr. Kevin Tracey

“My adage for this thing is, when you don’t understand a disease, think of epilepsy. You start off, you blame God. So they did exorcisms, and that doesn’t work. So if it’s not God’s fault, the next thing you do is you blame the patient. And when you realize it’s not the patient’s fault, in today’s era, oftentimes we find out it’s actually caused, there’s some infectious cause of this thing. And so autoimmune disease may have an infectious cause, it may have an environmental cause. People talk about genetic causes. You inherit some level of risk for autoimmune diseases, but in very few of these conditions do you actually inherit the condition.”

— Dr. Kevin Tracey

Want to hear another episode about the future of electroceuticals and brain stimulation? Listen to my conversation with Stanford’s Dr. Nolan Williams, in which we discussed 70%–90% remission rates for treatment-resistant depression, brain stimulation for sports performance, accelerated TMS protocols, de-risking ibogaine for TBI/PTSD, the future of “electroceuticals,” and much more.

The post Dr. Kevin Tracey — Stimulating the Vagus Nerve to Tame Inflammation, Alleviate Depression, Treat Autoimmune Disorders (e.g., Rheumatoid Arthritis), and Much More (#824) appeared first on The Blog of Author Tim Ferriss.

#824: Dr. Kevin Tracey — Stimulating The Vagus Nerve to Tame Inflammation, Alleviate Depression, Treat Autoimmune Disorders (e.g., Rheumatoid Arthritis), and Much More (#824)

Kevin J. Tracey, MD (@KevinJTraceyMD), is president and CEO of the Feinstein Institutes for Medical Research at Northwell Health, a pioneer of vagus nerve research and author of the recent book, The Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes. 

His contributions include identifying the therapeutic action of monoclonal anti-TNF antibodies and discovering the specific reflex control of immunity by the nervous system, called the “inflammatory reflex.” These discoveries launched the new scientific field called bioelectronic medicine, which investigates the therapeutic applications of vagus nerve stimulation to cure disease.

Dr. Tracey, a neurosurgeon, pursued studies of inflammation after the mysterious death, from sepsis, of a toddler who was in his care. His lab has since revealed molecular mechanisms of inflammation and identified the use of vagus nerve stimulation to treat it. An inventor on more than 120 US patents and the author of more than 450 scientific publications, he is among the most highly cited scientists in the world. He co-founded the Global Sepsis Alliance, is the author of Fatal Sequence, and is a national and international lecturer.

Please enjoy!

Listen to the episode on Apple Podcasts, Spotify, Overcast, Podcast Addict, Pocket Casts, Castbox, YouTube Music, Amazon Music, Audible, or on your favorite podcast platform. Watch the conversation on YouTube.

This episode is brought to you by:

AG1  all-in-one nutritional supplement Eight Sleep Pod Cover 5  sleeping solution for dynamic cooling and heating Wealthfront  high-yield cash accountListen onApple Podcasts[image error]Listen onSpotify[image error]Listen onOvercastDr. Kevin Tracey — Stimulating The Vagus Nerve to Tame Inflammation, Alleviate Depression, Treat Autoimmune Disorders (e.g., Rheumatoid Arthritis), and Much More

This episode is brought to you by AG1! I get asked all the time, “If you could use only one supplement, what would it be?” My answer is usually AG1, my all-in-one nutritional insurance. I recommended it in The 4-Hour Body in 2010 and did not get paid to do so. Right now, you’ll get a 1-year supply of Vitamin D free with your first subscription purchase—a vital nutrient for a strong immune system and strong bones. Visit DrinkAG1.com/Tim to claim this special offer today and receive your 1-year supply of Vitamin D (and 5 free AG1 travel packs) with your first subscription purchase! 

This episode is brought to you by Eight Sleep. Temperature is one of the main causes of poor sleep, and heat is my personal nemesis. But a few years ago, I started using the Pod Cover, and it has transformed my sleep. Eight Sleep has launched their newest generation of the Pod: Pod 5 Ultra. It cools, it heats, and now it elevates, automatically. With the best temperature performance to date, Pod 5 Ultra ensures you and your partner stay cool in the heat and cozy warm in the cold. And now, listeners of The Tim Ferriss Show can get $350 off of the Pod 5 Ultra for a limited time! Click here to claim this deal and unlock your full potential through optimal sleep.

This episode is brought to you by Wealthfront! Wealthfront is a financial services platform that offers services to help you save and invest your money. Right now, you can earn 4.00% APY—that’s the Annual Percentage Yield—with the Wealthfront Brokerage Cash Account. That’s nearly 10x more interest than if you left your money in a savings account at the average bank, with savings rates at 0.42%, according to FDIC.gov, as of 05/19/2025. It takes just a few minutes to sign up, and then you’ll immediately start earning 4.00% APY from program  banks on your uninvested cash. And when new clients open an account today, they’ll get an extra $50 bonus with a deposit of $500 or more. Terms and Conditions apply.  Visit Wealthfront.com/Tim to get started.

Cash Account offered by Wealthfront Brokerage LLC, member FINRA/SIPC. Wealthfront is not a bank. The APY on cash deposits, as of 04/30/2025, is representative, subject to change, and requires no minimum. Funds in the Cash Account are swept to program banks, where they earn a variable APY. Tim receives cash compensation from Wealthfront Brokerage for advertising and holds a non-controlling equity interest in the corporate parent of Wealthfront Brokerage. Tim and Wealthfront Brokerage have no other affiliation. Tim reflects his own opinions and Wealthfront does not endorse, sponsor, or promote them. See full disclosures here.

SELECTED LINKS FROM THE EPISODEConnect with Dr. Kevin Tracey:

The Feinstein Institutes of Northwell Health | SetPoint Medical | LinkedIn

Publications & MediaThe Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes by Kevin J. Tracey: A groundbreaking book exploring the potential of the vagus nerve to regulate the body’s vital systems and heal medical conditions without drugs.The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation by Stephen W. Porges: A comprehensive compilation of decades of research on the polyvagal theory and its implications for understanding the autonomic nervous system. STEM-Talk : A bi-weekly interview podcast produced by the Florida Institute for Human and Machine Cognition featuring conversations with groundbreaking scientists, engineers, and technologists. The New York Times : A major American daily newspaper that featured coverage on SetPoint Medical and other medical developments. HuffPost : An American progressive news and opinion website where Dr. Tracey was interviewed about his research. Cell : A prestigious peer-reviewed scientific journal that published research on topics including gut microbiota and the ketogenic diet.Explain Pain by David Butler and G. Lorimer Moseley: An evidence-based book designed for therapists, patients, and students that explains the science behind pain and recovery strategies.The Integrative Action of the Nervous System by Charles Sherrington: A classic 1906 work in neuroscience that established fundamental concepts about how the nervous system functions as an integrated whole.Medical ConditionsRheumatoid Arthritis: An autoimmune disease that causes inflammation in the joints.Crohn’s Disease: A type of inflammatory bowel disease that affects the digestive tract.PTSD (Post-Traumatic Stress Disorder): A mental health condition triggered by experiencing or witnessing a traumatic event.Chronic Fatigue Syndrome: A long-term illness characterized by extreme fatigue that doesn’t improve with rest and may worsen with physical or mental activity.Depression: A mood disorder that causes persistent feelings of sadness, hopelessness, and loss of interest in activities.Lyme Disease: An infectious disease caused by bacteria transmitted through the bite of infected ticks.Neurodegenerative Disease: A range of conditions that primarily affect the neurons in the human brain, leading to progressive deterioration of function.Anaphylaxis: A severe, potentially life-threatening allergic reaction that can occur rapidly after exposure to an allergen.Asthma: A respiratory condition in which airways become inflamed, narrow, and produce excess mucus, making breathing difficult.Sepsis: A life-threatening condition that arises when the body’s response to infection causes widespread inflammation and organ dysfunction.Psoriatic Arthritis: A form of inflammatory arthritis that affects some people who have the skin condition psoriasis.Autoimmune Conditions: Disorders in which the immune system mistakenly attacks the body’s own healthy tissues and organs.COVID-19: A contagious respiratory illness caused by the SARS-CoV-2 virus that can range from mild to severe symptoms.Alzheimer’s Disease: A progressive neurodegenerative disease that destroys memory and other important mental functions.Parkinson’s Disease: A progressive disorder of the central nervous system that affects movement, often causing tremors, stiffness, and difficulty with balance.Metabolic Syndrome: A cluster of conditions including high blood pressure, high blood sugar, excess abdominal fat, and abnormal cholesterol levels that increase the risk of heart disease, stroke, and diabetes.Diabetes: A chronic disease that occurs when the body cannot properly produce or use insulin, leading to elevated blood sugar levels.Cancer: A group of diseases characterized by the uncontrolled growth and spread of abnormal cells in the body.Malaria: A life-threatening disease caused by parasites transmitted through the bites of infected female Anopheles mosquitoes.Tuberculosis: A serious infectious bacterial disease that primarily affects the lungs but can spread to other parts of the body.Peptic Ulcer Disease: A condition characterized by painful sores or ulcers that develop in the lining of the stomach or the first part of the small intestine.Epilepsy: A neurological disorder in which brain activity becomes abnormal, causing seizures, unusual behavior, sensations, and sometimes loss of consciousness.Cluster Headaches: A series of extremely painful headaches that occur in cyclical patterns or clusters, often at the same time each day for weeks or months.Migraines: Intense headaches that cause severe throbbing or pulsing pain, typically on one side of the head, often accompanied by nausea and sensitivity to light and sound.Sciatica: Pain that radiates along the sciatic nerve pathway from the lower back through the hips and down one or both legs.Treatments & TherapiesVagus Nerve Stimulation (VNS): A medical treatment that involves delivering electrical impulses to the vagus nerve.Audio Chakra Cleanse Soundtracks: A type of alternative therapy mentioned as an example of “nonsense.”Biologics: Medications made from living organisms or their components.Ketogenic Diet: A very low-carb, high-fat diet.Exogenous Ketones: Ketones that are ingested through a nutritional supplement.GLP-1 Agonists (e.g., Ozempic, Mounjaro): A class of medications used to treat type 2 diabetes and obesity.Microbiome Transplants: The transfer of fecal matter from a healthy donor to a recipient to restore a healthy gut microbiome.TMS (Transcranial Magnetic Stimulation): A noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression.Focused Ultrasound: A non-invasive therapeutic technology that uses focused sound waves to target and treat a variety of medical conditions.Psychedelics (e.g., LSD, 2C-B, Ayahuasca): A class of hallucinogenic drugs whose primary effect is to trigger non-ordinary states of consciousness.TENS (Transcutaneous Electrical Nerve Stimulation) units: A non-invasive method of pain relief that uses a mild electrical current.Auricular Therapy: A form of alternative medicine based on the idea that the ear is a microsystem which reflects the entire body.Famotidine (Pepcid): An over-the-counter antacid that Dr. Tracey describes as a pharmacological vagus nerve stimulator.Antibiotics: Medications that fight bacterial infections.SSRIs (Selective Serotonin Reuptake Inhibitors): A class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions.Ibuprofen: A nonsteroidal anti-inflammatory drug (NSAID).Monoclonal Antibodies: Laboratory-made proteins that mimic the immune system’s ability to fight off harmful pathogens such as viruses.Optogenetics: A biological technique that involves the use of light to control cells in living tissue, typically neurons, that have been genetically modified to express light-sensitive ion channels.Key Concepts & TheoriesPolyvagal Theory: A theory that links the evolution of the autonomic nervous system to social behavior and emphasizes the importance of physiological state in the expression of behavioral problems and psychiatric disorders.Heart Rate Variability (HRV): The variation in the time interval between consecutive heartbeats.Sympathetic Overdrive: A condition where the sympathetic nervous system is overactive.Inflammatory Reflex: A physiological reflex that controls the inflammatory response.Bioelectronic Medicine: A field of medicine that uses electronic devices to treat diseases and injuries.Blood-Brain Barrier: A highly selective semipermeable border of endothelial cells that prevents solutes in the circulating blood from non-selectively crossing into the extracellular fluid of the central nervous system where neurons reside.Cytokines (e.g., TNF, IL-1, IL-6): A broad and loose category of small proteins that are important in cell signaling.Cytokine Storm: A severe immune reaction in which the body releases too many cytokines into the blood too quickly.Inflammaging: Chronic, low-grade inflammation that develops with advanced age.Neuroinflammation: Inflammation of the nervous tissue.Neuroplasticity: The ability of the brain to form and reorganize synaptic connections, especially in response to learning or experience or following injury.Interoception: The sense of the internal state of the body.Engram: A physical trace of memory in the brain.M1 and M2 Macrophages: Two different types of white blood cells with different functions in the inflammatory response.PeopleKelly Owens: A patient of Dr. Tracey’s who suffered from Crohn’s disease and rheumatoid arthritis and was successfully treated with a vagus nerve stimulation device.Murthy Simhambhatla: The CEO of SetPoint Medical, a bioelectronic medicine company developing vagus nerve stimulation therapies.Dave Chernoff: The Chief Medical Officer of SetPoint Medical, overseeing clinical development of bioelectronic therapies.Nolan Williams: A psychiatry professor and director of the Stanford Brain Stimulation Lab who pioneered Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT), an FDA-approved treatment for treatment-resistant depression using accelerated TMS.Nora Volkow: Director of the National Institute on Drug Abuse (NIDA) who pioneered the use of brain imaging to investigate addiction as a brain disorder and is researching focused ultrasound therapies for addiction treatment.Steve Liberles: A professor of cell biology at Harvard Medical School and Howard Hughes Medical Institute investigator who studies the molecular neuroscience of vagus nerve sensory systems and identified specific vagal neuron subtypes that control breathing and digestion in mice.K. Frank Austen: A leading expert on asthma research and respiratory medicine.Barry Jacobs: A researcher at Princeton University who studied the effects of LSD on cats and contributed to early psychedelic research.Andrew Weil: A physician and author with a background in ethnobotany who has written about his experiences with psychedelics including LSD and integrative medicine approaches.Ulf Andersson: A retired professor of pediatric rheumatology at the Karolinska Institute and friend of Dr. Tracey’s who used a TENS unit to treat his own inflammation-related depression.Paul Nogier: A French physician who created the first auricular acupuncture maps in 1957, pioneering modern ear acupuncture techniques.Kenneth M. Ford: Founder and CEO Emeritus of the Florida Institute for Human and Machine Cognition (IHMC), and co-host of the STEM-Talk podcast.Geoff Ling: Retired colonel who founded the biology technology office at DARPA.Richard Feynman: Nobel Prize-winning American theoretical physicist known for his work in quantum mechanics, quantum electrodynamics, and superfluidity.Charles Sherrington: One of the founders of modern neuroscience, known for his groundbreaking work on neural reflexes and The Integrative Action of the Nervous System, for which he won the Nobel Prize in Physiology or Medicine in 1932.Santiago Ramón y Cajal: The other founding father of modern neuroscience, known for his pioneering studies of the structure of the nervous system and the neuron doctrine, Nobel Prize winner in Physiology or Medicine in 1906.Asya Rolls: A professor who discovered that inflammation in the colon can form a neural network connection to the brain, advancing our understanding of the gut-brain axis.Sangeeta Chavan: A colleague of Dr. Tracey’s at the Feinstein Institute for Medical Research, contributing to bioelectronic medicine research.Stavros Zanos: A colleague of Dr. Tracey’s at the Feinstein Institute for Medical Research, specializing in neural engineering and bioelectronics.Okito Hashimoto: A colleague of Dr. Tracey’s at the Feinstein Institute for Medical Research, working in the field of bioelectronic medicine.Eric Chang: A colleague of Dr. Tracey’s at the Feinstein Institute for Medical Research, contributing to neuroscience and bioelectronics research.Martine Rothblatt: A friend of Dr. Tracey’s and CEO of United Therapeutics, she is a renowned polymath who founded SiriusXM satellite radio before entering biotechnology to develop treatments for her daughter’s pulmonary hypertension, becoming the highest-paid female CEO in America.Lorimer Moseley: Co-author with David Butler of the book Explain Pain and a leading researcher in pain neuroscience and clinical neurosciences at the University of South Australia.William Bushell: A scientist who works with the Dalai Lama on studies involving meditation, consciousness, and human potential.Elizabeth Blackburn: A scientist who won both the Lasker Prize and the Nobel Prize in Physiology or Medicine in 2009 for her work on telomeres and telomerase.Bob Thurman: Uma Thurman’s father and a professor of Tibetan studies at Columbia University, known for his scholarship on Buddhist philosophy.The Dalai Lama: The spiritual leader of Tibet and global advocate for compassion, peace, and interfaith dialogue.Bill Murray: Formidably funny man and serial-striking bowler.Kevin Rose: Probably not the Kevin you’re looking for, but Kevin, by any other name, would smell as sweet.Institutions & CompaniesSetPoint Medical: A commercial-stage medical technology company that developed the first FDA-approved neuroimmune modulation device to treat rheumatoid arthritis using vagus nerve stimulation.Feinstein Institutes for Medical Research: The research arm of Northwell Health and home to 50 research labs, 3,000 clinical research studies, and 5,000 researchers where Dr. Tracey and his colleagues work.Mayo Clinic: A world-renowned nonprofit American medical organization dedicated to integrated healthcare, education, and research.Stanford University: A prestigious private research university in California known for its groundbreaking research, including work on accelerated TMS and other medical innovations.Centers for Disease Control and Prevention (CDC): The national public health agency of the United States, responsible for protecting public health and safety through disease prevention and health promotion.Karolinska Institute: A prestigious medical research institute and university in Sweden, home to the Nobel Committee for Physiology or Medicine.Defense Advanced Research Projects Agency (DARPA): A research and development agency of the United States Department of Defense responsible for developing emerging technologies for military use.Defense Language Institute: A United States Department of Defense educational and research institution that provides language training to military personnel and federal employees.United Therapeutics: A biotechnology company focused on creating innovative products to address the medical needs of patients with chronic and life-threatening conditions, including pulmonary arterial hypertension and organ transplantation technologies.World Health Organization (WHO): A specialized agency of the United Nations responsible for international public health, setting global health standards, and coordinating international health responses.Columbia University: A prestigious private Ivy League research university in New York City, renowned for its contributions to medicine, science, and other fields of study.Pendulum: A science-backed biotechnology company founded by doctors and scientists that produces next-generation probiotics, including the only commercially available live Akkermansia supplement.WHOOP: 24/7 monitoring across sleep, strain, stress, and heart health.Oura Ring: A smart ring that monitors over 20 biometrics that directly impact how you feel.Fitbit: Wearables designed to “keep you close to your goals, boost your motivation, and show your progress throughout your health and fitness journey.”Relevant Research & ResourcesKevin Tracey on Neuro-Immunology and the Treatment of Inflammatory Diseases | STEM-TalkKevin Tracey, MD, Reveals Vagus Nerve’s Power in New Book | Northwell HealthSetPoint Medical Receives FDA Approval for Novel Neuroimmune Modulation Therapy for Rheumatoid Arthritis | SetPoint MedicalNew Implant Offers Hope for Easing Rheumatoid Arthritis | The New York TimesI Tried 22 Different Medications Before an Electrical Implant Healed My Crohn’s Disease | PreventionNolan Williams — A Glimpse of the Future: Electroceuticals for 70%–90% Remission of Depression, Brain Stimulation for Sports Performance, and De-Risking Ibogaine for TBI/PTSD | The Tim Ferriss ShowDr. Nora Volkow — Director of the National Institute on Drug Abuse (NIDA) | The Tim Ferriss ShowReappraising the Role of the Vagus Nerve in GLP-1-Mediated Regulation of Eating | British Journal of PharmacologyRole of Vagus Nerve Signaling in CNI-1493-Mediated Suppression of Acute Inflammation | Autonomic NeuroscienceGood-bye to Drugs? Kevin Tracey, MD on the Bioelectronics Revolution at the Dysautonomia International Conference | Health RisingNo Audible Wheezing: Nuggets and Conundrums from Mouse Asthma Models | Journal of Experimental MedicineHere’s What Happens When Animals Eat LSD | DoubleBlindSome Practical Thoughts on Suicide | Tim FerrissThe Evolution of Inflammation | PfizerFDA Black Box Warning Raises Awareness of Medication Risk | GoodRxEffects of Anti-Inflammatory Vagus Nerve Stimulation in Endotoxemic Rats on Blood and Spleen Lymphocyte Subsets | Inflammation ResearchVagus Nerve Stimulation for Epilepsy and Depression | NeurotherapeuticsVagus Nerve Active during Exercise, Research Finds | The University of AucklandJumping into the Ice Bath Trend! Mental Health Benefits of Cold Water Immersion | Stanford Lifestyle MedicineThe Thermoregulatory Theory of Yawning: What We Know from over Five Years of Research | Frontiers in NeurosciencePrevalence of Autoimmune Diseases Is Strongly Associated with Average Annual Temperatures: Systematic Review and Linear Regression Analysis | BMC RheumatologyNobel Prize Is Awarded to Doctors Who Discovered H Pylori | The British Medical JournalWhat Happens to Your Blood Sugar While You Sleep? | WebMDType A Personality Traits vs. Type B | Simply PsychologyFocused Ultrasound Neuromodulation of the Spleen Activates an Anti-Inflammatory Response in Humans | Brain StimulationHistory of Auriculotherapy: Additional Information and New Developments | Medical AcupunctureThe Medial Surface of the Auricle: Historical and Recent Maps. What Are the Possible Expectations of the “Thumb-Index Technique” | MedicinesOur Ears Share a Common Ancestry with Fish Gills | Scientific AmericanJP Errico Explains How Vagus-Nerve Stimulation Reduces Inflammation and Chronic Diseases | STEM-TalkVagus Nerve Stimulation May Enhance Language Learning, DoD Study Reports | Practical NeurologyGeoffrey Ling: From DARPA to Life | Twin GlobalVagus Nerve Stimulation (VNS) Therapy | Epilepsy SocietyThe Gut Microbiota Mediates the Anti-seizure Effects of the Ketogenic Diet | CellDr. Andrew Weil — Optimal Health, Plant Medicine, and More | The Tim Ferriss ShowThe Hidden Flaws of HRV Tracking | The Unlazy WayBreathe to Directly Control Heart Rate via Huberman Lab | InstagramFamotidine Activates the Vagus Nerve Inflammatory Reflex to Attenuate Cytokine Storm | Molecular MedicineWHOOP Adds Psychedelics Tracking | Fitt InsiderWhy Don’t We Know How Antidepressants Work Yet? | Chemistry WorldUlf’s Case Study: VAGUS Smartwatch ECG Test | VAGUS Health Ltd.Study of the Transcutaneous Auricular Vagus Nerve Stimulation May Advance Outcome in Chronic Pediatric Inflammatory Diseases | Medical Research ArchivesAcupuncture Enhances Chances of Pregnancy in Unexplained Infertile Patients Who Undergo a Blastocyst Transfer in a Fresh-Cycle | Chinese Journal of Integrative MedicineAcupuncture as Treatment for Female Infertility: A Systematic Review and Meta-Analysis of Randomized Controlled Trials | Evidence-Based Complementary and Alternative MedicineDr. Martine Rothblatt — A Masterclass on Asking Better Questions and Peering into the Future | The Tim Ferriss ShowImmunoception: The Insular Cortex Perspective | Cellular & Molecular ImmunologyNew Science Shows Immune “Memory” in the Brain | Quanta MagazineJennifer Aniston Strikes a Nerve | NatureQuantum Physics — His Holiness the Dalai Lama Participates in the 26th Mind & Life Meeting at Drepung | The Office of His Holiness The Dalai LamaSHOW NOTES[00:00:00] Start.[00:06:34] Factors alleviating my skepticism about vagus nerve stimulation.[00:11:12] SetPoint Medical receives FDA approval for vagus nerve stimulation device to treat rheumatoid arthritis.[00:13:24] How Crohn’s disease sufferer Kelly Owens went from a wheelchair to running up stairs in Amsterdam.[00:20:36] Placebo effect concerns and the conditions driving my interest in bioelectric medicine.[00:25:31] Vagus nerve anatomy 101.[00:32:53] Cytokines and inflammation: What happens when the vagus nerve is stimulated.[00:33:45] Discovery story: Accidental finding of brain-body inflammation connection.[00:35:39] Bioelectronic medicine approach vs. pharmaceutical approach.[00:38:18] Mice don’t wheeze.[00:40:13] Depression and inflammation connection: SSRIs may work through anti-inflammatory effects.[00:42:46] My personal experience with vagus nerve stimulation and mood stability.[00:44:22] The pros and cons of inflammation, and how controlling it may lead to even longer lifespans.[00:50:56] Weighing the safety of VNS vs. biologics in cytokine suppression.[00:56:27] Cold exposure, meditation, and breathing practices affecting the vagus nerve.[00:59:01] A population-level increase in chronic inflammatory diseases: Nature vs. nurture.[01:00:48] H. pylori: For when you can’t blame stress, God, or the patient for that nagging ulcer.[01:03:13] Stress, cortisol, and inflammation connections.[01:05:42] SetPoint device vs. non-invasive alternatives for different patient populations.[01:11:09] Auricular therapy’s curious French origins.[01:13:28] There’s something fishy about this vestigial vagus nerve pathway.[01:16:03] Overlapping activation patterns from brain imaging studies of ear stimulation.[01:19:01] DARPA support and Geoff Ling’s “What if it’s yes?” attitude.[01:21:58] Neurocognition and vagus nerve inputs.[01:27:20] How Ulf Andersson turned his depression around with a TENS unit.[01:31:55] Heart rate variability complexity and measurement challenges.[01:33:05] A breathing exercise for directly controlling heart rate.[01:35:30] Using a common antacid as a pharmacological vagus nerve stimulator during COVID.[01:36:23] A call for more inflammation-based depression research and patient stratification.[01:39:52] SSRIs and anti-inflammatory mechanisms in depression treatment.[01:42:20] Interoception: The body’s inflammatory signals reaching the brain via vagus nerve.[01:43:22] Ulf’s published protocol for TENS unit ear stimulation.[01:44:37] VNS, acupuncture, fertility, and Martine Rothblatt.[01:47:16] Chronic low back pain and an inflammatory overreaction analogy.[01:48:35] Implications of Asya Rolls’ engram research and inflammation memories in the brain.[02:02:35] Cervical TENS vs. true VNS.[02:07:12] Charles Sherrington’s reflex theory and nervous system integration.[02:12:15] Blue energy meditation and vagus nerve pathways with the Dalai Lama.[02:16:47] Parting thoughts: Serious medical conditions vs. self-help approaches.DR. KEVIN TRACEY QUOTES FROM THE INTERVIEW

“60 million people die on the planet Earth every year. And 40 million of them die from heart disease, stroke, neurodegeneration, Alzheimer’s, Parkinson’s, metabolic syndrome, diabetes, and cancer. So two thirds of the people that die every year on the planet Earth die of those conditions. And that’s according to the WHO. Those conditions all have one thing in common — they’re either caused by inflammation or made worse by inflammation.”

— Dr. Kevin Tracey

“It was just announced that the company SetPoint Medical, which will now be marketing a device to stimulate the vagus nerve to treat rheumatoid arthritis, has received FDA approval. So there’ll be a product launch underway for everything we’re about to talk about in the context of using a medical device that activates an evolutionarily conserved and ancient reflex through which the brain can suppress inflammation when it’s running out of control.”

— Dr. Kevin Tracey

“We’ve discovered that signals travel from the brain through the vagus nerve. … These signals traveling in the vagus nerve are like the brakes on your car. And when you tap those brakes to slow your car barreling down the hill, this device activates what we call the inflammatory reflex.”

— Dr. Kevin Tracey

“If we can find such nerves, then we can build devices to control the nerves, and the devices become the therapy. The bioelectronic medicine story works as long as you know the molecular mechanism, and that’s where people have to be really careful with vagus nerve stimulation.”

— Dr. Kevin Tracey

“Almost everybody until a hundred years ago, 150 years ago, almost everybody died by the time they were 30. And what happened in the last 150 years can be summarized in a very simple sentence. The human race in the last 150 years removed infection as the leading cause of death. … I think something similar will happen maybe in the next 20 years if we can really understand how to modify inflammation.”

— Dr. Kevin Tracey

“My adage for this thing is, when you don’t understand a disease, think of epilepsy. You start off, you blame God. So they did exorcisms, and that doesn’t work. So if it’s not God’s fault, the next thing you do is you blame the patient. And when you realize it’s not the patient’s fault, in today’s era, oftentimes we find out it’s actually caused, there’s some infectious cause of this thing. And so autoimmune disease may have an infectious cause, it may have an environmental cause. People talk about genetic causes. You inherit some level of risk for autoimmune diseases, but in very few of these conditions do you actually inherit the condition.”

— Dr. Kevin Tracey

Want to hear another episode about the future of electroceuticals and brain stimulation? Listen to my conversation with Stanford’s Dr. Nolan Williams, in which we discussed 70%–90% remission rates for treatment-resistant depression, brain stimulation for sports performance, accelerated TMS protocols, de-risking ibogaine for TBI/PTSD, the future of “electroceuticals,” and much more.

The post #824: Dr. Kevin Tracey — Stimulating The Vagus Nerve to Tame Inflammation, Alleviate Depression, Treat Autoimmune Disorders (e.g., Rheumatoid Arthritis), and Much More (#824) appeared first on The Blog of Author Tim Ferriss.