Welcome to Huberman Lab Essentials,

where we revisit past episodes for the

most potent and actionable science-based

tools for mental health, physical

health, and performance.

I'm Andrew Huberman and I'm a professor

of neurobiology and opthalmology at

Stamford School of Medicine. And now for

my discussion with Dr. Chris Palmer.

Chris, Dr. Palmer, thank you for being

here.

>> Thank you, Andrew, for having me. I have

a lot of questions for you and I'm

really excited about this topic because

I think most people know what mental

illness is or they have some idea what

that is. Most people have some idea what

nutrition is. Fewer people certainly

know how closely those things can

interact. I think everybody is familiar

with the feeling of a food or the

ingestion of a food making them feel

good in the short term. But I believe

that very few people understand or are

familiar with the fact that nutrition

and our mental health interact in this

very intimate, maybe even causal way.

And that is something that occurs over

long periods of time. Meaning what I ate

yesterday, the day before, maybe even 10

years ago could be impacting the way

that my brain and body are making me

feel now. So, if you would, I'd love for

you to just tell us about a little bit

of the the history, in particular, your

history with exploring the relationship

between nutrition and mental health. And

then we can dive into some of the um

more particulars of ketogenic diets

versus other diets and some of the truly

miraculous findings that you and others

are coming up with based on real

patients and real experiences of people

who suffer and then find relief by

altering their nutrition. Sure. This

story really starts with my own personal

story. I don't need to go into great

detail, but to set the stage, when I was

a kid, I definitely had mental illness.

Started with OCD. I went on to have

subsequent depression, suicidality, all

sorts of things. Somehow or another, I

pulled myself together and got through

medical school. Actually did quite well

in medical school and then was doing my

internship in residency at Harvard. And

at that point in time, I was diagnosed

with metabolic syndrome. So, uh, had

high blood pressure, horrible lipids,

uh, and pre-diabetes. And I was doing

everything right. Supposedly, I was on a

low-fat diet, and I was exercising

regularly. And year after year, my

doctor kept telling me diet and

exercise. I was doing everything he kept

telling me to do. Everything was getting

worse. My blood pressure kept going

higher. And at some point he said,

"You're going to have to go on

medication for your pre-diabetes,

something for your cholesterol, and

something for your blood pressure." So,

three pills, basically, you're screwed.

It's your genes. You're just going to

have to bite the bullet and take meds.

As a physician, I knew what that meant.

I knew that I'm in my 20s. If I'm

already on three meds for metabolic

syndrome, I'm going to be screwed by the

time I'm 40 or 50, and I'm probably

going to be having heart attacks. I'd

heard through the rumor mill that the

Atkins diet could somehow help people

improve their cholesterol and

pre-diabetes. I was highly skeptical and

I, you know, I believed everything I was

taught in medical school. Why would why

would my professors lie to me that they

knew what they were talking about?

Low-fat diet was the thing to do. Um,

and the Atkins diet was clearly

dangerous and reckless. And I had been

trying the medical dogma for years and

it wasn't working for me. And so for

whatever reason, I decided this is going

to be my last attempt at at something

different and then I'll just bite the

bullet and go on meds. So I tried the

Atkins diet. Within 3 months, my

metabolic syndrome was completely gone.

I probably lost about, you know, 10

pounds through this process. But

everything got normal. And when I went

back to my doctor, he was shocked. The

thing that was the most striking to me

after doing the diet for 3 months was

not the fact that my metabolic syndrome

was gone. That was my goal. And it was

a, you know, seemingly miraculous

uh achievement because I got rid of

everything with one dietary change. But

the thing that I noticed was dramatic

improvement in my mood, energy,

concentration, and sleep. For the first

time in my life, I started waking up

before my alarm went off and feeling

rested. That never happened to me

before. I was meticulous about planning

when my alarm went off and how many

times I could push the snooze button in

order to be on time for wherever I

needed to be, whether it was school or

the hospital or whatever. Prior to the

diet, I always felt like there are two

types of people in the world. There are

these happy, peppy people who just are

so positive and they've got energy and

they have these this saying, they like

to work hard and play hard. But I never

understood who the hell wants to play

hard. Like who's got energy for that?

Like aren't you tired from working so

hard? I assumed that they were just

lucky and privileged. They either had

good genetics or maybe they had good

childhoods or good parents or something

something that I didn't have.

>> What was the journey forward into the

work that you're doing now?

>> So within a few years I'm you know an

attending physician. I've got all these

patients in my clinical practice with

treatment resistant mental illness. I'm

in a tertiary care hospital. So, I

almost never get somebody off the street

with their first episode of depression.

Out of the gate as part of my career, I

get treatment resistant mental

disorders. So, I get people who've

already been to six plus psychiatrists,

therapists. They've usually tried dozens

of different medications. They've been

in decades of psychotherapy. They've

often had ECT and other things and

nothing's working. And I'm thinking, you

know, well, we're kind of out of options

for these other people and this diet is

having this really powerful

anti-depressant effect. I think I'm

going to try it and just see if any of

my patients are game to try it to see if

it might help them. Sure enough, it did.

didn't help everyone and not everybody

was interested and or able to do it. But

some of the ones who were able to do it

ended up having a remarkable and

powerful anti-depressant effect. One

woman actually became hypomomanic within

a month. And she had been depressed

pretty much nonstop for over 5 years,

chronically depressed, suicidal, in and

out of hospitals. And I saw her become

hypomomanic. And I'm thinking, wow, this

really is a powerful anti-depressant

effect. like this is amazing. This is

like a medication but better because it

actually is working for her. At that

point, we didn't have many clinical

trials of the safety or efficacy of the

Atkins diet for even weight loss or

diabetes, let alone any mental

disorders. And so, I really actually

felt like I'm on the fringe here and

this is not going to be met with with

praise by anyone. So, I'm just going to

lay low. I'm going to offer it to

patients and uh and I I went along that

way up until

2016.

>> So, low carbohydrate diet, certainly low

sugar.

>> Yeah.

>> I'm assuming you're not a nutritionist.

So, how did you prescribe a nutrition

plan for your patients?

>> The first few patients it was try this

Atkins diet. I want to see ketosis. So,

I was strongly recommending that

patients achieve urinary ketosis. And

the interesting thing is I noticed a

pattern that when they were trying the

diet and not getting ketones, they often

did not get a clinical benefit. It was

once they got into ketosis that I began

to notice the clinical benefit. The

thing that completely upended everything

that I knew as a psychiatrist though was

when I helped the patient in 2016,

33-year-old man with schizoeffective

disorder. He had been my patient for 8

years now. He had daily auditory

hallucinations. He had paranoid

delusions. He could not go out in public

without being terrified. This man was

tormented by his illness. It ruined his

life. He had already tried 17 different

medications and none of them stopped his

symptoms. He weighs 340 lbs and for

whatever reason he gets it in his head.

I'm never going to get a girlfriend if I

don't lose some weight. He also

recognizes I'm never going to get a

girlfriend cuz I'm a loser. I'm

schizophrenic. I live with my father. I,

you know, I have nothing going for me.

For a variety of reasons, we ended up

deciding to try the ketogenic diet. He

decides to give it a try. Within two

weeks, not only does he start losing

weight, but I begin to notice this

dramatic anti-depressant effect. He's

making better eye contact. He's smiling

more. He's talking a lot more. I'm

thinking like, what's gotten into you?

Like, you're coming to life. Like,

you're I've never heard you talk this

much. I've never seen you so excited or

present or alive. I haven't changed his

meds at all. The thing that upended

everything that I knew as a psychiatrist

was 6 to 8 weeks in, he spontaneously

starts reporting, you know those voices

that I hear all the time, they're going

away. And he says, you know, you know

how I always thought that there were all

these families who were controlling my

thoughts and out to get me and they had

targeted me. And I'm thinking, oh yeah,

we've been talking about that for years.

We could talk about that again. He says,

now that I think about it, I don't think

that's true.

And now that I say it, it sounds kind of

crazy. It probably never was. I've

probably had schizophrenia all along

like everybody's been trying to tell me,

and I think it's going away. He's now

lost60 pounds and kept it off to this

day.

>> Wow.

>> He was able to do things he had not been

able to do since the time of his

diagnosis. He was able to complete a

certificate program. He's able to go out

in public and not be paranoid. He

performed improv in front of a live

audience. At one point he was able to

move out of his father's home and live

independently.

>> Did he stay on any kind of antiscychotic

or other medication?

>> We have slowly but surely tried to taper

him off his meds. He has been on meds

for decades. He started medications when

he was a young child. His brain is

developed in response to all sorts of

psychiatric medications. And it has not

been easy to try to get him off. And I

just want to say for any listeners,

getting off your meds is very difficult

and dangerous and you need to do it with

supervision with a a mental health

professional or a prescriber to stay in

ketosis. Uh what sort of blood levels of

ketones do you like to see in your

patients? Uh what is the range that you

think most people could uh aspire to?

>> So it really depends on the patient and

what I'm treating quite honestly. And I

don't think every patient needs the

ketogenic diet. For some patients,

simply getting rid of junk food can make

a huge difference in a mood disorder,

for instance.

>> So, a junk food meaning highly processed

food, food that could last on the shelf

a very long time.

>> Highly processed foods that are usually

high in both sugar, carbohydrate, and

carbs and fats. Those seem to be the

worst foods. that combination, high

sugar, high fat, um, seems to be the

worst combination for metabolic health

and lo and behold, we've got emerging

data that suggests that strongly

suggests it's also bad for mental

health. So to step back from that, so

for some patients, I might just want to

decrease glucose and insulin levels and

I can do that by getting rid of sweets.

for other patients like patients with

schizopeeffective disorder or

schizophrenia or bipolar disorder

especially if it's chronic if I'm using

it as a brain treatment then I do want a

ketogenic diet and I usually want

reasonably high levels of blood ketones

for depression I want to see at least

greater than probably 0.8 8 mill mole.

For psychotic disorders and bipolar

disorder, I usually want to see levels

greater than 1.5. That's what I'm

shooting for if at all possible. I think

that for a lot of listeners and people

out there who are familiar with how

changing your diet or changing your

exercise can positively impact sleep and

weight and all these things and it

cascades into feeling better. That makes

perfect sense. But for a lot of the

world still,

the idea that changing or using

nutrition as a dissection tool or as a

treatment tool to understand and treat

mental illness is still a kind of

heretical idea that to them it kind of

falls in the okay well that's like a woo

science or something like that. They

immediately think, "Didn't Atkins die of

a heart attack?" You know, I hear that a

lot, you know, which I do think is

throwing the baby out with the bath

water, but it's an interesting thing

nonetheless. And then I think that the

majority of people sit in the middle and

just want to see science and medicine

come up with treatments that work. And I

have to say I'm very uh relieved to hear

what you said earlier, which was you

never said that people should come off

their medication and just become go on a

ketogenic diet and everything will be

cured. You're certainly not saying that.

>> No. and rather you're saying if I

understand correctly that nutrition

needs to be considered one of the major

tools in the landscape of effective

tools and that it can be very effective.

Let's talk about epilepsy and how the

ketogenic diet is not just used for

epilepsy but is one of the oldest if not

the oldest examples of the use of

nutrition to treat a condition of the

nervous system that can be incredibly

debilitating even deadly.

>> Yeah. The reality is that this

literature and this clinical history and

all of the research we have was the

godsend that I needed to do the work

that I'm doing. Otherwise, I would have

been discredited on day one. The

ketogenic diet, unbeknownst to most

people, was actually developed a 100

years ago 1921

by a physician for one and only one

purpose, to treat epilepsy. It wasn't

developed as a weight loss diet. It

wasn't developed as the the diet that

all human beings should follow. And the

reason it was developed is because of

this long-standing observation since the

time of Hypocrates

that fasting can stop seizures. Most

people think going without food is bad

and they equate it with starvation. But

in fact when we go without food it

causes tremendous shifts in metabolism

both brain and body metabolism

and it puts the body into a mode of

autophagy and conservation of resources

and all sorts of things that are

beneficial to human health. And this is

why fasting has been used as a

therapeutic intervention in almost every

culture and almost every religion for

millennia. But for the most part, that

was all thought to be religious

folklore. In 1921,

one physician used intermittent fasting

on a child with seizures and found that,

oh, lo and behold, this religious

folklore stuff has something to it. It

actually worked. The problem with

fasting is that you can only fast for so

long before you starve to death. And

that's not a very effective treatment.

As soon as people start eating a normal

diet again, their seizures usually come

right back, often times with a

vengeance. And so it can be a good

short-term intervention. The fasting can

take a few days because it can take a

few days to get ketosis and then you can

get some relief from chronic seizures,

but it's not a good long-term treatment

because again, people will starve to

death. As soon as they start eating,

seizures come back. So it was actually

Dr. Russell Wilder at the Mayo Clinic

who developed the ketogenic diet with

one and only one purpose. He wanted to

see, can we mimic the fasting state

using this special diet to see if it

might stop seizures long term? And lo

and behold, it worked. Early results

were extraordinarily positive. 50% of

patients who used the ketogenic diet

became seizure-free and another 35% had

a 50% or greater reduction in their

seizure frequency. So about 85% efficacy

rate. By the 1950s,

pharmaceuticals were coming out and we

had many more anti-vulsant treatments

and there's no question they work for a

lot of people. That's great. And taking

a pill is so much easier than doing this

diet. But lo and behold, even to this

day, people with epilepsy, about 30%

don't respond to the current treatments

that we have available. 30% will have

treatment resistant epilepsy, which

means they continue to have seizures no

matter how many anti-combulsants they're

taking, even if they've had brain

surgery. It just doesn't stop their

seizures. And so, in the 1970s, the

ketogenic diet was resurrected at John's

Hopkins for these treatment resistant

cases. And lo and behold, it works. Not

for all of them, but it works. And about

onethird become seizure free. And these

are people who've tried everything and

nothing's working. So one/3 becomes

seizure-free, another third get a

clinical benefit, meaning a 50% or

greater reduction in their seizure

frequency and the other third it doesn't

seem to work. And so the reality, the

godsend for me is that we have decades

of neuroscience research on the

ketogenic diet and what it is doing to

the brain. We know that the ketogenic

diet is influencing neurotransmitter

levels in particular glutamate, GABA,

adenosine. It changes calcium channel

regulation uh and calcium levels which

is really important in the function of

cells. It changes gene expression. It

reduces brain inflammation. It changes

the gut microbiome. And there are, you

know, gut microbiome is a huge topic

right now. And there are some

researchers who argue that is the

primary benefit of the ketogenic diet.

It's changing the gut microbiome in

beneficial ways. Um so it's doing a lot

of things. It obviously improves insulin

resistance. uh it lowers glucose levels,

lowers insulin levels, which improves

insulin signaling. The key for

my research that I've outlined,

the real magic is that this diet

stimulates two processes that relate to

mitochondria. It stimulates a process

called mphagy,

which is getting rid of old and

defective mitochondria and replacing

them with new ones. And it also

stimulates a process called

mitochondrial biogenesis.

Which means that after people have done

the ketogenic diet for a while, months

or years, many of their cells in their

bodies and brains will have more

mitochondria and those mitochondria will

be healthier. And I believe that is the

reason the ketogenic diet is such a

powerful treatment not only for epilepsy

but also for people with chronic mental

disorders. If you're looking for

randomized controlled trials documenting

efficacy in large numbers of patients

with these disorders, we don't have

them. They're underway now, but we don't

have them yet. Maybe we could just talk

about mitochondria for a moment and then

talk about these two major effects. What

are some of the other things that

mitochondria are important for uh in

neurons and um and maybe other cells of

the brain?

>> If you think of the cell as a computer,

a lot of people think of mitochondria as

the power cord to that computer because

they're providing the power and they are

in fact the power cord to that computer.

But actually their real function is the

motherboard of that computer. So

mitochondria are directing and

allocating resources throughout a cell.

that is their primary function and then

they happen to be powerhouses as well.

To give some clear examples,

mitochondria play a direct role in the

production and release and regulation of

some really key neurotransmitters

including serotonin, dopamine,

glutamate, ailchine.

Those are pretty powerful

neurotransmitters. Yeah, I would call

those I would consider those the I know

you listed more than three, but uh the

sort of primary colors of

neurotransmission,

you know, any one of those

>> in excess or deficiency is going to have

profound negative effects on a nervous

system.

>> Mitochondria are providing both some of

the building blocks, if you will, for

some of those molecules. They're part of

the KB citric acid cycle. some of the

some of the intermediate products

actually go into making those

neurotransmitters. Much more

importantly, mitochondria provide the

energy for the production of those

neurotransmitters. And fascinatingly,

mitochondria are directly related to the

release of neurotransmitters.

ATP alone is not enough. There have been

some research studies that have actually

found that mitochondria move along the

membrane of the syninnapse to release

batches of vesicles of

neurotransmitters.

And that if the mitochondria are removed

from the syninnapse and researchers

flood that cell with ATP,

neurotransmitters usually are not

getting released. Mitochondria are doing

other things. We don't entirely even

understand what all they're doing or how

they're doing it, but they're doing

other things than just providing the

power. Mitochondria at least play a role

in all of the aspects of the human

stress response. So, um when humans are

stressed either physically or

psychologically,

there are several things that happen.

increased cortisol, increased

adrenaline, nor adrenaline, uh

inflammation and gene expression in

particular in the hippocampus occur with

the stress response. And one group of

researchers actually genetically

modified mitochondria in four different

ways and found that all those four

buckets of stress response were impacted

in one way or another,

implying that mitochondria are somehow

playing a role in those. In terms of it,

their role in cortisol, we know that

mitochondria actually have the enzyme

required for the synthesis of steroid

hormones. So that includes cortisol,

estrogen, testosterone, and

progesterone. Some names that maybe

everybody's heard of. So that means that

if mitochondria

are in short supply or dysfunctional,

the production of those hormones may

become disregulated.

Mitochondria play a direct role in

inflammation and they turn the

inflammatory

system both on or they at least play a

role in turning the inflammatory system

both on and off. One paper in cell

actually identified mitochondria as the

key regulator in turning certain

inflammatory cells off and that when you

inhibit mitochondrial function those

cells don't turn off. That mitochondrial

levels of reactive oxygen species are a

key signaling process to turn the

inflammatory cell process off. Another

study found that macrofasages so

macrofasages are an important immune

cell that play a role in healing. So if

you cut yourself your your body will get

you know send inflammation that way and

uh and send immune cells that way to try

to heal your skin and macrofasages play

an important role in that healing. One

group of researchers tried to figure out

how do macrofasages know to switch

between the different phases of wound

healing because the macrofasages do

different things in the different phases

of wound healing. And the conclusion of

all of their research was that it's

mitochondria. Mitochondria are sending

the essential signals that change the

state of the macrofasages to induce

these different phases of wound healing.

So, I've just talked about

neurotransmitters, hormones, epigenetic

expression, inflammation.

For anybody familiar with the mental

health field,

they know these are like some of the key

variables that researchers have been

struggling with for decades trying to

figure out how do these fit together. We

know that all of the those buckets

can be disrupted in people with mental

disorders and our field has struggled to

understand but how do they fit together?

How can we make sense of this

disruption? I believe once you

understand the science of mitochondria,

you can actually connect all of the dots

of the mental illness puzzle. What I'm

hearing is that mitochondria in addition

to being important sources of energy

production and output in cells which of

course they are um probably have other

roles and that maybe maybe someday what

we call mitochondria will actually be

two or three different little subscellar

organel in the landscape of science

education. Uh often times people think

okay energy production there'll be a

picture or a cartoon of mitochondria

like flexing its muscles. People go okay

energy mitochondria mighty mitochondria

and then they'll think oh you know

they're just sort of like a dumb jock

portion of the cell right they're not

doing anything sophisticated and

everything you listed off is that they

are doing many sophisticated intricate

things within cells so now that um

everyone is well aware that mitochondria

are doing a large number of very

important things in a very regulated way

let's talk about mphagy which I have to

presume is the um intention

or not gobbling up of mitochondria

presumably to replace them with newer

healthier mitochondria. Is that right?

>> It is. So in and in many ways mphagy is

a subset of autophagy but it's got its

own name because it is specific to

mitochondria.

There do appear to be

some unique regulators of mphagy

compared to autophagy more broadly.

mitochondria actually are playing a a

role in autophagy itself. Um, and this

makes sense because one of so the global

picture of autophagy is stimulated by

fasting states or fasting mimicking

states. So when your body senses that

you don't have enough food, it actually

hunkers down and starts to recycle

dead old parts in this kind of carefully

orchestrated way and it takes them to

loos. They get degraded and then those

degradation products get used for either

energy or to build new things. Autophagy

is always occurring

um at a low level, but you can really

hyper stimulate the process through

fasting, calorie restriction, fasting

mimicking diets, other things. And this

is why fasting and fast, you know,

calorie restriction is so kind of such

hot topics in the medical field now is

because we they've been shown to induce

longevity and we think it's probably

through that process that you're you're

stimulating the body to become lean and

conservative in terms of its allocation

of resources.

And the body doesn't just destroy the

healthiest tissue along with the old

dead stuff. It has these processes that

identify the old and defective parts

first and they go first and that's

what's beautiful about the whole thing

and that's why fasting is so important.

So mphagy we know plays a really

important role because there's this term

called mitochondrial dysfunction which

some researchers are actually wanting to

get rid of and move away from because as

you just said mitochondria do so many

different things and different

mitochondria even within the same cell

may very well be specializing in

different tasks and mitochondria from

one cell to another are sometimes doing

very different things like not all

mitochondria can produce cortisol that's

specific to specific cells

where those genes are getting turned on.

So it's not like all mitochondria are

producing cortisol. Just the ones in

your adrenal gland, for instance, are

producing cortisol. And it has long been

known for decades

that mitochondrial dysfunction is

associated with everything that ails us

essentially. So David Sinclair

uh published a p paper in one of the

cell journals I think saying that oh

mitochondria are actually the unifying

link of everything that we know about

aging. Defective mitochondria or

defective mitochondrial function

mitochondrial dysfunction is possibly

the unifying cause of aging in all of

the aging related disorders. So mphagy

is trying to address all that is trying

to say okay this is bad we don't want

defective mitochondria and how can we

get rid of old ones or defective ones

and and replace them with new ones and I

think the most powerful signal

and tool that we have right now is in

fact related to diet it's calorie

restriction that is the oldest truest

best proven way to prevent aging in a

wide variety of animal species.

Fasting and intermittent fasting and

again you can only do those things for

so long and then fasting mimicking diets

um can also stimulate this process of

mphagy.

So what about the the typical person

who's an omnivore eating um you know

some rice, some pasta? Do you think that

those people might feel far better or

even a little bit better if they were in

a lower glucose state? I asked this

because I think there are a lot of

people out there who suffer from

full-blown depression, but there are

also a lot of people who suffer from

like moodiness and feeling not so great.

Subclinical depression.

>> Yes. Burnout is what I would call it.

>> Yeah. And and just feeling like some

days are great and then other days they

feel lousy for reasons they don't

understand. I kind of break this field

and I'm probably getting too nerdy right

now, but I kind of break this field into

cause. What's the actual root cause and

what are effective treatments? And I

really see them as two separate things.

Calorie restriction, ketogenic diet,

carbohydrate restriction

are inducing metabolic changes in the

brain and body.

And regardless of what the person was

eating,

they are inducing metabolic changes that

can be really beneficial to brain

health. So going to your broader

question about adults modern day, if

it's an average person who is not

currently under psychiatric care, not

taking prescription medicines, but is

saying, "I'm burned out. I'm exhausted.

I want some of that brain energy that

Andrew Huberman's talking about. I I he

he talks about feeling good. I want some

of that. I'm probably actually going to

recommend let's see if we can just carb

restrict for a while. Um and see if that

produces clinical benefit. I have one,

he's not even a patient, just a somebody

who read my book, had chronic anxiety,

was trying meditation, was trying all

sorts of things. He was ready to go on

prescription medicine. He read an early

copy of the book. He took it upon

himself without consulting with me to

restrict carbohydrates alone. He did not

go ketogenic. He is a vegetarian. He

restricted carbs. Within 3 weeks said,

"I don't need prescription medicine. I

can't believe how much better I feel."

And all I did was cut out some of the

high carb foods in my diet. So, I think

for some people, it can be that simple.

for people with serious mental

disorders, if they are chronically

depressed, if they're on lots of

prescription meds, if they're disabled

by their symptoms, and certainly if

you're bipolar or have schizophrenia or

something, those are the people I really

do want them to work with, a medical

professional, because meds may need to

be adjusted. They really need a they

need a real shot at this diet. It's not

like weight loss. weight loss, everybody

wings it and either you're successful or

you aren't. You you look on the internet

or you read a book and seeing whether it

works or not. If you're using it to

treat a serious disorder, I think you

need serious help. On behalf of myself

and the listeners and and certainly just

on behalf of everybody out there,

because everyone does need to be

concerned about mental health issues,

whether or not they have them and in

their family, themselves, or otherwise,

because they impact everybody. just

really want to thank you for doing the

work that you're doing. You've given us

a lot of hints into the underlying

mechanisms that suggest as to why it

would work and you've g us given us

examples as to how it has worked in

patients that you've worked with. So,

thank you for being brave and for taking

this on and doing it in such a

structured way and for communicating it

here today and with the general public

through your book and your online

presence. We will certainly point people

in the direction of those valuable

resources. Thanks so much. Really

appreciate it. Thank you, Andrew, for

being brave and having me on your show

and uh pleasure and for uh for a great

conversation.