Can Flying Make a Concussion Worse? Oxygen, Brain Injury, HBOT & Longevity Research with Dr. DeepSea | E80

Dr. Dituri: 00:00 When you change the pressure external to the head, right? You decrease the pressure here. It makes this intercranial pressure, if there's a possible slight increase, it exacerbates that difference and gives you a delta, right? So you'd probably have some brain fog. You might have some brain swelling. So how do you do this? Well, how do you check intercranial pressure? Geez, that's not easy. But intercranial pressure is really closely correlated with the interocular pressure. Dr. Ayla Wolf DAOM: 00:30 Welcome Dr. Ayla Wolf DAOM: 00:30 to Life After Impact, the Concussion Recovery Podcast. I'm Dr. Ayla Wolf, and I will be hosting today's episode where we help you navigate the often confusing, frustrating, and overwhelming journey of concussion and brain injury recovery. This podcast is your go-to resource for actionable information. Whether you're dealing with a recent concussion, struggling with post-concussion syndrome, or just feeling stuck in your healing process, know that you are not alone. This podcast can be your guide and partner in recovery, helping you build a better life after impact. Today I'm excited to welcome back Dr. Joseph Dituri, better known as Dr. Deepsea. Dr. Dituri is a retired U.S. Navy commander, biomedical engineer, neuroscientific researcher, and Guinness World Record holder who famously spent 100 days living underwater to study the effects of prolonged pressure on human physiology. He's also a traumatic brain injury survivor and a researcher at the University of South Florida, where he's helping conduct one of the largest clinical trials investigating hyperbaric oxygen therapy for traumatic brain injury. If you missed our first conversation in episode 32, I highly recommend going back and listening. We explored Dr. Dituri's remarkable background, his personal brain injury recovery, and the science behind hyperbaric oxygen therapy. Today, Dr. Dituri is back to share updates on that groundbreaking research, discuss his new book, Shattered to Strong, and explore some fascinating new directions in oxygen research from the effects of reduced oxygen and the potential of manipulating oxygen levels to promote healthy aging and longevity. Enjoy this conversation with Dr. Dituri. Dr. Joseph Dituri, welcome back to Life After Impact. How are you doing? Thank you for having me again. Absolutely. Congratulations on publishing your brand new book, Shattered To Strong. I have read it. Oh boy. I came prepared. Yeah. What has the feedback been so far? Dr. Dituri: 02:43 Overwhelming success, resounding like, wow, where the hell has this book been? Why didn't they tell me this when they kicked me out of the hospital? When I had my TBI, holy mackerel, this is great information. Yeah, you know. So, but again, none of the MDs have fed back to me yet. So I'm sure they're not happy with it, but that's okay. I'm not I'm not here to make people happy. I'm here to move the needle and help people with traumatic brain injury. Dr. Ayla Wolf DAOM: 03:10 Yeah, absolutely. You know, I just talked to, I reached out to Dr. Joseph Maroon, who, as you know, is a big name in concussion and CTE research. He had just published a study on the fastboat operators in the Navy, and I wanted to talk to him about that. And so I sent him an email, asked if he'd be a guest on the show. Shockingly, he got back to me within an hour to say yes, but even more shockingly, he attached a paper to the email and said, I I want you to read this also. I'm thinking it's gonna be like additional CTE research that he had done. It was his own review paper on HBOT and red light therapy for brain injuries. Shock. Really? Yes, yes. Uh-huh. Dr. Dituri: 03:59 You know, we may be moving the needle. We may exactly. You know? Exactly. Yeah. We're getting mainstream people to start going, you know, Secretary of the Navy, well, the acting secretary of the Navy right now, Hung Chow, is actually leaning in that direction. Now he's uh forming a committee and doing all that stuff. But right now, he's kind of like, look, I'm strong on this. How can we get there from here? What do we do? And I'm like, come on, let's go. Come with me. Let's do stupid things. Dr. Ayla Wolf DAOM: 04:29 Awesome, awesome. Well, and you know, honestly, so Dr. Maroon's paper was a review on PEMF, HBOT, and red light therapy in the context of neuroinflammation. And what that says to me is that somebody who's been studying neuroinflammation his entire career is now circling back to saying, well, we don't have any drugs out there yet. So what do we have, right? Dr. Dituri: 04:53 We have known, peer-reviewed, literature-supported mechanisms of action on which we can rely. Hyperbarics is an anti-inflammatory. We know that. It's a powerful anti-inflammatory, it stimulates brain-derived neurotrophic factor, it stimulates vascular endothelial growth factor, all fact. Like not, there is no debate on that. Now, can it be used for TBI, concussion, recovery? Blah, blah, blah. That's not proven yet. However, we're doing the largest clinical trial in hyperbaric medicine history at the University of South Florida right now. So we're trying. Does that mean that it's proven? Nope, that's not what it means. Does it hurt you? No, it doesn't. And remember the do no harm thing. I'm not a physician, but I teach them and do no harm. That's one of the very easy do no harm. Dr. Ayla Wolf DAOM: 05:43 Yeah, yeah. Okay. So you've spent your career studying humans at physiological extremes. Increased pressure, decreased pressure, more oxygen, less oxygen, diving, altitude, brain injury, and now aging, but not just aging, but aging well. And so I wanted to really explore both sides of oxygen, especially with this whole XPRISE challenge that you've been a part of. Why don't you? I want to circle back to your HBOT study and get an update on that, but let's first talk about the XPRIZE challenge. Explain what it is, what your team is doing, and let's go from there. Dr. Dituri: 06:24 Okay. So this really smart guy named Peter said, listen, I got some extra money lying around. We're talking billions. And I'm going to fund teams to go out there and do real cool things. The reason why rockets like SpaceX and um the other one, Blue Origin, are flying right now is specifically because of the X Prize, right? Because he generated interest and people were pushing and doing novel and innovative things. He's now doing the same thing in what we call health span. Now, this is not just, oh, your aging markers are getting better or your telomeres are getting longer. None of that is a key to longevity and health span. However, things like um grip strength, uh, things like uh your VO2 max, all those are drivers or indicators of longevity, no kidding, right? Because people get old, they fall because they're unstable. Why? Because they haven't been walking, they haven't been trying to get up, they've been uneasy on their feet. People need to get that balance. That's the kind of thing that's in the XPRIZE anti-aging or health spend thing, right? So what we're doing, uh, and I'm doing this in conjunction with uh University of South Florida as well as Arizona State University, is we've entered in and our premise is simple, right? I'm a keep it simple kind of a guy. My premise is simple. Hormetic stress is good for the body, and that's it. So what are the hormetic stressors? Well, think back. There's lots of them, right? Hormetic stressors are pulling oxygen away from your body or oxygen deprivation, increasing oxygen or hyper oxygenation, uh, red light therapies a stress, um, ice bath therapy, uh sauna therapy, heat shock proteins, cold shock proteins. All of these are hormetic stress extra exercise, right? It's just great hormetic stress, right? So uh, you know, incidentally, I turn 60 next year, right? And I'm still because I'm in the gym, I spell gym with a G. I take care of myself, I drink lots of water, I drink lots of, you know, tea, I don't drink any caffeine, da-da-da-da-da. You know, I'm just trying to live this thing the right way. Um, you know, not just go to the gym, but hormetically stress myself. So you know the old adage about strawberries, right? The strawberries that taste the sweetest are from what? Those years where the crop had the most difficulty growing. They were exposed to a cold, they were exposed to excessive heat, they were exposed to a drought, right? Those are the hormetically special stressed strawberries which taste better. Guess what? It's all the same. Humans, everybody, we're all the same. You hormetically stress something, it will be better. It can widen its path of survival. So that's all we can do at this point. Everybody's looking for a magic pill, something that I can just take. There is nothing. There's nothing. Trust me, I've looked under every rock. You know, everybody's like, oh, the rats are living longer if we give them this dose of this pill, which I'm the only guy who sells, by the way, and you know, it's only $2.5 million, and I'm gonna sell it to Big Farmer and it'll be $3.4 billion. And now it's an industry and everybody's on it. Nope. Hard work wins. Dr. Ayla Wolf DAOM: 09:43 Okay. And you advance, your team advanced to the top 20 finalists of this challenge, correct? Dr. Dituri: 09:50 That is absolutely true. So we are now out of 867, 864 teams, we are now 17th in the final progression, and we are going for it. And we are 17th, and unfortunately, it took a long time for us to get the IRB. So I literally only had 220 days worth of data. And some of those patients were noncompliant, and some of those patients, oh, I got a doctor's appointment, I don't want to come in today. Oh, I got this, my dog, my chicken, my cat. So it was kind of a really low-level study, and we're in 17. Dr. Ayla Wolf DAOM: 10:28 So what you're saying is you still got a lot of gas in the tank. Dr. Dituri: 10:31 Oh, wait, wait till you see what we do. I mean, we're gonna, we're literally gonna kick the doors down. That's exactly what we're gonna do with them. So we're we're still in it to win it. And uh, yeah, the team is really excited. You know, I'm easily excited because this is my passion. Like, and it's not just for me, it's for humanity, right? I mean, it's for my mom who is 49. She's been 49 since I was born. I have no idea, right? But my mom wants to age gracefully, right? So I'm like, here's what you here's what we're thinking about doing, right? You know, or you know, if we can extend this and push this a little bit, we can get some healthy. Because look, it doesn't matter. If you don't have cognitive enhancement as you get older, you're gonna have cognitive decline. That's all there is to it. It's very simple. The math, the shrinking, it's all there. That brain stuff degrades as we get older. We have to ramp that up. How do we do that? BDNF, how do we do that? You know, increasing VEGF. We know all the things to do that. This is all science-based papers written, published, you know. So it takes a leap because there are so many things that we're doing that we're compounding on them. Each one compounds on the next thing. And that's not the way normal science is done, but that's the way we have to do aging because you and I both know that if a plant has a problem, what's wrong with this plant? Oh, it needs water. Oh, it needs sunlight. Oh, it needs food. Well, I'm a researcher. I'm gonna isolate all those confounding variables like sunlight and food, and I'm just gonna give it water and keep it out of the other stuff to find out which thing it needs the most. And what happens? The plant dies because you overwater it, right? Or it dies because it gets too much sun, or it dies because it just gets food and no sunlight and water. We know inherently that humans plants everything, water, sunlight, food, in the right combination. Same thing with this hormetic stress. Dr. Ayla Wolf DAOM: 12:25 Yes. And you're doing something very interesting where you're not just studying the effects of HBOT, you're actually putting people under hyperbaric and hypobaric conditions and actually vacillating between them. And so talk about how you design the study, um, how much time people are spending under these conditions and the purpose of doing both instead of just studying one. Dr. Dituri: 12:51 Right. So what we're doing is something called hypo-barracks, which means I'm gonna go to altitude, and hyperbarics, which means I'm gonna increase the pressure. So hypo is high. Hypo is flying in an airplane, hypo is going skiing in Utah, hypo is going skiing in Colorado, right? You're at the top of a mountain. What does that do? It decreases the inherent amount of oxygen you're breathing, hormetic stress, right? And your body's compensatory behavior is to increase the number of red blood cells when you go hypoxic. So as you go hypoxic, I'm giving you more red blood cells. So we're doing that and we're stressing people in the morning, and then a three-hour break uh where they go work out and they get water and they go to the ice bath and the sauna. And then they go to hyperbarics where we heal all of that, where we stress them by giving them high concentrations of oxygen in varying amounts so that the body isn't going through that um that endogenous uh cycle of, oh, I'm okay. I know exactly what I'm doing. I'm here to get 2.0 oxygen uh for 60 minutes. Nope, we're giving them in varying amounts with air breaks. We're looking to raise things like brain-derived neurotropic factor by giving them air breaks. So there's a ton of science in that. It's not just like by guess and by golly. Even the time that we do hyperbarics has been necked down to work perfectly with people's circadian rhythm. So this is not just me. I mean, there are really smart people on this thing, and I don't even consider myself that smart, but I got a whole bunch of smart people we're working with. Dr. Ayla Wolf DAOM: 14:29 Yeah. And so explain the difference between like the hypoxic conditions versus, you know, I know athletes go to altitude to train, so that essentially it's like the natural form of blood doping. You go to altitude, you train, you come back down to lower altitude, and all of a sudden you've got more red blood cells, correct? Yeah. And so the amount of time people are spending in those hypoxic conditions in your study, how is that uh compared to somebody training at altitude, say, for two weeks? Dr. Dituri: 15:01 Right. So if you go at altitude and stay, there's really well published literature on how much your body has that compensatory behavior. Right. So we're gonna compensate by making more red blood cells. That's well established. What we're trying to establish is a 15-minute hypoxic position wherein we work out. So we're working out in that position, making us even more hypoxic, making the demand for oxygen that much greater, and attempting to go, yes, we're gonna have an increase in red blood cell, we're gonna have an increase in that hormetic stress, which is gonna do all kinds of other good things. We're attempting to establish that baseline and base point at this point. Right now, uh, I almost think, and and this is all preclinical data, but I almost think that the hypoxic exposure may be more beneficial than the hyperoxic exposure for the longevity and things that we're doing right now. Dr. Ayla Wolf DAOM: 16:02 But then the hormetic stress of the hypoxic, you're almost accelerating the recovery from that with the H bot, right? Dr. Dituri: 16:12 Not almost. Boy. See, I love it when I talk to smart people because you're like, hey, I think maybe this is, and I'm like, ding, ding, ding, winna winner, turkey dinner. So you're exactly right. So, so not only are we, yes, we're enhancing the recovery from that, but there's a two-stage effect, right? When I stayed underwater for 100 days, I was in a hyperoxic environment. That meant that I had less red blood cells that were produced, right? Because before I went in, I was at the hemoglobin of like 15.2. And then when I came out, I was at 13.9, right? There's a pretty decent reduction. I mean, it's not huge, but it's decent. So we know that, but we're balancing that with fixing the um fixing the stress that we gave us this morning, and then not only that, but agitating it, changing it on a regular basis, which is giving us some decent results. Now, which one's working the most? Hyperoxia, hypoxia, ice bath, uh red light therapy, cold shock therapy or ice baths, whatever, which one's working the most? We don't have any idea. Nor, frankly, do I care. Because science wins over BS, right? And we are making the science work and showing you in the end, if you do these five things, in the end, you will be this way. And and we are working with 55 to 70. Now our next phase is gonna go to 90 year olds. 55 to 90 year olds. We're not looking at, you know, we're not looking at young people. We're not looking at, oh yeah, we're just gonna fix the young people. And that doesn't even count the telomere extension, which is known peer-reviewed literature-supported paper for hyperbarics. We know it extends telomeres. That's easy, but it's not just telomeres. It's about enhancing your cognitive function through all of these things, increasing cerebral blood flow. It's about increasing your stability on your feet, uh, increasing your muscle density, right? Increasing your grip strength, things like that, increasing your VO2 max. And all of the stuff that we have done has shown great increases. And it proves it because we're 17th and we only had 20 days of data. Dr. Ayla Wolf DAOM: 18:27 Yeah, that's insane. My office manager, she just showed me a video of a 400-meter race between a bunch of 90-year-olds, and the guy that won it did it in a minute and 40 seconds. And he just blew everybody else out of the water. Dr. Dituri: 18:47 You know, 60 is the new 30. I'm I'm telling you, I I feel, I feel virile. I'm like, I'm good. I'm I'm still, you know, I'm still pushing it. I'm still in the gym. I'm still doing my stuff. I guess I'm I'm I'm blessed with good heredity. But uh who knows? Uh at this point, we're trying to do things that are gonna make us all last and live longer and prove it in science, which yeah. Exactly. Exactly. Dr. Ayla Wolf DAOM: 19:13 Okay, Dr. Ayla Wolf DAOM: 19:13 so I had a question from one of my podcast guests that I think you are in the perfect position to answer. And I also get this from some of my patients too. Many people that have had concussions or brain injuries, they experience cognitive symptoms, vestibular symptoms, other symptoms after flying on airplanes. So there's been some research that actually studied pretty young healthy athletes and military after flying 72 hours after a concussion. They didn't find anything. I don't know what all their endpoints were in that study, but that was only a two-hour flight. And I think there's maybe some recommendations that you probably should not take an international flight right after a concussion. But can you speak to what you would want to look at in terms of, or maybe what you would recommend to people if they've had a concussion? What are the kind of parameters for is it safe to fly? Because airplane cabins are pressurized to what, about six to eight thousand? Eight thousand, yeah. Yeah. And so what would you say are kind of maybe some recommendations or things to consider when flying, either acutely after or if people are still highly symptomatic? Is this something that needs to be studied further? It seems like it is. Dr. Dituri: 20:31 So the literature is is scant on this, but 72 to 96 hours post-schemic incident, right? So 72 hours to the it's three to five days, right? Uh post getting hit in the head real hard, you ought not change the pressure, right? Because what we're looking at is an increase in intranial pressure. Now, again, I am not a physician. I am a clinical researcher. So I do research on this. I'm not giving medical advice. However, comma, when you change the pressure external to the head, right? You decrease the pressure here. It makes this intercranial pressure, if there's a possible slight increase, it exacerbates that difference and gives you a delta, right? So you probably have some brain fog, you might have some brain swelling. So how do you do this? Well, how do you check intranial pressure? Jeez, that's not easy. But intercranial pressure is really closely correlated with interocular pressure. How do you check interocular pressure? Ask anybody that's got glaucoma, you go to a freaking eye doctor and go, hey, what's my interocular pressure? And if it's good, well, then it's probably good. There's a I'm I'm skimming the top here, right? There's a lot of stuff that goes with this. But you know, before you fly, you want to check in some way, shape, or form, validate your intranial pressure because, or before you do hyperbarics or before you do anything that may give you a push or a change in the uh in the pressure, right? Mm-hmm. Dr. Ayla Wolf DAOM: 22:02 Yeah. So good solid advice. There's some direct measures of intraocular pressure that can be measured, and probably a good rule of thumb not to fly three to five days after a head injury for sure. Dr. Dituri: 22:14 Yeah. Which is go goes in the face of everything I ever see professional athletes do. They get hit in the head, they get on a plane, they go to the next thing. People call me and they're like, hey, turn on the TV. Did you see this guy get hit? I look at this guy get hit, and he gets up and he's like, and I'm like, well, okay, no. He's like, should he go back in? I'm like, no, we should not go back in. What this is nuts. What do you think? And then they put him on a plane, they fly him to the next game. And I'm like, oh. We don't care about people. I mean, and you know, do I have any science to back that up? Absolutely not. But does what I'm saying make common sense? Yeah. Should we err on the side of caution with this guy? Yeah. Or should we err on the side of the team needs to make money? Hey, I'm not a team owner. I care about people. That's it. You know? Mm-hmm. Dr. Ayla Wolf DAOM: 23:02 Yeah. Yeah. No, I I appreciate that. And I definitely think we need more research on the difference between a two-hour flight versus an eight-hour flight, what's happening? I mean, you could take the same person with a concussion and bring them to 8,000 feet altitude. And, you know, they might have symptoms there too. Eventually they might acclimate. But when you're on a plane and then you get off the plane, there's a lot of other things going on in terms of how that pressure affects your vestibular system as well. And so there's just a lot going on there that I think we still need to look into. Dr. Dituri: 23:35 Yeah, the change in pressure is definitely going to affect your vestibular process. It's definitely going to mess things up. You're going to get dehydrated when you get on the plane, which we all know happens. The constipation, it changes your body's internal chemistry. Everybody knows it. When they get off the airplane, you're a little wonk, right? So is that probably the best thing to do post-head injury? No, probably not. Just an opinion. Dr. Ayla Wolf DAOM: 24:00 Yeah, yeah. No, I appreciate your opinion. Okay, let's talk about where you're at with the large HBOT trial with the veterans. Dr. Dituri: 24:09 So we're about three years into a five-year trial, three and a half years into a five-year trial. None of the results will be published anytime soon. We're looking at, and even after we're done with the five-year study, there's crunching all the data, right? We were supposed to go in the core cohort range, doing it once every year. Well, that kind of is difficult. We don't have enough staff, blah, blah, blah, money issues, you know. Again, things that are not necessarily my concern, but it's difficult to do things like that. So I don't know. Um, uh everybody thinks that studies should be like, let me know what's the information. And I'm like, oh, this is a long-range study here. There's a plan, and in a couple of years, you'll have an answer. When we started it, I warned people, I was like, look, you're looking at an answer in about six years. And they're like, what? I'm like, yeah, about six years. That'll be about when we get the paper written, you know, which will be like maybe definitive, maybe. Then again, it maybe uh we didn't know anything, but it didn't hurt anybody, right? Dr. Ayla Wolf DAOM: 25:07 Right. Well, I mean, you're certainly collecting a ton of data. So I think you'll be able to pull something out of it. Dr. Dituri: 25:13 Right, right, right. I mean, you know, blood, urine, saliva, uh, we're doing EEGs on people, diffuse tensor imaging of MRIs. You know, we're like, and we're banking the blood at Duke. So not only are we doing so, if there's a retrospective blood marker that we come through later, we'll have all that blood banked. So we are like really trying to do a good job at science on that one. We, they. I mean, you know, I'm not, I'm not doing everything. I'm not doing anything at this point. I'm just uh just having fun right now. Dr. Ayla Wolf DAOM: 25:46 Yeah. Yeah. And I I listened to your episode uh with Gary Brecke. And I remember you were talking about the frustration with the fact that there are really no good endpoints when it comes to studying TBI. And so you had some issues with what are the endpoints for an HBOT trial. And I think that in the process of submitting your papers and your protocols, this was kind of part of the conversation. Dr. Dituri: 26:13 Yeah, it's it's disheartening because, you know, the FDA comes back to us and goes, we don't like the endpoints that you've chosen for the trial. And I'm like, oh, what do you consider a traumatic brain injury? And they're like, you know, a cured traumatic brain injury. And they're like, well, we don't know, but we don't like yours. And I'm like, is that the way this is gonna go? Like, y'all have had this problem for thousands of years. Thousands of years, head injury has been on the books. Only in 1300 AD did they make a a difference, a differential diagnosis between a concussion and a traumatic brain injury. But so only in the last like 50 years have we really made some substantial headway. And you guys are like, yeah, we just we just don't have anything. And my problem, and that's why I wrote it up and shouted to Strong, they told me when I had a TBI, hey, you just need a tincture of time. And I was like, you know, like, uh really? I'm a researcher. You're gonna tell me uh that's all we got? I'm like, what about this? What about that? What about this? Like, none of that's proven. And I'm like, yeah, but proven and make sense from a scientific standpoint is not gonna hurt you. Like, look, I'm not even advocating that you go by a red light. What I'm saying is that red light therapy does a bunch of things. It increases uh veg, it increases, you know, it's it is a stimulant, it does a whole bunch of other things. So, do you know we have a red light that's awesome that we see every morning? Just face east and watch the sunrise. Or in the end, face west and watch the sunset. I'm not even suggesting that you waste a dime. Just get the right, start breathing, start meditating, start drinking water, things that you can easily do that are no kidding free, that are not gonna hurt you, that are only gonna contribute to your overall wellness. But no, you're right. It is not in science that looking at the sun will fix your traumatic brain injury. But, you know, don't look during the middle of the day when it's overhead. Let's not be silly. But, you know, things like that are easy peasy, right? Dr. Ayla Wolf DAOM: 28:25 Yeah. Dr. Ayla Wolf DAOM: 28:25 Okay. Well, circling back, uh, they didn't like your endpoints. What endpoints did you land on that they did like? Well, or at least agree to. Dr. Dituri: 28:34 If they didn't like them all, they just wound up taking them because, you know, you just kill them by resubmitting and resubmitting and resubmitting, right? Um, so they kind of sort of caved. So basically what we're doing is the NSI, the Neurosymptoms Inventory, and the Ohio State University, right? So these are both um pretty good tests that are out there that talk about traumatic brain injury changes, right? So it's a statistically significant change in any or both of those tests, if you will, right? But how do we get those tests? I ask you a bunch of questions and you answer them. So that is self-reporting. Right. They, FDA, have no problem with it. Well, I'm a damn scientist. What do you mean? I need objective quality evidence. That's not objective. That's called subjective quality evidence. But the FDA is perfectly okay with that. But, you know, when you put a drug to market, they're like, oh, you gotta have objective quality evidence for a drug, but we're gonna be okay with this for your traumatic brain injury, because we don't have objective quality evidence. Because look at it like this. I can, you know, we can look in an area in the brain with diffuse tensor imaging and we can go reduce blood flow right there. I see that. And then we can show through a series of our treatments and then a retest an increase in cerebral blood flow. But show me any paper anywhere that correlates an increase in cerebral blood flow with a cured traumatic brain injury. Oh, there's none. Okay. No. What do you do? Now we're hoping to correlate that, you know, uh causation correlation, you know the drill, but we're hoping to at least put that in the crosshair so we can start looking at it later to see if we can say, oh, a predetermining factor seems to be NSI scores decreased to whatever, OSU scores decreased to whatever, with a X percent increase in cerebral blood flow or in re-reperfusion in that area of decreased, you know, perfusion, whatever. Dr. Ayla Wolf DAOM: 30:46 Right. So now you're gonna have to try to correlate the subjective evidence with your objective evidence to say, hey, maybe the subjective evidence is important. That seems so backwards. Dr. Dituri: 30:57 Right. Or much better to be able to, you know, correlate a very simple blood marker, right? You know, here we are in 100% of the people. Uh HSCRP was reduced by uh 24.3% when we finished these treatments and they got better. Therefore, let's look at HSCRP. I I made that up, but that's what I'm looking for. A simple, you know, I don't want the costly blood test. I don't want the, you know, MRI with DTI, very expensive. Diffuse tensor imaging, it's not a cheap thing. And you're exposing yourself, right? We don't, we want to limit things like that. But if I can just take blood from you and find a marker, I mean, now we're good. Like I said, we're doing EEG tests as well. Now, EEGs, you know, electroencehalograms are kind of a weird science. It's uh it's still new, if you will, and and lots of people really don't accept it, but it's a science and it's here. So we're using it, we're trying it. Dr. Ayla Wolf DAOM: 32:00 Yeah. And are you looking at specific evoked potentials in that data? Dr. Dituri: 32:05 Yeah. So what we're doing is we're we're doing a retroactive study, right? So we do it before and we do it during and we do it after, right? And then we look at the changes. So basically we're just looking at the changes and again trying to correlate it to the NSI and the OSU and go, hmm, this guy got better. Oh, well, when he got better, he had increased, uh, dec a decrease in evoke potential, increase in, you know, um connectivity, or, you know, it's it's the coherence and the phase lag seem to me, to me, to be the key driver in uh increasing cerebral blood flow and helping traumatic brain injuries. But that's really preclinical data, right? I'm just telling you what I've seen in the people that we did preclinically. Hopefully we find some good matches afterwards. But what we're looking for is low-cost, easy-to-do markers that we can then correlate to better scores or, you know, on OSU and NSI, which just seems to be the standard. Dr. Ayla Wolf DAOM: 33:04 Got it. Isn't it amazing that in 2026 there's still so much we don't know and don't have a good grasp on when it comes to the brain? Dr. Dituri: 33:14 You know, I talk to these guys that are, you know, cutting edge of medicine, you know, heads of medical departments, and you're talking to them, I'm like, hey, what percentage do we have of the data that we have in the textbooks is correct? And they're like, yeah, it's staggeringly low. I'm like, yeah, give me a thought. It's like, how's uh 80% is incorrect? And I'm like, no. Like, yeah. Like, we're still guessing how often do we change stuff, you know? We used to perform what they call the trephonism. When you were a little cuckoo, we'd crack you on the top of the head, let the evil spirits out of your head, and then put the cap back on and see if you healed. If you healed, we went, yeah, see, we let the evil spirits out of your head. We don't do that anymore. Dr. Ayla Wolf DAOM: 34:01 No, but it wasn't that long ago that we were doing frontal lobotomies. Frontal lobotomies. Yeah, with a mobile van that would tour around the country and basically uh take all the women that seem to have emotional problems and just take part of their frontal lobe out through their nose. Dr. Dituri: 34:19 So you you get it. Um, science is changing all the time, and that's what we're doing. We're literally trying to change science on a daily basis. So is any of this in stone? Absolutely not. Could we be wrong? Absolutely. Are we trying to hurt people? Absolutely not. That's one of the going in premises of everything that we're doing is look, this is stuff that is low threat to hurt you. And if it's low threat to hurt you and decent probability of helping, well, let's try that kind of stuff. Dr. Ayla Wolf DAOM: 34:49 Well, and what a great point you bring up in just going back to like how medicine is taught and the fact that we use textbooks and that textbooks are horribly outdated because they take a very long time to write, a very long time to publish. And by the time they're published, there's so much research that has come out that now they're immediately outdated. And so we're constantly teaching outdated information. And one of my podcast guests made the great point of if we continue, if the insurance companies continue to have the textbooks that say, oh, people heal from a brain injury in four weeks, well, then they're gonna keep using that as proof of why they're not gonna pay on all these claims for people with TBI, because like, well, we have medical textbooks that still say you heal in four weeks or less. And so it's like until we update the textbooks, even like people will just keep getting screwed over by their insurance companies. Dr. Dituri: 35:42 Yeah. Uh the uh I I'm sorry, I'm looking down because I'm I'm trying not to go crazy. Insurance companies, health insurance companies, have nothing to do with your health. Nothing whatsoever to do with your health. Dr. Ayla Wolf DAOM: 35:58 And I know personally, one of your frustrations is how slow science moves sometimes. Dr. Dituri: 36:04 At a speed just faster than glacial. Glacial. I mean, like I said, we are, you know, we are trying. But you know, things like this, this research study that we're doing at the University of South Florida, all the research studies in hyperbaric medicine, they are unfunded. Now, the governor and the uh the speaker of the house came through a bunch of money and gave it to the University of South Florida to do this great study. Now, that's terrific. However, there's no huge nationwide, you know, 400,000-person study in hyperbaric medicine being conducted because there is no claimant. There is no drug company that's pushing it, there is nobody who's gonna profit from it. Everybody's like, oh, I want to get into hyperbaric medicine so I can make a million dollars. I'm like, go in with two and then you'll come out with a million, it'll be great. You know, nobody's making money off of hyperbaric medicine is the is the key takeaway, right? It's just people are trying to help people. Yeah. Sorry, frustration mounting. But yeah, we do move slowly. Now, trust me, you give me a couple of million dollars, tens of millions of dollars, I'll cure traumatic brain injury. I mean, what me and this team, we will kick down the doors, right? But nobody's given us that money. Nobody is given any kind of money like that because unless you win the X prize. Dr. Ayla Wolf DAOM: 37:29 Isn't that a uh $100 million prize? Dr. Dituri: 37:33 So here's the trick. Yes, it's $100 million. Truly, by the time you get it, it's $81 million. But it's $81 million spread over the top three teams. And it's spread over a longitudinal period of time. So you get it here and then here, and then a little bit here. And by the time you're done, it's two fifths of five eighths of whatever, right? But so it's not, it's not like, oh my God, life-changing money. It's it's a good, it's a good step in the right direction, you know. But then you got to go pay back the cost, right? Like, so I have um, I have a half a million dollar chamber, you know, I have a $15,000 ice bath, I have a all this came out of the International Bank of Joe, which is running a little dry nowadays, you know. It's like, whoa, wait a minute. So, you know, I'm just trying to, but that's what's happening. We are self-funding research, and there is no payback. There's no project to be paid back, nobody's making money off this. I just submitted another grant where they're like, yep, we're at the cap. And I'm like, okay, do me a favor, just take my salary out of it. Uh that'll be uh that'll be good. But because what are we gonna do? We don't get either we don't get the research, or you know, I get pittance of a salary from whatever. And I if I give up my salary, we'll get the research. Okay, let's do that. Who cares? Yeah, right. You gotta help human beings and and more people need to kind of do this sort of stuff. Now, look, I'm graced. The grace of God has given me a retirement from 28 years of active duty service. So I'm okay, right? I'm I'm blessed and I'm in a position that I can give back to the to the universe, right? Hopefully we can take this science and push it so that people can start seeing. I have an option. And that's literally why I wrote the book. I was like, if I can give people hope that they have options that are not high cost, that are not sit at home and do nothing. And I mean, that's what they told me. Go sit on your couch and do nothing for two weeks. You'll get better. And I was like, I cannot believe you just told me those words. That's just foreign to me. Dr. Ayla Wolf DAOM: 39:34 Yeah, yeah. Okay, so your ice bath is $15,000. Does it also do your laundry? What what is what is your ice bath doing? Dr. Dituri: 39:43 Right. So, so it's an ice forge, and you get these ice forges, and literally you have to break up the ice in them, right? Uh, it has the right temperature. And it'll, by the way, has an ozonator that cleans the water so that it's not just for me, it's for every person that goes in it. Because guess what? When you teach when you're treating 16 people a day, 16 people a day get to go in your ice bath. Do you want to go in the ice bat right after me? I I love you. Dr. Ayla Wolf DAOM: 40:12 So yeah, so the ozone prevents you from having to drain it in between everybody's. Dr. Dituri: 40:18 So it's a professional sort of a system, right? Yeah. You open the top, it doesn't smell. You open the top, it doesn't have an oil layer on top. You know, you open the top and you have to break up the cook the ice. I mean, it's not like it's real. It's not just, oh, because when I started this, you did you ever hear the story of how I started ice bats? Dr. Ayla Wolf DAOM: 40:38 Uh no, I don't think so. Dr. Dituri: 40:40 All right. I had a simple premise of increasing cerebral blood flow. That's what I wanted to do. So everything that I pointed at was increased cerebral blood flow. So I'm driving home and I saw the polar bear on the side of the road with at the ice machine that said ice, ice, ice, five dollars. Everybody's probably seen that sign, right? And I went, what happens when you immerse the body in cold water? You shunt from the peripheries to protect the core. If you decrease the flow here, here, and in your legs, you have to increase the flow here. And what's the only thing that's out of the water? The brain. Common sense tells you that it's going to increase cerebral blood flow. We should probably do that. Guess, right? Like I'm rolling dice and throwing them against the wall. I have no idea what I'm doing. I got it. How long ago is this? Uh 2021. Okay. I didn't even know what cold shock proteins were. I didn't even know a 13% increase in brown adipose tissue. I didn't know anything about any of this, you know, hormetic stress that comes with ice bath. However, I got in the ice bath and I got out and I was like, oh, I feel good. I'm like, okay, but I can't publish I feel good. So Joe, get to school, right? Go to school, find out about this, this, this, this, where to where are the studies that have been done on ice bath? How are they, how does it increase cerebral blood flow? We don't have that data yet. But how do, you know, all the people in Finland and over, you know, over in that area of the world, they've been doing ice baths and and saunas for years, right? So let's read some of that literature and who did this study and that study. And then I'm like, ooh, this is some good stuff, right? Cold shock protein, I understand what that is. You know, heat shock proteins from the sauna, you start reading and you start going, oh yeah. Now, all of that intel is in the book, right? It's because I wanted people to have that intel in one spot where I can go, here's what I found out, and here's what you can do. Dr. Ayla Wolf DAOM: 42:44 Okay, Dr. Ayla Wolf DAOM: 42:44 so tell me, how often are you doing hyperbaric, cold plunge, red light? What is your weekly uh agenda around wellness? Dr. Dituri: 42:54 So you you don't want to know it, but I live my life for wellness. It's the single most important thing I do. I pray slash meditate every day. That is a non-negotiable. I drink a gallon of water a day, right? I go to the gym probably five, six days a week. I do cardio most days for at least 30 minutes. I walk, you know, five miles on the on the backside. Uh, you know, I'll probably walk 20 miles a week, sort of a thing. Um, but what do I do with ice bath? I go in cycles, right? So you can't do hyperbarics every day. That's just silly because when you're at that high partial pressure of oxygen, you're going to decrease the amount of hemoglobin you have. It makes sense, right? So you can't do it all the time. So I do low and very changing hyperbarics. So I do low pressure hyperbarics like 1.75 to 2.0, maybe even down to 1.5 occasionally. Um, and in cycles, right? I change it over the course of about a month every nine months or so, right? So I'll do it steady for five days on, two days off. For about a month. And then I'll take about eight months off. Right. And that's great because I have a ridiculous travel schedule. And I'm going to the World Extreme Medicine Conference to lecture in November in Scotland. And then from there I go to Munich. And then so it's great. I get the I can't take my hyperbaric chamber with me because it's a hard shell. So it doesn't come to Munich or wherever I happen to be going. So that those breaks are in life. They're already programmed in there. Same thing with ice bath. I go through cycles. Although ice bath, I have been on more in the mornings. So pretty much every morning we get out there, we hit it, and we've been doing it for like a month on, a month off, a month on, a month off. Sauna, way better for you. If you look at all the stats, all the stats suggest that look, if you can do sauna, you can decrease your risk of heart problems. I mean, and that's like we're talking an 80% decrease. It's not like a minimal change, right? Again, all that study is done in Finland, Sweden, that kind of an area. Um, so we try and do that more regularly. So, like three times a week, four times a week, but you know, life gets in the way. And then, you know, Stamatis calls me and says, bro, we're going out tonight. And I'm like, okay, you know, balance, right? I don't drink a lot. Occasionally I drink, you know. Dr. Ayla Wolf DAOM: 45:23 Yeah. Oh, you know. Another minor hormetic stress. Dr. Dituri: 45:26 All minor hormetic stress, exactly. unknown: 45:30 Yeah. Dr. Dituri: 45:30 No, you gotta enjoy this life. You know it, right? Dr. Ayla Wolf DAOM: 45:33 Yes. And how important is the temperature of the ice bath? Because I know people sometimes are doing 46, sometimes lower than that. How big of a difference is it based on temperature? Dr. Dituri: 45:46 The I'll answer that truthfully. Nobody knows. Okay. Here's what we need. We need you to get in the ice or get in the cold. And when you're in the cold, and this is not cold air. Let me tell you about cold air later. Let me tell you about the cold water. When you get in the cold water, you need to, it needs to be cold enough for you to go, right? Dr. Ayla Wolf DAOM: 46:08 And you it doesn't take much for me to do that. Dr. Dituri: 46:11 Right. Right. You're like 85. 85, that's me. Right? But you need to get over that gas reflex and control your autonomic nervous system stress, like right. And everybody does ice bath wrong because they get in the ice bath and they go, and what does that do? Sympathetic nervous system. Sympathetic nervous system is fight or flight, right? Let's go. Ah, right? Parasympathetic nervous system. It's supposed to be a calming effect, right? This is supposed to be a when you can do this in the ice bath, that's when you know you've gotten it, right? Dr. Ayla Wolf DAOM: 46:52 When you come on, so don't get in and start hyperventilating. Dr. Dituri: 46:56 Right. Stop the freaking hyperventilating, right? You should be attempting to control that. And once you get to that point, you're now then you can work down the temperature because you're gonna have to work down the temperature, right? So what temperature is best, nobody knows. Everybody's like not enough people are doing ice best that we can do research on it anyway, consistently, statistically significant. There's no real info out there. Cold 40, 30, 20, 52, whatever, you know. You hold on, I gotta break up four feet of ice to make sure it's this cold, and I need to have a running water fan blowing the cold water through. Oh, come on, give me a break, right? It seems right now to be all about the gas breflex. Dr. Ayla Wolf DAOM: 47:39 Interesting. Okay. And then you mentioned the difference between cold air versus cold water. Dr. Dituri: 47:43 Oh my gosh. So you are made of mostly water, right? If I'm water and this thing that I'm in is water, the chances of me getting a cold injury are much, much less because where is all the energy? All the energy is required in the state change operation. So changing from a solid to a liquid and a liquid to a gas. So if you surround yourself with air that's really, really, really cold, which is what we do in those frigid freezers, right? Really cold, you know, carbon dioxide cold, you know. So you make yourself so cold that you can freeze extremities. People have burned pinkies, people have burned not pinkies, right? People have burned pinky toes, right? So when you're when your nipples are burned off from the cold, it's a state change operation. You're going from a gas to a liquid. That is a tremendous amount of energy, right? So this is where science comes in. It's like, oh, that makes sense, right? Would you rather be burned by 212 degree water or 212 degree steam? You always want to be burnt by water. Water is way better for you to be burnt because you're water, right? Same thing in the state change operation when it comes from going to a gas to a liquid uh when it comes to uh your body in the cold. I mean, I I've seen football players that have lost use in their fingers because they go in those things. I've seen many people that have lost use of other things because they went in the cold. It's just a bad idea. You're talking cryo you're talking those cryo chambers. Cryo chambers, yep. And I don't get paid by the ice bath people to say this. I'm literally talking the physics of it, right? The physics and human physiology of it. And it makes sense. When you think about it, you go, oh shit, that makes absolutely perfect sense. Dr. Ayla Wolf DAOM: 49:48 What Dr. Ayla Wolf DAOM: 49:48 do you believe today about TBI brain injury that you did not believe 10 years ago? unknown: 49:55 Huh. Dr. Dituri: 49:59 I believe that it is a way harder problem to solve than I thought it was. I was like, what the hell is the problem? Come on, let's get on this. You know, coming out of the military, I'm like, we got guys with TBIs, we got to help them. I can do it. Like, oh boy, did I learn a lesson. Yeah. And that's the one traumatic brain injury. You've seen one traumatic brain injury, right? So things like that, these epiphanies that come to me, I'm like, oh, we got to treat this very differently. You know? I mean, yeah, I see this happen all the time. We we are limited by our knowledge of what we don't even know what we don't know yet when it comes to the brain. And I thought we had a good handle on it 10, 15 years ago. I was like, yeah, I guess we got a pretty good handle on it. Doctors are smart, right? Let me talk to them. Like, I don't know. I'm like, what do you mean you don't know? And you know, I'm talking with honest people who are honest with me. Uh yeah, we just don't know, Joe. And I'm like, wow, that's shocking. So yeah, there you go. Dr. Ayla Wolf DAOM: 50:59 Yeah, yeah. Uh perfect answer. And so true. Dr. Ayla Wolf DAOM: 51:04 Amazing. Well, I wanted to talk a little bit about the book. Um anything specific um that you want to touch on regarding your book. Dr. Dituri: 51:12 So interestingly enough, the drug companies want to throw drugs at you, and then bro science wants to throw other drugs at you that the drug companies aren't throwing at you, right? So know before you go, right? Every bro says, bro, you gotta do ibogaine. Okay, what do you need to know before you do ibogaine? It's in the book, right? What do you need to know before you do marijuana? What do you need to know before you do this? What do you need to know before you do that? I go through the pharmacokinetics, the pharmacodynamics, you know, the utilization review. I I go through the prep beforehand and afterward. I wish when when I was going through my TBI that this was available because I went, I went and did a ibogaine study. So I go down there and I do ibogaine and I come out of it and I'm in a really bad relationship at that point. And I come back and she's yelling and screaming about how I was talking to somebody and blah, blah, blah, blah, blah. And it was horrible. I didn't wind up sleeping for 30 days because ibogaine can have a stimulant effect afterwards. They don't tell you that before going into it. Nobody does. It's in the book, right? Like stuff like that. And then I went back and I just did another experience recently when I was finishing up the chapter in the book about ibogaine. And I it was way more positive because I controlled the environment, right? And when I returned, I returned to a peaceful environment and everything was tranquill, you know, like, and you know, so, and I did not, you know, things that go with that, you go, oh wow, if only I had known that before I started Endeavor down this path. But things like people are using alcohol, people are using GLP ones, right? GLP1s, we've been using them to increase cerebral blood flow for years. For 15 years, we've been using GLP ones. Everybody's losing to lose, lose weight right now. But nope, they were to increase cerebral blood flow. It's yet another thing. Here's the pharmacokinetics on it, here's the pharmacodynamics, here's what you need to know before you start and how this can affect that and second, third order consequences. Don't do this with this drug. And I go through everything that I know of that has come up at that point: synapsin, BPC 157, things that people like bro science, good broscience. I'm like, no, let's let's separate fact from reality. That is the good part of the stuff that's in this book. And I give people the hope in this book that they can do something for zero dollars that isn't gonna hurt them, that can't, that could possibly help them, right? Change your mindset, right? Go to the gym, increase autophagy, kind of try and work yourself into that uh, you know, strength and conditioning sort of a thing. Hydrate. You see me, I hydrate all day long and twice on Sundays. I'm a gallon of water a day, every day. Dr. Ayla Wolf DAOM: 54:10 Yeah, I love that that's how you're phrasing it is the book helps people to know what they should know before they attempt to go do something or try something. I think that's a phenomenal way of phrasing it. And your point on ibogaine is huge because ibogaine just like opens up all your receptors and places you into this really amazing state where you're you're able to have like massive leaps and bounds in neuroplasticity. But then if you go back into a toxic environment when your brain is in that state, ooh, that is not the neuroplasticity you want to be wiring shortly after doing ibogaine. Dr. Dituri: 54:48 Yep. Nope, that is a hundred percent correct. You want sleep, you want relaxation, you want calm, you want nobody going above 88 decibels. And everybody's like, how do you know what 88 decibels is? I'm like, it's it's loud. When you go, ooh, that's loud, right? It should everybody should be calm in your life and in your area for the week afterwards for sure, right? And everybody should know, and you should be maybe in a place where you can rest and relax. Take the time to take care of yourself. Look, and I say this to everybody that's going through a TBI. I'm like, if you don't take the time to take care of yourself now, your body will go, all right, I'm done. It's time to check out. Now I'm gonna check you into a hospital and I will force you to take care of yourself, right? Pay me now, pay me later. Everybody's like, oh, I can't do all that wellness stuff every day. You don't have to do it every day just for a 30-day period or so. You give me a 30-day period, I guarantee you we will change your life in some way, shape, or form. Am I guaranteeing that your TBI is gonna be cured? Nope. I'm guaranteed that you're gonna be different and better. That's all I can say at this point, right? We have the way to get from here to there. Now, cured? Well, it's a long way from here to there. So I agree with the FDA in that there is no real good endpoint for a cured traumatic brain injury. Well, you know why? Because we don't have a starting point. I don't have an EEG and a diffuse tensor imaging on you before you went in the military. And then I can compare it to after you went in the military, after you're back from the military after 20 years. Oh, no, I don't have any of that. The football player with the chronic traumatic encephalopathy, I don't have any of that. So I'm like, here's what we need to do for all the Navy guys that are all the military guys that are going in. You know, we need to do MRIs with DTIs beforehand, spec scans, PET scans. We do all that beforehand, and then when they retire, we can show the vast difference in what happened to them. And the military's like, no way. No, who's gonna pay for that? No, who no, no, that seems ridiculous. There's no science behind it. I'm like, but does it make sense? Dr. Ayla Wolf DAOM: 57:00 Yeah. Yeah. It makes perfect sense. And yet I think, you know, deep down people don't want that data because then when the data comes out, who's gonna join the military? Dr. Dituri: 57:11 Nope, nobody. You get it. Dr. Ayla Wolf DAOM: 57:15 Yeah. Okay. Well, this has been a pleasure. Thank you so much for your time again. Thank you. Dr. Dituri: 57:22 No, you're amazing. Dr. Ayla Wolf DAOM: 57:23 Thank you. Thank you. Well, I'm happy to share your book. I'll get the word out there and I'll let you know when the episode's out. Dr. Dituri: 57:30 And short little tidbit for you: this book is free to every military or veteran or you know, anybody that has been in the military or is in the military currently, free. Just email info at ibum.org and Rebecca will send you a copy for free. Zero dollars. You don't need to fill out anything, just need to tell what service you were in and how long you spent or something like that. And then done. Easy. Dr. Ayla Wolf DAOM: 57:59 Amazing. Yeah, love it. I will love you. We gotta take care of our bets. That's so nice of you. unknown: 58:04 Thank you. Dr. Ayla Wolf DAOM: 58:05 Excellent. Medical Dr. Ayla Wolf DAOM: 58:08 disclaimer. 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