March 12, 2026 • 50 mins
This week, Emily and Perry shine a light on red light therapy: its origins, its heroic use of the mighty mitochondria, and the supposed countless benefits (better mood, wound healing, facial rejuvenation, hair regrowth?) of sitting in front of a hot red light that may or may not even be able to penetrate your skin.
Plus: the disturbing return of polio, whether multivitamins have an effect on epigenetic aging, and if the pitch clock, while modestly good for Emily's enjoyment of baseball, is ruining pitchers' elbows.
Submit a question for our weekly mailbag at wellnessactually.fm.
See omnystudio.com/listener for privacy information.
Listen
Watch
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Perry.
Speaker 2 (00:01):
I have been feeling like a liar as we've been
doing more of these podcast episodes, and so I want
to come clean to you and the listeners. I spend
a lot of time, and we're going to talk about
red light therapy today, and I'm going to tell you
that I think it's a bit of a scam. But
I do so many scammy wellness things and I feel
(00:24):
like I'm not being honest about them.
Speaker 3 (00:27):
WHOA.
Speaker 1 (00:28):
I feel like, first of all, I should put on
my like priestly frock and you know, prepare to hear
this confession. But all right, I'm in the headspace. This
surprises me, Emily. You're an evidence based person.
Speaker 4 (00:38):
Yeah, I know.
Speaker 2 (00:39):
And I want to tell you that one of the
things I think is so compelling about these wellness influencers
online is they're selling people the thing they want. So
they're telling you, like, you are worried about your wrinkles,
and so you should get this red light mask or
this cream or whatever. And the thing is, it's easy
for me to say, like, you shouldn't do that because
I don't care about.
Speaker 4 (00:59):
All my wrinkles. That's not important to me.
Speaker 2 (01:01):
But I really, really, really care, like an unbelievable amount
about running fast, and I will do any crazy thing
to try to run faster. The other day, I spent
twenty eight dollars on four tiny bottles of broccoli sprout
juice because the Norwegian ski team uses it. And I
(01:23):
don't know, if you watch that guy ski, he was
really good and my friend Shana said it improved her
long run, and I.
Speaker 4 (01:29):
Was like, that's it, all right, no problem, I'm buying
it right now.
Speaker 1 (01:32):
I twenty eight dollars is a small price to pay
to get whatever it is extra, So.
Speaker 2 (01:38):
Who knows it could be could be as much as
two to three extra seconds.
Speaker 4 (01:42):
I haven't tried it yet.
Speaker 2 (01:43):
They haven't come and I haven't tried it, and I'm
actually injured. So I'm also going to go do another
thing this afternoon to fix my injury, which is called
shockwave therapy, which is also probably a scam. Anyway, this
is all to say, I just I I want to
be clear to the audience that I am very susceptible
(02:04):
to the Internet, just maybe not the particular topics that
we are talking about.
Speaker 1 (02:09):
Like today, it is so important to recognize your own biases.
We all have them. We're all human, we all have limitations,
and fortunately, for when it comes to red light therapy,
even if you don't care about your wrinkles, there's enough
purported benefits across a wide variety of things that surely
you'll find something that you're motivated reasoning will compel you
(02:32):
to believe in and purchase these thousand dollars devices. Surely
I am.
Speaker 2 (02:36):
Hoping for that, because you know, so if it's only
been twenty eight dollars this week, but.
Speaker 4 (02:39):
It could be more. Let's get lit.
Speaker 2 (02:44):
I'm Emily Aster, I'm an economist and a data expert.
Speaker 1 (02:47):
And I'm Perry Wilson, I'm a medical doctor. It's Thursday,
March twelfth, twenty twenty six. And this is wellness actually,
because you're getting a staggering amount of health and wellness
information nowadays from every source imaginable, and some of it
is awesome and.
Speaker 4 (03:03):
Some of it is well actually bulls.
Speaker 2 (03:07):
Fortunately, we're both people who know how to read studies,
how to parse the data, and can tell you what's
worth thinking about and what you can safely ignore.
Speaker 1 (03:16):
But before we dig in, a note that this podcast
is for educational purposes and should not be construed as
medical advice. We don't know your unique situation, so talk
to your doctor for personal health decisions. This week, we'll
answer the age old question, Roxanne, do you have to
put on the red light? As we ask what's the
deal with red light therapy? Emlyn. I will give the
(03:38):
official smash or pass and we'll get to your question
of the week, But first let's do the health news
roundup after the break. We're looking at the health news now.
(04:00):
The CDC has issued a new travel advisory for thirty
two countries over the spread of polio, a disease that
is a particular interest to me. My mom had polio.
She was actually in an iron lung for a period
of time when she was five or six years old,
so just to remind people how horrible this paralyzing condition
(04:23):
can be. She recovered to the point where she was
only paralyzed in the lower part of her left leg,
but my mom walked with that limp for her entire life.
She caught it just before the infamous SOK vaccine was
developed and released, which essentially eradicated polio, at least in
the West. I never liked to see polio spreading again. Emily,
(04:45):
what are your thoughts on the travel advisory.
Speaker 2 (04:48):
So I also don't like to see polio spreading in
I mean, I think it's it's polio is spreading again
for the same reason the measles is spreading again, which
is some vaccine hesitancy.
Speaker 4 (04:58):
We actually, maybe.
Speaker 2 (04:59):
Last years saw the first community spread, non travel associated
polio case in the US in very very very long time,
an unvaccinated teenager, I think in Upstate New York. So
most people who are listening to this, most people in
the US are vaccinated for polio. The vaccine's extremely effective,
and so the travel advisory is probably not something that
(05:22):
is going to cause people to change their travel plans
unless they are not vaccinated for polio. But you really
should be vaccinated for polio.
Speaker 1 (05:30):
Yeah, It's one of these things where some of these diseases,
I think people have kind of forgotten. They forgot, they
forgot how bad it was, so it's like, oh, no,
like what is polio even, right, But.
Speaker 2 (05:39):
It's real, yeah, and it's not too long ago. I mean,
the rates of polio in the nineteen fifties. I think
it's hard for people our age, we don't remember that,
but for people our parents' age, they do.
Speaker 4 (05:49):
And this was a really really.
Speaker 2 (05:51):
Really scary thing where healthy kids were dying. We're spending
time in iron lungs because of being at the pool.
Speaker 4 (05:58):
So polio bad, all right.
Speaker 2 (06:00):
A new randomized trial has found that a daily multi
vitamin decreases something called epigenetic aging. Perry, have you upped
your multi vitamin intake as a result of this exciting
new finding?
Speaker 5 (06:13):
Oh?
Speaker 6 (06:14):
I have not.
Speaker 1 (06:17):
As you know, I'm not a big vitamin and supplement guy,
and despite what you see on social media about a
multivitamin a day reducing genetic clocks, I'm not really buying it.
This is a sub analysis of a trial called Cosmos,
which did randomize people to get either a multi vitamin
a day. It was centrum silver or cocoa extract or
(06:40):
both or placebo. So four groups followed them for a
few years. And the original Cosmos trial was designed to
show that coco extract reduced the risk of cardiovascular disease.
It didn't. But they've done sub analyzes over and over
and over again. This one looked at what are called
epigenetic clock. So as you age your DNA, it gets
(07:00):
these little methyl groups attached to it. It's like dust
on the mantle of our lives, and it does correlate
with age. You can measure that and assign someone a
biological age that might differ from their calendar a So
like I'm forty six, but maybe my DNA age is
like fifty. And there are studies that show if your
biological age is older than your calendar age that that's bad,
(07:21):
like you have higher risk of cancer and cardiovascular disease
and death. Like there is something there. Here's the problem.
There are multiple different age and clocks, like there's one
clock on your wall. There's like any number of algorithms
that will spit out an age based on DNA information
that you feed it. And in fact, in this study
they used five different algorithms. They examined those five different
(07:42):
algorithms across two different time points. So now we've got
ten things and across two different interventions, a multi vitamin
and coco extract. Now we have twenty things. Okay, of
those twenty things, two and only two two showed any
statistically what we call statistically significant trend in benefit, and
(08:06):
that benefit was very small. What's the problem, Emily? You
know what the problem is.
Speaker 4 (08:12):
The problem is that that is called pe hacking, Perry.
Speaker 2 (08:15):
I mean This is something I think we should spend
more time on at some point because it it's actually
a really important statistical point. But put very simply, if
you have those twenty different effects, twenty different things you're
looking at, even if there is no effect on any
of them, you would expect probably one of them to
show up as very statistically significant, maybe two, because that's
(08:40):
what statistical significance means. And I don't want to like
ruin this whole episode by explaining statistical significance. We'll ruin
another episode on that. But fundamentally, this is not a
real result. This is just I tried a lot of
different things and I picked the one thing that worked,
and you can always do that with statistics, but it
is not consistent with it being true exactly.
Speaker 1 (09:01):
I will just make one note, which is that whenever
I come down hard on vitamins and supplements, someone comes
after me and is like, you're you know, these are
natural things, and you're a pharma schill. And I just
want to point out that in this particular study, the
Centrum silver was donated and partially funded by the makers
of Centrum silver at the time, that was Pfizer and
Glaxosmith KLEINB and the cocoa extract was provided by the
(09:25):
Mars Corporation.
Speaker 2 (09:27):
And I just want to disclose that I take vitamin
D and vitamin B every day because somebody told me
it was good for my performance.
Speaker 4 (09:33):
See Cold Open. Okay.
Speaker 2 (09:35):
Last thing I want to talk about is the baseball
pitch clock. Okay, the baseball pitch clock, Perry is a
thing that I think the goal of this is to
make baseball less boring because it was taking too long
and then now it's fast because you have to pitch
real fast. You can't just screw around spitting on the
ball and like stretching and pulling up your pants or
whatever is to do.
Speaker 4 (09:54):
I'm not a fan of this sport, and I believe.
Speaker 2 (09:57):
There was some concern that my making people pitch really
fast it was going to increase this very common injury
in pictures.
Speaker 4 (10:05):
Someone's called the Tommy John injury.
Speaker 2 (10:07):
I think it's a UCL tear, but it sounds like
that's not true.
Speaker 4 (10:10):
No concern there.
Speaker 1 (10:11):
The most recent study suggests probably not. The Tommy John
injury is clearly becoming more common, especially in younger pitchers
like high school kids are getting more and more surgeries
for the UCL is the owner collateral ligament tear, but
the Tommy John surgery is what it's called in part
because pitchers are throwing much faster, like training regimens are
(10:33):
getting them stronger, they're putting a ton of stress on
that elbow. I mean, I remember when I was a kid.
You don't like baseball, but like, if you saw someone
throwing a pitch at one hundred miles an hour, you
were like, holy cow, Like what a fastball? And now
it's like, routinely they're throwing these one hundred plus mile
an hour fastballs. It's ridiculous. This new study examined changes
in UCL injuries since the pitch clock, and the thought
(10:55):
was that you're just pitching faster, more like, you're doing
it more often, so maybe you're going to hurt overall,
no effect there was. Were skeptical of subgroup analyzes, but
I will say that starting pictures tended to get a
little more frequently injured than the rest of the pictures.
We probably don't want to overread that. If anything, the
rate of Tommy John injury is increasing because of sort
(11:17):
of the way we have optimized for this thing, which
is throwing balls as fast as possible. Which is not
really what our arms are designed for.
Speaker 2 (11:25):
I also think there's a sort of interesting thing here
around youth sports that.
Speaker 4 (11:29):
Kids used to do more variety of sports.
Speaker 2 (11:32):
The increased youth sports specialization has pushed kids to do
more and more and more of one sport early on,
when your ligaments and so on are more susceptible to overuse.
So I think that is part of what we always
seen more of this in high school kids over time.
Speaker 1 (11:50):
And that's it for the health news of the week.
After the break, what's the deal with red light therapy?
Speaker 2 (12:01):
All right, so let's talk about red light therapy. So,
for people who are not on the internet, red light
therapy refers to the idea of putting red lights lights
of the particular wavelength we'll get into that on your face,
your wound, your body, your brain, and a helmet in
some way exposing some part of your body to this light.
(12:22):
And it's supposed to improve a wide variety of things.
So the way I would like to structure this is,
I want to talk about why we might think this
would work, but then really think about the relationship between
biological plausibility and is it likely this actually works for
the things that people say that it works for but
then also is buying that red light mask on Instagram
(12:45):
like the way that I should implement this even if
it works. And I think those are always really important
benchmarks in these discussions, like is it plausible? Are we
seeing it in studies? Is it actually something you could
implement on your own? So if that works for you,
I want you to tell me why we would think
putting lights on our face is good or anywhere?
Speaker 4 (13:04):
And why what is this thing?
Speaker 1 (13:06):
I thought we might get through an episode without talking
about mitochondria, but here we.
Speaker 4 (13:11):
Are so far no, so far.
Speaker 1 (13:14):
So far, No. This is so biologic plausibility. This is
like the central technique of wellness influencers to sell you
on something is to convince you that there is a
biologically plausible mechanism and then jump to the conclusion that
because there's plausibility, it must work. And I think we
can teach people anything, it's that that you have to
prove that biologic plausibility is table stakes for something that
(13:37):
you're going to invest in for your health. But let's
talk about the table stakes. Because at first you hear
it and you're like, I'm gonna shine red light on
my skin like, what of course that doesn't work. That
seems ridiculous. It's not actually ridiculous. So I'll try to
go through this very quickly. First, a bit of physics,
the wavelength of light.
Speaker 2 (13:54):
I'm sorry, but when somebody starts with I'm going to
go through this quickly and then begins with just a
bit of physics, let's do it.
Speaker 4 (14:01):
Do it quickly. Now, a little bit TDB.
Speaker 1 (14:05):
Let's start the big bang. I'm gonna start the big bang. Okay,
the universe was hot and dense. Okay, no skip forward light.
Light has wavelengths. Longer wavelengths are redder, Shorter wavelengths are
bluer as wavelengths, yet longer you go in the visible
light spectrum, go from blue to red to infrared. And
the longer the wavelength is, the easier it passes through stuff.
(14:29):
The longest wavelength that you're typically exposed to are probably
radio waves, which are very long, much longer than infrared light,
and they go right through your walls and through your
body and all these kind of things, right, So wavelength
matters because of that, Some wavelengths of light can actually
get below the surface of your skin and even slightly
deeper we'll talk about that, Okay. In your cells, there
(14:51):
are mitochondria, the powerhouse of the cell. As you learned
about in high school. What's actually happening in mitochondria is
called aerobic respiration. Aerobic means having to do with air,
but in this context it means oxygen. So mitochondria are
the things in your cells that metabolize the oxygen you
breathe and help turn it into energy by combining it
(15:14):
with byproducts of glucose and other energy containing molecules. They
are burning the gas of your cells basically to make
the ATP that is the energy of your cell, and
this is a very complicated process. In the mitochondria is
a protein called cytochrome c oxidase, and cytochrome cy oxidase
(15:35):
is the final step that the mitochondria needs to transform
glucose and all the other sugars and other sources of
energy you need into ATP, which is the energy your
cells use. It's very critical. If you were to try
to kill someone with cyanide, the way you would kill
them is because cyanide binds irreversibly to cytochromesy oxidase, shutting
(15:58):
it down, which shuts down all your mita chondria and
all your cells start to die. Fascinating, Okay, very important, Okay.
Noting that in nineteen eighty one a paper comes out
entitled cytochrome c oxidase is a possible photoreceptor in mitochondria
and Emily in Layman's terms, what do you think that means?
Speaker 4 (16:19):
Not going to kill you.
Speaker 2 (16:21):
With cyanide, Barry, And that's what I'm taking from this conversation,
all right.
Speaker 1 (16:26):
What that means is that this is a protein that
light interacts with, which is odd because most of the
proteins that light interact with in our bodies are in
our eyes and like some in our skin to help
make vitamin D and stuff like that, but a little
bit unusual to see in mitochondria, and I suspect it
probably comes from the bacterial that the mitochondria were in
(16:47):
our deep evolutionary history or something. So in a petri dish,
it has been shown that certain wavelengths of light interact
with cytochrome c oxidase, and this begins the entire like
redl light therapy movement. Essentially what happens when you shine
red light certain wavelengths, So we're talking wavelengths of somewhere
(17:10):
between six hundred and eight hundred nanimeters. There's different frequencies
that seem to work better and worse. Is that it
changes the electrical state of cytochrome cy oxidase and makes
it work a little bit more efficiently. You're going to
see influencers online tell you that it like kicks out
nitric oxide from cytochroncy oxidase. Actually don't think that's true,
(17:30):
but we don't have to go into that, but it
clearly does ramp up in a Petri dish. It ramps
up the production of ATP that's the fuel of yourself
by shining light on this thing. And that's interesting and
surprising that you could give a little light and you
would slightly increase ATP production, and then we're off to
(17:50):
the races, right.
Speaker 2 (17:51):
And I think then because ATP just to sort of
step back, because ATP is such an important driver of
our cell and driver of book kinds of things, I
think that is why this has become a space where
we're evaluating the potential of this therapy for like almost anything,
because it's like ATP, we're using that all the time.
Speaker 4 (18:10):
That's like how your cells.
Speaker 1 (18:11):
Yeah, if you don't have it you literally die.
Speaker 2 (18:13):
Right, So before we get into the details, I do
want to like double click on the you know, this
is a really cool paper from nineteen eighty one. But
the beginning of the summary of this paper says, the
effect of light on respiration of intact mouse liver mitochondria
was examined at various temperatures using various inference filters. And
what that means is in this study, you know, it's
(18:35):
not that they went to people and they did stuff
to them and they saw how it's they have some
mouse liver mitochondria in a petritis and they're putting light
on it and then they're seeing what happens. And it's
super super cool science and very interesting biological plausibility, but
not some direct like we shine light on people and
things happen, and that's what you then need to evaluate
(18:57):
in these studies.
Speaker 3 (18:58):
Right.
Speaker 1 (18:58):
So again, the that wellness space tends to work, Like
if I want it to be a very popular wellness influencer,
I would be like, look at this, it's amazing. It
increases ATP by twenty percent, and here by my thing,
and it'll increase your ATP by twenty percent, and that'll
make you younger and more virile and like everything will
get better.
Speaker 4 (19:16):
There's a really big nack between you guys.
Speaker 1 (19:19):
You got to tie those things together. Let's time together.
Speaker 4 (19:21):
Let's time together. So they're actually because of this ATB
is so important.
Speaker 2 (19:25):
There are many many, many, many many things which people
will claim, and so I think we should start with
actually something that is that is real.
Speaker 4 (19:31):
There is you know, there are is at least.
Speaker 2 (19:34):
Kind of one thing in this space, I think, which
is called photodynamic therapy. That is a real kind of
positive red light effect. So tell me positive effect.
Speaker 1 (19:45):
Yeah, photo dynamic. I mean this is this is this
is definitely real, but it's definitely not the wellness space.
So what photodynamic therapy is is a combination of light
plus some chemical to affect a change in the cell.
So this is usually used for skin conditions like actinic keratosis,
which is a precancerous skin condition. You put a special
(20:07):
cream on the spot on the skin. The cells sort
of take up that cream, and then you shine light
of a certain frequency on that area and the cream
undergoes a chemical reaction that creates a toxic byproduct. And
the idea is that you know, like a chemotherapy, the
cells that took it up get killed because these are
(20:28):
precancerous cells that you're trying to kill. And because light,
as we pointed out, doesn't penetrate that far beneath the skin,
we should probably talk about how much it penetrates you
limit the toxicity of that therapy. So like, yes, these
things exist, Obviously, that's cool. It's like a combination of
light and medicine. I like it, But that's not really
(20:49):
what people are talking about online.
Speaker 2 (20:51):
Yeah, and that's something that if you had this condition,
your doctor would potentially prescribe this, but it is not
something you would you do on your own because there's
a weird dry spot on your face exactly.
Speaker 1 (21:00):
I mean, I think where the bulk of what I'm
seeing online is about skin, skin skin related stuff, sprinkles
and discolorations and acne and things like that. So, Emily,
I know you've thought about this a bit. What does
the evidence suggest in terms of red light affecting meaningful
changes in people's skin. I know you don't care about it.
(21:22):
You've told us you don't care about wrinkles, but I do.
Speaker 2 (21:25):
So I think this is a very interesting space because
it's actually quite hard to study. So imagine that I
do something to you and I tell you, like, here, Perry,
here is this cream, this mask, this whatever, like, use
it on your face every day for you know, three weeks,
and then come back and tell me how you feel
like your face is.
Speaker 4 (21:45):
Okay.
Speaker 2 (21:46):
I could give you almost anything, a bottle of aqua
for some you know, see to fill face wash, a
cream glow recipe from my kid, whatever it is, and
you would come back and you'd be like, I think
my face looks amazing.
Speaker 4 (21:59):
And that's called the place effect.
Speaker 2 (22:00):
Basically, we are really susceptible to the suggestion that something
might work.
Speaker 4 (22:06):
So one of the issues with many of.
Speaker 2 (22:08):
The studies of these masks or these kind of red
light wrinkle treatments is that they are using as the
perceived outcome, either the sort of evaluation of the individual
or an evaluation of an investigator who kind of knows,
potentially knows whether somebody was in fact using the red
light mask. And so what the ideal approach to a
(22:31):
study like this is to have a blinded approach where
some people get red light therapy and some people get
a placebo. But the placebo needs to actually seem like
red light therapy. But since the therapy is just putting
light on your face. It's actually very hard to have
a placebo form of this. It's not that it's not
like a pill where you can give them a pill
and it looks the same and then you can have
(22:54):
a placebo. So I think a lot of the studies
of this, just like before we get into the results,
a lot of them are really pretty limited because it's
very very difficult to have it like what's called a
sham placebo.
Speaker 1 (23:05):
But you could have a blinded evaluator, like so instead
of the person that did the therapy, just like have
their picture or something and have some third party decide
if their skin looks better or not right.
Speaker 2 (23:16):
And so the better studies do that, but even there
you want a sham placebo because like, how do you
know the effect is red light rather than something else, right,
And so I mean maybe that doesn't really matter, But
if you actually care about the sort of biological plausibility
and linking that to these effects, we would like to
(23:36):
test this particular you know, this wavelength or this you know,
this particular treatment, and that's very hard to do without
having a true placebo, because maybe there's an effect, but
maybe it's not really about the red light. Maybe it's
about the laying down and having the warm stuff on
your face, like I don't know, right, or.
Speaker 1 (23:54):
The patient or the participant in the trial kind of
knows they're getting the red light because, as you say,
it's hard to placebo and they like or something after moisturizer,
whatever it is.
Speaker 2 (24:03):
So when we look at these studies, there are a
small number of mostly very small sample size RCTs, some
of which show maybe some small impacts of some red
light therapies and sort of different directions.
Speaker 4 (24:21):
I would say my take on.
Speaker 2 (24:22):
This is the effects are generally very small, and the
dosing is really inconsistent, and in many of the cases
it has the problem that you know, there's twelve different
things we can measure about your wrinkles, and you know,
two of them it kind of seems to work, and
most of them it doesn't. So this is not a
statistically very compelling literature. I'm not sure that I would
(24:45):
say we completely rule out any possible small effects on
wrinkles or other sort of skin elasticity, but you know,
it's not botox for getting rid of or I mean
just realistically, this is not very large impacts, and I
think it will be hard to study. I mean, I
think it's not. I'm not sure we're gonna get really
super to the bottom of that just because of this
sham because of the sham problem.
Speaker 1 (25:07):
Let's move off of skin then a little bit to
some of the other claims that people talk about.
Speaker 2 (25:13):
One I was extremely interested in is wound healing, which
feels like, again a more directly medical thing, but maybe
something where there's a little more positive evidence.
Speaker 1 (25:25):
Maybe maybe, but not really. Yeah, So I dug into
this a little bit. Most of the literature here actually
comes from real medical device studies, not so much the
wellness space. So we're talking about lasers being used to
treat diabetic foot ulcers and things like that. There was
(25:48):
one decent randomized trial, I mean also small, thirty people,
but nicely blinded. In this case, these were patients with
diabetes who had diabetic foot ulcers, and they did demonstrate
some accelerated wound closure through the use of this very
specific nine hundred and four nanimeter laser that is not
available to be purchased anywhere. This is a medical device
(26:10):
that is used in certain doctors' offices. This is one
of the like meta problems of red light therapy. Is
that like red light, this isn't like a chemical like
an antibiotic or a chemotherapy drug that is difficult to
synthesize and you know, requires a giant lab like you
can buy a red led at you know. I was
(26:33):
going to say radio shack, but you can't because radio shacks.
Speaker 2 (26:35):
Anymore am to you.
Speaker 1 (26:40):
And you can buy these things for you know, sense,
does that sell this? Probably? I bet it does. It
definitely does. But you know what I'm saying. So you
do also have to be careful when influencers are like, oh,
look at this study and it does show this good
it's good for wounds, and they're using like this very
specific type of thing that is not necessarily what you're
buying online. Yeah, again, is there plausibility a little bit,
(27:05):
But I don't think this is something that you really
should be strapping to open wounds or shining at open
wounds necessarily. I think you should be using your triple antibiotic,
ointment and band aid and abandoned. Yeah, let's move off
of wound and go to like weirder, weirder stuff. Let's
go to the head. Because I saw some people arguing
(27:27):
that this red light therapy might improve cognition or thinking.
I am skeptical, Emily.
Speaker 2 (27:35):
So this is a place where I think the biological
plausibility kind of falls down, right. So you talked about
sort of different wavelengths at the beginning, and the idea
that this sort of might work by wavelengths kind of
these longer wavelengths being able to penetrate your skin. It's
not really obvious that those wavelengths could penetrate far enough
to be into your skull. I think there's like disagreement
(27:56):
about surely some wavelengths like radio waves go long enough,
but it's not clear that even at the upper end
of the wavelength of red light that they can actually
get into your brain.
Speaker 1 (28:08):
Yeah. I tried to look at this, and for red
light that you can see, so not infrared, but kind
of deep red light that you can see, the penetrance
into the skin is about a millimeter. So we're really tough.
I mean a millimeter is a tiny, tiny amount, maybe
enough to get at like some of the cells that
have to do with wrinkles and stuff, you know, but
(28:30):
definitely not deeper than that. The infrared light can maybe
get five millimeters beneath the skin. You sure aren't getting
through the skull with that kind of light, like your
brain is staying dark.
Speaker 2 (28:41):
So there's one kind of double blind, placebo, randomized controlled
trial of evaluating people with traumatic brain injury, and you know, broadly.
Speaker 4 (28:51):
It kind of shows nothing.
Speaker 2 (28:54):
They don't have any symptom improvement on the sort of
standard measure of symptoms on this which is a questionnaire.
There's like some stuff in that paper saying that maybe
when you put people in MRIs, like on one of
the metrics that you measure in the MRI, maybe there's
something statistically different. But again, we're in a space where
we're looking an awful lot of different outcomes and one
(29:15):
of them is working, and that's kind of how statistics works,
even if the results are zero. So the combination of
lack of biological plausibility and lack of any real good
evidence here, I think there's this feels like a real
no go on.
Speaker 1 (29:34):
It's a reach when you've got a lot of placebo
effects and issues with blinding and things like that. Sometimes
the animal literature can clue you in. You know, we
often see positive studies and animals that don't work in humans.
That's a typical pathway but this is one of those
cases where actually the study in mice is negative. So
there are mice that develop Alzheimer's disease or in Alzheimer's
(29:56):
disease like condition with the same sort of brain pathology
that humans have, and they can test them by their
ability to get through mazes and stuff like that. And
they tried near infra red eight hundred and ten nanimeter
transcranial therapy three times a week for five months, and
the mice got no better at working through mazes or
doing any of the problem solving tasks that mice are
(30:19):
good to do. So we're here, We're yeah, agree limited, No,
essentially no biologic plausibility.
Speaker 4 (30:24):
Not for people and not for mice.
Speaker 1 (30:26):
Probably not strapping it to your head for that reason.
Speaker 4 (30:29):
Well what about Perry?
Speaker 2 (30:30):
Okay, so obviously on the Internet, I think that women
get more of the wellness influencer push. But the one
thing that men are really really into is their hair.
Then really I don't like to lose their hair.
Speaker 1 (30:45):
I can confirm that this is true.
Speaker 2 (30:47):
And so this comes up as like red light for
hair loss? So should I put red light on my
head for hair loss? If I am a man or
a woman, I guess, but men specifically, I.
Speaker 1 (30:56):
Think I have good news and bad news here.
Speaker 4 (30:57):
Okay.
Speaker 1 (30:58):
From my read of this research is that the good
news is that red light therapy seems to be maybe
as effective as monoxidal or finasteride, the two most common
medications that we use for hair loss in terms of
hairy growth. The bad news is it seems to be
as effective as monoxidal and finasteride for hairy growth, just
(31:24):
to say, not very We're not good at this. And
this is something like you don't care about wrinkles. You
care about your running times. I care mildly about wrinkles,
but boy, I would take like a thick, luscious head
of hair like I, yes, I am into it. And
so this is where this is where they twist the
knife on me. So yes, there have been some studies
(31:46):
which showed increased hair density with near infrared and deep
red therapy, about an increase in hair density of forty
one hairs per centimeter squared. And I had to look
into like how good that is? But again, that's similar
to what you see for finastride. There was actually a
(32:07):
believe it or not, a randomized head to head comparison
of monoxidil and red light therapy for hairy growth, and
there was no difference between them, which again could be
because neither of them work, but it could be because
both of them work. I mean will say that monoxidyl
and finastride both are medications that have side effects. Monoxidal
(32:29):
can lawrier your blood pressure, lead to a little bit
of dizziness when standing up, things like that. Finasteride can
have some sexual side effects reported and things like that,
Whereas the adverse event rate for red light therapy is
very low. So I'm not willing to write this one
off completely, but I'm even if I were really excited
about this, I come to the same problem and I
(32:51):
think we've got to address this at the end is
like okay, sure, let's even say like, yeah, this works
as well as fanastride and I might as well try it.
What do I do?
Speaker 3 (33:01):
Right?
Speaker 1 (33:01):
Like, what am I supposed to buy if finastriides a prescription?
Speaker 4 (33:04):
Yeah?
Speaker 2 (33:05):
This is the sort of core problem with this space
because in some ways this is a very simple idea,
like We're going to put some wavelength of red ish
or red more red less red light onto something your head,
your face, your wounds, something else, there is no like
specific wavelength, specific criteria, specific dosing. Every one of these
(33:27):
studies has a slightly different wavelength, a slightly different delivery mechans,
a slightly different dosing, a slightly different timeframe. It's all
like really wild West, and so relative to some kind
of medication where you'd say, Okay, we're evaluating a medication.
We have a dosing schedule, we have a dosing amount.
You take the medication. We know exactly what the activity
is you do to get the treatment effect. This is
(33:50):
a place where even if you said, okay, you want
to use it to grow your hair, we wouldn't really
be able to give super specific information about what to do,
or what to buy or how to achieve.
Speaker 1 (34:02):
I tried to keep like a running list of the
parameters that these different things could have. And so there
are different wavelengths. You mentioned that there's different power density, right,
like how much wattage do you put into these bulbs?
Basically there's different what they call fluence, which is that
total energy delivered during a therapy session. Right, So if
you think like is more better, is less better? Some
(34:24):
of these pulse at different frequencies. I have no idea
if that makes a difference. And then there's the timing.
Are you doing this every day? Are you doing it
for thirty minutes, two hours, you know, just once a week,
et cetera. When you have a parameter space that big,
it's nearly impossible to read any study, And unless you're
using the exact same device that was used in that study,
(34:45):
it's really hard to know that you're getting anything similar
to what was actually studied. Yeah, all right, this is
stressing me out thinking of all the different possibilities for
red light therapy. It's affecting my mood. But fortunately I
have something for you, red light therapy there.
Speaker 2 (35:01):
You don't for me, you don't, okay, So I actually
I want to talk about mood because I think that
the evidence on mood, the way that the impacts of
the sort of idea that red light therapy might improve
your mood. I think the way that literature has moved
is actually a really interesting thing about science and almost
a cautionary tale. So there's like one series of papers
(35:23):
in a set of trials called the Elated Trials, And
so what happened in these trials was there's like a
pilot trial where they did a actually quite good like
double blind sham controlled study in which they tried to
deliver red light therapy to people with major depressive disorder,
and they found in this like small initial pilot that
(35:45):
the effects on the subjects were much like the people
who were treated were much more likely to be doing
better than the people who were control So it looked
like it had a very big effect.
Speaker 4 (35:56):
But when they like looked further.
Speaker 2 (35:58):
Into that particular, they actually found that although they intended
for the treatment to be blinded to the evaluating clinician,
the evaluating clinicians like eighty percent of the time were
able to figure out what the treatment was, so like
effectively they were even though they had tried to blind,
they were not blind. And so then they sort of
took this as what it should be, which is like,
(36:19):
this is an interesting suggestive hypothesis but not conclusive with
twenty subjects and this problem. And then they went to
a much bigger study of like fifty people across multiple
places and they did the same thing, and they found nothing.
And so it just turned out like in the better data,
this does not seem to impact depression in this way,
but I think it is a sort of it's a
(36:40):
good illustration of the kind of follow up studies you'd
want for other things in this space. If you thought, hey,
this might work for this, let's do it in a
larger setting where we're testing something much more specific, where
we're doing much less pea hacking. That's kind of how
science should work. It doesn't often doesn't totally.
Speaker 1 (36:57):
The power of replication is so huge.
Speaker 2 (37:00):
I mean, we do know that light affects mood, which
is different from red light therapy affecting mood. I mean
I know because this winter is very depressing for many people.
Speaker 1 (37:08):
Oh yeah, yeah, for seasonal effective disorder. Yes, light box
therapy has clearly been shown to improve mood.
Speaker 4 (37:15):
But it is not red.
Speaker 1 (37:16):
It's white, it is not red. It's multi spectrum like
the sun.
Speaker 4 (37:19):
Like the sun.
Speaker 2 (37:21):
So another thing that I see a lot is in
the sports people, is red light for a muscle recovery.
You know I'm going to sit under a red light
thing after by a workout.
Speaker 4 (37:33):
Yes? No, should I buy that? Probably? Yes, right, I
should buy it. I'm going to buy it. I'm actually
ordering it right now.
Speaker 1 (37:38):
I mean, if I told you it would make your
long run time faster, I know you're going to get
your credit card out right now. So again I think
the depth of the tissue is the key biological plausibility
indicator here. Again, even the infrared light therapy is only
getting about five millimeters below the skin. So if you're
talking about stuff that's deeper, and you know, five millimeters
(38:01):
is a quarter of an inch, right, Like, this is
really not getting very deep. So if you're talking about
any sort of deep tissue stuff, it's just not plausible
that the light gets there. There are muscles on the
surface and there are joints that are sort of in
the surface. Even that I think is probably too deep.
I will say that there. If you look, you'll see
some randomized trials in some athletes where they did see like,
(38:25):
for example, one trial and forty healthy subjects saw that
they could do more REPS after being given some of
this red light therapy as opposed to when they hadn't
been given the red light therapy. You've pointed this out
plenty of times. REPS is totally susceptible to placebo effect, right,
you just like believe in yourself and you can do more.
(38:46):
I'm not very compelled by that. There's a nice negative
trial which looked at people doing eccentric bicep curls to
exhaustion and compared a variety of different light sources, and
there's no difference across any of these groups. So it
doesn't really make sense to me for exercise. It just
(39:09):
doesn't get deep enough. That's basically the bottom line. There
are I think a couple other things that we can
just quickly knock out that I've seen online.
Speaker 4 (39:19):
Things we can reject.
Speaker 1 (39:20):
Yeah, I think we just have to cross them off
the list. So testosterone no, that fat loss no, although
although where are you shining the red light for the testosterone.
Speaker 4 (39:32):
That actually it seems like a source of sunburn. I
don't know that things could go very poorly.
Speaker 1 (39:39):
We'll talk about that when we talk about safety.
Speaker 2 (39:41):
Fat loss is a no, this is not this is
not going to give you better fat loss.
Speaker 1 (39:45):
Yeah, So taken altogether before we move on to sort
of the safety issues. Is like maybe for things that
are very superficial, basically we're left with maybe some skin,
maybe some hair.
Speaker 4 (39:57):
Maybe, but very very small effects.
Speaker 2 (40:00):
I think we always want to think about, you know,
is it likely that this is the like life changing
you know, is this the difference between a full, luscious
head of hair and baldness. Is that the difference between
looking like you're sixty and you know, is this going
to turn you into a thirty year old? No?
Speaker 4 (40:15):
Could there be some very marginal effect where when your
partner squints at your face really really carefully, maybe it
looks a little bit different for them. Maybe also why
are they doing that? And so I think those are
the like that for me.
Speaker 2 (40:30):
It's just like a eh, like, maybe it's something there,
but also it's definitely not something important.
Speaker 1 (40:37):
Okay.
Speaker 4 (40:38):
So then there are two.
Speaker 2 (40:39):
Other like sort of downsides I think or we're talking
about here. So one is the question.
Speaker 4 (40:42):
Of just like is this safe.
Speaker 2 (40:44):
Like let's say I hear you're like, yeah, I hear you, Emily,
but my partner does squint in my face a lot,
and I really want to get these small improvements.
Speaker 4 (40:51):
Should I be concerned about safety?
Speaker 1 (40:53):
Yeah? Again, one of the problems is there's a million
of these devices online and it can be really hard
to know what to get. We can talk about that
in a second. But one aspect of safety is just like,
these are electronic devices that may be manufactured in less
than safe conditions, and things can spark and catch on
fire and stuff like that. That's sort of the generic
like don't buy these things from TIMU bit of warning.
(41:16):
But biologically there's some concern here too. Even in the
Petri dish studies, they found what's called a biphasic response
depending on how much red light they put on these cells.
It seems like at the lower level, at kind of
the right level, you increase ATP production and the cells
kind of do their thing a little bit better. If
(41:38):
you exceed that, you start to generate what are called
reactive oxygen species. You're essentially like goosing your mitochondria too much,
and it causes these inflammatory oxygen molecules to be created,
which can actually kill the cells. So this is a
mechanism that is, you know, one of the ways that
light can actually hurt you, inflammation and things like that.
(42:02):
And so there's this therapeutic window where like there's the
right amount and there's too much, and we don't really
know what that is. So I would say if you
were going to use this, you probably don't want to
like leave it on your face overnight or whatever you're doing.
The second thing is, as you alluded to, is heat.
So these things give off a lot of heat. In fact,
(42:23):
one of the complaints I saw in some of the
products online is that they're loud, which I really realize.
But they're loud because they have fans in them that are,
you know, blowing off the heat from all the LEDs
that are going through them. So they've got the fan
blowing that heat is potentially damaging, particularly if it's right
up against your skin. It's also one of the mechanisms
(42:43):
that these things might could work.
Speaker 4 (42:44):
This could be how it works. Yeah, right, we.
Speaker 1 (42:46):
Talked about muscle strain. It's like, oh, yeah, the light
doesn't get to your muscle, but it's warm.
Speaker 4 (42:50):
It's like a nice heating pad. Yeah we have, I
have one.
Speaker 1 (42:53):
Heat it's a heating pad. Might work, yeah, exactly, And
it's a lot cheaper to get a heating pad. But
too much heat can cause can cause problems, and so
generally these things are pretty safe, but there are some
theoretical concerns that people should be aware of.
Speaker 2 (43:06):
I think the much bigger problem is these things are
incredibly expensive.
Speaker 1 (43:09):
Oh my god.
Speaker 2 (43:10):
Led lights are cheap, like so if you just go
to you know, the home depot when you get some LEDs,
like that's that's nothing. But these masks are like I mean,
this stuff is really expected.
Speaker 1 (43:22):
About fifteen hundred dollars, and I tried to like, like,
how much could this possibly cost to make? And I
know it's not just LED's which costs like a cent
to maybe fifty cents each, but like, I know, there's
like some probably some circuit boards and stuff in there,
but there's no way these things cost one thousand dollars
to make. I think these are all drastically effli.
Speaker 2 (43:43):
So cost plus pricing, it's the cost plus the marketing budget,
and that is most of it.
Speaker 4 (43:49):
Most of it is the marketing budget.
Speaker 2 (43:51):
So I mean, I think there are some of these
devices that are sort of FDA cleared, which I think
makes people feel like they are more legitimate.
Speaker 4 (44:03):
That does not defend the pricing though now FDA clearance.
Speaker 1 (44:06):
Has nothing to do with pricing, but if people are again,
if you are looking for something, this is one way
to distinguish one product from another. So an FDA cleared
device is one that has gone through pre marketing approval
from the FDA. It's not that high a bar. They
just have to prove that they're substantially similar to an
(44:29):
already approved device, so it's called a predicate device. They
have to show safety in some like manufacturing parameters, so
at least you kind of know that, like they went
through a process. It's not a total scam. They also
if they are FDA cleared, then get the ability to
make health claims, which are those you know you've seen
(44:50):
it on non FDA clear devices. Right, this is not
intended to diagnose, prevent, cure, or treat any disease. So
devices that haven't gone through the FDA care can't say that.
So you'll see the non FDA clear face mask that
say like promote you know, facial wellness, facial wellness, but
they can't say like will treat acne, or like will
(45:11):
treat rosetia. It doesn't mean they don't work per se,
but that FDA clearance is something you could potentially look for,
but it comes at a premium.
Speaker 2 (45:21):
Yeah, all right, Perry, red light therapy smash or pass.
Speaker 1 (45:28):
I am passing at the current price. I do think
someone invents something to put on my scalp that costs
like one hundred bucks and actually works. I might. I
might do it. How about you, Emily smash a pask.
Speaker 4 (45:45):
I'm a pass on this.
Speaker 2 (45:46):
I think that the effects are not big enough and
I think the likely actual effects, if you really got
good ones, would be even more minuscule than the ones
we estimate in the trials.
Speaker 4 (45:59):
And so I'm a pass. Save your money, spend it
on botox if that's what you want. That's my feeling.
Speaker 1 (46:06):
Rock Sand, you don't have to put on the red light.
Speaker 4 (46:11):
You're really going to make that work.
Speaker 2 (46:12):
You're going to make it work. So that is it
for red light therapy. Your mail back Question of the
Week after the Break.
Speaker 6 (46:24):
Hi, Emily and Perry. This is Adrian from Minneapolis, and
I have a question always wanted to know the answer to,
and that is the illusion or the reality of periods sinking.
Speaker 3 (46:37):
I'm wondering if it's the kind of thing where like
if I live with two female roommates and all of
our periods seem to line up. Is that a real
thing with some kind of scientific basis or is it
just like frequency illusion where we are all thinking about
blue volkswagons and so we see them all the time.
Speaker 4 (46:57):
Thanks for your help, Ah, this is an interesting question,
people ask us.
Speaker 1 (47:00):
So before you get into it, do you know what
the teenagers call this? Now?
Speaker 4 (47:04):
Oh god, what do they call it?
Speaker 1 (47:05):
They call it getting bluetoothed. Have you heard that?
Speaker 4 (47:09):
Oh I did, someone did tell me that. That's so weird.
It's like I'm going to bluetooth you my peers.
Speaker 1 (47:15):
Yeah, because it's like you're connecting you you're sinking up
right like anyway modern times, I don't know, how do
you even know that I have a sixteen year old daughter?
Speaker 4 (47:24):
Sixteen year old daughter? Okay, fair enough. I think it's
nice that you know that.
Speaker 2 (47:29):
So there was some early research that suggested that people
who live in a household together I think it was
based on dorms, would have periods at the same time.
But then basically, further more detailed research shows that in fact,
this is not true. People do not sink their cycles.
I mean, of course, if you have a dorm of
(47:51):
twenty girls, many of them will have their period at
the same time because your period is seven days typically
five to seven days of a twenty eight day cycle.
So you could easily feel SYNCD because everyone has their
period at the same time as some other person. But
it is not like a it's not a true sinking
in that way of period's not moving around to match
(48:13):
other people's. And I think it's not surprising because I
don't know what the evolutionary reason for that would be, Like,
why would it be beneficial for everybody to be fertile
at the same time.
Speaker 4 (48:22):
That almost seems like the opposite of what you would want.
Speaker 1 (48:25):
Right, Yeah, I don't know. I always hear like pheromones
and stuff like that. There's an interesting mathematical correlate here,
which is that in any system where there's periodicity, where
there's things that are happening at recurring time points but
the periods are slightly different, they will sink over time
and dcink over time. So you see this if you're
(48:45):
in traffic and you all have your left blinker turned
on right and everyone's kind of blinking at slightly different
rates because car manufacturers can't get it together. By the way,
side note, car manufacturers can we all blink at the
same rate. Okay, they all blink at different rates. If
you kind of follow it, you'll see that, like they
kind of are blinking, and then they'll sort of sync
up and you'll feel like, oh, we're all blinking, and
(49:06):
that kind of dcincs again. So that's just a phenomenon
of periodicity that could also be a play here.
Speaker 2 (49:10):
Which would totally work here because of course, some people's
psycles it's a little bit different cycles. Normal cycles can
range from twenty one to thirty five days, so everybody's
got a different blinker. That's totally fascinating. You knew a
lot more about this than I thought that you would.
Speaker 4 (49:21):
I will say, I.
Speaker 1 (49:22):
Want to give you I'm a man for all your renaissance.
Speaker 2 (49:26):
Your renaissance Maneah. That's that's all there is. All right,
that's it for us for today. Stick with us next
week and we'll ask what's the deal with microplastics. Wellness
Actually is produced in association with iHeartMedia. Our senior producer
is Tamar Avisheik. Our executive producer at iHeart is Jennifer Bassett.
(49:49):
Our theme music is by Eric Deutsch, and our content
is for educational purposes only.
Speaker 1 (49:54):
If you like the show, help other people find us,
leave a rating and review on Apple Podcasts or your
podcas catcher of Choice, and help us spread the word
about the show. You can follow us on Instagram at
Wellness Actually pod and don't forget We want to hear
from you. Head over to Wellness Actually dot fm and
leave us a question for our mailbag or suggest a
topic for a future show.
Speaker 4 (50:15):
We'll let the influencers have the last word.
Speaker 5 (50:17):
They make your eye gollows. Watch what happens to your
vision after a week to fourteen days of being in
a red light therapy that without eye protection, If you
don't have a marked improven in your vision, I'd be
very surprised.
Speaker 4 (50:28):
So what is the negative aspect or why do they
tell you to cover your eyes?
Speaker 3 (50:31):
Well?
Speaker 5 (50:31):
Because you know, I guess the bright light. If you're
staring directly at one in one of those lights and
you have some kind of damage to your rods or
your cones, or your macula or your retina. I mean,
if you had iyepathology, which you would know about, then
there might be some some downside consequences
Perry.
Speaker 2 (00:01):
I have been feeling like a liar as we've been
doing more of these podcast episodes, and so I want
to come clean to you and the listeners. I spend
a lot of time, and we're going to talk about
red light therapy today, and I'm going to tell you
that I think it's a bit of a scam. But
I do so many scammy wellness things and I feel
(00:24):
like I'm not being honest about them.
Speaker 3 (00:27):
WHOA.
Speaker 1 (00:28):
I feel like, first of all, I should put on
my like priestly frock and you know, prepare to hear
this confession. But all right, I'm in the headspace. This
surprises me, Emily. You're an evidence based person.
Speaker 4 (00:38):
Yeah, I know.
Speaker 2 (00:39):
And I want to tell you that one of the
things I think is so compelling about these wellness influencers
online is they're selling people the thing they want. So
they're telling you, like, you are worried about your wrinkles,
and so you should get this red light mask or
this cream or whatever. And the thing is, it's easy
for me to say, like, you shouldn't do that because
I don't care about.
Speaker 4 (00:59):
All my wrinkles. That's not important to me.
Speaker 2 (01:01):
But I really, really, really care, like an unbelievable amount
about running fast, and I will do any crazy thing
to try to run faster. The other day, I spent
twenty eight dollars on four tiny bottles of broccoli sprout
juice because the Norwegian ski team uses it. And I
(01:23):
don't know, if you watch that guy ski, he was
really good and my friend Shana said it improved her
long run, and I.
Speaker 4 (01:29):
Was like, that's it, all right, no problem, I'm buying
it right now.
Speaker 1 (01:32):
I twenty eight dollars is a small price to pay
to get whatever it is extra, So.
Speaker 2 (01:38):
Who knows it could be could be as much as
two to three extra seconds.
Speaker 4 (01:42):
I haven't tried it yet.
Speaker 2 (01:43):
They haven't come and I haven't tried it, and I'm
actually injured. So I'm also going to go do another
thing this afternoon to fix my injury, which is called
shockwave therapy, which is also probably a scam. Anyway, this
is all to say, I just I I want to
be clear to the audience that I am very susceptible
(02:04):
to the Internet, just maybe not the particular topics that
we are talking about.
Speaker 1 (02:09):
Like today, it is so important to recognize your own biases.
We all have them. We're all human, we all have limitations,
and fortunately, for when it comes to red light therapy,
even if you don't care about your wrinkles, there's enough
purported benefits across a wide variety of things that surely
you'll find something that you're motivated reasoning will compel you
(02:32):
to believe in and purchase these thousand dollars devices. Surely
I am.
Speaker 2 (02:36):
Hoping for that, because you know, so if it's only
been twenty eight dollars this week, but.
Speaker 4 (02:39):
It could be more. Let's get lit.
Speaker 2 (02:44):
I'm Emily Aster, I'm an economist and a data expert.
Speaker 1 (02:47):
And I'm Perry Wilson, I'm a medical doctor. It's Thursday,
March twelfth, twenty twenty six. And this is wellness actually,
because you're getting a staggering amount of health and wellness
information nowadays from every source imaginable, and some of it
is awesome and.
Speaker 4 (03:03):
Some of it is well actually bulls.
Speaker 2 (03:07):
Fortunately, we're both people who know how to read studies,
how to parse the data, and can tell you what's
worth thinking about and what you can safely ignore.
Speaker 1 (03:16):
But before we dig in, a note that this podcast
is for educational purposes and should not be construed as
medical advice. We don't know your unique situation, so talk
to your doctor for personal health decisions. This week, we'll
answer the age old question, Roxanne, do you have to
put on the red light? As we ask what's the
deal with red light therapy? Emlyn. I will give the
(03:38):
official smash or pass and we'll get to your question
of the week, But first let's do the health news
roundup after the break. We're looking at the health news now.
(04:00):
The CDC has issued a new travel advisory for thirty
two countries over the spread of polio, a disease that
is a particular interest to me. My mom had polio.
She was actually in an iron lung for a period
of time when she was five or six years old,
so just to remind people how horrible this paralyzing condition
(04:23):
can be. She recovered to the point where she was
only paralyzed in the lower part of her left leg,
but my mom walked with that limp for her entire life.
She caught it just before the infamous SOK vaccine was
developed and released, which essentially eradicated polio, at least in
the West. I never liked to see polio spreading again. Emily,
(04:45):
what are your thoughts on the travel advisory.
Speaker 2 (04:48):
So I also don't like to see polio spreading in
I mean, I think it's it's polio is spreading again
for the same reason the measles is spreading again, which
is some vaccine hesitancy.
Speaker 4 (04:58):
We actually, maybe.
Speaker 2 (04:59):
Last years saw the first community spread, non travel associated
polio case in the US in very very very long time,
an unvaccinated teenager, I think in Upstate New York. So
most people who are listening to this, most people in
the US are vaccinated for polio. The vaccine's extremely effective,
and so the travel advisory is probably not something that
(05:22):
is going to cause people to change their travel plans
unless they are not vaccinated for polio. But you really
should be vaccinated for polio.
Speaker 1 (05:30):
Yeah, It's one of these things where some of these diseases,
I think people have kind of forgotten. They forgot, they
forgot how bad it was, so it's like, oh, no,
like what is polio even, right, But.
Speaker 2 (05:39):
It's real, yeah, and it's not too long ago. I mean,
the rates of polio in the nineteen fifties. I think
it's hard for people our age, we don't remember that,
but for people our parents' age, they do.
Speaker 4 (05:49):
And this was a really really.
Speaker 2 (05:51):
Really scary thing where healthy kids were dying. We're spending
time in iron lungs because of being at the pool.
Speaker 4 (05:58):
So polio bad, all right.
Speaker 2 (06:00):
A new randomized trial has found that a daily multi
vitamin decreases something called epigenetic aging. Perry, have you upped
your multi vitamin intake as a result of this exciting
new finding?
Speaker 5 (06:13):
Oh?
Speaker 6 (06:14):
I have not.
Speaker 1 (06:17):
As you know, I'm not a big vitamin and supplement guy,
and despite what you see on social media about a
multivitamin a day reducing genetic clocks, I'm not really buying it.
This is a sub analysis of a trial called Cosmos,
which did randomize people to get either a multi vitamin
a day. It was centrum silver or cocoa extract or
(06:40):
both or placebo. So four groups followed them for a
few years. And the original Cosmos trial was designed to
show that coco extract reduced the risk of cardiovascular disease.
It didn't. But they've done sub analyzes over and over
and over again. This one looked at what are called
epigenetic clock. So as you age your DNA, it gets
(07:00):
these little methyl groups attached to it. It's like dust
on the mantle of our lives, and it does correlate
with age. You can measure that and assign someone a
biological age that might differ from their calendar a So
like I'm forty six, but maybe my DNA age is
like fifty. And there are studies that show if your
biological age is older than your calendar age that that's bad,
(07:21):
like you have higher risk of cancer and cardiovascular disease
and death. Like there is something there. Here's the problem.
There are multiple different age and clocks, like there's one
clock on your wall. There's like any number of algorithms
that will spit out an age based on DNA information
that you feed it. And in fact, in this study
they used five different algorithms. They examined those five different
(07:42):
algorithms across two different time points. So now we've got
ten things and across two different interventions, a multi vitamin
and coco extract. Now we have twenty things. Okay, of
those twenty things, two and only two two showed any
statistically what we call statistically significant trend in benefit, and
(08:06):
that benefit was very small. What's the problem, Emily? You
know what the problem is.
Speaker 4 (08:12):
The problem is that that is called pe hacking, Perry.
Speaker 2 (08:15):
I mean This is something I think we should spend
more time on at some point because it it's actually
a really important statistical point. But put very simply, if
you have those twenty different effects, twenty different things you're
looking at, even if there is no effect on any
of them, you would expect probably one of them to
show up as very statistically significant, maybe two, because that's
(08:40):
what statistical significance means. And I don't want to like
ruin this whole episode by explaining statistical significance. We'll ruin
another episode on that. But fundamentally, this is not a
real result. This is just I tried a lot of
different things and I picked the one thing that worked,
and you can always do that with statistics, but it
is not consistent with it being true exactly.
Speaker 1 (09:01):
I will just make one note, which is that whenever
I come down hard on vitamins and supplements, someone comes
after me and is like, you're you know, these are
natural things, and you're a pharma schill. And I just
want to point out that in this particular study, the
Centrum silver was donated and partially funded by the makers
of Centrum silver at the time, that was Pfizer and
Glaxosmith KLEINB and the cocoa extract was provided by the
(09:25):
Mars Corporation.
Speaker 2 (09:27):
And I just want to disclose that I take vitamin
D and vitamin B every day because somebody told me
it was good for my performance.
Speaker 4 (09:33):
See Cold Open. Okay.
Speaker 2 (09:35):
Last thing I want to talk about is the baseball
pitch clock. Okay, the baseball pitch clock, Perry is a
thing that I think the goal of this is to
make baseball less boring because it was taking too long
and then now it's fast because you have to pitch
real fast. You can't just screw around spitting on the
ball and like stretching and pulling up your pants or
whatever is to do.
Speaker 4 (09:54):
I'm not a fan of this sport, and I believe.
Speaker 2 (09:57):
There was some concern that my making people pitch really
fast it was going to increase this very common injury
in pictures.
Speaker 4 (10:05):
Someone's called the Tommy John injury.
Speaker 2 (10:07):
I think it's a UCL tear, but it sounds like
that's not true.
Speaker 4 (10:10):
No concern there.
Speaker 1 (10:11):
The most recent study suggests probably not. The Tommy John
injury is clearly becoming more common, especially in younger pitchers
like high school kids are getting more and more surgeries
for the UCL is the owner collateral ligament tear, but
the Tommy John surgery is what it's called in part
because pitchers are throwing much faster, like training regimens are
(10:33):
getting them stronger, they're putting a ton of stress on
that elbow. I mean, I remember when I was a kid.
You don't like baseball, but like, if you saw someone
throwing a pitch at one hundred miles an hour, you
were like, holy cow, Like what a fastball? And now
it's like, routinely they're throwing these one hundred plus mile
an hour fastballs. It's ridiculous. This new study examined changes
in UCL injuries since the pitch clock, and the thought
(10:55):
was that you're just pitching faster, more like, you're doing
it more often, so maybe you're going to hurt overall,
no effect there was. Were skeptical of subgroup analyzes, but
I will say that starting pictures tended to get a
little more frequently injured than the rest of the pictures.
We probably don't want to overread that. If anything, the
rate of Tommy John injury is increasing because of sort
(11:17):
of the way we have optimized for this thing, which
is throwing balls as fast as possible. Which is not
really what our arms are designed for.
Speaker 2 (11:25):
I also think there's a sort of interesting thing here
around youth sports that.
Speaker 4 (11:29):
Kids used to do more variety of sports.
Speaker 2 (11:32):
The increased youth sports specialization has pushed kids to do
more and more and more of one sport early on,
when your ligaments and so on are more susceptible to overuse.
So I think that is part of what we always
seen more of this in high school kids over time.
Speaker 1 (11:50):
And that's it for the health news of the week.
After the break, what's the deal with red light therapy?
Speaker 2 (12:01):
All right, so let's talk about red light therapy. So,
for people who are not on the internet, red light
therapy refers to the idea of putting red lights lights
of the particular wavelength we'll get into that on your face,
your wound, your body, your brain, and a helmet in
some way exposing some part of your body to this light.
(12:22):
And it's supposed to improve a wide variety of things.
So the way I would like to structure this is,
I want to talk about why we might think this
would work, but then really think about the relationship between
biological plausibility and is it likely this actually works for
the things that people say that it works for but
then also is buying that red light mask on Instagram
(12:45):
like the way that I should implement this even if
it works. And I think those are always really important
benchmarks in these discussions, like is it plausible? Are we
seeing it in studies? Is it actually something you could
implement on your own? So if that works for you,
I want you to tell me why we would think
putting lights on our face is good or anywhere?
Speaker 4 (13:04):
And why what is this thing?
Speaker 1 (13:06):
I thought we might get through an episode without talking
about mitochondria, but here we.
Speaker 4 (13:11):
Are so far no, so far.
Speaker 1 (13:14):
So far, No. This is so biologic plausibility. This is
like the central technique of wellness influencers to sell you
on something is to convince you that there is a
biologically plausible mechanism and then jump to the conclusion that
because there's plausibility, it must work. And I think we
can teach people anything, it's that that you have to
prove that biologic plausibility is table stakes for something that
(13:37):
you're going to invest in for your health. But let's
talk about the table stakes. Because at first you hear
it and you're like, I'm gonna shine red light on
my skin like, what of course that doesn't work. That
seems ridiculous. It's not actually ridiculous. So I'll try to
go through this very quickly. First, a bit of physics,
the wavelength of light.
Speaker 2 (13:54):
I'm sorry, but when somebody starts with I'm going to
go through this quickly and then begins with just a
bit of physics, let's do it.
Speaker 4 (14:01):
Do it quickly. Now, a little bit TDB.
Speaker 1 (14:05):
Let's start the big bang. I'm gonna start the big bang. Okay,
the universe was hot and dense. Okay, no skip forward light.
Light has wavelengths. Longer wavelengths are redder, Shorter wavelengths are
bluer as wavelengths, yet longer you go in the visible
light spectrum, go from blue to red to infrared. And
the longer the wavelength is, the easier it passes through stuff.
(14:29):
The longest wavelength that you're typically exposed to are probably
radio waves, which are very long, much longer than infrared light,
and they go right through your walls and through your
body and all these kind of things, right, So wavelength
matters because of that, Some wavelengths of light can actually
get below the surface of your skin and even slightly
deeper we'll talk about that, Okay. In your cells, there
(14:51):
are mitochondria, the powerhouse of the cell. As you learned
about in high school. What's actually happening in mitochondria is
called aerobic respiration. Aerobic means having to do with air,
but in this context it means oxygen. So mitochondria are
the things in your cells that metabolize the oxygen you
breathe and help turn it into energy by combining it
(15:14):
with byproducts of glucose and other energy containing molecules. They
are burning the gas of your cells basically to make
the ATP that is the energy of your cell, and
this is a very complicated process. In the mitochondria is
a protein called cytochrome c oxidase, and cytochrome cy oxidase
(15:35):
is the final step that the mitochondria needs to transform
glucose and all the other sugars and other sources of
energy you need into ATP, which is the energy your
cells use. It's very critical. If you were to try
to kill someone with cyanide, the way you would kill
them is because cyanide binds irreversibly to cytochromesy oxidase, shutting
(15:58):
it down, which shuts down all your mita chondria and
all your cells start to die. Fascinating, Okay, very important, Okay.
Noting that in nineteen eighty one a paper comes out
entitled cytochrome c oxidase is a possible photoreceptor in mitochondria
and Emily in Layman's terms, what do you think that means?
Speaker 4 (16:19):
Not going to kill you.
Speaker 2 (16:21):
With cyanide, Barry, And that's what I'm taking from this conversation,
all right.
Speaker 1 (16:26):
What that means is that this is a protein that
light interacts with, which is odd because most of the
proteins that light interact with in our bodies are in
our eyes and like some in our skin to help
make vitamin D and stuff like that, but a little
bit unusual to see in mitochondria, and I suspect it
probably comes from the bacterial that the mitochondria were in
(16:47):
our deep evolutionary history or something. So in a petri dish,
it has been shown that certain wavelengths of light interact
with cytochrome c oxidase, and this begins the entire like
redl light therapy movement. Essentially what happens when you shine
red light certain wavelengths, So we're talking wavelengths of somewhere
(17:10):
between six hundred and eight hundred nanimeters. There's different frequencies
that seem to work better and worse. Is that it
changes the electrical state of cytochrome cy oxidase and makes
it work a little bit more efficiently. You're going to
see influencers online tell you that it like kicks out
nitric oxide from cytochroncy oxidase. Actually don't think that's true,
(17:30):
but we don't have to go into that, but it
clearly does ramp up in a Petri dish. It ramps
up the production of ATP that's the fuel of yourself
by shining light on this thing. And that's interesting and
surprising that you could give a little light and you
would slightly increase ATP production, and then we're off to
(17:50):
the races, right.
Speaker 2 (17:51):
And I think then because ATP just to sort of
step back, because ATP is such an important driver of
our cell and driver of book kinds of things, I
think that is why this has become a space where
we're evaluating the potential of this therapy for like almost anything,
because it's like ATP, we're using that all the time.
Speaker 4 (18:10):
That's like how your cells.
Speaker 1 (18:11):
Yeah, if you don't have it you literally die.
Speaker 2 (18:13):
Right, So before we get into the details, I do
want to like double click on the you know, this
is a really cool paper from nineteen eighty one. But
the beginning of the summary of this paper says, the
effect of light on respiration of intact mouse liver mitochondria
was examined at various temperatures using various inference filters. And
what that means is in this study, you know, it's
(18:35):
not that they went to people and they did stuff
to them and they saw how it's they have some
mouse liver mitochondria in a petritis and they're putting light
on it and then they're seeing what happens. And it's
super super cool science and very interesting biological plausibility, but
not some direct like we shine light on people and
things happen, and that's what you then need to evaluate
(18:57):
in these studies.
Speaker 3 (18:58):
Right.
Speaker 1 (18:58):
So again, the that wellness space tends to work, Like
if I want it to be a very popular wellness influencer,
I would be like, look at this, it's amazing. It
increases ATP by twenty percent, and here by my thing,
and it'll increase your ATP by twenty percent, and that'll
make you younger and more virile and like everything will
get better.
Speaker 4 (19:16):
There's a really big nack between you guys.
Speaker 1 (19:19):
You got to tie those things together. Let's time together.
Speaker 4 (19:21):
Let's time together. So they're actually because of this ATB
is so important.
Speaker 2 (19:25):
There are many many, many, many many things which people
will claim, and so I think we should start with
actually something that is that is real.
Speaker 4 (19:31):
There is you know, there are is at least.
Speaker 2 (19:34):
Kind of one thing in this space, I think, which
is called photodynamic therapy. That is a real kind of
positive red light effect. So tell me positive effect.
Speaker 1 (19:45):
Yeah, photo dynamic. I mean this is this is this
is definitely real, but it's definitely not the wellness space.
So what photodynamic therapy is is a combination of light
plus some chemical to affect a change in the cell.
So this is usually used for skin conditions like actinic keratosis,
which is a precancerous skin condition. You put a special
(20:07):
cream on the spot on the skin. The cells sort
of take up that cream, and then you shine light
of a certain frequency on that area and the cream
undergoes a chemical reaction that creates a toxic byproduct. And
the idea is that you know, like a chemotherapy, the
cells that took it up get killed because these are
(20:28):
precancerous cells that you're trying to kill. And because light,
as we pointed out, doesn't penetrate that far beneath the skin,
we should probably talk about how much it penetrates you
limit the toxicity of that therapy. So like, yes, these
things exist, Obviously, that's cool. It's like a combination of
light and medicine. I like it, But that's not really
(20:49):
what people are talking about online.
Speaker 2 (20:51):
Yeah, and that's something that if you had this condition,
your doctor would potentially prescribe this, but it is not
something you would you do on your own because there's
a weird dry spot on your face exactly.
Speaker 1 (21:00):
I mean, I think where the bulk of what I'm
seeing online is about skin, skin skin related stuff, sprinkles
and discolorations and acne and things like that. So, Emily,
I know you've thought about this a bit. What does
the evidence suggest in terms of red light affecting meaningful
changes in people's skin. I know you don't care about it.
(21:22):
You've told us you don't care about wrinkles, but I do.
Speaker 2 (21:25):
So I think this is a very interesting space because
it's actually quite hard to study. So imagine that I
do something to you and I tell you, like, here, Perry,
here is this cream, this mask, this whatever, like, use
it on your face every day for you know, three weeks,
and then come back and tell me how you feel
like your face is.
Speaker 4 (21:45):
Okay.
Speaker 2 (21:46):
I could give you almost anything, a bottle of aqua
for some you know, see to fill face wash, a
cream glow recipe from my kid, whatever it is, and
you would come back and you'd be like, I think
my face looks amazing.
Speaker 4 (21:59):
And that's called the place effect.
Speaker 2 (22:00):
Basically, we are really susceptible to the suggestion that something
might work.
Speaker 4 (22:06):
So one of the issues with many of.
Speaker 2 (22:08):
The studies of these masks or these kind of red
light wrinkle treatments is that they are using as the
perceived outcome, either the sort of evaluation of the individual
or an evaluation of an investigator who kind of knows,
potentially knows whether somebody was in fact using the red
light mask. And so what the ideal approach to a
(22:31):
study like this is to have a blinded approach where
some people get red light therapy and some people get
a placebo. But the placebo needs to actually seem like
red light therapy. But since the therapy is just putting
light on your face. It's actually very hard to have
a placebo form of this. It's not that it's not
like a pill where you can give them a pill
and it looks the same and then you can have
(22:54):
a placebo. So I think a lot of the studies
of this, just like before we get into the results,
a lot of them are really pretty limited because it's
very very difficult to have it like what's called a
sham placebo.
Speaker 1 (23:05):
But you could have a blinded evaluator, like so instead
of the person that did the therapy, just like have
their picture or something and have some third party decide
if their skin looks better or not right.
Speaker 2 (23:16):
And so the better studies do that, but even there
you want a sham placebo because like, how do you
know the effect is red light rather than something else, right,
And so I mean maybe that doesn't really matter, But
if you actually care about the sort of biological plausibility
and linking that to these effects, we would like to
(23:36):
test this particular you know, this wavelength or this you know,
this particular treatment, and that's very hard to do without
having a true placebo, because maybe there's an effect, but
maybe it's not really about the red light. Maybe it's
about the laying down and having the warm stuff on
your face, like I don't know, right, or.
Speaker 1 (23:54):
The patient or the participant in the trial kind of
knows they're getting the red light because, as you say,
it's hard to placebo and they like or something after moisturizer,
whatever it is.
Speaker 2 (24:03):
So when we look at these studies, there are a
small number of mostly very small sample size RCTs, some
of which show maybe some small impacts of some red
light therapies and sort of different directions.
Speaker 4 (24:21):
I would say my take on.
Speaker 2 (24:22):
This is the effects are generally very small, and the
dosing is really inconsistent, and in many of the cases
it has the problem that you know, there's twelve different
things we can measure about your wrinkles, and you know,
two of them it kind of seems to work, and
most of them it doesn't. So this is not a
statistically very compelling literature. I'm not sure that I would
(24:45):
say we completely rule out any possible small effects on
wrinkles or other sort of skin elasticity, but you know,
it's not botox for getting rid of or I mean
just realistically, this is not very large impacts, and I
think it will be hard to study. I mean, I
think it's not. I'm not sure we're gonna get really
super to the bottom of that just because of this
sham because of the sham problem.
Speaker 1 (25:07):
Let's move off of skin then a little bit to
some of the other claims that people talk about.
Speaker 2 (25:13):
One I was extremely interested in is wound healing, which
feels like, again a more directly medical thing, but maybe
something where there's a little more positive evidence.
Speaker 1 (25:25):
Maybe maybe, but not really. Yeah, So I dug into
this a little bit. Most of the literature here actually
comes from real medical device studies, not so much the
wellness space. So we're talking about lasers being used to
treat diabetic foot ulcers and things like that. There was
(25:48):
one decent randomized trial, I mean also small, thirty people,
but nicely blinded. In this case, these were patients with
diabetes who had diabetic foot ulcers, and they did demonstrate
some accelerated wound closure through the use of this very
specific nine hundred and four nanimeter laser that is not
available to be purchased anywhere. This is a medical device
(26:10):
that is used in certain doctors' offices. This is one
of the like meta problems of red light therapy. Is
that like red light, this isn't like a chemical like
an antibiotic or a chemotherapy drug that is difficult to
synthesize and you know, requires a giant lab like you
can buy a red led at you know. I was
(26:33):
going to say radio shack, but you can't because radio shacks.
Speaker 2 (26:35):
Anymore am to you.
Speaker 1 (26:40):
And you can buy these things for you know, sense,
does that sell this? Probably? I bet it does. It
definitely does. But you know what I'm saying. So you
do also have to be careful when influencers are like, oh,
look at this study and it does show this good
it's good for wounds, and they're using like this very
specific type of thing that is not necessarily what you're
buying online. Yeah, again, is there plausibility a little bit,
(27:05):
But I don't think this is something that you really
should be strapping to open wounds or shining at open
wounds necessarily. I think you should be using your triple antibiotic,
ointment and band aid and abandoned. Yeah, let's move off
of wound and go to like weirder, weirder stuff. Let's
go to the head. Because I saw some people arguing
(27:27):
that this red light therapy might improve cognition or thinking.
I am skeptical, Emily.
Speaker 2 (27:35):
So this is a place where I think the biological
plausibility kind of falls down, right. So you talked about
sort of different wavelengths at the beginning, and the idea
that this sort of might work by wavelengths kind of
these longer wavelengths being able to penetrate your skin. It's
not really obvious that those wavelengths could penetrate far enough
to be into your skull. I think there's like disagreement
(27:56):
about surely some wavelengths like radio waves go long enough,
but it's not clear that even at the upper end
of the wavelength of red light that they can actually
get into your brain.
Speaker 1 (28:08):
Yeah. I tried to look at this, and for red
light that you can see, so not infrared, but kind
of deep red light that you can see, the penetrance
into the skin is about a millimeter. So we're really tough.
I mean a millimeter is a tiny, tiny amount, maybe
enough to get at like some of the cells that
have to do with wrinkles and stuff, you know, but
(28:30):
definitely not deeper than that. The infrared light can maybe
get five millimeters beneath the skin. You sure aren't getting
through the skull with that kind of light, like your
brain is staying dark.
Speaker 2 (28:41):
So there's one kind of double blind, placebo, randomized controlled
trial of evaluating people with traumatic brain injury, and you know, broadly.
Speaker 4 (28:51):
It kind of shows nothing.
Speaker 2 (28:54):
They don't have any symptom improvement on the sort of
standard measure of symptoms on this which is a questionnaire.
There's like some stuff in that paper saying that maybe
when you put people in MRIs, like on one of
the metrics that you measure in the MRI, maybe there's
something statistically different. But again, we're in a space where
we're looking an awful lot of different outcomes and one
(29:15):
of them is working, and that's kind of how statistics works,
even if the results are zero. So the combination of
lack of biological plausibility and lack of any real good
evidence here, I think there's this feels like a real
no go on.
Speaker 1 (29:34):
It's a reach when you've got a lot of placebo
effects and issues with blinding and things like that. Sometimes
the animal literature can clue you in. You know, we
often see positive studies and animals that don't work in humans.
That's a typical pathway but this is one of those
cases where actually the study in mice is negative. So
there are mice that develop Alzheimer's disease or in Alzheimer's
(29:56):
disease like condition with the same sort of brain pathology
that humans have, and they can test them by their
ability to get through mazes and stuff like that. And
they tried near infra red eight hundred and ten nanimeter
transcranial therapy three times a week for five months, and
the mice got no better at working through mazes or
doing any of the problem solving tasks that mice are
(30:19):
good to do. So we're here, We're yeah, agree limited, No,
essentially no biologic plausibility.
Speaker 4 (30:24):
Not for people and not for mice.
Speaker 1 (30:26):
Probably not strapping it to your head for that reason.
Speaker 4 (30:29):
Well what about Perry?
Speaker 2 (30:30):
Okay, so obviously on the Internet, I think that women
get more of the wellness influencer push. But the one
thing that men are really really into is their hair.
Then really I don't like to lose their hair.
Speaker 1 (30:45):
I can confirm that this is true.
Speaker 2 (30:47):
And so this comes up as like red light for
hair loss? So should I put red light on my
head for hair loss? If I am a man or
a woman, I guess, but men specifically, I.
Speaker 1 (30:56):
Think I have good news and bad news here.
Speaker 4 (30:57):
Okay.
Speaker 1 (30:58):
From my read of this research is that the good
news is that red light therapy seems to be maybe
as effective as monoxidal or finasteride, the two most common
medications that we use for hair loss in terms of
hairy growth. The bad news is it seems to be
as effective as monoxidal and finasteride for hairy growth, just
(31:24):
to say, not very We're not good at this. And
this is something like you don't care about wrinkles. You
care about your running times. I care mildly about wrinkles,
but boy, I would take like a thick, luscious head
of hair like I, yes, I am into it. And
so this is where this is where they twist the
knife on me. So yes, there have been some studies
(31:46):
which showed increased hair density with near infrared and deep
red therapy, about an increase in hair density of forty
one hairs per centimeter squared. And I had to look
into like how good that is? But again, that's similar
to what you see for finastride. There was actually a
(32:07):
believe it or not, a randomized head to head comparison
of monoxidil and red light therapy for hairy growth, and
there was no difference between them, which again could be
because neither of them work, but it could be because
both of them work. I mean will say that monoxidyl
and finastride both are medications that have side effects. Monoxidal
(32:29):
can lawrier your blood pressure, lead to a little bit
of dizziness when standing up, things like that. Finasteride can
have some sexual side effects reported and things like that,
Whereas the adverse event rate for red light therapy is
very low. So I'm not willing to write this one
off completely, but I'm even if I were really excited
about this, I come to the same problem and I
(32:51):
think we've got to address this at the end is
like okay, sure, let's even say like, yeah, this works
as well as fanastride and I might as well try it.
What do I do?
Speaker 3 (33:01):
Right?
Speaker 1 (33:01):
Like, what am I supposed to buy if finastriides a prescription?
Speaker 4 (33:04):
Yeah?
Speaker 2 (33:05):
This is the sort of core problem with this space
because in some ways this is a very simple idea,
like We're going to put some wavelength of red ish
or red more red less red light onto something your head,
your face, your wounds, something else, there is no like
specific wavelength, specific criteria, specific dosing. Every one of these
(33:27):
studies has a slightly different wavelength, a slightly different delivery mechans,
a slightly different dosing, a slightly different timeframe. It's all
like really wild West, and so relative to some kind
of medication where you'd say, Okay, we're evaluating a medication.
We have a dosing schedule, we have a dosing amount.
You take the medication. We know exactly what the activity
is you do to get the treatment effect. This is
(33:50):
a place where even if you said, okay, you want
to use it to grow your hair, we wouldn't really
be able to give super specific information about what to do,
or what to buy or how to achieve.
Speaker 1 (34:02):
I tried to keep like a running list of the
parameters that these different things could have. And so there
are different wavelengths. You mentioned that there's different power density, right,
like how much wattage do you put into these bulbs?
Basically there's different what they call fluence, which is that
total energy delivered during a therapy session. Right, So if
you think like is more better, is less better? Some
(34:24):
of these pulse at different frequencies. I have no idea
if that makes a difference. And then there's the timing.
Are you doing this every day? Are you doing it
for thirty minutes, two hours, you know, just once a week,
et cetera. When you have a parameter space that big,
it's nearly impossible to read any study, And unless you're
using the exact same device that was used in that study,
(34:45):
it's really hard to know that you're getting anything similar
to what was actually studied. Yeah, all right, this is
stressing me out thinking of all the different possibilities for
red light therapy. It's affecting my mood. But fortunately I
have something for you, red light therapy there.
Speaker 2 (35:01):
You don't for me, you don't, okay, So I actually
I want to talk about mood because I think that
the evidence on mood, the way that the impacts of
the sort of idea that red light therapy might improve
your mood. I think the way that literature has moved
is actually a really interesting thing about science and almost
a cautionary tale. So there's like one series of papers
(35:23):
in a set of trials called the Elated Trials, And
so what happened in these trials was there's like a
pilot trial where they did a actually quite good like
double blind sham controlled study in which they tried to
deliver red light therapy to people with major depressive disorder,
and they found in this like small initial pilot that
(35:45):
the effects on the subjects were much like the people
who were treated were much more likely to be doing
better than the people who were control So it looked
like it had a very big effect.
Speaker 4 (35:56):
But when they like looked further.
Speaker 2 (35:58):
Into that particular, they actually found that although they intended
for the treatment to be blinded to the evaluating clinician,
the evaluating clinicians like eighty percent of the time were
able to figure out what the treatment was, so like
effectively they were even though they had tried to blind,
they were not blind. And so then they sort of
took this as what it should be, which is like,
(36:19):
this is an interesting suggestive hypothesis but not conclusive with
twenty subjects and this problem. And then they went to
a much bigger study of like fifty people across multiple
places and they did the same thing, and they found nothing.
And so it just turned out like in the better data,
this does not seem to impact depression in this way,
but I think it is a sort of it's a
(36:40):
good illustration of the kind of follow up studies you'd
want for other things in this space. If you thought, hey,
this might work for this, let's do it in a
larger setting where we're testing something much more specific, where
we're doing much less pea hacking. That's kind of how
science should work. It doesn't often doesn't totally.
Speaker 1 (36:57):
The power of replication is so huge.
Speaker 2 (37:00):
I mean, we do know that light affects mood, which
is different from red light therapy affecting mood. I mean
I know because this winter is very depressing for many people.
Speaker 1 (37:08):
Oh yeah, yeah, for seasonal effective disorder. Yes, light box
therapy has clearly been shown to improve mood.
Speaker 4 (37:15):
But it is not red.
Speaker 1 (37:16):
It's white, it is not red. It's multi spectrum like
the sun.
Speaker 4 (37:19):
Like the sun.
Speaker 2 (37:21):
So another thing that I see a lot is in
the sports people, is red light for a muscle recovery.
You know I'm going to sit under a red light
thing after by a workout.
Speaker 4 (37:33):
Yes? No, should I buy that? Probably? Yes, right, I
should buy it. I'm going to buy it. I'm actually
ordering it right now.
Speaker 1 (37:38):
I mean, if I told you it would make your
long run time faster, I know you're going to get
your credit card out right now. So again I think
the depth of the tissue is the key biological plausibility
indicator here. Again, even the infrared light therapy is only
getting about five millimeters below the skin. So if you're
talking about stuff that's deeper, and you know, five millimeters
(38:01):
is a quarter of an inch, right, Like, this is
really not getting very deep. So if you're talking about
any sort of deep tissue stuff, it's just not plausible
that the light gets there. There are muscles on the
surface and there are joints that are sort of in
the surface. Even that I think is probably too deep.
I will say that there. If you look, you'll see
some randomized trials in some athletes where they did see like,
(38:25):
for example, one trial and forty healthy subjects saw that
they could do more REPS after being given some of
this red light therapy as opposed to when they hadn't
been given the red light therapy. You've pointed this out
plenty of times. REPS is totally susceptible to placebo effect, right,
you just like believe in yourself and you can do more.
(38:46):
I'm not very compelled by that. There's a nice negative
trial which looked at people doing eccentric bicep curls to
exhaustion and compared a variety of different light sources, and
there's no difference across any of these groups. So it
doesn't really make sense to me for exercise. It just
(39:09):
doesn't get deep enough. That's basically the bottom line. There
are I think a couple other things that we can
just quickly knock out that I've seen online.
Speaker 4 (39:19):
Things we can reject.
Speaker 1 (39:20):
Yeah, I think we just have to cross them off
the list. So testosterone no, that fat loss no, although
although where are you shining the red light for the testosterone.
Speaker 4 (39:32):
That actually it seems like a source of sunburn. I
don't know that things could go very poorly.
Speaker 1 (39:39):
We'll talk about that when we talk about safety.
Speaker 2 (39:41):
Fat loss is a no, this is not this is
not going to give you better fat loss.
Speaker 1 (39:45):
Yeah, So taken altogether before we move on to sort
of the safety issues. Is like maybe for things that
are very superficial, basically we're left with maybe some skin,
maybe some hair.
Speaker 4 (39:57):
Maybe, but very very small effects.
Speaker 2 (40:00):
I think we always want to think about, you know,
is it likely that this is the like life changing
you know, is this the difference between a full, luscious
head of hair and baldness. Is that the difference between
looking like you're sixty and you know, is this going
to turn you into a thirty year old? No?
Speaker 4 (40:15):
Could there be some very marginal effect where when your
partner squints at your face really really carefully, maybe it
looks a little bit different for them. Maybe also why
are they doing that? And so I think those are
the like that for me.
Speaker 2 (40:30):
It's just like a eh, like, maybe it's something there,
but also it's definitely not something important.
Speaker 1 (40:37):
Okay.
Speaker 4 (40:38):
So then there are two.
Speaker 2 (40:39):
Other like sort of downsides I think or we're talking
about here. So one is the question.
Speaker 4 (40:42):
Of just like is this safe.
Speaker 2 (40:44):
Like let's say I hear you're like, yeah, I hear you, Emily,
but my partner does squint in my face a lot,
and I really want to get these small improvements.
Speaker 4 (40:51):
Should I be concerned about safety?
Speaker 1 (40:53):
Yeah? Again, one of the problems is there's a million
of these devices online and it can be really hard
to know what to get. We can talk about that
in a second. But one aspect of safety is just like,
these are electronic devices that may be manufactured in less
than safe conditions, and things can spark and catch on
fire and stuff like that. That's sort of the generic
like don't buy these things from TIMU bit of warning.
(41:16):
But biologically there's some concern here too. Even in the
Petri dish studies, they found what's called a biphasic response
depending on how much red light they put on these cells.
It seems like at the lower level, at kind of
the right level, you increase ATP production and the cells
kind of do their thing a little bit better. If
(41:38):
you exceed that, you start to generate what are called
reactive oxygen species. You're essentially like goosing your mitochondria too much,
and it causes these inflammatory oxygen molecules to be created,
which can actually kill the cells. So this is a
mechanism that is, you know, one of the ways that
light can actually hurt you, inflammation and things like that.
(42:02):
And so there's this therapeutic window where like there's the
right amount and there's too much, and we don't really
know what that is. So I would say if you
were going to use this, you probably don't want to
like leave it on your face overnight or whatever you're doing.
The second thing is, as you alluded to, is heat.
So these things give off a lot of heat. In fact,
(42:23):
one of the complaints I saw in some of the
products online is that they're loud, which I really realize.
But they're loud because they have fans in them that are,
you know, blowing off the heat from all the LEDs
that are going through them. So they've got the fan
blowing that heat is potentially damaging, particularly if it's right
up against your skin. It's also one of the mechanisms
(42:43):
that these things might could work.
Speaker 4 (42:44):
This could be how it works. Yeah, right, we.
Speaker 1 (42:46):
Talked about muscle strain. It's like, oh, yeah, the light
doesn't get to your muscle, but it's warm.
Speaker 4 (42:50):
It's like a nice heating pad. Yeah we have, I
have one.
Speaker 1 (42:53):
Heat it's a heating pad. Might work, yeah, exactly, And
it's a lot cheaper to get a heating pad. But
too much heat can cause can cause problems, and so
generally these things are pretty safe, but there are some
theoretical concerns that people should be aware of.
Speaker 2 (43:06):
I think the much bigger problem is these things are
incredibly expensive.
Speaker 1 (43:09):
Oh my god.
Speaker 2 (43:10):
Led lights are cheap, like so if you just go
to you know, the home depot when you get some LEDs,
like that's that's nothing. But these masks are like I mean,
this stuff is really expected.
Speaker 1 (43:22):
About fifteen hundred dollars, and I tried to like, like,
how much could this possibly cost to make? And I
know it's not just LED's which costs like a cent
to maybe fifty cents each, but like, I know, there's
like some probably some circuit boards and stuff in there,
but there's no way these things cost one thousand dollars
to make. I think these are all drastically effli.
Speaker 2 (43:43):
So cost plus pricing, it's the cost plus the marketing budget,
and that is most of it.
Speaker 4 (43:49):
Most of it is the marketing budget.
Speaker 2 (43:51):
So I mean, I think there are some of these
devices that are sort of FDA cleared, which I think
makes people feel like they are more legitimate.
Speaker 4 (44:03):
That does not defend the pricing though now FDA clearance.
Speaker 1 (44:06):
Has nothing to do with pricing, but if people are again,
if you are looking for something, this is one way
to distinguish one product from another. So an FDA cleared
device is one that has gone through pre marketing approval
from the FDA. It's not that high a bar. They
just have to prove that they're substantially similar to an
(44:29):
already approved device, so it's called a predicate device. They
have to show safety in some like manufacturing parameters, so
at least you kind of know that, like they went
through a process. It's not a total scam. They also
if they are FDA cleared, then get the ability to
make health claims, which are those you know you've seen
(44:50):
it on non FDA clear devices. Right, this is not
intended to diagnose, prevent, cure, or treat any disease. So
devices that haven't gone through the FDA care can't say that.
So you'll see the non FDA clear face mask that
say like promote you know, facial wellness, facial wellness, but
they can't say like will treat acne, or like will
(45:11):
treat rosetia. It doesn't mean they don't work per se,
but that FDA clearance is something you could potentially look for,
but it comes at a premium.
Speaker 2 (45:21):
Yeah, all right, Perry, red light therapy smash or pass.
Speaker 1 (45:28):
I am passing at the current price. I do think
someone invents something to put on my scalp that costs
like one hundred bucks and actually works. I might. I
might do it. How about you, Emily smash a pask.
Speaker 4 (45:45):
I'm a pass on this.
Speaker 2 (45:46):
I think that the effects are not big enough and
I think the likely actual effects, if you really got
good ones, would be even more minuscule than the ones
we estimate in the trials.
Speaker 4 (45:59):
And so I'm a pass. Save your money, spend it
on botox if that's what you want. That's my feeling.
Speaker 1 (46:06):
Rock Sand, you don't have to put on the red light.
Speaker 4 (46:11):
You're really going to make that work.
Speaker 2 (46:12):
You're going to make it work. So that is it
for red light therapy. Your mail back Question of the
Week after the Break.
Speaker 6 (46:24):
Hi, Emily and Perry. This is Adrian from Minneapolis, and
I have a question always wanted to know the answer to,
and that is the illusion or the reality of periods sinking.
Speaker 3 (46:37):
I'm wondering if it's the kind of thing where like
if I live with two female roommates and all of
our periods seem to line up. Is that a real
thing with some kind of scientific basis or is it
just like frequency illusion where we are all thinking about
blue volkswagons and so we see them all the time.
Speaker 4 (46:57):
Thanks for your help, Ah, this is an interesting question,
people ask us.
Speaker 1 (47:00):
So before you get into it, do you know what
the teenagers call this? Now?
Speaker 4 (47:04):
Oh god, what do they call it?
Speaker 1 (47:05):
They call it getting bluetoothed. Have you heard that?
Speaker 4 (47:09):
Oh I did, someone did tell me that. That's so weird.
It's like I'm going to bluetooth you my peers.
Speaker 1 (47:15):
Yeah, because it's like you're connecting you you're sinking up
right like anyway modern times, I don't know, how do
you even know that I have a sixteen year old daughter?
Speaker 4 (47:24):
Sixteen year old daughter? Okay, fair enough. I think it's
nice that you know that.
Speaker 2 (47:29):
So there was some early research that suggested that people
who live in a household together I think it was
based on dorms, would have periods at the same time.
But then basically, further more detailed research shows that in fact,
this is not true. People do not sink their cycles.
I mean, of course, if you have a dorm of
(47:51):
twenty girls, many of them will have their period at
the same time because your period is seven days typically
five to seven days of a twenty eight day cycle.
So you could easily feel SYNCD because everyone has their
period at the same time as some other person. But
it is not like a it's not a true sinking
in that way of period's not moving around to match
(48:13):
other people's. And I think it's not surprising because I
don't know what the evolutionary reason for that would be, Like,
why would it be beneficial for everybody to be fertile
at the same time.
Speaker 4 (48:22):
That almost seems like the opposite of what you would want.
Speaker 1 (48:25):
Right, Yeah, I don't know. I always hear like pheromones
and stuff like that. There's an interesting mathematical correlate here,
which is that in any system where there's periodicity, where
there's things that are happening at recurring time points but
the periods are slightly different, they will sink over time
and dcink over time. So you see this if you're
(48:45):
in traffic and you all have your left blinker turned
on right and everyone's kind of blinking at slightly different
rates because car manufacturers can't get it together. By the way,
side note, car manufacturers can we all blink at the
same rate. Okay, they all blink at different rates. If
you kind of follow it, you'll see that, like they
kind of are blinking, and then they'll sort of sync
up and you'll feel like, oh, we're all blinking, and
(49:06):
that kind of dcincs again. So that's just a phenomenon
of periodicity that could also be a play here.
Speaker 2 (49:10):
Which would totally work here because of course, some people's
psycles it's a little bit different cycles. Normal cycles can
range from twenty one to thirty five days, so everybody's
got a different blinker. That's totally fascinating. You knew a
lot more about this than I thought that you would.
Speaker 4 (49:21):
I will say, I.
Speaker 1 (49:22):
Want to give you I'm a man for all your renaissance.
Speaker 2 (49:26):
Your renaissance Maneah. That's that's all there is. All right,
that's it for us for today. Stick with us next
week and we'll ask what's the deal with microplastics. Wellness
Actually is produced in association with iHeartMedia. Our senior producer
is Tamar Avisheik. Our executive producer at iHeart is Jennifer Bassett.
(49:49):
Our theme music is by Eric Deutsch, and our content
is for educational purposes only.
Speaker 1 (49:54):
If you like the show, help other people find us,
leave a rating and review on Apple Podcasts or your
podcas catcher of Choice, and help us spread the word
about the show. You can follow us on Instagram at
Wellness Actually pod and don't forget We want to hear
from you. Head over to Wellness Actually dot fm and
leave us a question for our mailbag or suggest a
topic for a future show.
Speaker 4 (50:15):
We'll let the influencers have the last word.
Speaker 5 (50:17):
They make your eye gollows. Watch what happens to your
vision after a week to fourteen days of being in
a red light therapy that without eye protection, If you
don't have a marked improven in your vision, I'd be
very surprised.
Speaker 4 (50:28):
So what is the negative aspect or why do they
tell you to cover your eyes?
Speaker 3 (50:31):
Well?
Speaker 5 (50:31):
Because you know, I guess the bright light. If you're
staring directly at one in one of those lights and
you have some kind of damage to your rods or
your cones, or your macula or your retina. I mean,
if you had iyepathology, which you would know about, then
there might be some some downside consequences
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
Kingdom of Fraud
It’s the unlikeliest of criminal partnerships: a devout polygamist from an insular Utah sect joining forces with a shadowy Armenian tycoon from LA. The result - a billion dollar fraud conspiracy. In Kingdom of Fraud, investigative reporter Michele McPhee traces the origins of the extraordinary alliance between Jacob Kingston and Levon Termendzhyan. Together, the two men trigger the largest tax investigation in American history and weave around themselves a web of dirty cops, influential political relationships and transnational money laundering. All this is set against the backdrop of Jacob Kingston’s clan – The Order. A powerful and secretive polygamist organization in Salt Lake City. To whom Jacob is desperate to prove his worth. Kingdom of Fraud is produced by Novel for iHeart Podcasts. For more from Novel, visit https://novel.audio/. You can listen to new episodes of Kingdom of Fraud completely ad-free and 1 week early with an iHeart True Crime+ subscription, available exclusively on Apple Podcasts. Open your Apple Podcasts app, search for “iHeart True Crime+, and subscribe today!