Arizona Center for Integrative Medicine

Transcript

Dr. Victoria Maizes: Hi, Andy

Dr. Andrew Weil: Hi Victoria.

Dr. Victoria Maizes: Our next guest James nester wrote a really interesting book called breath [00:36:00] and I learned so much from it. I thought I knew a lot about breathing. I teach breathing to my patients. I learned so much from this book,

Dr. Andrew Weil: Me too. And it's great to see the reception that this book is getting.

It's being very widely read and I hope it's really, it will really raise awareness of the importance of breathing

Dr. Victoria Maizes: Well, let's welcome, James.

Intro Music

Dr. Victoria Maizes: James Nester is a journalist who has written for Outside, Scientific American, the Atlantic, the New York Times and many more. His recent book Breath, the new science of a lost art was released earlier this year and was an instant New York Times’ bestseller. James first book, Deep Free Diving Renegade Science, and What the Ocean Tells Us About Ourselves was published in 2016. Welcome James.

James Nestor: Thanks a lot for having me.

Dr. Victoria Maizes: I'm delighted to have you on the show, you first became interested in breath when you were interviewing divers. I'd love to know, what did you learn that made you want to investigate this topic more deeply?

James Nestor: I had been learning a whole bunch of things about breathing over several years, I'd been suffering from a number of respiratory problems that no one could seem to help me with. And it wasn't really, until I went to go in bed with three divers as part of a reporting assignment for Outside magazine that I learned the true potential of where breathing could take us. Now, these are people who have trained themselves to hold their breath for six, seven, eight minutes at a time and dive down to depths of 300, 400 feet, no fins, no anything.

And when I came back and reported this to my mom, she said, this is totally impossible. I heard I've heard this, the same thing from numerous people since then, even though there's video of it, you know, but, it, me to understand that there was still so much, we didn't know about the human body, its potential, and where breathing could take us and I wondered what else breathing could do for us on the terrestrial plane.

My job, as a journalist is going into this field and report objectively on what what's happening. So I had never written this deeply about medicine before. And let me tell you, it was a very steep learning curve. Learning about the electron transport chain and Oxy hemoglobin disassociation curve. I've had zero experience with that. Luckily, my father-in-law's a pulmonologist and my brother-in-law is an ER doc. So they helped me out along the way. But I think that the thing with, with breathing in science, is there, there is a huge foundation of science showing how breathing benefits, the mind, how it benefits the body, how it can help increase lifespan.

It's just, these studies have been locked away in these academic journals with these 30-word titles for so long that they haven't made it out to the general public. And so I spent years and years in medical libraries, reading through all of these articles and trying to piece together, this, this science for, for the general population.

But there's still so many people researching this. It's just, it seems. That research is just going by the wayside. As people are looking for a quicker fix, you know, they're looking for a pill or a powder.

 Move here:

Dr. Victoria Maizes: Yeah, Andy you've been writing and teaching people how to breathe better.

For so many years. And I know that you sometimes talk about your disappointment, that there's not more science and that there's not more instruction

Dr. Andrew Weil: I started practicing yoga when I was 28 and I became branched in Pranayama.

And that was my first exposure to, information, which was mostly coming from India about the potential of breath, the change, the function of the body and the mind. So I began exploring that on my own. I found nothing in clinical medicine that paid any attention to breath. And then, in the 1980s, I, late seventies, eighties, I had the good fortune to have find a mentor, an elderly osteopathic physician, Dr. Robert Fulford, who I think was the greatest healer I've ever met. He had come to Tucson to retire, in his early eighties. And, but he couldn't retire because he was in such demand and he placed great [00:04:00] emphasis on breathing. He said that was the master function of the body and he felt that restrictions in breathing, which could come about from birth trauma or physical trauma or possibly emotional trauma, were the root cause of many chronic ailments and his manipulative treatment was designed to free up breathing. And often one treatment would produce remarkable changes. I saw him end recurrent ear infections in kids with just one section of manipulation that improved their breathing, for example. So that really inspired me to look further into the potential of breath and to experiment with myself and over the years until really quite recently, I have found so few people in clinical medicine that paid attention to this or made use of it. And to me, you know, it's an example of the power of integrative medicine to find something that's not on the radar of conventional medicine. And that is completely cost effect if it's free, uses no equipment, is extremely time efficient and has this remarkable, potential to change many conditions in the body, both physical and emotional as James, you know, documents in this book.

Dr. Victoria Maizes: Yeah. I'd love at the end for us to point people to some of the useful resources out there, because one of the wonderful things about integrative medicine is many of the things that we point people to are indeed free and don't require special equipment and can be widely used. And I think, especially now with, the wide availability of the internet and of smartphones, these tools are just at our fingertips.

Dr. Andrew Weil: In reading your book, which I am absolutely pleased to see that out there and finding such a wide readership, you know, many of the main points are very familiar to me, such as increasing the depth of breathing increasing, the depth of exhalation particularly, of slowing the breath, but one idea that you present, was very new to me and that is you're take on carbon dioxide. You, my thought was always that it's desirable to get rid of carbon dioxide as much as possible. and you know, that was one of the reasons I thought that was useful to increase exhalation, but you have a very different idea about carbon oxides function in the body.

James Nestor: Well, I learned about this from research that was published more than a hundred years ago by Yandell Henderson at Yale who found that without proper amounts of carbon dioxide oxygen had a really hard time doing what it was supposed to do, which was to provide energy to hungry cells. So this had been going on this research had been going on for decades and decades. And then in the fifties and sixties, people started experimenting with giving people who had chronic anxiety and even chronic asthma, hits of carbon dioxide. Which sounds crazy because we assume that carbon dioxide is a waste gas and, you know, there's, there's a reason the climate is changing and the ocean is acidifying, because there's too much CO2 in the atmosphere.

If you don't agree with that, then, then you're wrong because the science is very clear, but, but the body needs a. Balance of CO2 and oxygen to operate efficiently. So with CO2, therapies, right now, they've found that populations with anxiety with panic, with asthma, with other fear-based disorders, they traditionally have very low CO2 and their entitled breath.

And so the theory right now, and there's actually a decent amount of research going on in this area is that by increasing the tolerance for CO2, these people can become more comfortable and they can read more slowly and they can get that balance of CO2 and O two in their bodies.

So Justin Feinstein at the Laureate Institute of brain research has been doing this therapy that has been around for over a hundred years where he's given people with chronic anxiety, a hit of CO2, and it hasn't been published yet the data hasn't, but I've heard from him and it's working incredibly well.

Dr. Andrew Weil: The one experience that I've, I've had that connects with that is I remember, I think this was the only, I was an intern in San Francisco learning a trick, which I practice a number of times on patients that came in with panic attacks, who were hyperventilating you had them breathe in and out of a paper bag, and this would calm them down and slow the breathing. And that was increasing their intake of CO2.

James Nestor: That's exactly right. And they've suggested you're, you're a qualified, you are a doctor, you can, but they suggest that that everyone not do this because some people have confused panic attacks with heart attacks, and they've given people, heart attacks, paper bags, which is a big problem.

So a safer way of doing this and this is what Alicia Merritt has been doing at Southern Methodist University for, for years and years is taking control of your breath, becoming aware of it and slowing your breath down and using these two bags in your chest right here, your lungs to slow your breath and, and take control and naturally increase that CO2.

And by doing this instead of breathing more, or you can calm yourself down. I mean, she's shown 10 years ago, she had an NIH study showing this was incredibly effective for people with panic and asthma.

Dr. Andrew Weil: And the other idea that I was struck by in your book was you, you, questioned people not to over breathe and say that it's good to learn how to breathe less.

Can you expound on that?

James Nestor: Sure. A lot of us think that by breathing more, we're bringing more oxygen to our body. But the opposite is often true. And you can test this right now. If you take 20 or 30 big breaths or 40 big breaths, maybe you'll feel some tingling at the ends of your fingers. You'll get lightheaded. This is not from an increase of oxygen through these areas. This is from a decrease of circulation. So by breathing over your metabolic needs, you are causing this vasoconstriction in these areas, which you want to be doing is breathing in line with your metabolic needs, which for the vast majority of us means breathing less.

And by breathing less, you get more oxygen. When we breathe too many breaths per minute, we take in air and it enters into her mouth and our throat and the upper regions of our chest and the bronchitis. But it doesn't really make it to all those lungs work and participate in gas exchange. So they've found, they've looked at percentages and if you breathe about 18 to 20 times a minute, you use about 50% of your breath.

So that is very inefficient. If you breathe at a rate of six times a minute, the same amount, six liters, you use 85% of that breath. So who doesn't want a 35% increase in efficiency 20,000 times a day? I mean, obviously you're going to benefit from that.

Dr. Victoria Maizes: So in addition to the speed and the depth, you also point to how many people are mouth breathers and the problems with being a mouth breather.

The data that you shared and the experience of taping the mouth in order to force yourself to become a nose breather was really fascinating. Can you talk about how we got into this mess? That's so many people have become mouth breathers.

James Nestor: Well, a lot of us think that poor breathing habits are caused by environmental inputs or maybe anxiety, mental problems but a lot of it is anatomical. And the sounded crazy when I first learned about it, but I met some biological anthropologists and they showed me ancient skulls and all of these ancient skulls had perfectly straight teeth. These very pronounced thick faces these wide nasal apertures.

And if you look at modern skulls, the vast majority of us, some 90% have some sort of, some sort of malocclusion or crookedness in our jaw deformation, crooked teeth. So the reason we have crooked teeth is our mouths have grown so small and a small mouth makes for a smaller airway. So, this is one of the reasons why so many of us are suffering from restricted breathing, from sleep apnea, from snoring and other respiratory problems.

And, and again, this seems extraordinary, but all you have to do is look at ancient skulls and then all you have to do is look in the mirror and you could see what has happened to our skulls over the past 300, 400 years.

Dr. Victoria Maizes: And learning about those skulls took you underground to an ancient burial site.

James Nestor: You, you can only get so far in labs. you know, I was able to touch a few skulls, at the University of Pennsylvania, the archeology and anthropology museum. They have hundreds and hundreds of ancient skulls. And let me tell you, it was pretty creepy standing in these rooms, surrounded by these skulls, and they're all smiling back with perfectly straight teeth you know.

Yeah, so, so what have we lost? What have we done wrong? So I had an opportunity to go see some other skulls that weren't behind protective glass, in the catacombs of Paris. A lot of people don't realize that underneath the streets of Paris, about 60 feet underneath, there is 170 miles of queries. And they didn't know where to put all the skeleton. So there are 6 million skeletons down there, below the streets of Paris. And I've heard the rumor is that you can find certain people who know their way around there, who can show you these enormous ossuaries of skulls from a thousand years old to 400 years old, just, just all surrounding, these, these ancient caves.

So the, I had the opportunity to do that and I did it.

Dr. Victoria Maizes: So the, the change in our anatomy is occurred in a relatively short amount of time. And, you point to things like the food we chew is awfully soft and that's one of the reasons why we don't develop as good a jaw or maybe our mothers and fathers didn't teach us to close our mouth, you [00:14:00] know, the way some cultures do, they'll actually close the baby's lips so that the baby learns through childhood to breathe more effectively, to breathe through their nose.

James Nestor: There's a number of reasons why our mouths have grown so small and our oral posture has gotten so poor. And why 25 to 50% of the population now habitually breathes through its mouth. It's because our, you know, our faces have been formed in early life to, to be open like this. If you constantly walk around with your mouth open, you will change the skeletal structure of your face.

You will change your profile. This is so well known that it's called adenoid face because so many kids have it. So they found that that chewing stressed is one of the main culprits, specifically the lack of chewing stress and chewing starts at birth. They know that kids who have been breastfed versus those who have been bottle fed, those were breastfed will have lower incidents of snoring and sleep apnea later on in life.

And if you look at brothers and sisters who have been breastfed versus bottle fed, they have different teeth… that, that is more anecdotal. No, one's done a huge study of that, but they have done studies looking at breathing later on in life. So after that, if you are eating soft, mushy processed food, you don't get any masticatory stress.

And without that stress, you, aren't going to be able to develop the proper bones, the proper musculature. And, and we've known this for, for 30, 40 years. And yet still you go to the NIH and at least I did, and I looked up the causes of crooked teeth and they said it was hereditary. That doesn't make too much sense if our ancestors 300 years ago all had perfectly straight teeth. So it brings into question a whole, whole bunch of things.

Dr. Victoria Maizes: Andy, you regularly teach fellows in our program how to be breathing teachers on their own and you teach two different breathing techniques. One's a more stimulating breath called the Bellow’s breath. And the other is the more relaxing breath called often the four, [00:16:00] seven, eight breath. Why'd you pick those two. And what do you hope that people gain?

Dr. Andrew Weil: I first teach people to pay attention to the breath. And the importance of keeping your attention on your breath. That's a very safe place to have it. Secondly, I teach people to breathe through the nose, to breathe diaphragmatically, to slow breathing, to increase exhalation. Those are basic principles that I teach. And then I just, as examples of the power of breath that you change physiology, I have people experiment with those two the breath of fire, bellows breath, rapid in and out, breathing through the nose, which is stimulating and also is warming. It warms you up. It's muscular exertion.

And I find, you know, I experience energy in, especially in my extremities. When I do that, I experienced that as a kind of tingling. It's not the thing we have flavored ventilation. It's, it's different it's in my forearms and hands, and I think that's Qi energy. And I think that that's, that's how you've been used breath to increase the flow of that subtle energy.

And then I teach everyone that I meet that four, seven, eight relaxing breath, which I learned from Dr. Fulford. And that is specifically a way to change autonomic nervous tone and increased parasympathetic activity, which most of us need to do because most people are in a sympathetic overdrive, you know, in fight or flight response and we want to activate the relaxation response. And that's a very powerful way to do that. And I have done that with large groups of people. I think the largest I did it with was a group of 7,000 physicians at the annual meeting of the American Academy of Family Practice. And it was amazing to have an audience of 7,000 doing that together it's very powerful. And as you know, a few years ago, I was invited by the NSA to come to their headquarters and give them a lecture on stress. And, this was an audience of a thousand that was televised to various remote sites and it was very satisfying to have that group doing that, that breath.

I always remind people after I do that, that the literal meaning of the word conspiracy is to breathe together. And I tell people that we are engaging in the conspiracy for better health. So that's a very simple technique I was pleased to see the James referenced that at the end of his book, it's just a very simple, powerful way to, change the balance of functioning in the autonomic nervous system.

James Nestor: I think one of the great things about all of these breathing methods is we can measure them. We can measure what happens to the brain. We can measure what happens to the body. So if people are apprehensive and I, and I certainly was, you know, I hooked myself up with various sensors over various years at various institutions, from UCLA to Stanford all over the place. And you can see, literally within a few seconds, what happens to your body when you change your breathing. So luckily a lot of these instruments are pretty cheap. You can get a pulse oximeter, you can get a heart rate variability monitor. So many people have these and you can breathe differently and, and watch this transformation that occurs.

And if you can elicit that transformation, that healthy pivot into the parasympathetic state, then imagine after just doing that for a couple of minutes, what will happen after a couple of days or a couple of weeks. It, it can transform you. I've seen this time and time again, and talked to experts in the field who have been working for decades.

Dr. Andrew Weil: But this is so under utilized in clinical medicine. And my impression is that most doctors just don't take it seriously. And most researchers. Because it's too simple and anything that doesn't involve a drug or a device possibly affects physiology. And, and it's getting over that, you know, that, obstacle, that I think keeps this from being more put to practical use.

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Dr. Victoria Maizes: So you mentioned conspiracy earlier. You're both evangelists for breath. How do we get it out there so that every child learns this… every adult, perhaps with asthma is taught that they actually do have, a degree of [00:20:00] control over their breathing so that they can change the circumstances.

James Nestor: Well, I think these studies have been done for in the 1960s at the Papworth Hospital in England. They had shown that slower breathing had an incredible beneficial effect for people with asthma. But, but again, these, and there were a few studies. There were a few dozen studies on this, but, you know, doctors from, from what I've heard from the doctors in my family, they just don't have time when, when they're seeing 20 patients in an hour, they can't sit them down and say, you have asthma. I'm going to show you some slow breathing techniques, you know, over the next hour and a half. So I think that it's a systemic problem. I think doctors really want to help, at least the ones that I've talked to, but they just aren't able to. So there are other ways that people can get information through this podcast.

And I think that that podcasting has really opened up so many doors for people to get real information. There's a lot of garbage out there too, but, but, you know, look, look at who the host is, look at where the references are at the end of this. At the end of the podcast. And, and you can really, find ways of getting information that I, I won't say has been buried, but, but has been ignored for so long.

Dr. Andrew Weil: You know, I can teach this to patients in five minutes, you know, I can sit with a patient and in five minutes, explain the basics and do the four, seven, eight breath with them. And I get all of the fellows that come through our program to learn how to do this and do with patients. Doesn't take a lot of time.

James Nestor: Incredible. And one thing I want to mention when I said they don't have the capacity to teach someone, they just don't have the time to do this. Some of these people like with asthma who take OPAC, takes many different sessions over many weeks for these people learn something they say it feels good. And then, then they forget about it. So that, that's what I was talking about. Not breathing awareness.

Sorry. I hope I didn't give the wrong...

Dr. Victoria Maizes: No it almost makes me think that we probably need to have a specific group of people who are breathing coaches the way we have health coaches for other areas.

James Nestor: Absolutely. yeah, I think it's a long time coming. You know, they call them yoga teachers in some parts of the world  [laughs]

Dr. Victoria Maizes: Yeah, you mentioned one of your relatives is an emergency doc. I think that's one of the most effective places. And the reality is, is people often spend a lot of time waiting in an emergency room. So then we need to have them watch, the YouTube that's been watched, I think by 4 million people of Dr. Weil teaching for seven to eight, or to go to your website where you point people to, five or six other breathing exercises that range in difficulty, some of them are super simple. and some of [00:22:00] them, for example, the Wim Hof method are much more complex.

Dr. Andrew Weil: Let me ask you about one of the simple ones. You, advise people to practice a breadth of breathing in to a count of five seconds. And then out for five seconds. And to do as many breaths like this as you can. Do you want to tell us about how to do that? I've been practicing that since I read, read the book.

James Nestor: This is called coherent breathing. And I think it really people became aware of about 20 years ago when some Italian researchers were recording what happened to people's bodies and brains when they recited different prayers. So from the, the Ave Maria, the Catholic prayer cycle of the rosary or om mani padme hum, the famous Buddhist mantra. These prayers and some dozens and dozens of others om satta nama. They all seem to, to circle around the same respiratory rate, but an inhale of about five to six seconds, exhale about five to six seconds, which is about five to six breaths. Minute. And they found that when people breathe this way, you could pray if you want it to, but you didn't need to.

You just needed to breathe in this way. You could increase oxygenation to your brain. Your heart rate would slow down. Your blood pressure would decrease in the systems of the body would enter the state of coherence, where everything was working at peak efficiency. So Dr. Richard Brown at Columbia has been using this for, for decades, for his patients, with depression and anxiety and all it's so simple that people think there's no way this is going to work. You know, it's very unsexy unglamorous. It is an inhale of about five to six seconds. Don't worry if you're half a second off, the point is to relax and an exhale for the same amount. And throughout the day, if you find yourself getting increasingly stressed, you can extend your exhale. So you can inhale to account of about four and extend your exhales to a count about six. When you do this, you can place your hand over your heart. And every time you exhale, your [00:24:00] heart rate is going to be going down because that is eliciting more of a parasympathetic response. So these are just little tools you can have in your breathing toolbox because we carry our breath around with us all day long.

So you can take advantage of this, whether you're on zoom calls or whether you're answering email or watching Tiger King or whatever you're doing nowadays.

Dr. Victoria Maizes: So that's a great, simple practice. And I have to say, I'm, I'm very moved that all of these different prayers, elicit the same breathing response, that seems important.

I'd also love for you to touch on one of the more complex practices you did and I'll let you pick which one you think was maybe the most profound for you.

James Nestor: I think that the Wim Hof method, we call it the Wim Hof method. I don't know why, because this has been thousands, thousands of years and whims a great guy, and he's brought awareness to hundreds of thousands of people.

And I talked to them quite often, but, that method is, is so confounding to people because you're not supposed to over breathe, right? It has all the problems that, that we just addressed earlier. And yet when you consciously over breathe for certain amount of time, it can have so many benefits. And we know this in pranayama, Sudarshan kriya, these practices that have you for about 20 let's go, and you're really working, getting yourself out.

And the point of these is to elicit that sympathetic stress so that you can get in better control of it. Most of us have this low-grade stress throughout the day that is just eating away at us. But if we were to focus the stress at one period of time, we can spend the rest of the day relaxing and I've found that, that method, and I practiced that aversion of that method, this didn't make it into the book at the UCF hypoxia center and they they put catheters on. It took my blood before and after and laid me out on a gurney. And they were so completely freaked out by what happened to my body during it. They, you know, this was like, [00:26:00] like, ER, level a red alert, stuff that they were seeing happening in my body, but I felt perfectly fine because I was doing this consciously.

So talking to people who have had auto-immune problems for 20, 30 years, talking with people who event anxiety problems, hypertension on and on. They've been able to blunt the symptoms of those problems. And in some miraculous cases actually healed themselves completely no more medications at all by adopting this breathing practice.

And I know this seems impossible, but there are studies in nature that, that show that, the human body, when we are able to take control of our breathing, we can take control of our autonomic nervous system. We can take control of some aspects of our immune function, and that's exactly what these people are doing.

Dr. Victoria Maizes: You know, breath, is one of those unique physiological systems that can be completely involuntary, which is maybe why health professionals have thought it's not important because you don't have to remind yourself to breathe. You just breathe and yet we can also do it in all of these diverse ways voluntarily.

And, the potential for, to train or maybe retrain your autonomic nervous system? It's certainly the, the quieting side, the parasympathetic nervous system, I think has been underutilized a few people, Dr. Weil, amongst them have been teaching people this, but broadly it's not in our repertoire as physicians.

James Nestor: Yeah. And I can't tell you how many, I almost didn't write this book because I interviewed about six to seven doctors at the beginning of it, who said, told me how we breathe does not matter needs. These were professors at top universities. I won't name them. They said how you breathe will have zero effect on your asthma will have zero effect on anxiety, because it's unconscious and so I gave up on this book for, for six [00:28:00] months till I started talking to other people who had different research and had a different take on this. But I think that the point is not to walk around with, with a notepad or an app, or to constantly be obsessing over your breathing. What you want to do is acclimate your body.

To what healthy breathing is and allow it to become a habit so that we don't have to think about it so that we're habitually breathing through her noses. We're habitually breathing slowly. We're calming ourselves down. you know, writing a book about breath makes you complete neurotic about your breathing.

And that's not a good thing. luckily a lot of these things have become habit for me at this point.

Dr. Victoria Maizes: Andy, what do you think in terms of the shift in consciousness that when you learn that you can stress the body, change your blood pH, do things that many people would say are not doable. Hold your breath for long periods of time. How that shifts your sense of self.

Dr. Andrew Weil: You know, the body is incredible. And, I have always tried to encourage other people to have greater confidence in the body's ability to maintain itself, extend itself, do things that, you know, we don't think are usual or possible. I think the human body is just remarkable and there probably are many potentials out there that are yet untapped.

And I think in terms of applications and clinical medicine, there's probably nothing that is out of reach of change through change in breath. You know, one thing I remember for example, that, Dr. Fulford taught was that scoliosis, which we think of as purely a mechanical problem, that the root cause of that was unequal breathing on the left and right side.

And this often started in infancy. And if, if one half of the chest expanded greater than the other half this is what led to the initial curvature of the spine. That then increased over time. I mean, who would have ever thought about that could be modified maybe even corrected by changing breathing patterns.

And I suspect that as I say, there's really nothing that's out of bounds, in terms of what breath can influence.

James Nestor: I did along those lines. some research that, that I found that just blew me away was about a hundred years ago when a German lady had scoliosis when she was a teenager and was given a brace in bed and told a third of your life.

And she learned to breathe in ways. And she, she straightened her spine with breathing was something called Orthopaedic breathing. This sounds impossible. Sure. But then she went and taught it to thousands and thousands of women for whom the hospitals had totally given up on. And I didn't believe this until I saw the pictures until I saw the scientific studies until I learned that after she was derided for 40 years, the German medical establishment tried to stop her from doing this for 40 years. At the end of her life, she was awarded a medal for her contributions in medicine. Sometimes the stuff takes a long, long time to sink in. I mean, look at, look at nutrition. We've known for a hundred years that process modern industrialized food is garbage. I mean, there's nutritionist, I've found studies showing people saying this and it took us a hundred years to really get clued into that.

So, you know, I guess you just gotta be patient.

Dr. Victoria Maizes: I don't know, I'm just glad it wasn't a posthumous award.

James Nestor: Yeah. Those are the worst.

Dr. Andrew Weil: Well James, I think you've done a great deal to raise awareness of all this. And, so as I said, I'm very pleased to see the book out there and getting their perception of it is I think that's going to help speed the change.

James Nestor: Thank you very much. And thanks for your contributions. You know, I've, I've been reading up on all your stuff and practicing your methods is, and I've felt in my own body, a significant changes from just breathing those simple methods.

Dr. Victoria Maizes: One last question for you to view the [00:32:00] same question. Sometimes people say when they come in to see us, that they just can't get a deep breath often they're anxious, but they can't get a deep breath. Give a simple tip for those folks.

James Nestor: I would say baby steps, don't go all the way. Don't go from 0 to 10. There's some people who have chronic anxieties, chronic asthma, they go to Wim Hof method and they really lose it. I think that's the worst thing they can do.

I would start by breathing in, at a rate of about three seconds in. And three seconds out. And get comfortable with that and then go to four and then make it up to six. You know, there's, there's no rush to this. And especially with these people who have had these bad habits for decades and decades who suit CO2 tolerance is extremely low.

It's going to take a long time. and, and I think to be, to be patient with it and, and know that your body has this miraculous way of healing itself, if you allow it to.

Dr. Andrew Weil: Very sensible. I have encountered a few patients who say they become more anxious when they try to do the four, seven, eight breath. So I tell them, well, don't worry about it. You know, just do little bit of it at a time and pieces of it and wait, and be patient and it'll happen.

Dr. Victoria Maizes: Thank you. The other tip I've heard is hum that humming can sometimes be helpful.

James Nestor: Releases 50 15 times the amount of nitric oxide, just humming. So that's a great trick, especially now knowing that nitric oxide interacts directly with viruses and other pathogens.

Dr. Victoria Maizes: James, thank you so much for being on the show. Thank you for your wonderful book. I do hope that it reaches many and causes a revolution around our ideas about breath and breathing.

James Nestor: Okay. Thank you very much for having me.