HBOT Demystified: How to Use Oxygen Therapy the Right Way with Dr. Scott Sherr. EP 018

 Stephen McCain: Dr. Scott, welcome to the Stephen McCain podcast.

Dr Scott Sherr: Happy to be here, Stephen. Thanks for having me.

Stephen McCain: Yeah, we got to know each other at the World Peptide Congress and, , we had a good chat. It's one of my favorite, , conferences just because the think tank that it is of knowledge is it's, I just feel like it's where it's at right now. , and I really adore like all the, the, the people that I get to meet.

And so when I met you. I was really excited to have you on the podcast because you are an HBOT, for people who don't know what that is, it's Hyperbaric Oxygen Therapy Expert, and, , you have an, you know, incredible resume with that, and so I, I have to be honest, I've been a little on the fence about HBOT, and we can talk about why and all that stuff, But I'm hoping that you, I wanted to wait until I had the right person and I think you're the right person for it.

So, , if you could just briefly tell my audience, why HBOT, how did you get into this and, and what are you doing with it right now? And why is it special?

Dr Scott Sherr: Well, yeah, it was nice to meet you at the event to Steven. I feel like the, it was, it's very different than most medical conferences. Now, most medical conferences, you don't get a lot of information. You get sort of like whitewashed a couple of things here and there. And it's mostly about the vendors and mostly about hanging out, which is, which is still great and is a nice way for colleagues to meet up.

But just the intensity of the science was, was impressive. And I really did enjoy being there. And, and to speak about hyperbaric therapy was really, really Amazing for me. I've been doing and involved in hyperbaric medicine now for over a decade, and I got involved in it when I was back in medical school.

I was in training in the University of Maryland in Baltimore, and there was a shock trauma center right next to it. And Baltimore is very well known for its shock and trauma and still is to this day, as many people would likely know. And so I got Experience with hyperbaric therapy because in the basement, they had this large submarine looking like, uh, chamber there where they were taking people in when they had severe injuries, uh, wounds, uh, infections, burns, carbon dioxide, poisoning, and I'm seeing some amazing results.

And it was pretty profound, even though I was sleep deprived at the time. I remember going like, wow, that's really cool technology. And, and to take a couple steps back in my, my journey, my father's a chiropractor. So I grew up very much out of the box. I'm always looking at going to medical school as a kind of conduit to bridge the chasm between conventional medicine and what was then called alternative medicine.

There really was no other functional medicines or integrative medicines. None of that stuff really existed when I went to medical school, at least not in a huge way at all. And so, I found that hyperbaric therapy was being used for lots of different conditions around the world, uh, and not just for the ones that were approved for indications here in the United States.

And so I got very much interested in how you could use hyperbaric therapy in an integrative way to truly help people thrive and heal wounds and accelerate their performance, improve their endurance and, and so many other aspects of what hyperbaric therapy can do. And so. When I finished my internal medicine residency, a couple of years later, I started getting more involved in hyperbaric medicine as medical director of a number of facilities in the Bay Area, where I was living for many years.

And through that experience, I created an integrative practice where I really think of hyperbaric therapy as The main technology that I use and I, that I am an expert in, however, I do think that the, a integrative perspective is really important. What are you doing before, during and after hyperbaric therapy to truly leverage the technology?

And that's kind of where my practices evolved over the last decade. I have a foundational framework that I use outside of hyperbaric medicine to, to optimize the way that hyperbaric therapy is going to work. And then I use that. as a base and then hyperbaric therapy as this, you know, fantastic tool to help people truly optimize, heal, accelerate, and, you know, be at their best and get back to where they were.

Oftentimes too.

Stephen McCain: Yeah. Nice. I, you know, when I think about hyperbaric oxygen therapy, it's, there's a couple of different ways to do it, right? You have these hard chambers, you have these soft chambers that a lot of people are buying now. You have with oxygen, without oxygen, you know, are you just using the pressure to push the oxygen in?

Could you explain a little bit of the difference between those just so that we, we know what they are and maybe what they're applicable for?

Dr Scott Sherr: So the, the best way to kind of get in there is probably to talk about what hyperbaric therapy is, because there's really two things that are happening in a chamber. You're increasing atmospheric pressure and you're increasing inspired oxygen. So those are the two main things that we're doing. And by increasing atmospheric pressure, you're driving more oxygen in circulation. 

Now, Most people know about oxygen already. At sea level, there's about 21 percent oxygen in the air that you're breathing. The rest of that is nitrogen. So if you want to increase your oxygen carrying capacity, you have to saturate the cells that carry oxygen from your lungs to the rest of your body. And those are your red blood cells.

So we have a number of red blood cells, but we have a finite number of them. And so if you want to increase your oxygen carrying capacity, you have to do. Something to increase the number of red blood cells you have in circulation. So you could do that a number of different ways. Uh, the most common way is to come to hang out with me in Colorado here, where I'm at 16 percent oxygen at 5, 000 feet.

And as a result of that, less oxygen in the air is going to stimulate a hormone called epigen to be produced. Um, epigen is a natural hormone produced by our kidneys to increase the number of red blood cells we have in circulation. Okay. And the thing about red blood cells, I should also mention is that most of the sites on the red blood cell to carry oxygen are saturated after they leave your lungs.

So if you put a pulse ox on your finger, typically that pulse ox is going to show somewhere between 96 and a hundred percent. And that's because all of those sites are 96 percent to a hundred percent of those sites are bound with, with, with oxygen on those red blood cells. There's not a lot more you can do by even breathing a face mask.

Even breathing a face mask of oxygen is not going to get a lot more oxygen circulation because. That oxygen is going to have to have some place to be carried. And that carrier is red blood cells, typically. So you can go to altitude. You can increase your red blood cell number that way by increasing EPO.

You can take EPO as a drug, as we know that cyclists and other performance enhancing athletes have in the past for Olympic athletes and others, of course, to increase their oxygen carrying capacity. And so that's, um, those are the common ways. And then you can also transfuse yourself blood right before a race or something like that to increase the number of red blood cells you have in circulation.

But in a hyperbaric chamber, we're doing something different. We're increasing the amount of atmospheric pressure that you're under. So we're simulating the pressure you feel under a certain amount of seawater. So. Water we know is very heavy. If you dive 20 feet below the sea, you look up all that water is extremely heavy, although you don't feel it because water is the density of water.

But you know, if you pick up a bucket of water, it's very heavy. And we know that the pressure gets higher and higher, the deeper you go. Right. And so that pressure, what it does is it changes our physiology, allowing more oxygen to get into that liquid of our bloodstream called the plasma. So again, typically on the red blood cells, but if you have a Pressure, you're going to pressurize your lungs, and that lung pressure is going to drive more oxygen into the liquid of your bloodstream, and that's the power of hyperbaric therapy is that that liquid oxygen can get up to about 1200 percent more in circulation compared to just having, uh, just breathing 21 percent oxygen in the air, and That's why you need the pressure because the pressure drives the oxygen in.

So just wearing a face mask, for example, is not going to do a whole lot more. Maybe you had 98 percent on that pulse ox. You brought it to a hundred percent. Great. That's nice, but it's not like a huge amount compared to 1200 percent more. You can get saturated into the actual plasma itself. And so the, the way hyperbaric therapy works is that you have all of that oxygen now in circulation.

You have a number of different things that are happening as a result of it. And so. To go back to your question, which is just to kind of give a framework though, for people, what hyperbaric therapy is. So there are different pressures that we use for different indications because the different pressures are going to drive different amounts of oxygen in circulation.

So typically the brain and the spinal cord. So your central nervous system is more sensitive to oxygen pressure and oxygen tensions. So that doesn't mean we typically need to be at as a deeper pressure to get a benefit. In fact, going too deep in the brain can actually be Too much stress on the system.

Okay. The deeper, the pressure, the more systemic you're going to get an optimization so that you're going to get. Blood flow, blood flow and oxygenation to your, uh, to your systemic system. So your tissues outside of the central nervous system, like your toe, like that's far away from your central nervous system, your brain, like you want to get deeper pressure hyperbaric therapy, but there's a window there.

Typically the window we're talking about for most therapeutic potential is in our nomenclature 1. 3 to about 2. 4 atmospheres of pressure. And that ranges from a seawater perspective, that's about 15 sea feet of seawater to about 45 feet of seawater. The 1.3 at about 2.0, which is the equivalent of about 33 feet of, of seawater.

That's more of your, where your brain and your, your, uh, your neurocognitive optimization, you're gonna see, and then from about 1.8 to 2.4, that's where you're gonna be more systemic optimization. So it's not so much about the type of chamber, right, in the sense of is it soft, is it hard? For me, it's more what pressures.

Are most optimal for you depending on your indication and then you can add in the pressure You add in the oxygen side of as well. So typically we're adding increased inspired oxygen You're either breathing a mask or you're increasing the amount of oxygen by like actually having the whole Chamber at deeper pressures be pressurized with oxygen as well

Stephen McCain: Fantastic. This is good. I really appreciate you explaining that. I, I have used, I have had an EWOT system, exercise with oxygen the LiveO2 extreme adaptive. And so it's two, it's two bags. The top one is hypoxic air. No, the top one is hyperoxygen. So I think it's four times the amount of oxygen that's then is in the room.

The lower bag is hypoxic and that you can use a dial and say, what altitude equivalent do I want to be at? So you could be at pretty rare air. It tells you to work up to that and they have you ride on a bike with a mask that no air can get in and out. It's just, and you breathe through the hypoxic chamber. And when you get to that point where you feel like you're underwater and you can't breathe and you got to come up. There's a little switch and you switch, you take in three deep breaths or maybe even two of this hyper oxygen. And so effectively what I assume you're doing is you're staying right at the cusp of an adaptation where your body is trying to basically utilize more oxygen is saying, shoot, we're being starved here.

Like let's make more, more red blood cells. Let's open up the portal vein of the brain, and so. I've always liked an approach where I said, how can I. Increase my oxygen capacity. It's processing and capacity components because I exercise. I think exercise in itself is going to deliver blood and oxygen to

Dr Scott Sherr: Definitely.

Stephen McCain: Right? And so I have always been afraid. And this, a lot of this came from my good friend, Sandra Kaufmann. I don't know if you know who she is, but she's a very, she speaks cell. So she's very into cellular medicine She has always warned me like, be careful with hyperbaric oxygen. It can cause oxidative damage.

And so it's always kind of scared me to think that, oh, I'm just gonna be doing this protocol where I get in my chamber. 'cause , I'm one of these guys that like, I will stick to a protocol perfectly for years and I thought, I'll get one of these chambers and I'll, and I'll get in it and I'll be driving oxygen through my system and maybe I will.

increase my oxidative damage. And I have to be honest, I don't, this isn't a causation, but there is, I never had gray hair ever until I started doing that EWOT machine. And when I first did the EWOT machine, it wasn't, it was more like ride with oxygen and go nuts. It wasn't fully adaptive. And I don't know if that's, if that is it all related at all, it could be COVID, the stress, you know, and moving and all that stuff.

But

Dr Scott Sherr: you're probably getting a little older too. I think Stephen. Yeah.

Stephen McCain: some point it was probably bound to happen and it is in my genes. I can see my mom and my sister have gray hair. But I wonder if you could just unpack what I just said in a way that allows me to go, you know, and maybe it's just as simple as you just got to know the right dosing.

Dr Scott Sherr: Um, well, there's lots to say there. I think starting on the oxidative stress part of it, I think is important because one of the ways that hyperbaric therapy works and one of the ways that exercise works in general is by creating something called oxidative stress, right? There's different ways that the body produces this.

Yeah. But when you're in a hyperbaric chamber, what happens is that all that extra oxygen in the system does increase your oxidative load. And that just means that you have more reactive oxygen species, uh, reactive oxygen molecules. Um, there's free radicals that that's the other name for it. There's all these other names that people use for them, but these are actually signaling molecules.

And the way hyperbaric therapy works is that it's creating more of these oxidative. molecules to create signaling stress in the system so that you can recover and do the things that we want. So what happens when you're in a chamber, for example, is that you create a stimulus to increase the number of stem cells that are being released from your bone marrow.

Um, and stem cells are the baby cells in our body that can go anywhere that that's required to help heal tissue, decrease inflammation. So that's one of the reasons why oxidative stress is so important. The other reason is that It also causes an epigenetic shift, which means that, um, our epigenetics are how our genes are expressed.

And so what hyperbaric therapy does is it creates an epigenetic shift to optimize the gene expression for things like increasing blood vessel, um, creation, decreasing inflammation. Preventing cells from dying. These are all things that are being done as a result of, um, of the oxidative stress that's going in because of hyperbaric therapy.

Now what happens, and there's been some studies that looked at this is that after about three hyperbaric sessions in a row, what the body's supposed to do is create a. Um, a reflexive antioxidant surge so that it balances out the oxidative load that happened as a result of being in the chamber. Now, this is provided that you have the capacity to do that.

And so that is something that I always like to emphasize is that if somebody is already under a lot of oxidative load and they're getting into a hyperbaric chamber, they may not be. As equipped to be able to balance out additional oxidative load that's going in. And so this one, what I often say here is that if it's an acute issue, hyperbaric therapy is fantastic at healing things faster.

Like if it's a surgery, if it's a wound, if it's an injury, um, it's a trauma, hyperbaric therapy is going to do a very good job very quickly without a whole lot of fanfare and other things that you need to do other than your standard of care, depending on what it might be. When it's a chronic issue, though, it's an issue that's been going on a long time, or you have a long term goal, like say you want to reverse your age or something like that, or you have an endurance race that's coming up in six months, you want to be thinking about creating a foundation that's going to allow you to best, um, to best benefit from being in a hyperbaric chamber and at the same time mitigate any potential downside of that oxidative load.

So, and for me, that means testing their. uh, their cellular data, looking at their antioxidant capacity, looking at their oxidative stress levels, inflammation, and trying to balance all of those things with behavior, lifestyle, diet, supplementation, before getting into the chamber at all. And that's actually what's gotten me in trouble over the years in my hyperbaric field, because I would, I often, I was going to give a talk once at a hyperbaric conference at, The title of the conference was, please do not put them in the chamber and, and, and, and the reason that was my title was, if you put people in too early, if they're, if they're on their kind of earlier stages of working on a chronic, complex medical illness, like they often.

Will not see a benefit or if they do see a benefit It would only be a transient benefit because of that oxidative stress that the system's under So I think my first comment is that oxidative stress is good. We all need this This is how our body responds to exercise to to sauna to cold But at the same time you don't want to have too much of it that the body can't handle So and this is what and the more hyperbaric pressure you put on somebody under The more oxidative load, you're going to put them under two.

And so like at a 1. 3 is a very mild, you know, amount of oxidative love versus 2. 4 is going to be more significant. So you can mitigate that by, um, knowing what their status is ahead of time, making sure that they're well established with their vitamins, minerals, and nutrients, you can even protect them more by giving ketone supplementation, which I think you know about too, Steven.

So you can give ketone esters ahead of time that presents, prevents from oxidative stress too. Everything we're talking about here is the same for exercise with oxygen therapy to exercise with oxygen therapy is, um, it's, it's probably a better delivery mechanism for oxygen. Then, you know, then many, any, maybe anything else other than a hyperbaric chamber, actually, uh, and the, the data and the studies haven't been done since the 1980s on EWOT.

So it's not kind of, it's really unclear exactly how much oxygen you're getting to deliver because of exercise. But, um, with this EWOT system, especially. The adaptive system, which I do think is probably an upgrade compared to just 100 percent oxygen exercise. Um, and I have seen some significant benefit in my patients using it over the years, for sure.

So I don't think they're mutually exclusive. I think you could use them both. I think it just kind of depends on what your goals are as to which ones might be more beneficial, like either hyperbarics or EYP.

Stephen McCain: Yeah, I really appreciate you, uh, diving in like that and talking about the benefits of oxidative stress because a lot of times we just vilify things, right? And then we just hold on to that and say, Oh, and it's like, no, no, the oxidative stress signals your body to adapt, to do something.

And this is why. exercises like the centerpiece for me because You're signaling an adaptation and it's almost like what I'm getting from you unless you had maybe a concussion or something or you're incapacitated and you have a massive injury and you need to just get in a chamber and you got to get oxygen into that area.

It seems like just if you're just a healthy person that you want to stage this thing in a way where you're actually doing it like exercise where you're not. Yeah, you're not lifting too heavy to break the body. You're not killing yourself, right? You're stressing or you're delivering this oxygen.

You're getting a benefit from that, and then you're delivering this oxygen and you're getting a benefit from that, and , you're playing coloring within the lines, so to speak, right? Yeah.

Dr Scott Sherr: to the T and for like years at a time, what you also don't want to do is do very extended daily hyperbaric therapy for these reasons, right? So typically, when we think about hyperbaric protocols, if you have an acute issue, you may have to go in maybe three, Maybe even once, but three times, five times, maybe 10 times to see a, see a massive benefit as compared to, if you have more of a chronic issue, we might have you going in 20 to 30 to 40 sessions, five days a week, but you're not going to do that forever.

Five days a week, you're going to take a break after that. And depending on the indication or what your goals are, we may have you do maintenance hyperbaric therapy, where you go in a couple of times a week regularly, and then maybe go in for another protocol when you're going Five days a week again, every six months to a year, but the key is to take breaks.

The key is to actually modulate the pressure. The key also is to understand your basic foundational health and understand how your cells are working and then monitor this stuff over time. And so, um, and you're not doing it in a black box. So like with my patients that have. Chambers in their house, for example, we're repeating their blood work at least every year to look at their oxidative stress levels and their vitamins, minerals and nutrients, um, depending what type of chamber that they have to, if they have a deeper pressure at their house that goes to 2.

0, then I want potentially to be looking at this more frequently compared to looking at if they have like a mild pressure that goes to like 1. 3 to 1. 5. So. But yeah, the protocol is really, really important. So you're not going to be doing EWOT every day forever. You're taking breaks and you're recovering.

And, and, and it's the same thing with hyperbaric therapy. But the difference with hyperbaric therapy, I think is that this epigenetic shift that we get, this shift in expression of your DNA for new blood vessels, for downregulating inflammation, for these stem cells getting matured in the various tissues.

Like that is, I think, very important. Singular to what hyperbaric therapy can do, as opposed to EWOT. I think EWOT is great for, for like some of these more immediate changes, right? Some of these more immediate, uh, the oxygen delivery piece of it. And especially with the adaptive part, even probably making new mitochondria, which is obviously a big deal.

But I think where hyperbaric therapy really shines is, Uh is definitely on the epigenetic shifts that are happening So you have people with these chronic conditions that have been ongoing for many many years the architecture of the tissue Is in such a dysregulated sort of way that it takes time to rebuild that like rebuild it with stem cells rebuild it with blood Vessels rebuild it with connective tissue rebuild it with you know, new bone new brain new heart new collagen like new Yeah, lots of different types of cells that you can make as a result of being in a hyperbaric environment so You That's the, I think the power of it.

And of course, there's power in using it very acutely after initial injury. And there's been lots of great studies for like heart attacks and strokes and traumatic brain injuries and spinal cord injuries and limb ischemia. Like your limbs kind of fallen off. You can go into a chamber, you're going to potentially be able to save that tissue because if you can hyper oxygenate that tissue very, very quickly under significant you can see the saving of that tissue over the longterm.

So I think that's where you see the benefits really, and on the kind of both sides of that, but again, on the chronic side, chronic issues or long term issues, going into a chamber is likely not going to be the first thing that I would recommend for you. It might be like the 10th thing. Um, but it's down the line could be very helpful, but if you don't have your foundational stuff in order, and this is really where I got very frustrated with the hyperbaric community many, many years ago.

Now, I was like, what are we doing? Just people. And, and this is my own experience. When I first started in 2012, 2013, we put people in the chambers. I'm like, why are they not getting better? Why aren't they getting better? And then, you know, kind of realizing why people weren't getting better over time. 

Stephen McCain: And again, it goes to show that this isn't just about buying gadgets and climbing in chambers and just turning it on and being like, Hey, I'm doing all this great stuff for my health. I mean, you really, you, it's why, you know, I started out as. Somebody who got really interested in health. And then this whole biohacking movement started.

And of course I became enamored by it. And I bought, I had red lights in 2017. Huge ass panels. And, I had all this gear and all this stuff. And, , and I, you know, I tore my Achilles tendon. I bought that EWOT machine. And, uh, It was incredible for, , what I thought it was healing that, , that scaffolding down there and really getting, that tissue to that tendon to repair.

, but , the more I've spent in this space, the more now I really just hunt down the healing. Doctors that are in the cellular space that are talking in terms, you know, they're, they're, you know, it was, it was, the next thing was like functional medicine. And then it was like, even beyond that now.

And so the more you speak with people like yourself, the more you realize. You don't want to just be willy nilly with this stuff. I mean, you can, you can be an amateur and somebody who manages their sleep, their diet, their stress, their exercise, their environmental toxic load. Like that stuff you can pretty much do , and take the bull by the horns.

But when you start getting into some of these things, , you don't want to just wing it and just be doing it because somebody is doing it , and you hear all these great things about it. , , it's, and that's why I was so excited. It was like, finally, I found an HBOT guy that, you know, so thank you, Dr.

Scott for coming on.

Dr Scott Sherr: smokescreen though, Steven, which is kind of funny because like I've been doing it long enough now that people know me about hyperbaric therapy, but then like 90 percent of what I talk to people about has very little to do about hyperbaric therapy at all. And that's kind of how I got into it because I realized if you're going to give the system a whole lot more oxygen, you better hope that that system can use that oxygen to make energy number one.

And number two, you better hope that that energy and those energy byproducts can be utilized effectively. If they can't be, then what are we doing this for? It's not going to be helpful. And so what I. Started getting into something called metabolomics, which is like the study of our metabolism. It's small little molecules that are made, uh, in our cells that are corresponding to making energy and detoxification.

You have vitamins, minerals, nutrients and cofactors that you can all measure. You can measure heavy metals, you can measure toxins, you can measure your fatty acids. And so it's sort of like the best way to look at what's happening in your genome from your genes and what's happening in the environment.

Both together in real time. And I got involved with a nonprofit in 2017 called health optimization, medicine and practice, which you talked about functional medicine being like an intro level for a lot of this. And this is like, we're talking cellular medicine now, right? Like just like Dr. Seeds and like, and health optimization, medicine or home, as we call it for sure is That's what it is.

It's cellular medicine, looking at metabolomic data. And my, my insertion into that was, well, if you can't make energy, well, why am I putting you in a chamber? Like, I, it's not going to be a very good idea. And if you can't detox well, then you're going to not have a good response to being in the chamber. So it's like, what about, there's more than just looking at energy metabolism and looking at detoxification.

There's also, you know, there's also protein metabolism and there's also carbohydrate and macronutrient. Metabolism. And so all these things play into all these aspects. And then you get into you're like, well, holy shit. I really have to work on this cellular function first. And then I can think about getting them in the chamber.

Right? So like, what am I doing to optimize energy metabolism? Do they have the, do they have the right B vitamins? Are they toxic? Do they have heavy metals in the system? You know, et cetera. Like these all kind of play into it. So my clinical practice has very much colored how I think about hyperbaric therapy.

Right? So when I think about somebody that comes to me that says, Hey, Doc, I'd love to get into a hyperbaric chamber for fill in the blank, say it's a, say it's a concussion that they've had for a year or something like that. So most people in my field will be like, let's get you in the chamber. Let's go. I mean, but for me, I'm like, no, let's, let's talk about this.

And so, and then what we do is I think about, you know, what laboratory data would be really helpful in this case. And usually that's metabolomic data. And then what supplementation is going to be helpful. What, uh, what other types of technology might be helpful on top of using hyperbaric therapy as well, because you want to.

Really take the time and well, you're taking a lot of time to go into a hyperbaric chamber. Typical sessions are between 60 and 120 minutes, 60 to 90 is more common, but you're going in five days a week for a period of time. This is like a lot of time. So how are you going to leverage it? Right? So, and I'm thinking about, so I'm thinking about labs.

I'm thinking about technology. I'm thinking about supplementation. I'm thinking about other types of practitioners that might be very, very helpful on this person's journey. To help them. So it is for, for concussion. Is it a neurofeedback specialist? Is it a chiropractic neurologist, which I have a lot of friends that do chiropractic neurology that help retrain the brain after these kinds of injuries, retraining their eyes, like eye movement therapy, whatever.

Like I have a huge network of people that I've, that I have over the years that I can refer out to and then How am I going to help surveil these people over the time that they're going into the chamber so that we know that they're getting better, or is there anything we need to tweak along the way, um, while they're in the chamber and then finally, there's the hyperbaric protocol itself and how you're going to start the hyperbaric protocol and then where you're going to go.

I mean, unfortunately, not only is it. Everybody should get in the chamber, but it's also everybody should get in the chamber at the same pressures for the same amount of time. But what I found over the years is that a dynamic, a dynamic, excuse me, a dynamic approach is much more optimal for patients where oftentimes we're starting off at a milder pressure than we classically would think would be their target.

And then we increase their pressure over time as their system kind of gets used to Being in the chamber and this is more important for people that are under higher, higher oxidative load that are, um, that are older in general, younger people tend to be able to, to be able to, um, uh, to tolerate going deeper faster.

But in general, um, that's kind of my, my, that's the framework that I use right there. So I talked about hyperbaric therapy last, right? Because there's like 7 or 8 other things that I think about be ahead of getting into the chamber. And then I think about. All of that first, if I can, not everybody's willing to have these kinds of conversations, of course, but I at least tried to introduce this, this, this conceptual framework.

And then I say, these are the ways that if you're not willing to do any of these things, because you don't want to, whatever, these are some things that we can do to support you along the way with, you know, blood vessel dilation and, and, and making sure you're making energy a little bit better detoxing a little bit better along the way, if we don't have all that data, which again, I would ideally like to have.

Stephen McCain: Yeah. Yeah. Amazing. , , I'm, this is why I have just not just bought a chamber and just started getting in it. I just intuitively I was like, you know, um, well, let's talk. First of all, I want to ask somebody, you do telemedicine and you, so if somebody is listening to this and they, you know, feel they need a hyperbaric oxygen treatment and yet they listen to you and say, shoot, I want to really have a well, well rounded protocol.

You offer that through telemedicine, right?

Dr Scott Sherr: Yeah, I do. I consult with people all over the world on trying to help them understand how best to, uh, to integrate hyperbaric therapy into their healing recovery optimization, their goals, their protocols. And I also work with clinics all over the world. So I clinics and with, with practitioners and non practitioner run clinics as well that are integrating hyperbaric therapy with another mode of other modalities.

I definitely work with them in those, in those capacities too. So yeah, I have, uh, very much. I'm happy to talk to people in those capacities. I do that a lot.

Stephen McCain: Great. Yeah. So if you're, you're listening to this and you've been using a chamber or you're thinking about it and you now realize that there's probably more to it than you originally imagined, here you go. Reach out to Dr. Scott and we'll, at the end of the podcast, I'll, I'll ask you how they can get ahold of you.

What are, yeah, what are some of the, , compounds, like I would imagine nitric oxide, methylene blue, , I would imagine, , astaxanthin for an antioxidant boost, , what are some of the things you've found just to kind of humor us in terms of, you know, just,

Dr Scott Sherr: Yeah, I have some pretty standard protocols that I think about. Uh, the one category, and you're alluding to this with nitric oxide, is I, the one category that kind of falls across multiple, uh, types of modalities is blood flow, right? So you want to increase blood flow to certain areas, especially if you want to heal these areas.

Oftentimes people are getting hyperbaric therapy because they're looking to heal. And so, Some supplements that increase blood flow. So the one that I use a lot of actually is nitric oxide. So nitric oxide boosters, I have a couple of different companies that I, that I use them from, but nitric oxide is a, it's something that's produced in the body that dilates blood vessels and also increases the capacity to make energy as well.

So. Um, and many of us will get depleted in nitric oxide as we get older. And also the deeper you go in a hyperbaric chamber, you actually deplete high nitric oxide, um, briefly by doing that. And the reason for that is that, that it's because of the oxidative stress that's happening in the chamber, it actually neutralizes your nitric oxide.

And so you don't have as much around for a short period of time. So this is actually used clinically in some ways, um, for people with severe injuries, for swelling, for damage to a blood vessel, you can use hyperbaric therapy to. Decrease the caliber or the size of the blood vessels to prevent them from leaking out stuff.

They're not supposed to leak out

Stephen McCain: interesting.

Dr Scott Sherr: But there's in in a non traumatic indication or Condition you can mitigate some of that vasodil vasoconstriction by causing some react some vasodil vasodilatation Uh, dilation instead. So, uh, the most common I'll use from a supplement would be nitric oxide. I'll also use niacin sometimes too, because niacin helps open up blood vessels.

Um, you have to watch out for flushing with people, of course, depending on the type of niacin. Also use CoQ10. CoQ10 is also a vasodilator and also enhances mitochondrial function. Yeah.

Stephen McCain: I knew it was a mitochondrial function. I didn't know vasodilator.

Dr Scott Sherr: Yeah, just a little bit. It's not, not as significant as nitric oxide, but I will use it. You can also use some of the nitric oxide precursors like arginine and citrulline, for example, you can use those in younger people, though, and older people, they have a harder time converting arginine to nitric oxide.

So I typically would give the nitric oxide directly. So, but I

Stephen McCain: about low dose Cialis?

Dr Scott Sherr: so that's something I haven't started working with quite yet, but there are, Okay. But I have been interested in looking at Lodos Cialis and the Lodos Viagra and Tildalafills of the world because I think actually that's Cialis, right?

So, um, but yeah, so that's, that's become more interesting to me. Um, I haven't used it a lot quite yet in practice, but, um, it would be very similar. What I actually learned recently, though, which is important for people to know is that the, the Cialis, the Viagras of the world, um, they do not increase. You have to have enough nitric oxide in the system to be able to benefit from these medications, so

it doesn't take, it doesn't take the place of, of having enough nitric oxide in the system. Um, but you, but yeah, but I think if, as long as you have enough nitric oxide in the system, you could potentially benefit from, you know, maybe being on these low dose Cialis Viagra of the world as well, which, uh, which I'm just starting to play around with now.

Is that something you've worked with?

Stephen McCain: Yeah. When I think of the nitric oxide products on the market, you have Berkeley Life. You have, , that new one, , that, uh, Arteriosil, like their complementary one. It's called, it starts with a C, I forget. I took that one. Yeah, Vasconox. Vasconox. Yeah, , and then I've dabbled around with, , Nathan Brian's, you know,

Dr Scott Sherr: And 101.

Stephen McCain: Yeah. You know what? Yeah. He's kind of has two brands. And that one is the one I usually take the most consistently , and then I will occasionally do low dose. Cialis , I've it's very effective, , I've dabbled with that stuff for a long time,

Dr Scott Sherr: right. Yeah, especially for the gym. Yeah, for exercise and things. I've heard it's really quite good for that.

Stephen McCain: Yeah. I heard it's good for the brain too, as

Dr Scott Sherr: Yeah. Yeah. I mean, there was a crazy study that was done that showed that, you know, men who were taking Viagra on a relatively regular basis had like a 30 percent decreased risk in dementia.

Like it was not subtle. So it's, I mean, so getting more blood flow to the

Stephen McCain: yeah, so you gotta,

Dr Scott Sherr: the, uh, Into the other part of you is, is a good idea at the

Stephen McCain: yeah, and it makes you wonder, , is it really the Viagra, or is it having more sex is better for,

Dr Scott Sherr: That's probably not a bad thing, but I think a lot of it is blood flow, honestly. And I think that's why we're using it now and kind of cross pollinating and things like exercise and performance. So I use a lot of those. And then like for the visa dilatory portion, I also use like light therapy, like, so red light therapy is great because it's going to increase dilation.

So I have people that will like, if they have a shoulder injury for something, like we'll have them put like a light device on their shoulder and then go into the chamber afterwards because you've created a. Uh a stimulus for more blood flow to go to that particular area because you've dilated the blood vessels around the area that you're looking to stimulate.

So, um, so you can do that. So I use red light therapy. You can use, um, cryotherapy in cold, but that's much more difficult for people to to tolerate because, so what happens with cryo is like you, you know, you clamp everything down and then after you open everything up, so you dilate like crazy, right? Like the post.

And if, so what, what happens with that, you have lots of blood flow to your periphery, which is great. Lots of dilation, but that's also very difficult for people to sit still while that's happening. They want to move, they want to exercise because they have all those stress hormones that just got released from being under cryo.

Um, you can do it with sauna as well. Typically I use cryo and sauna after hyperbaric therapy as more of like a detox kind of thing. As opposed to before, because it's just, it's hard to be sweaty in a chamber or, you know, just warming up and, and not wanting to sit still, but, um, other than the blood flow, the other thing that I think about a lot, Stephen is the energy production capacity.

So, like, how are you going to make sure you're flooding the body with more oxygen, 2000 percent more or 1200 percent more, I should say, and then. What are you going to do with all that oxygen? Is it going to make energy or is it just going to make all that oxidative stress? And so are your mitochondria in a place where you're going to be able to make energy?

So this is where I think about your basic things like your B complex or your B complex vitamins, right? So you need your bees and you need your minerals, your magnesium and, and things to be able to make energy. This is where methylene blue comes in a lot for me too, because.

Stephen McCain: was, I was sitting there waiting, I knew I was hoping you were going to bring it up.

Dr Scott Sherr: yeah, it's a methylene blue is a fantastic mitochondrial optimizer.

It's been around for over a hundred years at high doses. It's an anti infective and it's actually significant help for severe mitochondrial stress and ischemic episodes because it can rescue mitochondrial function, but at lower doses, it's a mitochondrial optimizer. It helps with energy production and it helps with detoxification at the same time.

So it does both, which is very uncommon. And so very low doses, like four, eight, 16 milligrams are really good at supporting mitochondrial function. So I use a lot. Before hyperbaric therapy, because it's going to support that mitochondria. So there's like these four parts of your mitochondria called these complexes, and oftentimes they're not working very well in people that have complex medical illness, long COVIDs, your fibromyalgias, your chronic fatigues.

And so if you can support those, Aspects of the mitochondria to work better or bypass them if needed, and to help allow and maintain energy production, you are going to see these people do much better over time. And so your energy enhancers, your, you know, your basic supplementation, like your bees, for example, like a multivitamin is really important minerals, but nothing blue is a fantastic addition.

And then you asked about antioxidants. So. You want to be careful with antioxidants. And this is the, this is interesting, right? Because the way hyperbaric therapy works, if it's not an acute issue, if it's an acute issue, you can kind of give them whatever you want, because all you really want to do is get more oxygen in the system and get more, uh, potentially prevent a lot of that tissue that might've been at risk from not dying.

Um, so that's what oxygen is really doing in the acute setting. But in the longterm, you want to make sure that you have that oxidative stress in the system to create that epigenetic. shift. So if you give too many antioxidants, you might prevent the oxidative load from doing what it's supposed to do, which is cause a hormetic or a eustress, a good stress on the system so that you can see the benefit.

So now if you're antioxidant deficient, then you should be taking your antioxidants, but you got to be careful and you don't want to take too many antioxidants to potentially mitigate the benefit. Benefit of being in a chamber,

Stephen McCain: Yeah, yeah, I knew you just basically blanketing all that signaling, right? And I mean, it's why with exercise, I always tell you, , don't be taking your antioxidants around exercise because your body's basically saying, Hey, , I need help over here. Come build me up, , repair me and all that.

So, um, well, I'm,

Dr Scott Sherr: one kid. You know, there's one caveat there. The caveat is that if somebody is super sick and they already antioxidant deficient, then giving them antioxidants before hyperbaric therapy can be a very, very helpful way to help them get through hyperbaric therapy and still benefit without having a lot of downsides of having too much oxidative load.

So I've done that in the past for people with severe, you know, severe illness and seeing benefit there.

Stephen McCain: Interesting. Yeah. Yeah. To the point that you always have to look under the hood and get some data on them so that you're, , appropriately because, you know, people always people ask me even like, what's, what's the best thing I should do? What's the most important thing I should do? I'm like, the most important thing you should you need is the thing you need the most.

You know, I mean, it could be something as simple as just being severely vitamin D deficient or something, and you can't really know that stuff unless you do consistent testing, you know, and I, I really think that's where people go from, they take , their health approach to the next level, , and most of the time you got to work with a professional in the beginning.

And probably for a good long time. I mean, I worked with some really great anti aging functional medicine doctors for a long time to learn how to read my own labs and, and, you know, eventually you, you kind of learn the ropes, so to speak. If I was going to be doing any sort of HBOT stuff, I would be asking you, I would be going, Hey, here's who I am.

Here's, , my lifestyle. Here's what it is. Here's my blood work. Here's any sort of testing. What do you think would be good? 

Dr Scott Sherr: What I, what I would say is that the reason why I got involved on the, the business side of hyperbaric medicine about three or four years ago was, is I was so tired of having to re educate people all the time in the sense of the challenge. There's so many companies out there that are selling chambers and this is the challenge, right?

All they care about is selling you a chamber. That's all they care. Like they just care about their margin on selling chambers. And so you'll have a lot of companies out there that just sell the soft Side of chambers that will tell you that you can do everything in a soft side of chamber that you can do in a hard chamber, except you'd have to just do more soft hyperbaric therapy to get there.

And that's absolutely not the case at all because there's no way that the pressure at a mild units ever going to equal the pressure at a deeper unit. So for systemic like things for outside the central nervous system, like that's just not going to happen. And so, um, you have a lot of people out there in that are selling chambers that say that, you know, you can do everything in a soft chamber.

This is not the case, right? And then you have. Other companies out there that are giving you protocols on how to use hyperbaric therapy, which they should not be doing because they're not practitioners, but these companies give you protocols. Yeah, just do 40 sessions and due to this pressure, you're going to be fine.

And, and then I got, I got all the brunt of that for people saying, well, this, This company told me I needed to buy this chamber, but I have this condition. I'm like, well, you don't have the right chamber for that condition or, or you have, um, you know, this company said I could use it every day and it was fine.

I'm like, no, you can't use it every day. You have to take breaks. And I don't care what pressure you're at, you're at, you have to take breaks at times as well. You know, or, you know, they gave me a protocol. It didn't work. And like, that's, that was actually the most common, which is like, they gave me a protocol.

It didn't work. I don't know what to do. And we have to recalibrate all of it because and start from the beginning. So I started a company in 2019, 2020. That was the idea was to try to create an educational platform that people could have a better understanding of how to use all these technologies together.

And that's kind of what we've been working on for a while now. But, but I, I would just kind of echo that it's really hard to find good information out there and you have to be careful if you're looking to buy a chamber because they have a very significant incentive to sell you one.

Stephen McCain: Oh, yeah. I mean, I have a person that every couple of months I just, I met at a 4m, , that just, Hey, Hey, Hey. But I, I really respect, , your approach and the, Kind of caution a little bit, you know, you're kind of saying, Hey, it's don't, you know, this is not something you just want to be willy nilly with.

And, , you go to a four M, which is a medical conference here in Vegas. A lot of people go to it's really popular and they have big, hard shell chambers and they have the soft shell and they'll throw anybody in there. They'll turn those things on. And I got in the hard shell and I'm claustrophobic and they shut that door and I freaked and I was like knocking on the little window like, let me out.

You know, they couldn't hear me. I'm just going. And I just couldn't do it. I, I, I think I could do the soft shell if I, if I was, I could unzip it myself. But when they shut that door and it was like, ching, ching, ching, ching, they like lock it. Is that like an issue? I mean,

Dr Scott Sherr: for some people it is. I mean, for, I mean, it's rare that it's an issue. Um, but because there's different types of chambers, like there's hard shell chambers that have completely translucent outside. It's all made of an acrylic glass. So you can see outside, but there is the submarine looking ones that you were in.

That could be more claustrophobic for some people. Soft sided chambers are more enclosed in general too. Um, but I think, you know, for me, you know, The main thing with, that I always tell my, my team is that I want to know when we don't turn well, then we don't recommend hyperbaric therapy, not when we do, because I think that, and that's one thing that I, I'm very emphatic about is that, um, we, I, what I, what I often say is that it's not if hyperbaric therapy will be helpful, it's when, because I do think that everybody will benefit or could benefit at some point, but the question is, is now the right time.

So if you come to me and you have severe Lyme disease, or you've had even a severe concussion and. Um, you're like a year, two years, three years, you're, you're kind of at the early stages of getting better, right? Um, especially something like Lyme disease. I'll be like You need to get about 60 to 70 percent better before you even think about getting into a hyperbaric chamber Because if you go in too early, you're not going to see a benefit If you do see any benefit that benefit is not going to sustain so you're going to go back to the way you were before And so, I mean, there were people when I first started that were being taken into hyperbaric clinics on wheelchairs, like, because they could not tolerate being in the therapy, like, like, they couldn't even drive home, like, it was, it was nasty.

And we would try to support them with, with antioxidants ahead of time, and I would see them get a little bit better. They would often get a little bit better, but then after 40 sessions, they would be a little bit better, then they would get worse again. And I was just like, what are we doing? And, and so, Um, that's why I'm using emphatic emphatic is if they have, if somebody has a chronic complex medical illness that they're about 60 to 70 percent better before they get into a chamber so that that way I know.

That we're going to be able to get them across the finish line. Now, there's a couple of caveats to that. Like I might start earlier if it's a concussion, for example, or if it's more of a brain related kind of thing sometimes, but sometimes I won't either. Because again, if, if they don't have the optimized levels of, or even close to it, of vitamins, minerals, nutrients, to be able to make energy to detox.

It's like, I run into the same issues all over and over again. So, um, it's for me, very, very important to give people. A perspective here and I use a lot of soft cell hyperbaric chambers in people's homes all over the, all over the world. I have some people that have hard chambers in their house too. And these are all very, very helpful and can be used very, very effectively.

But again, what are you doing it for? Why are you doing it? When are you doing it? And how are you not doing at times too, right? That's all important.

Stephen McCain: yeah, yeah. Awesome. And I have one last selfish question for someone like me who I don't, I don't have any injuries. I'm very consistent with working out. , all my labs look really good. At least from the thing. I mean, maybe there's something I'm not testing, but for the most part, pretty good health.

, where would. Uh, HBOT be effective for someone like me? , what would you even say about it? With something like that?

Dr Scott Sherr: Yeah. So, I mean, there's a lot of different ways to think about it from like a, uh, so there's been a number of studies that have been done on the 2. 0 pressure in what's called anti aging medicine or longevity medicine, because there are some indications that this pressure done over a period of time can reverse.

The production of things like senescent cells, which are like zombie cells that happen in the body that could increase telomere length, which is potentially a sign of longevity, although there's controversy there, you know, decreasing inflammatory levels of various types of markers. Um, there's also been studies looking at this pressure for increasing endurance and increasing VO two max, increasing the capacity of the left ventricle to, to beat more effectively and efficiently as well.

So from a longevity performance, endurance perspective, you can do some longer protocols. to potentially see the benefit, um, and then, you know, over, over time, potentially do maintenance to help, you know, maintain those kinds of benefits. Um, but in, but for most people that are healthy and they don't have any medical issues for the most, I, I usually use hyperbaric therapy as kind of a recovery tool overall, because it can be really great at helping with recovery from, from exercise, from, you know, Being on an airplane from jet lag and those kinds of things, you know, when you're on an airplane, you're at, you're pressurized to about 8, 000 feet.

So I use a lot of methylene blue in this case too, because nothing blue can help protect you. But when you get off an airplane, you can reactionate very, very quickly with you getting into a chamber. So we can help, you know, get rid of jet lag. If you're a high flyer, if you're working all the time, um, it also can improve your immune system function.

And so, um, I think it's a great. Thing to have from like a day to day operations perspective, just to have as a tool in the toolbox. Like I have four kids at my house and one's a pretty big soccer player. So I'm always happy. I have the chamber in case she gets hit in the head. She's not as big as, as everybody else on her team.

So, and she plays defender, so she gets knocked around sometimes. And so we, you know, we, we, we go in the chamber. I have, I give her a little bit of methylene blue. I give her a little bit of some of the other stuff that I have and like, you know, and protect her brain and some fish oil, some vitamins, and so, you know, you know, we do the whole thing.

Right.

Stephen McCain: Some creatine maybe. Hmm.

Dr Scott Sherr: um, so I made this, I have a lot of tools in the toolbox, but for me, the foundation is really essential. So, you know, are we working on our health on a day to day basis and how can hyperbaric therapy be a, an accelerator of, of those kinds of goals, right? So if you're an endurance athlete and, uh, you want to do better, you can use hyperbaric therapy to increase your endurance.

If you are just, Trying to stay healthy. You can use hyperbaric therapy in various ways, either five days a week for a period of time to help with your brain function. That works, um, that you will see a benefit there. Um, you can do it at deeper pressures and you can see a systemic benefit for endurance VO, two max, um, Or you could just use it periodically.

So there's like, that's why it's like, you know, if you were consulting with me, Stephen, I'd be like, well, Stephen, what are your goals? Like, would you have any, like any, any events coming up? Are you just looking to stay? Like, are you just looking for longevity and health span? Right. And so if you're looking at more longevity and health span, I'm thinking, um, the most versatile type of chamber would be your 2.

0 chamber, because that's what you're going to give you the most capacity to do various protocols. But I often say too, though, you don't need to use that deep pressure very often either because you don't want to get too much oxidative load. And so most people, what I would recommend they get for their house, if they're relatively healthy is like a 1.

5 chamber that can go, it's a soft sided chamber. Typically you can do most of your day to day operations, see significant benefit. And then maybe once every one to three to five years, depending on your health, you have the, you have access to a deeper pressure chamber in your community. You can use that.

For like a more systemic optimization protocol that, but there's lots of different ways to skin this, but, um, but my, oh, my, my framework is always, again, hyperbaric therapy is like the number six thing on the framework and number seven. It's like, like, get your labs done. What's your diet? Like, what's your, what are your behaviors?

Like lifestyle? Like, you know, what are you, what are you, what kind of supplementation are you taking? Like that? All those things are especially important. If you have a longterm goal or have a longterm issue. Okay.

Stephen McCain: Yeah, well said, and, I'm kind of proud of myself for, , being a little bit skeptical about, you know, the thing is, when you hear a thousand doctor, or a thousand, but a lot of really smart people talking about things over a course of a decade, and you go to these conferences, these, and you listen to these podcasts, you read their books.

You kind of start having intuition about a lot of this stuff. And I'm happy that I didn't just wing anything with HBOT because if I'm going to do it now, I'm definitely going to reach out to you. If somebody is interested in that, , where can they reach out to you, Dr. Scott?

Dr Scott Sherr: So a couple of places. So I have my own website that's dedicated to hyperbaric therapy. It's integrative H B O T. com. So the word integrative and the letters H B O T for hyperbaric oxygen therapy. com. That's probably the fastest and most direct way to find me. If you're interested in hyperbaric therapy, if you're interested in learning about how it can help you, or if you run a clinic and you want to integrate it into your practice.

I do have a company called one base health as well. One base health is a company that is creating a whole bunch of technology, uh, that's. Involved in both hyperbaric therapy, lights, cryo and sauna. We, we do have those for sale, but at the same time, our main focus is actually the technology that's powering those particular types of technologies.

And so we're creating this really cool, uh, sensor technology and app technology that allows you to understand what's happening when you're in these types of modalities and using them. Now you can integrate your own wearable technology alongside that as well. So, um, our, my goal with that company is to create really an educational Ecosystem where people understand why they're using what they're using and then measuring their data over time so that they know, you know, when things are going well and when things need to change.

And, um, and so one day self is really kind of like my clinical practice in a company really. And then, as I was mentioning as well, that we do have chambers for sale. We do have hard chambers and soft chambers. The key for me always is the education to make sure it's right for you as you're looking into it.

Um,

Stephen McCain: Yeah, and I will, I will include links to all of this in the show notes. And you can find that at Stephen with a P H McCain. com backslash H bot H B O T. So Stephen mccain. com backslash H bot. , you did mention that you could give, , my listeners a 5 percent off of a chamber. 

Would we be able to set that up?

Dr Scott Sherr: Yeah, I mean, I think the best way to do it was because it depends on the type of chamber, depending on, uh, because there's like, there's, there could be a different percentage off, depending on what chamber they get. So you can say that there's a, there's a, we can say that there's a discount, uh, for people like listening to the show.

Um, just, you know, mention my name, uh, when you're, you know, when you're, uh, when you're talking about it and we will go get.

Stephen McCain: Yeah.

Dr Scott Sherr: Yeah, because it's like, it probably anywhere between like five or like anywhere between like five to 10 percent off, depending on the type of, you could write that if you could say that if you want, you can be, you can be anywhere between five to 10 percent off, depending on the type of chamber that, that you decide to purchase.

Stephen McCain: Just let them know you, you came from the Stephen McCain podcast and , they'll take care of you. Uh, Dr. Scott, man, I re I really appreciate, , your information and I've waited a long time to pick somebody's brain about this stuff. And I think you, Really, , showcased exactly what I was, I wanted.

And hopefully that my listeners, , learned something great and I like the fact that people can reach out to you and that you've set yourself up in a way where, , people can learn to use this very effective tool, but in a very effective way. So, uh, thank you so much for coming on. I really appreciate it.

Dr Scott Sherr: It's been my pleasure, Stephen. Thank you. And then I would also just mention that, um, if people are interested in methylene blue, I do have a company that makes some products in that space. The company is called Trescriptions and we'll get Steven a, we'll get you a discount code as well for 10 percent off.

Anybody interested in trying some of those products as well.

Stephen McCain: Fantastic. Yeah, I've actually used those before. Awesome. I mean, I'm a huge fan of methylene blue. Huge. And I think a lot of people are, I think, especially even after covid people's brains turned back on with that stuff.

Dr Scott Sherr: For sure.

Stephen McCain: Yeah, we'll put links to everything in the show notes, stephenmccain. com backslash backslash H bot.

And, , dr. Scott really appreciate you coming on everybody else. Appreciate you listening and we will catch you on the next episode of the Stephen McCain podcast. Stay healthy, everyone.