Dr. R’s Fast Facts
- HRV (heart rate variability) is a tool to assess how much stress your body is under.
- It measures the tiny variations between heartbeats.
- A low variability indicates your body is under too much stress.
- It can be used to help you determine if you need to undergo stress reduction; sleep more, exercise less, drink less caffeine, fast less, meditate more, etc.
- HRV can be measured in just 2 minutes a day using a pulse measuring device and cell phone app.
- If you are an over achiever or type A, this tool may be great in preventing burn out.
- If you are trying to recover from a health condition, this tool could be used to help you determine if you are making progress or regressing with your therapies.
The Doc interviews Mike T. Nelson in this episode of Dr. Ruscio Radio. They dig deep into the subject of Heart Rate Variability (HRV). Dr. Mike T. Nelson has spent 18 years of his life learning how the human body works, specifically focusing on how to properly condition it to burn fat and become stronger, more flexible, and healthier.
Mike T Nelson intro…..4:27
Heart Rate Variability (HRV) defined…..13:01
Many things can affect HRV…..20:28
Guide to measuring HRV…..26:20
Mike T Nelson’s most important clinical intervention…..42:40
Best and worst thing Mike T Nelson his done lately for his health…..45:25
Parasympathetic properties of aerobic activity…..48:08
- (25:38) iThlete app http://www.myithlete.com/
Right click on link and ‘Save As’
HRV – A Novel Tool for Assessing Your Stress Levels
Welcome to Dr. Ruscio Radio, discussing the cutting edge of health, nutrition, and functional medicine. To make sure you’re up today on this and other important topics, visit DrRuscio.com and sign up to receive weekly updates. That’s D-R-R-U-S-C-I-O.com.
The following discussion is for educational purposes only, and is not intended to diagnose or treat any disease. Please do not apply any of this information without first speaking to your doctor.
Now, let’s head to the show!
Dr. Michael Ruscio: Hey, folks. Before we jump into the call, I wanted to give you your Fast Facts, which is a quick summery on the issue in case you want to get the summery and then get on to something else; and also a couple of quick announcements.
So, this episode Fast Facts on heart rate variability: heart rate variability or HRV is a tool to assess how much stress your body is under. It measures tiny variations between heartbeats. A low variability indicates your body is under too much stress. So, a higher variability would be healthier. It can be used to determine if you need to undergo stress reduction. So, do you need to sleep more or exercise less, or drink less caffeine, or maybe even fast less, or meditate more, or what have you. It can be measured in just two minutes a day using a fairly inexpensive pulse measuring device and a cell phone app. If you are an overachiever or Type A, as I am, this tool may be great in preventing burnout, because you may start to see your HRV score drop, and that may predict a coming phase of burnout. So, I think it has some really nice potential application there.
If you are trying to recover from a health condition, this tool could be used to help you determine if you are making progress of if you’re regressing. Or maybe if you’re recovering and you’re starting to do more and more in your life, this may tell you if you are doing too much too soon.
At the end of the interview, we segue into what will be one or two follow-up conversations about exercise with adrenal fatigue, which I think is going to be a terrific episode in the future; and also, one on sports supplements. So we spent a couple minutes just doing a very cursory chitchat on that. But we will definitely have Mike T. Nelson back on to go into more detail about those.
So, that’s your Fast Facts.
And just a couple other comments: for people listening to the podcast, please remember that on the website where this is published, we have a transcript available. So, if you want to have the transcript, that’s available there. Also, if you have questions about an episode, it’s much better to leave comments there rather than emailing the office. There is a contact submission form on the website, but that’s more so for patients. If you have a question about something more academically, like a podcast or a question about what was discussed there, use the comment section because that’s really the best spot to put those comments.
Also, please remember that on the website, also, if you wanted to ask question for an upcoming podcast, there is a submission button for questions there. And then, also through the website or through the newsletter, there are non-podcast videos with transcriptions and articles that you can get through the newsletter or through the website. So, unfortunately not everything I do goes out through the podcast. Somethings are just unique to video or to article.
And we’ve had a lot of questions about new patients. I am currently accepting new patients, so if you are listening to this and wanting help, please feel free to contact the office.
OK, so we will jump into the episode, which I think you guys are going to love. All right. Thanks a lot. Bye.
Dr. Michael Ruscio: Hey, folks. Welcome to Dr. Ruscio Radio. This is Michael Ruscio. I am here with my good friend and fellow super geek, Mike T. Nelson. Hey, Mike. Thanks for being on the show.
Mike T Nelson: Yeah, yeah. Thanks for having me on the show. This will be a good time, as always, to geek out a little bit again.
Mike T Nelson intro
DR: Absolutely, absolutely. I want to have you give the whole background piece and all that in a second. I wanted to quickly open with what we are going to talk about today, just so people will know. And I do not know much about this at all, so I think this will be a neat perspective of me being new and kind of like a beginner to this dialogue and just asking what I am assuming will be a lot of the same questions that people listening may have. This is regarding HRV heart rate variability.
We’ve spoke about it before, and the main appeal it had to me was potentially as a tool for people to know if they are themselves under too much stress. That stress might be work stress, it might be exercising too, not sleeping enough; maybe if someone is playing around with fasting, maybe they are fasting too much. So, at least from my very cursory understanding of it, it seemed like a really novel tool where someone could have an external, or an objective piece of feedback, letting them know, ‘OK, I’ve got to reel it in now, because I am putting myself under a little too much stress.’
So, that’s kind of the prelude. Mike, can you tell people, before we dive in, a little bit about you and what you’re up to and what you’ve been doing?
MN: Yeah. So, the shortest version is I did a bachelor of arts in natural science, and then went off and did some engineering work. Initially I was going to do biomedical engineering.I had an interest in physiology back several years ago – oh, God, 20-plus years ago now; makes me sound old – I just didn’t know what I was going to do with it. People were like, ‘Oh, you should go do biomedical engineering.’ ‘Oh, OK, that sounds cool.’
So then I went to Michigan Technological University – in the Upper Peninsula of Michigan – for two years. (I) decided I was going to do a Masters at that point, so it was another two-and-a-half years. I ended up doing a Masters, actually, in mechanical engineering – I did more of the bio-mechanics angle for class work. And then my research was more in more of the biology side. So in essence I made a computer generated model of this super huge microwave transmitter, and it was a monkey head. So, in essence you have this model of this big gigahertz transmitter pointed at a monkey head. We wanted to see if there (was) any deep-tissue heating effects. At the time they said, ‘Ah, you know this is for collision-avoidance systems on cars for safety stuff.’ I’m like, ‘OK, sure. Whatever.’ You know, sponsored by Brooks Air Force Base in Texas. What do they care about it?
Several years later it was declassified, and they said that the military was actually using it to make what they called a “ray” gun. So, you would literally point this microwave transmitter at a crowd of people, and then they would disperse because the frequency is so high, that it causes pain when it hits your skin. But, there is no deep tissue heating effects. So, if we were to create a microwave out of this specific frequency, if you left food int there long enough, it would just burn the piss out of the outer layer, and the inside would still be frozen. It was actually called and active-denial system.
All that is to say that kind of how I started doing more of the engineering side. So I finished that – I actually worked for a medical device company for over 14 years. They did some work in heart rate variability, too. Once I finished school the first eight years instead of never going back, it lasted like two years. And then 4-5-year stint in the biomed program at the U and then transferred to exercise physiology. I was so tired of math; I didn’t want anything to do with math ever again.
MN: Literally the first day I sit down. We have a department meeting, and my adviser walks in and goes, “Hey, we’ve got two new projects. And they both involve math.” And he’s looking around the table, and he gets to me at the end and goes, “Hey, you, math boy. These are your new projects.”
MN: I was like, ‘You’ve got to be fricking kidding me.’ I’m like, ‘I dropped out of another program that only had two classes left but no research. I come over here and I am looking at metabolic flexibility and heart rate variability – this is probably nine years ago now.’
So, that was the first time I heard of either one of them. So, I’m like, ‘Oh, OK.’
So, yeah, finished that; (I) published some research on that looking at heart rate variability and energy drinks, things of that nature. And then, right now I do different projects for different people. I do some nutrition stuff for you to perform. I actually do some mindset stuff for the Mindset Performance Institute, more on the research side. And with my own clients, I’ve done HRV on them, which we will get into, almost three-ish years now coming up on that. I’ve got daily HRV readings on myself for almost three-and-a-half years. So, through that whole process I’ve known the background and stuff. But only recently has it been able to get daily readings at an at-home situation, which I think is really, really useful. We will talk more about that. So, yeah, I’ve found that it’s been very useful because the conversations you have pretty much always revolve around some type of stress and some type of lifestyle intervention. But to have that marker of stress to say, ‘Hey, here’s what your body is reacting to, and here’s how it’s reacting. To me, I think that’s a huge missing component of fitness.
DR: Right. And the way I look at this also is, something you can’t get people to relax or distress or do less until it’s almost too late – until they crash. And so, this is something that they can preemptively help you head that off. I think it could be a hugely helpful tool.
MN: Yeah, and the same crazy people email me and they are like, ‘Well, if you’ve been doing this so long and training and all this stuff, why do you still do your own HRV? Don’t you know what the hell’s going on with your body?’ And it’s a valid point to some degree, and I do know what’s going on. The problem is, I tend to solve everything with louder music and more coffee and less sleep, which, as we all know, you’re going to pay for that at some point.
So, now at least I know if I look at it says, ‘Hey, you are actually becoming more stressful.’ Now I know, OK I…it’s just more of an awareness thing. I can, in essence, kind of get out of it and say, ‘OK, I’ve been here before. This is lower than what I want. I am going to actually take the day off. I am going to maybe do more recovery work or whatever. So I try to circumvent it a little bit sooner, instead of always thinking, ‘Oh, I can get by with one more day. Oh, one more day I can get by.’
DR: That’s what a a lot of workaholics…I am the same way. You took the words pretty much right out of my mouth, being a workaholic. You always want to push that envelope.
DR: Sometimes you just keep kidding yourself thinking you can do things that in the past have burnt you out, but this time it’s somehow going to be different. Eventually, the impending crash comes, and you finally reset. So, yeah, I think this could be a great way, again, to help people get out ahead of that.
Now, Mike, where can I get one of these ray guns that you made?
MN: The military actually has them now. Because after 9/11, everyone branch in the military wanted one. So, if you look it up, it’s actually called active denial system. A buddy of mine who was actually in the military had it tested out on him, and he said, “Man, it hurts like hell.” But, as soon as you are out of the beam, it literally goes away. There is no deep tissue heating or any effect. I did a presentation for DARPA – Defense Advanced Research Projects Agency – a couple years ago on some metabolism stuff. I was talking to one of the colonels there just about if they’ve heard of this system, and how do they use it – because that part has been declassified now – and he said, “Well, we use it but we’re not really sure how exactly to use it, because it’s a non-lethal method.” I said, “Oh, that’s interesting.” He’s like, “Now and generally, if it doesn’t deter the person, and they are still coming at us, we know 100 percent for sure they are a threat – so, we just shoot them then.”
DR: Well, they know what they are doing I guess, right?
MN: After my buddy said how bad it hurts, he’s like, “Yeah, you’ll do everything possible to get the hell out of there.”
MN: If someone is still coming at you, in the beam, they are intending to do you big harm.
DR: Sure. So, they have a kind of a one-strike system.
Heart Rate Variability (HRV) defined
DR: Can you tell us, first off, what is HRT? And as you are explaining HRT if it makes sense along with the explanation of what it is and how it works, maybe how we can use that as a tool to help us gauge when we are putting our bodies under too much stress?
MN: Yeah so, ‘HRV’; obviously it’s not ‘HRT’…
DR: Sorry, I have such a bad habit of…yeah, I always talk about ‘HRT’, so I will probably do that five times today.
MN: Yeah, no worries. So, intravenous heart rate variability. I explain it to people as at its basis, it’s a little bit more abstract, which we will get into. But in essence, it’s a marker of the status of your autonomic nervous system. So, most people listening to this know that the autonomic nervous system is divided into two main branches: one is the parasympathetic – this the rest and digest branch of the nervous system. And the other one is the sympathetic, or the fight or flight; potentially, freeze or faint. There is actually a goat that gets really stressed that it actually faints – it’s a fainting goat. Which is kind of weird.
So HRV is telling you – are you becoming more parasympathetic, or are you becoming more sympathetic? So, you can think of it as parasympathetic is like the break on your car; sympathetic is like the gas pedal on your car. Your body always those of mix of one or the other, and actually both at all times. So, HRV is telling you that percentage. Are you becoming more stressed? Or are you becoming more, in essence, relaxed? Does the parasympathetic side being increased, meaning their body is trying to do a more active recovery-type thing? So, of you look at heart rate under parasympathetic control, which the heart is normally, you have a lower resting heart rate. Under sympathetic control, you have a much higher resting heart rate. If you briefly look at the math that is involved, it’s a variability analysis – actually not an average. So, most people on this call who are listening, they’ve been able to take their average heart rate off a polar unit or something like that.
HRV is looking at these small, millisecond changes from one beat to the next. They used to thing that if you were just resting, your heart rate should be 70.00 beats-per-minute or whatever ends up being. And the next beat should be 70.00 bpm – that it should be the exact same because you are resting – you’re not in essence quote/unquote doing anything.
What they found when they started measuring it with more accurate equipment a long time ago was that, in healthy individuals, it was not true. So, they’d measure it and you’d be like, ‘Oh, 68.5; oh, 71.2; oh, 69.3.’ They were like, “What the hell is this? You’re suppose to be at rest; why is it changing?”
They find that those small changes are actually the variability from one beat to the next. So, in essence, I explain it as, if you had a whole pile of numbers – let’s say you have 12 numbers, and you do the average of them. OK, cool. Now, I take those 12 numbers and I mix them all up again, and then I run the average again. The average is going to be the same. It doesn’t matter which order I did the average in. But, if I run the variability analysis, and I do it the first time, and then I mix them all up and do it again, I actually will get two different numbers, because the relationship from that one number to the next number and so on actually matters. So, it’s a variability analysis on a really, really small level – a millisecond level. And that’s what the devices are actually measuring. So, when you’re healthy, you have more of superfine scale variability. As you become more diseased and more stressed…there is some really good data looking at increased risk of cardiovascular disease, myocardial infarction or heart attacks. You lose that fine-scale variability – it becomes much closer to almost a more perfect steady-state, which m in this case, is actually bad. In pretty much every system in the body that we’ve studied so far, has this inherent fine-scale variability. So, the second part of my research was on the research was looking at that fine scale variability and metabolism. That was the second part of that – it’s kind of how they are tied together.
DR: Gotcha, gotcha. OK, so essentially the higher the level of the variability, the healthier that is. Maybe a really simple analogy to encapsulate this for people – this may not be totally, factually right, but maybe it will help people connect with the concept. What I picture in my head when you are saying that is, if you starts becoming more and more stressed, and you start pushing your heart rate higher and higher, you’re almost running with your engine maxed out, and you are going to have less variability when your engine is maxed out. Whereas, if you’re driving much more slowly through town, let’s say, you may be going 35 to 30, back to 35 again. So if you are less towards maxing out, you may have more natural variability. But, if you’re maxing out a system, you may be like you floored your engine, and so you are just at that steady, super-high rate.
I don’t know if that helps anybody; that’s what I was thinking in my head while you were saying…
MN: No, and I would agree with that, too, So, how I explain that to people is exactly that – is that, as you become more sympathetic, you’re literally just jamming the gas pedal down in the car. People email me and they’ll be like, ‘Oh, my HRV went into the hopper; oh, but I went and lifted today and get a new PR. Ahhhh, HRV sucks. It’s worthless.’ I’m like, ‘Well, if I take my little 2001 Jetta, I can redline it and drive faster. The car will go faster. But, I can’t do that every day and expect the car to last real long.
MN: Right, so if your heart rate variability is kind of skewed – in essence, if your really sympathetic driven, and you’re very stressed, you may you enough residual capacity to train that day and do OK. I can absolute guarantee you you’re not going to do that every day.
DR: The exception doesn’t define the rule, so to speak.
MN: No, no. If I could only get one point across to people, and I made this mistake early on – years ago – is that I think HRV is much better looked at as to what was the cost of what you did instead of trying to be predictive.If people just get that, that makes a lot more sense. So, if I do mu HRV in the morning and it’s red, I want to see what did I do yesterday, what did I do the day before? Because something is making you more stressed- whether it be training, lack of sleep, nutrition, whatever; something is skewing your autonomic nervous system to be more stressed.
Now, you may or may not be able to train OK that day. In general, we would recommend you probably don’t want to. But, you know, if you’ve got a competition or things of that nature, you know? And you have to perform – you know, a lot of times you can do that for one day, but not every day.
Many things can affect HRV
DR: So let’s say someone has insomnia. Something that can certainly make insomnia very pronounced is stress.
DR: And maybe they notice of their insomnia waxes and wanes, and they are trying to figure out what is it that I’m doing that driving that insomnia? And they may have a few things that are trying to sort out in their head – could it be caffeine? Could it be working out too late in the day? Could it be fasting? Could it be, you know, every Thursday we have a staff meeting at work and I get chewed out, and that really seems to rev me up? So, potentially people could start looking at what their HRV is the next morning after these events in reflection. And if you were to see your HRV take a turn for the worse – more pronounced, let’s say, after caffeine – you may then want to really reflect on and consider scaling back caffeine because that may be more stressful than all the other things, and maybe you didn’t realize it until you used this tool to sort that out.
MN: Yeah, and the big bugger with all that is all of those things can actually affect your HRV. That’s where people get really hung up, too. They are like, ‘Oh, I think it’s just training stress.’ No, it’s your whole lifestyle stress. What I’ve seen in pretty much every single person so far is that sleep is a huge determinant of HRV. So, I agree with what you’re saying. The hard part is: let’s say you had a lot of caffeine, and that causes you to sleep less, your HRV is skewed the next day. You don’t really know. Is it the caffeine or was it the lack of sleep?
But, you can run the next experiment, right, and figure it out. So, if I decrease my caffeine, and I had just happened to sleep the same amount, OK, HRV was better. Oh, OK, so maybe caffeine is a little bit of a bigger driver.
MN: And the new apps will have ways you can make notes and report on different things on that. I tell people that it’s a way of looking to see what do I think is the biggest thing. So, if I think a lack of sleep is a big thing. So, with clients I work on, OK, you know, have your room dark – all of the things you guys talk about. And let’s have you go to bed a half-hour earlier. Let’s try to have you get more sleep. Let’s leave your training the same; let’s try to hold the other variables the same, as much as we can. Does your HRV start going up? Or does it keep trending down?
The hard part with sleep, that I’ve noticed, is that it appears to be more dependent upon sleep debt than acute sleep. The first has mystified me, because I’d sleep, like, four hours a night, do my HRV in the morning, and it would actually be, some days, pretty good. I’m like wait a minute. I only sleep four hours; I thought this was suppose to tank. In other days I would sleep – on a weekend, I used to sleep in for 11 hours. I’d take my measurement and I’m like, ‘Oh, it’s still crap. What the hell? I slept 11 hours.’
What I realized was that it’s more dependent upon your sleep debt. So, if I sleep those four hours, and I did not have much of a sleep debt going into it, I may be OK. The fact that I had to sleep 11 hours on a weekend still tells me I have a pretty massive sleep debt I’m still trying to repay. So, that residual stress is still giving me a lot higher (readings).
DR: Right, right.
MN: And that really trips people out. That took me awhile to figure out, too. I was like, ‘Oh, that makes sense.’
DR: That’s a key point – so it’s not an acute reaction to sleep; it’s more of a long-term sleep-debt reaction. I think that’s a key point for people to realize.
MN: Yeah, because it’s a total body autonomic nervous system stress, right? So, a lot of things go into that. And we know from studies, and our good friend Dan Pardi, that as you get less and less sleep, right, the stress level tends to accumulate a little bit higher and a little bit higher. And a lot of times with that kind of stuff, people don’t realize it.
Classic studies on people who are sleep-deprived, the researchers would say, ‘Oh, everybody comes in and reports they are doing pretty good. Then we have them do a boring task that we record. Half the subjects fall asleep within 5-10 minutes, you know? As you become sleep deprived, the ability to tell that you are sleep deprived actually gets worse. So, you don’t really notice it as much then.
Guide to measuring HRV
DR: All right. Certainly in the clinic, one of the things that can sometimes be the hardest sell for people is just getting an hour more sleep.
MN: Oh, totally.
DR: I think what you said just totally reinforces that point where they’ve probably forgotten what it feels like to be super sharp…
DR: …and to feel super on-point and be able to get through the morning lull without caffeine. This could be an objective way of saying, “I know you think you’re getting enough sleep, but we have an external point here showing that your body is under more stress than you think it is. Let’s have you get that hour more sleep for a week or two, or what have you. And let’s see if this number responds really favorably. I really like it.
MN: The really cool part about the app I use, which is from a company called iThlete (1). What you can do then in the morning after you take your measurement. It takes about 60 seconds. You then self-report things like sleep, fatigue, nutrition, mood, that type of thing. Just on a 1-to-7 scale. Then the clients will email me that. What’s really cool, then, is I have objective, quantitative data – I’ve got resting heart rate and HRV. And I also have qualitative data – how they reported their sleep and fatigue and that sort of thing.
MN: I usually then point out to them and say, ‘Oh, look at this! Your last four or five days, the sleep you reported is a lot less or worse. And your HRV shows you became a lot more stressful. Literally, that’s all I will do. I will send that back to them, and they go, ‘Oh wow, you’re right! Oh!’
MN: So what do I do to get better sleep? In one case, it was the same person. Before we were doing HRV, we had a sleep conversation probably every time I talked to her for, like, three months. (laughter) But, it didn’t register, right? But now that she has a way of visualizing and looking; ‘Oh wow, that does seem to matter.’ So now they are asking me, “What can I do to fix it?” As they start to fix it, they get a positive reinforcement, right? So, you are closing that feedback loop. ‘Oh wow, my HRV is starting to go up. Oh yeah, I do actually feel a little bit better.’ Because, as you know from working with people that if you have a super-massive sleep debt, you may sleep for quite a while better. But you may not necessarily feel better right away. So, if you are looking and it’s saying your body is actually less stressed, you may not feel it yet. It’s sort of that positive reinforcement that you are going in the right direction. A lot of times, that’s enough just for them to keep up the habit change.
DR: Yeah, no, I absolutely agree. Anything we can do to get people more aware of the importance of sleep and stress, I think it will be huge. I do think that, as a society as a whole, moving toward a point of this accepting as normal a progressively higher level of stress.
DR: And part of that stress, of course, includes sleep deprivation. So, Mike, what would you say would be the simplest way to get someone starter on HRV? What tools should they use to measure it? Apps they should use? How they should measure? What would be your beginner’s guide to getting started with this?
MN: Yeah, there are all sorts of different systems now to measure it. The one I am most partial to, as I mentioned, is ithlete, which is just i-t-h-l-e-t-e. I don’t make any money from them, but I know the guy who runs the company – I’ve known them since they started. They have a lot of literature now showing that their system is accurate, that it is reproducible, especially compared to fancier HRV-type of equipment. They use what’s called a time domain analysis, which you don’t need to get into. But it’s an industry-based standard for how they calculate the HRV numbers. Then they just translate them to a 1-100 scale to make it a little bit more user-friendly.
So the next part is I can trace all the numbers back through the research and all that kind of stuff. How they would do it is buy a unit. It runs through their phone, so the app right now is around $10. That may change in the future. If you have a Bluetooth-compatible strap already, you actually just only need the app. If you don’t, you can get a little finger sensor or a Bluetooth heart rate strap. I just have people set it next to their bed.
DR: This strap, you said, can be a finger or a chest? What kind of options are available for the actual measuring?
MN: Yeah, so there is three options. So, if you’ve got a super old phone, and you’ve got the super old Polar system that does not use Bluetooth – if it’s called AMT+ – you plug this little dongle in, and that allows you to communicate with the phone. If you have a new Bluetooth low-energy – so, like, iPhone 4s and forward; so most new phones now…
DR: And Droids – most of the modern Droids have the same thing?
MN: Yep. You just need the low-energy Bluetooth heart rate strap, and then the app for $10. If you want, you can bypass the strap and everything, and they have a little finger sensor you can use. It actually looks at changes in pulse pressure in your finger in order to determine HRV. Some people like that a little bit better because they don’t have to hassle with Bluetooth and that kind of stuff.
DR: And are both comparably accurate?
MN: From the data I’ve seen, yes. There is a little bit more date on the ECG strap, just because of the history of them. The data I’ve seen on both is actually very accurate. When I was teaching at St. Thomas, it was funny. I was talking about HRV and I had an old Droid 1 phone at the time, which I had for three-and-a-half years. So, I put it on the little display, and everyone is like, ‘Whoa’. I’m like, “What?” They’re like, “Your phone, it’s so old.”
MN: It’s not that old. It’s only a couple years ago. So I am explaining to them all of the HRV stuff. I said, “Even if you have to buy everything off the shelf, you can get a system for $100.” And they go, “Oh my God, $100. That’s so expensive. That’s just crazy.” And I’m like, “Well, the equipment…” literally at that point three years earlier in the lab I used was about $10,000. So, literally within a couple of years it went from $8,000-$10,000 to about $100.
DR: Not a bad shift at all.
MN: No. And like I said, if you have the strap already, it’s $10. And there are other systems, like Jason Moore’s HRV Elite. They have a system that is currently free for just the basic system. So yeah, once you have that, I tell people, ‘Just put it next to your bed. Turn off your at night; you don’t need your phone on.’
DR: So, hang on one second before we go any further.
DR: What would someone – let’s say they wanted to go buy one on the computer right now – what would have them type in, or what specifically should they shop for and actually purchase?
MN: Yep, just type in Google ‘iThlete’.
DR: And that’s for the app, right? I will put that link (1 http://www.myithlete.com/) in the notes. Can they buy a measurement device through iThlete also?
MN: Yep. They can get everything there.
DR: Oh, perfect. That’ll make it real easy for people.
MN: The Bluetooth strap that I use is the same one they sell. The reason I use (the strap) is because it’s pretty durable. I’ve literally had the same strap for almost four years now. You can replace the battery – it’s just open the back. So, it’s pretty easy. Some of the other ones you have to send it in to replace the battery and all of this other monkey motion. So, it’s just kind of my bias. Again, I don’t make any money off of selling them. I probably should, but…
MN: Once you have that, I tell people to buy a little tiny bottle of nasal saline, and then just put that next to your bed. If the conditions are really dry, the little electrode pad sometimes don’t have very good conductivity, and you don’t want to mess with EKG gel and all the other stuff. So just use that to whet the pads a little bit. Put it on first-thing in the morning. The catch is that, when you measure it, most people are probably going to have to measure it in a seated position.
MN: So in essence, if your resting heart rate is below about 50 beats-per-minute (bpm) or somewhere around there, you’ll want to measure it at lest resting seated – in some endurance athletes I actually have them measured standing. The reason for that is a fancy term called parasympathetic saturation, which in English just means that if you’re an endurance athlete, your resting heart rate is 43 (bpm), you are very, very high parasympathetic stimulation. So the rest and digest branch is very, very active. And changes due to training and other types of stress may actually not show up because that branch is so active. But the sheer act of setting up or standing, now you’ve got a little bit of an increase in heart rate, you’ve got other sort of compensatory regulations that have to happen. Then, that’s enough that the changes due to training and other stressors will show up. So, most people will just put their feet over the side of their bed, put on the strap, and I tell them to wait there for at least 60 seconds or so – you want the measurement to actually start to stabilize; it’s going to initially change because of the seating position change. Once that stabilizes – it’s usually only a minute or two – I just hit start, it’ll tell you to breathe in a specific pattern, because we know that breathing can actually change HRV – you want that to be constant. A little circle that goes in and out, and then after about 55 seconds, it gives you all of the data. You can type in all of your notes, and then rate yourself on sleep, fatigue, mood, that type of thing.
DR: And it reports that in a 1-100 (scale). Is 100 the best, I am assuming?
MN: Yeah, so the scale is a 1-100 – the higher number is more parasympathetic.
MN: Technically, you could go over 100, but it’s pretty rare. The next question people have is, ‘What number should I have?’ It varies a lot from one person to the next. I tell people to get a good baseline for about three-to-four weeks before you do anything too crazy. So, when I work with new clients, I’ll send them unit; I do this part of their training. ‘OK, here is your first training program. We are going to measure this for three-to-four weeks everyday, just whenever you get up in the morning. And then, we will go back and look to see what was the biggest stressor? Was it your training? Was it nutrition? Was self-reported fatigue? Was it sleep? And now we’ve got a pretty good baseline to know where you are at. And so, I will try to make one change at a time; maybe it’s sleep, maybe it’s their training. So, we will work on that and just keep measuring and going forward.
DR: So you’re more interested not so much right out of the gate in hitting a particular number, but in getting a gauge for where they are, and, essentially, moving them in a healthier direction from their baseline?
MN: Yeah, and that’s the big thing. I still get emails, not so much now, from people who are like, ‘Hey!’ One guy who actually sent me awhile ago…sent me a number, “Hey, I did HRV on this iThlete. What do you think?” The number, you know, was pretty high – so very parasympathetic. I was like, “Well, it could be good. But you could also end up in what’s called parasympathetic over training or being over-reached, which is actually bad.” I said, “Where is the rest of your data?” And he was like, “I just took one data point.” I said, “Oh.” I said, “Well, how does the athlete feel?” “I don’t know; let me ask him.”
MN: “He feels horrible.” “Oh, OK. You may be parasympatheticly over trained even though his number looks good.”
So you think about the process of what happens to the body. Everyone always cites Han Silo and the gas law and all of that kind of stuff. I don’t think that’s necessarily wrong, I just think it’s a little too oversimplified. I think of it as your body will do everything possible in order for you to survive. Your physiology is hardwired to be very survival based. So, if you are having more and more stress in whatever form, your body says, ‘OK, I am going to try to put out more sympathetic – so I’m going to try to keep up with the stress,’ whatever it is. But at some point, your performance is going to start to drop off. You’re not going to feel good. You’re going to have all of these symptoms that are telling, ‘OK, dude, you need to pull back and rest.’
But, if they keep ignoring all of those, at some point – which can be months for some people, usually years for a lot of other people, it’s like, ‘Hey, I told you, and I warned you so much that you become more and more sympathetic, sympathetic,’ and literally almost overnight, you become massively high parasympathetic. It’s almost like your body is saying, ‘Hey, your performance dropped, everything dropped. I am going to make you feel so incredibly crappy, you’re going to lay on the couch and drool on yourself and get nothing else done. Because, if you keep continuing down that path…’
DR: That’s the crash. That’s a crash I think a lot of us have maybe experienced.
DR: We just push, push, push, push, push. I’ve had that very thing happen myself where I’ve been a bag of shit on the couch for entire Sunday and just watched movies.
DR: I’ve burnt myself out. Sometimes your body is saying, ‘Nope. We are going to do this now.’
MN: I’ve worked with a couple people now that…one girl, in particular, it took us a year-and-a-half for her to recover back to almost normal. You talk to some higher level Olympic athletes who are really pushing the levels. They would say even two-to-three years after it’s happened, they are still not 100 percent. I kind of did it to myself. I saw you last fall and all of that kind of stuff.
MN: By that point I had been burning the candle at both ends for 12-ish-15-ish years. I knew better, but trying to finish a degree and open your own business and all this other kind of stuff.
MN: At that point I was sleeping 10-and-a-half-to-11 hours a night for two or three months before I saw you.
MN: It can get so bad where people actually have their sleep disturbed. So, there are people who now they can’t even sleep, right? Their body is just so confused. The thing I always tell people is that it’s not a linear progression. And you never know where your body is in essence going to go right off the cliff. That may be years; it may be months. It’s usually more in years. It’s quite awhile. But you can go from ‘I feel crappy, I feel crappy;’ it goes on for months and months to years. And literally within a week or a few days, you can just be pretty much shutdown. And when that happens…yeah, that’s much, much harder to come back from.
MN: It’s rare, but it’s a lot harder to recover from that.
DR: Sure, sure. The accumulated effects of stress and not taking care of yourself are a big deal. And sleep and stress, I think, for all different types of clinicians, can be – sometimes for some people – the hardest thing to convince them of. Like that gal you were mentioning.
DR: That’s another reason I see a lot of allure with this tool – it’s another way of getting people to say, ‘All right; I am overdoing it. I’ve got to scale back.’ Especially for Type A types, overachiever types, I think this could be a really nice tool for them.
MN: Oh yeah. My rule of thumb: I do it on all the athletes and people that I train, but I will not train anyone who is Type A does CrossFit without measuring HRV. Just because I know I don’t have any leverage to pull them back. Not that CrossFit’s bad or anything like that – I do a fair amount of work with CrossFit athletes. But, I need that leverage point to say, “Don’t yell at me. This is what your body is telling me.” You know?
MN: I try to get myself out of that whole loop. And, you know, some athletes can handle it and they do fine. Cool. I am definitely not again training, you know? I’ve had some people do two-a-days, pretty heavy intense stuff, but it took them years to build up to that and they were at a pretty advanced level. The average person who walks in who has a Type A personality, has a busy job, has a family, and then they are going to do high-intensity exercises four-or-five days a week…it’s usually not going to go so well. You know?
The training, a lot of the times, is the only thing that they can really control, you know? A lot of times they don’t want to change their sleep and other habits, and so sometimes just getting them to take a day off is really hard. But, you know, take a few days off, just go for a walk. ‘Oh look, your HRV is better.’ Oh, OK. Oh, wow. OK.’ So now you have a little bit of leverage, right? Where in the past…
DR: Never convinced, no.
MN: They would go, ‘I don’t feel so good. I am going to go train again.’ I am like, ‘Well, OK.’ So, it gives you some leverage to say, “If you can handle that sort of training, and your body is telling me that you are doing good, cool.” I would still insist on trying to make some other lifestyle changes, but you’re not at as big a risk, you know? Someone else, all the indicators are showing that they are stressed out to the max – I even told one client once, I said, “OK, here is the deal. I have this information that tells me over the last two-or-three months you’re progressively becoming more and more stressed.” So I said, “You have to take the next three-to-four days off.” I said, “In reality, I’m even wondering if I am liable if something bad happens to you. I had all the data that says you shouldn’t be doing it.” You know?
MN: To get them to a sort of a weird area – and I’m not an attorney. It’s just like, ‘Oh, Ok.’ Most of the time they do that, their performance goes up, not down. So.
DR: Right, right. You have to have that time for recovery, absolutely.
DR: So, Mike, kind of a couple things to bring us to a close here.
DR: What would you say – and it may or may not be HRV – your most important clinical intervention, and your most important test is or are that you do with people?
MN: Ah, I would say clinical intervention – I stole this from my buddy Coach Cal Dietz – which is as trainers all we are doing in essence is stress management, whether that is training stress, lifestyle stress, nutrition, digestion, whatever. We are just trying to manage that level of stress, because we know the training is stressful, and that your body does need some type of stress, you know? We know from bed rest studies and micro gravity that if you remove all forms of stress, your body gets worse real fast.
MN: So, it’s not the stress that’s bad, it’s your response to it. So, my personal bias is I like looking at performance first and then HRV second. If you only measure performance really closely…all my clients, I monitor volume, density, intensity, RPE, and sometimes I’ll put a push unit on them and measure velocity, because I really want to know if the performance is getting better or not. And if I am trying to purposely push them a little bit hard, yeah, it may drop a little bit, but it should come back. If that’s the only thing you did, you’d probably be pretty good, because that will give you most of what you need to know.
I do like the HRV because it’s telling me the cost of everything else – the cost of their lifestyle. For example, if I say that their training performance is getting better and better, but their HRV is becoming more sympathetic, that’s going to tell me that I probably need to pull back sooner than what I would otherwise.
MN: So, a lot of the programs I run for people could be three-to-seven weeks, you know? It just depends on how they respond. I think that allows you to customize it for each individual, and also I think gives them the nice reward of, ‘Hey, you’re doing much better with your nutrition, your sleep hygiene is better, you are managing your stress, your mindset is better. Oh look, your HRV is better, and now your performance is better, too. It kind of gives them that, like we talked about, positive feedback, instead of having to wait three, four, five, or six weeks to see what’s changed.
DR: Right, right. OK. So, the intervention would be, like you said, stress management, and would the test then be the HRV? Is that your main test for assessing these things?
MN: Yeah, I would say performance, and then second would be HRV.
DR: Gotcha, gotcha. OK.
DR: And something else I’d like to ask every guest. Chris Kresser was on awhile back (https://drruscio.com/chris-kresser-dark-side-healthy-episode-16/), and we did an episode that I thought was a very important concept. We are all trying to become heathier, but sometimes we become too infatuated or obsessed with becoming healthier. (But) we become unhealthy because we are trying so hard to be healthy, right?
MN: Yeah, yeah.
DR: We won’t have a sip of beer or eat anything bad. So, I like to ask people: what is the best and what is the worst thing you’ve done for your health lately? What would you say to that question, Mike?
MN: Uhm, yeah I agree with…
DR: I really put you on the spot.
MN: No worries. Lewis Black’s quote – ‘In the US, we are so worried about our health that we’re not f-ing healthy,’ right?
MN: I thought that was just brilliant. The biggest thing I’ve done for my own health lately is I’m pretty good with sleep now. That took me a couple years, to be perfectly honest. I am getting much better at programmed down-time, and actually having that be a set period of time. Whether I do something like a float tank – which scares the piss out of me because I have to hang out there with my own brain for 90 minutes and not do anything. But you don’t have any other options. For me, kite boarding, because you have to pay attention, but it’s a very relaxing type of experience for me, but you still have to pay attention – the whole state of flow, that type of thing.
The thing that I do that is probably not as healthy is I probably still drink too much coffee. Again, not that coffee is bad, but if I’m not very careful…I always think, ‘I can make it one more day. I can make it one more day.’
MN: What I’ve noticed over time is that my HRV average will actually start to go down. So, the next thing I am doing is basically running an aerobic-base intervention. Doing more aerobic training – only one-to-two days of lifting per week (and) the rest aerobic training to increase that base. And I increase my base level of para sympathetic tone so that in the future – two, three, four, five months – I can actually handle a higher amount of stress. That has been hard for me to do, because I love lifting stuff and stones and all of that kind of stuff. But, at some point, I’m going to have to build a bigger base of the pyramid in order to handle those increasing levels of stress.
DR: Do you think – and this actually might be a great topic to even do a follow-up call on. But, do you find that aerobic conditioning has an anti-stress or a parasympathetic affect? Is that what you are saying? Am I hearing you right on that?
MN: That’s actually what I’ve found. I’ve been looking at this for a couple years now, and so, anecdotally, I’ll interview top power lifters like Mike Tuchschere, a bunch of other guys. Drugs aside, you look at Westside stuff or whatever. Almost all of those athletes CrossFit have super-high work capacity. Now, if you look at Mike Tuchschere’s training, he doesn’t necessarily do aerobic work, but a lot of his accessory stuff is higher reps, long training sessions. So let’s say you do 5×5 on the squats, right? When you are doing the lift, it is very anaerobic driven. The second you rack the weight, you start moving down into aerobic. And what I’ve noticed in people whom have a low level of aerobic fitness, their ability to do repeated high-quality work is usually not very good, right? Because their aerobic system is taking so long to replace that ATP and whatever energy system they are working at. And, if you think about what energy system are we using most of the day – in a perfect world – it’s actually more aerobic base, aerobic-type work.
MN: So I’ve noticed…I’ve talked to Coach Cal Dietz about this a lot. They will run an eight-to-12-week aerobic base for their new athletes. Then they’ll maybe touch up a little bit throughout the season. The part that really changed my mind on this is from (undecipherable) and it showed what’s called residual training effects. What they showed was, like, strength and, like, aerobic at like 30 days, plus-or-minus six – meaning, if you went out tomorrow and did almost no strength training at all for almost 30 days, you wouldn’t be that far off of your max. You’re going to go down a little bit because of loss of skill and that type of thing.
DR: Sure, sure.
MN: But, if you look at speed work – which is, like, three-to-five days, plus-or-minus one-to-two days – you have to do speed work pretty consistently in order to keep it at that high level.
MN: All that to say, I think if you run an aerobic base-type thing for awhile, you probably don’t need to do too much in order to keep that at a pretty high level. The hard part is, you probably need a concentrated period of time to elevate that high enough to see an effect.
DR: This is to elevate your aerobic capacity?
MN: Aerobic capacity, yeah. And what I’ve noticed about people that are more sort of burnt-out buggers is the thing that will toast them really fast is sometimes strength work – that’s a little bit hit-or-missed. But lactate work will just fry them. So, if I told them to go to high-output, 30-to-60 seconds worth of work. And if I really shorten the rest period on that, what I’ve seen that will just roast people pretty bad.
MN: And if you look at it, high amount of anaerobic activity…anecdotally, what I’ve notice lately is, if you stay under 10 seconds of total work, some people can actually do a fair amount of that with not a huge aerobic base. So for example, I had a client recently who was kind of getting burnt out. But he’s a strength athlete; he’s like, “Hey, man. I don’t have time to run an aerobic base thing for three-to-five months. I have a competition coming up.” I said, “OK.” So, we would have him do singles, doubles and triples at only 50-to-60 percent of his one-rep max, and then just alternate back and forth. So, maybe, a bench press, maybe a row, maybe a dead lift. But he is doing very high amounts of speed, high anaerobic, but low percentage and trying to keep that under 10 seconds.
MN: So, we are trying to basically stay as far out of the lactate area as we can. Anecdotally, some people can actually do that kind of work, and then we’d ratchet up the percentage of one-rep max so that they can get some specific strength-training practice at a lower cost in terms the amount of time it takes them to recover.
DR: Gotcha. I definitely think we should do a follow-up call.
MN: Yeah, yeah.
DR: These are very interesting, and I think very practical, issue. Just in brief, when you say build up an aerobic base, are you talking about just doing something like jogging or swimming or do you ever use lighter weights – I am assuming you don’t use weight training or resistance training in an aerobic application based upon what you said a minutes ago about the lactate threshold. How do you build up that aerobic base?
MN: Yeah, so. There is a big debate about should it be continuous amounts of work, like running, swimming, biking, versus a little bit more intermittent. I don’t know if that’s really been sorted out. What I do is I put a heart rate monitor on people. Most people are going to be 110-to-130 heart rate. I tell them, “If I had to tell you one thing, do whatever the hell you want, (but) never go above 130, and keep your heart rate above 110.
MN: So, for some people that’s very light circuit. Here I will have them do circuits of sledgehammer strikes, overhead body weight squats, and push-ups to the tire. And you cut your reps before you get to 130. What I want to see over time is that can they do some low-level work almost continuously? Now, that’s a quote/unquote anaerobic-type exercise. Can you walk with a weighted vest and go bike for a specific amount of distance. I even started doing very light kettle bell snatches – just 16 kg kettle bell, just keep going until your heart rate gets to 130. Stop, rest. When it gets back down to 110, go again. So that’s usually what I will do for people. Most of the people are more of an anaerobic-type base, and that’s kind of their goal also. So, it’s a little bit more specific to that. And then, if they can, I will have them do very light stuff but for as long a duration as they can – 20, 40, 60, 90 minutes, but I don’t want their heart rate to be above, maybe, even 120. So, very low, continuous-type work. If you want to get really fancy over time, actually have them do that fasted, because I don’t want insulin levels to be high. I want insulin levels to be lower to push their body to increase fatty acid synthesis, which should be the main fuel for aerobic training.
MN: Some of those people, they get squished, and everything they do becomes very anaerobic, it becomes very carbohydrate based, too, which is what I’ve seen.
DR: Right. Again, definitely want to have you back, because a lot of what you hear coming from the – to put it loosely – adrenal fatigue community…
DR: …suggests that prolonged steady-state cardio can be a really bad idea for people who are burnt out. I do think there is some truth to that, but perhaps what has happened now with so many people understanding that excessive cardio can potentially burn you out. With so many people being aware of that now, maybe the pendulum has swung to the other end for a lot of people, and they’ve gone too far in the direction of building up an anaerobic base like you are saying, and they’ve lost that balance of both of these energy systems. So, I’d be really curious to pick this apart in a follow-up call. Let’s definitely get that one in the books.
MN: Yeah, for sure. And real quickly, how I look at that. So, if I have an athlete who comes in, I want to know what method did they burn themselves out on, right? I don’t work with a ton of endurance athletes, I have a couple. They can be very what is called parasympathetic over-trained. They do a lot of ultra-long distances, lowish intensity, and that’s all they do, right? So they do not have a very good strength base, their mechanics are crap. And they don’t have much of an anaerobic base, either. If that is the reason they got burnt out, the first thing I do is they don’t do any work in that zone. So, they may do pure strength work, a light percentage of one-rep max, and then once they can handle it, I will have them do bodybuilding hypertrophy stuff, just really easy. And then I will have them do some tempo stuff. So sprint real fast, very long rest periods, and the last thing I will add in is that moderate area that they were in before.
DR: That makes a lot of sense. I like that angle of not making a blanket recommendation about exercise but trying to personalize the therapeutic type of exercise based upon where they burnt themselves out.
MN: Yeah, if you think about it, right, if you just go really basic, and you go, ‘What the hell is going on?’ Well, whatever happened to their body, whatever stimulus you were giving it, it didn’t like.
MN: I mean, so, why are you going to pound them in that same area again? Their body already told you that this isn’t good for me. It’s why I had this reaction.
MN: But yeah, and then anaerobic athletes – not to pick on CrossFit, but it tends to happen more with them – they tend to go the opposite, right? If you trend their performance, it tends to trend down over time. They become very fatigue base. ‘Oh, I went to the gym and I tried really hard. It felt good to sweat.’ ‘Oh, that’s cool. Did you do more? Did you get better by actually training that day?’ If they can’t tell you, odds are if they are going by fatigue, what I’ve seen is they are getting worse. They don’t feel it, right? Because their brain literally gets rewired to search for that fatigue, and that fatigue is what they associate as a positive adaptation, right?
MN: Which is a whole other conversation.
DR: No, I like it, I like it. I think we’ve just opened up a great can of worms that hopefully we will be able to dig into in a follow-up.
MN: Yeah, yeah.
DR: And I actually to really kind of bait people to be interested here in the future, there is another topic I want to get your talk on, too. I’ve got to admit because I used to be a super exercise geek back in college. I did exercise therapy, personal training, got a degree in exercise physiology and exercise science. I used to be so, so into this, and that’s how…we initially met at PaleoFX and started hashing into some of this stuff. It’s that latent passion that it’s great just to be able to geek-out on this stuff with you. But the other topic I’d like to get you back on for because I know you’ve done some research – I think you presented at PaleoFX, or maybe it was AHS on this, which are sports supplements.
DR: Which I think is just loaded with crap – crap science. There are also some things that could probably be helpful for people, so I’d live to get you back on – I’m thinking probably two separate calls, and we can tackle each one of these. I know you’re a guy who is looking deeply into all of these. Through the dialogs we’ve had, you aren’t the guy who is going to take crap science and say, ‘OK, I am going to recommend beta alanine now because of this study done at Clown University or whatever it is. So, yeah. Let’s definitely get that one in the books. And once we hang up, I will shoot you an email about trying to get another time scheduled.
MN: Yeah, yeah. For sure. Just to bait people a little bit more, if you look at the meta-analysis that was done on beta alanine, since you mentioned that -one of the main authors is Roger Harris, the guy whom discovered beta alanine, the average percent increase in performance – again, an average – was 2.8 percent. Now, the range on that was a little bit negative to possibly 10 percent. It’s only about a three-percent bump if you take the average.
MN: Maybe beneficial, maybe…but it’s not that massive. So, anyway.
DR: And I agree. I use the same thing. When I pick up these studies – I do a lot of this with microbiota research for something like a prebiotic. A prebiotic is going to help with weight loss. But those conclusions are true, if you read the conclusions of the research studies, a significant weight loss was produced; which was statistically significant but I don’t think it’s real-world meaningful if the average was about two pounds.
DR: And that’s what gets left out of the dialog. So, definitely. Anyway, we are bromancing here. We will get off the line before we get too our-of-control. But, Mike, thank you so much for coming. In closing, where can people track you down and what would you like to make people aware of if they want to hear or get more information from you.
MN: Yeah, yeah. So, the best part is probably just my website, which is just MikeTNelson.com. If you scroll down on the first page there, you can sign up to my newsletter. We have a pretty daily-ish newsletter that goes out with information. It’s mostly content-based. They can contact me through there and sign up for the newsletter.
DR: Sweet. Well, Mike, I love what you are doing. I love your thought process. And we will definitely get you back on.
MN: Thank you very much!
DR: All right, buddy. Thank you. Take care, man.
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