How to Prevent Overtraining and Adrenal Fatigue, Plus Tips for Optimum Performance with Ben Greenfield

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Dr. Michael Ruscio: Hey, everyone! Welcome to Dr. Ruscio Radio. Before we jump into the show, or the body of the show, I had a couple notes regarding stool testing and HIPAA-compliant video tools I just wanted to quickly cover.

We’ve got a few people asking about what are the best stool tests to use, and why. And there’s a couple of things to really consider there. There’s insurance versus non-insurance, which is a significant issue. And don’t be fooled by some of what you hear potentially in certain functional medicine circles that you have to use special functional labs because they’re, for some reason, better than these huge lab companies, like LabCorp and Quest, that have quite a depth of testing.

In my experience, that’s not true at all. It’s just you have to work quite a bit harder to carve out all the codes needed to put together a panel that’s comparable in terms of the comprehensiveness to the functional medicine labs. But if someone has health insurance, and you’ve got the right test codes, you can do a good job for stool testing using labs like LabCorp and Quest. And that can save a significant amount of money. So it’s something that should definitely be emphasized.

There’s also the balance between being comprehensive and also being unnecessary. There are definitely several markers on a number of functional medicine stool tests that, in my opinion, are pretty much clinically useless. And it’s just important that we recognize again that if a test hasn’t been shown to be predictive of a condition or a corresponding treatment, or tell us something that we wouldn’t otherwise know, or helps guide treatment in a way we wouldn’t otherwise have guidance, then it’s not really necessary.

And also, the question of one stool test or two overlapping stool tests. And so I answered this question in a recent edition of the Future of Functional Medicine Review and gave the full expansion and narration on this issue there. And I also discussed something about a HIPAA-compliant video consultation platform. So if you’re a provider that does video consults, there is a HIPAA-compliant platform. And I think the most attractive thing about this platform is it requires about half the bandwidth that Skype does. And if you ever do Skype consultations, you’re probably frustrated by intermittent Internet connectivity, which can be very frustrating.

So all this information has been answered in the Future of Functional Medicine Review clinical newsletter. And so far, this has gotten some amazing feedback. And I really appreciate all the people that have joined. But I wanted to also make it easy for people who haven’t joined yet, especially new people to our audience, because we’ve grown quite a bit since the launch of this product. So for the new people on board, I wanted to take a moment to make everyone aware of this and also let everyone know that to make it easy to get started with accessing the Future of Functional Medicine Review clinical newsletter, for the month of July, you can purchase your first full month of access for only $1.00. And so I think that’ll make it really easy for people to sign up. It’s only $1.00. You’ll have access to all the published editions to date. And it’ll really give you a chance to look up the information on stool testing, this HIPAA-compliant video platform, and everything else.

So there’s a ton of information there. I hope you take advantage of it. You can sign up for that at DrRuscio.com/review. That’s DrRuscio.com/review. I hope that you will join us there.

Okay, on to the rest of the show.

Episode Intro

DrMR: Hey, everyone. Welcome to Dr. Ruscio Radio. This is Dr. Ruscio. I am here with Ben Greenfield, who’s been on in the past. He’s our exercise guy who can give us some great tips about exercise, fitness. He definitely has a pretty impressive background in that area. Ben, welcome back to the show, my man.

Ben Greenfield: I like it when you call me “the exercise guy,” dude. It makes it sound like I’m just standing here in a wife beater, baseball cap, maybe a dumbbell in each hand doing curls, tennis shoes. I’m the resident meathead.

DrMR: That’s why we get along so well, I think, because I have that inner meathead. And you just bring it out. So it’s a perfect—

BG: Oh, yeah. Well, granted, you still kicked my ass in our last arm wrestling contest at Paleo f(x) last year. But as I was describing to you prior to us hopping on this call, I’ve been training like a badass out here in the backwoods of Washington State, pulling sleds through the snow. And I’ve got posters of you up on the wall. I’m getting my flex on every single day. You’re going down, dude. I’m just saying.

DrMR: I’m actually a little bit nervous. I’ve really got to step it up. And I don’t have that much time to catch up to you. So I might be going down this year. I’m nervous.

BG: Yeah. Yeah, well, that’s okay. There are other things in life than being good at arm wrestling. And you’ll find out in a couple weeks what those are. You’ll have to. You’ll be forced to.

DrMR: At least you let me have one win. I appreciate that.

So what have you been up to, my man? I know you’ve had a lot going on. But what have you been up to?

BG: Well, I recently signed a contract with Reebok and Spartan to race professionally for Spartan. So I’ve been having to amp up my obstacle racing game.

DrMR: Sweet.

BG: So copious amounts of rope climbing and pull-ups. I’ve been travelling around the world a lot, doing a lot of speaking at different health and fitness and nutrition events. So that’s keeping me busy. I’m working on a new book. And then just, dude, hanging out with my kids.

DrMR: Yeah.

BG: Well, hanging out with my kids and helping my wife out with—I get jealous of her actually, because my job is still as a freelance writer and running my company and everything.

But I have this big picture window looking out of my office. And all I see her doing all day is pushing wheelbarrows around and hauling rocks and tending to the goats and the chickens and planting in the garden.

And she has the life that I kind of want in a decade, which is pretty much just hanging out outside tending the farm.

DrMR: Yeah.

BG: But yeah, I help her out a little bit. I had to beat our dog with a dead chicken last week. That was my big help-on-the-farm day.

DrMR: Wow!

BG: Essentially when a dog kills a chicken, the way to keep a dog from killing more chickens is you take said dead chicken, and you just basically beat the dog with the chicken. And then you put the dog into a cage or a kennel with that dead chicken for a day, a full day, with the little chicken that it killed.

So last week, I’m beating the dog with the chicken. There’s blood spraying all over the garage. And the dog is crapping himself because he’s so scared and nervous of me beating him with the dead chicken. And then I had to lock him in the kennel with the chicken.

And I walk in the house covered with blood and dog poo and chicken gizzards. And my kids are standing there crying because it was the chicken that they liked. So yeah.

DrMR: Geez. It’s pretty serious.

BG: Farm life is tough life, dude.

DrMR: Man! But I’m sure in a weird, deep, primal way there was probably some fun in that. That sounds kind of weird, but just having that contact with animals, and having that farm side drama to manage I’m sure was kind of satisfying in a weird, primal way.

BG: Well, they say wood chopping boosts your testosterone. So it’s possible that dog beating with a dead chicken also boosts your testosterone. Who knows?

Prevent Over-Training

DrMR: Oh, man! Well, so you’ve been clearly busy. And maybe as a cheesy transition here, you had a lot going on. One of the things that can happen when someone has too much going on is they can over-train. They can burn out. Or they can fall into this pattern of adrenal fatigue, even though I really don’t like that term. We’ll just use it because people are used to that term.

So excited to talk about the topic today, which is ways to prevent overtraining. Really, the terms—and please correct me if I’m wrong, because I’m not an expert in this area, you are. Despite being a resident meathead, you’re also actually really smart, so we should give credit where credit is due. I believe most of the time in the research literature you’re going to see this termed as overtraining or overreaching.

So to prevent this overtraining/overreaching or adrenal fatigue, to use the term that people may be more comfortable with, we’re going to talk about some ways to prevent that.

So I guess, Ben, to kick us off, I’m sure people kind of know some of these symptoms. But let’s go over some of the symptoms that are associated with more accurately termed overtraining, overreaching, but also may be termed as adrenal fatigue.

BG: Right. And I like where you’re going with this idea that adrenal fatigue is an overused word. And I think you know that it really hasn’t been recognized—I don’t think—by any major endocrinology societies or anything like that.

DrMR: Right.

BG: It’s just a term we throw around in alternative medicine a lot. And really, when you break it down, there are a variety of reasons that something like adrenal fatigue actually occurs, or something that we call adrenal fatigue actually occurs.

The reasons are widespread. In athletes, for example, in many cases you’re looking at imbalances or deficits in DHEA or corticosterones or ACTH or something like that.

And I interviewed a guy about this on my podcast, about hidden causes of fatigue. And we talked about how athletes, a lot of times, will have other issues. Isaac Jones was the guy that I interviewed on the podcast.

We talked about mitochondrial dysfunction. We talked about Lyme disease. We talked about environmental biotoxins—a lot of things that athletes can also have going on that the general population can having going on that go above and beyond just low DHEA or mineral loss/mineral depletion, overtraining, or just the excess musculoskeletal damage—some of those types of things.

But when you look at the athlete population generally, some of the things I tend to see quite commonly are mineral depletion. So folks who are exercising, sweating heavily, and not replacing minerals with a full spectrum of minerals, which are pretty necessary for adrenal health. So that’s one thing that you tend to see pretty commonly in endurance athletes.

I personally use copious amounts of salt. I use a ton of really good sea salt.

DrMR: Same here.

BG: I travel with sea salt.

DrMR: Yeah.

BG: I have a bag in my man bag. I use this Aztec clumpy sea salt. It’s great flavor enhancer. I travel with it. I put a pinch in a glass of water when I wake up.

I’ve got a few different other mineral sources that I use. There’s one called Oral I.V. that I load with the week before a race that’s just a blend of a whole bunch of different minerals in a tiny little shot. So you can mainline this stuff into your bloodstream. I use trace liquid minerals. I use a lot of those folic acids and humic acids a lot of the time too. So a lot of more soil-based probiotics, soil-based minerals.

But that’s one thing. Mineral depletion can cause the low blood pressure that we a lot of times associate with adrenal fatigue and a lot of other issues. And so that’s one thing.

A basic lack of a lot of calories. I find that calories or glucose deficits or carbohydrate deficits, especially in folks who have gotten on this low carb bandwagon, that’s an issue because they’re taking trickledown advice from people who are writing ketogenic books for controlling epilepsy or managing something like multiple sclerosis or epilepsy or diabetes or Alzheimer’s or something else where the recommendation is to take in no more than, let’s say, 20-40 grams of carbohydrates per day.

And someone who’s competing in an iron man triathlon or marathoning sees that recommendation, takes it, runs with it—literally.

And they really truly need closer to—what I’ve found—150-200 grams of carbohydrates a day in order to just adequately replenish liver glycogen levels or have enough proteoglycans on board for joint health or to be able to have adequate T4 to T3 conversion or mucin lining in the gut. A lot of those things are dependent on glucose.

That’s another thing that you tend to see—just either not enough damn calories or not enough carbohydrates.

And then there’s the idea of just musculoskeletal and neuromuscular fatigue. Musculoskeletal fatigue is something—when you look at inflammatory biomarkers and you look at muscle fiber breakdown byproducts in the bloodstream—high blood urea nitrogen levels—a lot of the things that you’ll see on a blood test in athletes, that’s just inadequately programmed recovery days. That’s one big issue.

And that one is pretty straight forward. And it’s something that I’ve had to come to realize later on in my athletic career—the importance of days where you’re not lying around on the couch eating Twinkies.

But there are days where I’ll have, for example, two days of the week where all I’m doing is foam rolling, infrared sauna, cold plunges, easy walks in the sunshine—things that still allow me to put work into my body, still move, beating dogs with dead chickens, but that don’t cause the same type of musculoskeletal damage that I used to get when I would do five hard workouts a week and then take it easy on the weekends. I’ll instead space things every 48 hours now.

And then for the really hard workouts, I’ll space things by anywhere from three to five days. And the reason for that is because even when musculoskeletal fatigue has subsided and you’re no longer sore, a lot of times you still do have neuromuscular fatigue.

And that’s something that can be elucidated with, for example, something I do every day, which is heart rate variability training. I’ll wake up in the morning, and I’ll strap on my Bluetooth strap. Or I’m experimenting with this other thing now called the Life Track, which is like a wearable watch that you can use that will also track your HRV.

And I just wear that for five minutes in the morning to see what my sympathetic nervous system score is, what my parasympathetic nervous system score is, what my actual interbeat individuality is as far as the variation in time between each heartbeat, so that I can get a little bit of a picture of neuromuscular fatigue.

And in many cases, I won’t have any soreness. I won’t have any musculoskeletal issues. I’ll be well fed. I’ll have adequate minerals on board. But my nervous system just needs a little bit more time to recover from a hard workout, even though all those other things are taken care of. So that’s another big one is just basic neuromuscular fatigue even if you’ve accounted for something like musculoskeletal fatigue.

Recovery Days

DrMR: And let’s go into that one a little bit, Ben.

BG: Yeah.

DrMR: Because there are a lot of great things that you just said. But one that I think maybe we can go through an example regarding that may help people is regarding recovery days, because I’m sure that some of the people on the line are either struggling themselves with, or if they advise patients or clients, are trying to advise their patients or clients with what the optimum frequency of exercising is.

And one of the things that really struck me about one of the last times you came on the podcast was your—just paraphrasing loosely here—but your recommendation that to hit a high and optimum level of performance as you have with your training, you’re not doing these six, seven days a week, grueling exercise programs.

But rather, you’re doing some hard efforts, but you’re also leaving quite a bit of time for recovery. So yeah, let’s expand a little bit more on the recovery aspect.

BG: Yeah, sure. And just to paint a picture, it’s one thing just to throw around the word neuromuscular fatigue. Musculoskeletal fatigue, we can all wrap our heads around. It’s muscle fiber damage. It’s inflammation. It’s a rise in inflammatory cytokines. You get a buildup of fibrinogen. You just basically need some time to recover and to allow muscle fibers to actually repair from an anatomical standpoint.

But when I say neuromuscular fatigue, we’re talking about things like—when you look at central fatigue, an actual deficit in your motor cortex or in the activity of your motor neurons, we’re usually talking about deficits in neurotransmitters or a drop in available pool of amino acids or, in some cases, an accumulation of calcium or a decrease of adenosine triphosphate stores—all these little things that can cause neuromuscular fatigue, even in the absence of musculoskeletal fatigue.

So I just want to make sure I clarify the difference between the two and the fact that when you have that neuromuscular fatigue sometimes it can be, not just rest, but repletion of amino acids, repletion of adenosine triphosphate, supplementation with things like creatine to restore creatine phosphate stores more readily, and even taking care of some of the damage that can occur to myelin sheaths by making sure that you get adequate DHA and omega-3s and oleic acid on board. So that’s the idea behind neuromuscular versus musculoskeletal fatigue.

But what was your actual question before I went down that stupid, little rabbit hole?

Training Frequency

DrMR: Well, yeah, and I’m definitely making a note here to ask you about maybe some supplements or techniques for both repleting musculoskeletal and neuromuscular. I definitely want to come back to that.

But maybe to lead into this just from a training frequency perspective, let me use myself as an example to maybe give people something to anchor onto.

So right now, I typically am training about five days a week. And I do think sometimes I teeter on the border of overdoing it. And what I have noticed is I just listen to my body. And I really think when you do just learn to listen to your body—

And I think, for the people listening, in my experience, one of the biggest things you can do for your own health and well-being is just learn to listen to your body, because you can find your truth with relation to a lot of these different recommendations.

But I may notice that if—I play outdoor soccer on Sunday. So it’s a full two 45-minute halves, so it’s two hours. And I’m typically on the field the whole time. So that’s definitely a decent amount of exercise.

And if it’s playing against a team that is a really good team—so I play sweeper, the last line of defense. And if they’ve got a really aggressive and fast and athletic forward, then I’m working a lot harder than if they don’t.

So on some of those days where it’s just a grudge match, I will almost always take off Monday. But then there are other days where it’s an easier game. I’m saying to myself, “Ah, I feel pretty good today.”

And I wrestle with myself internally. There’s this dialogue, this angel/devil on the shoulders if you will, where the overachiever in me beats myself up if I’m saying, “I’m feeling kind of tired. Maybe I won’t go to the gym today,” and I feel almost guilty. But then the other side of me answers it back and says, “Well, yesterday was a pretty tough game. And you’ve got a bruise on your thigh. Your glutes are kind of sore. Maybe a day off today wouldn’t be too bad.”

So I get the perspective of wanting to overwork and overachieve. But I’ve also learned to temper that a little bit. So for me, five days a week. Two days are soccer, and then three days are weights. And those are all pretty robust days. But even that, I think, may be a scotch too much even though I’m getting adequate rest now.

My life isn’t super stressful. Yes, I work a lot, but it’s stuff that I love. And I feel like I have everything pretty well dialed in, meaning I’ve optimized the foundation—sleep, rest, stress, food.

BG: Right.

DrMR: So five days may be too much for me. Those are just some thoughts there of maybe specifics you could critique or pick into to give people some recommendations in terms of training frequency.

BG: Yeah, so training frequency is definitely going to vary based on a few different factors. Part of it really is genetics, too. When you look at endogenous antioxidant production and injury risk based on genetic SNPs associated with, for example, increased risk of tendon rupture or increased amount of time necessary for actual muscle fiber repair to occur.

And sometimes that’s fast twitch/slow twitch muscle fiber balance in terms of what percentage that you have. Sometimes, that’s, again, how many antioxidants you produce. Sometimes, it is the actual structure of the fiber itself or your body type—ectomorphic, mesomorphic, endomorphic.

But basically what it comes down to is that not everybody is the same. Rich Froning probably recovers much more quickly from a hard CrossFit workout than does somebody that might be a little bit just genetically more frail or more susceptible to injury.

And so what I like to do is A) you pay attention to soreness. That’s, of course, one big, easy one. And it’s not like you don’t do things after a workout to mitigate soreness—so everything from stretching to foam rolling to other forms of deep tissue work.

We could talk about being careful not to shut down the hormetic response too much. But even the moderate use of things like cold baths and antioxidants and things that are going to help with recovery to a certain extent without necessarily using some things too much, because you want to strike a balance between hormesis and completely shutting down the inflammatory response basically. So you do need to be careful.

But ultimately, some people need to just pay attention to musculoskeletal recovery and pay attention to soreness. And when you’re not sore anymore, that can be a sign that you can exercise again. But I also like to, like I mentioned, pay attention to neuromuscular fatigue.

And what I’ve found is that some people can work out really hard every two to three days. And some people can handle a tough workout every three to four days. And some people every four to five days. And that all depends on heart rate variability testing. And so it’s really interesting.

When I’m working on a program, let’s say, for an iron man triathlete or a Spartan racer, if I give two people the same program—because all of my clients take little Instagram photos of their HRV scores each morning.

And I just like Instagram because that means that—it’s kind of technology agnostic. One person might be using whatever—Elite HRV. And one person might be using NatureBeat. And one person might be using some other HRV measurement tool.

But as long as they’re taking pictures of it, I can see it. I just go to their Instagram account. And they keep track of what they’re eating. And they keep track of their HRV. And they keep track of their sleep.

And when I look at the HRV for any given athlete or any given exercise enthusiast I’m working with or soccer mom or CEO or whatever, you can see that one person has a really high HRV within a couple of days after a hard workout, and another person just stays suppressed and beat up for a really long period of time.

And so when you look at something like that, you can certainly see that there’s a lot of individual difference between folks. And it does come down to figuring out what works best for you.

Like I mentioned, for me, I can do three pretty hard workouts a week, which I do. So I’ll do a Monday/Wednesday/Friday type of routine where I’m doing pretty hard concurrent strength and endurance combined together type of obstacle course style training.

And then I’ve got my Tuesday and my Thursday and my Saturday, which are swimming, walks in the sunshine. I do a lot of infrared sauna. I’ll do a cold plunge. I’ll have some days where I’m literally just making love to a foam roller for an hour. Just all these things that are still kind of “workouts” but that aren’t really beating up the body.

And then I’ll have a Sunday where it’s like a stamina day where it’s something like a low level aerobic intensity three hour hike with relatively low amounts of fuel. So I’m staying in that fat-adapted state. Or a long bike ride or something that’s a little bit easier, longer aerobic. I’ve found that that’s what works really well for me in particular.

And some people who bounce back more quickly, they might be able to handle four or five hard workouts each week. So it really does depend.

But some of the things I pay attention to—there’s a really good piece of software that does a running algorithm of your approximate recovery score based on your weight, based on your urine color, based on your profile of mood state, based on your HRV, your resting heart rate, a whole bunch of different variables. And that’s called Rest Wise. And I think it’s just RestWise.com, but you can download their app.

And you just check in each day, uploading these different metrics. And you can actually keep track of that score. And that’s a pretty good thing to pay attention to, even though I’ve found that if you don’t want to track all those metrics if time is a limiting factor for you, HRV is probably the one single most important factor to pay attention to when it comes to figuring out how well recovered you are and how often you can actually get away with training.

And then, of course, as I started to mention, there are things you can do to accelerate the recovery and perhaps allow yourself to be able to squeeze, so to speak, more hard workouts during the week.

Man! There are a lot of things that you can do as far as that’s concerned. Some of my biggies that I’ll use, just to be able to squeeze in more during the week as far as recovering more quickly—

One would be I do a lot of gradated compression. I’m doing it right now actually. So I use a standing work station. And I also do this if I’m sitting around at night. But I actually have compression boots that pump air up and down my legs and will also pump air—there’s a set for the low back. There’s a set for the hips. There’s a set for the arms.

I use a unit made by a company called NormaTec. I’m standing in the boots right now. And it’s just circulating pumped, compressed air up and down my legs as we’re talking. So it’s almost like I’m getting a massage without having to hire somebody to stand here while you’re interviewing me, Michael, and actually massage me, even though that’d be pretty cool.

DrMR: So you’re more like the Russian in Rocky. You’re not really doing the backwoods Rocky training. You’re doing the high tech training.

BG: I do both, dude. I’ve got one foot in the camp of ancestral living—

DrMR: Actually, yeah.

BG: And one foot in the camp of modern biohacking.

DrMR: Because of the chicken beating.

BG: Yeah, that’s right. I’m beating chickens. But I’m also using compression boots. So that’s one thing that I’ve found to be really effective.

DrMR: And what does that do? Take off some circulatory pressure from your body? Is that what it does?

BG: Yeah, it pumps out a lot of the metabolic byproducts. When you look at fatigue and how the body recovers from exercise, some things are depletion based—depletion of creatine phosphate, depletion of ATP, depletion of course of muscle and liver glycogen. That’s one reason that the body becomes fatigued or recovers more slowly from exercise.

But then in addition to depletion of energy stores and in addition to the neuromuscular fatigue that we talked about earlier is the issue of just basic waste product accumulation, primarily blood lactate, which, granted, will diffuse back into the muscle and other organs and get oxidized sooner after a workout than most of us would believe.

You usually don’t have a lot of blood lactate the next day. But I worked out this morning, so I’m accelerating the disposal of blood lactate.

And then you also get accumulation of calcium. You get accumulation of carbon dioxide. You get increased blood acidity from a buildup of hydrogen ions and bicarbonate ions.

So basically, all that this mechanical pumping is doing is it’s pumping all those metabolic byproducts up and out of tissue, back up to the heart.

DrMR: Gotcha.

BG: And you get some extracellular fluid accumulation too that can contribute to soreness or heavy legs. It can also help with that. So that’s one thing that I’ll use to be able to squeeze in more workouts during the week.

Another one is hot/cold contrast. And so, you can, if all you’ve got access to is a shower, just do 20 seconds of cold, 10 seconds of hot, 10 times through, a five minute hot/cold contrast shower.

But what I personally do is when I’m traveling, if I’m staying at a hotel that has a sauna, I’ll just go sauna to the cold shower to the sauna to the cold shower and do a few rounds of that.

Once a week, I try to do something a little bit more intensive. I will, for example, get in my infrared sauna. And I’ll stay in my infrared sauna for 20 minutes.

And what I did was I ordered one of these units from Clearlight. And it just came as a bunch of boxes. And I built it in my basement. It took my kids and me like two hours. And it works really well. You sweat like a dog in there.

And then I’ll go jump in the cold pool and then get back in the sauna, then go jump in the cold pool, then get back in the sauna, then jump in the cold pool. And that’s like a full workout. But that’s on a recovery day. And in a pinch, you could use a hot tub and a cold pool. But that hot/cold contrast works really, really well for accelerating recovery. That’s another thing that I’ll use quite a bit—a combination of sauna, like infrared sauna, and then cold.

So gradated compression, hot/cold contrast. Mechanical tissue therapy, specifically just basic foam roller type of stuff, works really well. But even better than that, I’ve found, is percussive therapy with vibration tools.

And there are a whole bunch of different vibration tools. But there’s one called MyoBuddy. It’s like a car buffer for your whole body, and you can just run that up and down any sore spots. And it accelerates especially your decrease in soreness and musculoskeletal recovery dramatically.

There are other ones. There’s one called a Rapid Release, which is more like a recovery—it’s almost like a wand, like a really, really expensive, fancy vibrator basically, although I don’t know of any woman who is insane enough to actually go spend $2000 on a vibrator. But this works well for muscle therapy as well. All my vibrator jokes are falling flat; I can tell.

The other one—there’s one called a TheraGun which is almost like a high intensity screw driver with a smaller head on it for targeting little joints that have areas of soreness or tightness in them. But yeah, a TheraGun or a MyoBuddy. Yeah, I like portable things versus a big, expensive vibration platform that I can’t take with me when I travel.

DrMR: Right.

BG: But I can totally put a plug-in vibrator in my bag. I can do hot/cold contrast just about anywhere. The compression boots I actually can—I’ll wear compression gear sometimes when I’m on a plane or whatever. But these compression boots are actually a pretty small unit. I can squeeze that into a carryon case and still take that on an airplane or in a backpack or whatever. So that’s another thing that I’ll use.

But yeah, ultimately, it depends A) on your genetics and things like I mentioned, like your endogenous antioxidant production, your fast twitch/slow twitch muscle fiber capacity, etc. Companies like DNAFit will actually run tests on you to determine how quickly you recover.

And then B) it’s also about how many of these recovery tactics that you decide you’re going to work into your lifestyle to allow you to bounce back more quickly from a musculoskeletal standpoint.

And then from both the musculoskeletal and a neuromuscular standpoint, whether you’re actually replenishing some of the things that you’re breaking down during that workout in an efficient enough manner—creatine phosphate, ATP, glycogen from a neuromuscular fatigue standpoint, like I mentioned. Neurotransmitter precursors like amino acids.

Acetylcholine is another one that tends to get depleted pretty readily during hard and heavy exercise. Magnesium is another. And so you’ve got to look at things from a nutrient standpoint, too.

Neuromuscular Recovery

DrMR: So are there some certain nutrients that are particularly helpful? You mentioned creatine, amino acids, electrolytes. Are there some specific products or recommendations you have for that nutritional/neuromuscular recovery?

BG: Yeah, I think some of the big wins. One flies under the radar. I don’t know if you’ve heard of it before, but it goes by the name HMB, which is beta-hydroxy beta-methyl butyrate. Beta-hydroxy beta-methyl butyrate is HMB.

And that one came out with ATP. Some pretty interesting studies show a relatively accelerated recovery time, especially for people who are doing strength training and fewer overtraining symptoms when using that, because all you’re doing is replenishing your ATP pools more quickly.

And the HMB seems to have a double whammy effect of helping to replenish the ATP and also shutting down some of the inflammation that occurs after exercise. So that’d be one.

So we all hear about creatine, but really a holy trilogy would be taking creatine phosphate to replenish your creatine phosphate pool and then this combination of ATP and HMB to replenish everything else. So that’s one stack that works really well from a supplement standpoint.

DrMR: Is there a good product for the ATP/HMB one? Is there is a product you like?

BG: The one that I use that’s up in my pantry right now is Millennium Sports. Millennium Sports makes one. They’ve got a stack, I want to say. And this would totally be—actually I don’t know if this is an affiliate link. I think it’s just a link to their stack. But BenGreenfieldFitness.com/ATP—that’s the exact stack that I use. It shows the ATP and the HMB.

DrMR: Okay. Cool.

BG: The HMB doesn’t taste very good. But I do two little scoops of that one and then the ATP, two capsules of that. And it comes out to the exact amount that they used in the actual study on ATP and HMB. And the holy trilogy, like I mentioned, is to combine that with creatine.

That same company sells a creatine. Or I’ve also got the Thorne creatine, which is pretty good. Their Creapure has pretty good absorption. And about 5 grams of that per day. No loading. No de-loading. No cycling. Nothing like that. But the creatine and ATP and HMB altogether, that’s a really, really good nutrient stack for replenishing a lot of what would stand in the way of musculoskeletal recovery.

And of course, in addition to those, is just basic muscle and liver glycogen. And I already hinted at that when I talked about making sure that you are replenishing enough. And you’re not jumping on the full keto for disease management versus a little bit more intelligent, like keto for athletes, kind of approach in terms of the amount of carbohydrates that you consume for restoration of muscle and liver glycogen stores.

But yeah, glycogen, ATP, creatine phosphate, and HMB would be the biggies from a musculoskeletal standpoint.

And then from a neuromuscular standpoint, I’d say your biggest wins in addition to eating lots of DHA and oleic acid from food sources, and choline from food sources. So lots of eggs and egg yolks and lots of olives and olive oil. And from a DHA standpoint, either wild caught fish or 4-6 grams–ish of fish oil intake. Or even throwing in a little spirulina or chlorella would be another good source looking at replenishing neurotransmitters.

Specifically what I like for hard charging athletes especially is the equivalent of about 10-20 grams or so of amino acids each day. Or you could go with about 30-50 grams of some kind of a whey protein source per day or a vegetable protein source like a pea or hemp or rice with the understanding that a vegan protein source, when combined with digestive enzymes, seems to have just as much amino acid availability as a whey protein source. But you have to stack a vegan protein with digestive enzymes for that to happen. So that’s what you do in that regard.

But you’ve got to understand that for people with gut issues, because I know you talk a lot about gut issues on your issues—as you know, some people don’t do well with whey protein isolate. They get the shitting-out-of-a-straw syndrome.

And I personally get that way with whey protein isolate. I discovered that back in my body building days when I was doing five ABB body building shakes a day.

DrMR: Sheesh.

BG: Maybe it was the 80 other artificial ingredients in those shakes.

DrMR: Yeah, right.

BG: But I don’t do that well with whey protein isolate. And the problem with the pea, hemp, rice, you just need to be careful, because then you bump up against the whole lectin issue in some of those sources.

And so if you don’t do well with lectin, sometimes you need to just pay attention to whether those sources have been soaked or sprouted where they’re getting pea and hemp and things along those lines.

And so because of that, you may want to choose amino acid sources that are things like essential amino acids or what are also called whole amino acids in a powder or capsule form, around 20 grams of that per day combined with lots of amino acids from just real food like your wild caught fish, grass fed beef, seeds, nuts, things like that.

So those are some of the biggies as far as things I would take into consideration from a nutrient standpoint. Aside from, of course, what I know—

DrMR: And Ben, sorry. One question there.

BG: Yeah.

DrMR: Is there a difference between a whole amino acid powder and a branch chain amino acid powder? Or is it kind of the same thing?

BG: Yeah, I don’t like the BCAAs. You tend to get a pretty significant blood sugar spike. And you really aren’t replenishing your full amino acid pool. They’re more expensive, but I get a lot better results from essential amino acids compared to branch chains.

Branch chains, if you consume them during a workout or during a race or something like that, they are pretty readily burnt as a fuel. But as far as recovery goes, they’re pretty inferior to a full spectrum of amino acids.

DrMR: Gotcha.

BG: And then as far as antioxidants go, vitamin C, vitamin E, glutathione, even full spectrum of antioxidants from things like wild plants and fruits and Acerola cherries or tart cherries and dark berries, and a lot of these things that really can assist with quelling reactive oxidant species or free radicals or a lot of the things that will tend to build up from exercise.

You just need to be careful. I personally don’t do a lot of antioxidants, especially in the immediate post-exercise window, because I don’t want to shut down the inflammatory response or shut down the hormetic response to exercise too much, because there is some evidence that—especially studies they’ve done in high-dose vitamin C or high-dose vitamin E—you may actually lose out on some of your body’s own endogenous antioxidant production and your body’s own ability to recover from exercise or to become better able to recover from exercise when you dump a bunch of antioxidants down the hatch post-exercise.

In the same way that, strangely enough, you tend to see amplified growth hormone and amplified testosterone in folks who don’t eat right after their workout who wait. And I do this.

Post-Workout Shake

DrMR: Ooh. So let’s talk about this because I was going to ask you about a post-workout shake. So yeah, please.

BG: I wait two to three hours after a workout. That’s what I do because I’m fine with staying lean. I’m not going after size. If you’re going after size, you do want to take advantage of that post workout upregulation of your GLUT4 transporters, that post-workout insulin sensitivity window, that post-workout protein synthesis window. Again, if you’re trying to put on size.

If size is your main goal, then you do want to prioritize that 20 minute to one hour-ish—it varies depending on the studies that you look at—up to two hours post workout window.

But then there’s a variety of studies out there that show that when it comes to HGH and also testosterone, you actually tend to see those go up a little bit with post workout fasting or going into the workout fasted.

And so when you look at that and you also look at the potential for constant activation of mTOR from a potential decreased longevity standpoint, from feeding copiously after every single workout, my recommendation is, unless you really are trying to put on size, that you not necessarily go out of your way to suck down a maltodextrin whey protein shake in that post workout window.

And my own scenario is I’ll finish a hard workout—I usually work out around 5 or so, 5 or 6 p.m. in the late afternoon, early evening when your body temperature peaks and your grip strength peaks and your reaction time peaks and everything that’s necessary to assist with a hard workout will peak.

But then we usually don’t eat dinner until 8 or 8:30. And I might have some essential amino acids at some point during that time. I may have a glass of wine or whatever.

But I don’t have a big meal or anything like that or go out of my way to necessarily replenish things when it comes to a post-workout shake, just so I can take advantage of the increase in growth hormone and in testosterone that can occur with that.

And that’s also why I don’t do, right after the workout, a cold bath or a cold shower or a whole bunch of antioxidants, because I don’t want to shut down the hormetic response to exercise. So I’ll save that stuff for later.

I’ll a lot of times do a cold bath the morning after a workout or have some really good antioxidants with a smoothie for breakfast when I’m in a completely different window than that hard workout scenario where I would rather force my body to recover on its own.

Heat Therapy

DrMR: And we had been emailing about using different herbal agents to increase erythropoietin. And you made a remark that I’ve been experimenting with—a great way to increase erythropoietin is to do either infrared sauna or steam room after a workout.

So how would you say using some sort of heat therapy after work—does that potentiate the exercise effect of maybe even giving you more growth hormone, more testosterone if you apply it that way?

BG: Yeah, yeah. Some really interesting studies in which they’ll typically have athletes in a sauna or hot environment for about 20-30 minutes after a workout when their bodies are already heated, and you see a really significant rise in erythropoietin. You also see an increase in growth hormone. And there are a whole bunch of effects.

I have somewhere—I want to say it’s BenGreenfieldFitness.com/SaunaScience. The title of that one is “10 Scientifically Proven Reasons I’m Addicted to a Daily Sauna.”

And it goes into, not just the detox and the heart-health effects but, yeah, growth hormone, EPO, pain relief, even a decrease in the rate of sarcopenia or muscle loss in the absence of being able to exercise. There are a lot of interesting things that happen with a sauna, but especially in a post-workout scenario like that.

But yeah, the EPO production is pretty significant to the extent where they’ve actually found that it can be a strategy for training for altitude even if you don’t have access to an altitude training chamber or a mountaintop to go train on. So yeah, it can be pretty cool technique to throw in there.

DrMR: I did it for a week. And I felt like I was a little better in terms of my win on the field. Now, it’s hard to say—is that placebo or not? But for a good week there, I’d have a pretty intense workout and then sit in the steam room for about 20 minutes afterward. And I felt pretty good after it. So maybe, you got an edge.

BG: Yeah, the steam room, I’m careful with it. This sounds—I don’t know—orthorexic or tin-foil-hat-wearing-esque, but I always check with the gym or the health club or whatever just to see if they filter their water so I’m not just breathing vaporized chlorine in the steam room. Otherwise, I’ll just do a dry sauna. I actually get warmer in a dry sauna anyway, or an infrared sauna.

But yeah, it really is. It can be a good post workout performance enhancing technique really, especially when it comes to that erythropoietin production.

Exercise Tolerance

DrMR: Sure. Sure. Awesome. So you’ve gone through some really interesting stuff here. And I know we’re kind of getting toward time. But I did want to ask you one follow-up question, which is—how do you observe people’s ability to exercise change with time?

And I’m more so asking for the perspective of people listening who are either just recovering from an illness or for the clinicians listening who are working with clients or patients who will be recovering from illnesses and trying to ramp up their exercise as they become more vital.

Do you have any big picture thoughts in terms of people’s ability to gain more exercise tolerance and what that might look like? Or any key things to be on the lookout for as they try to ramp up?

BG: That’s a tricky one. You tend to see people get stronger within about two to four weeks. And that’s usually nervous system adaptations.

And then you tend to actually see the musculoskeletal adaptations taking place closer to a four to eight week period of time in terms of just putting on muscle, putting on size, getting hypertrophy or an increase in the size or the number of muscle fibers.

And so generally the timeline is you’ve got to go at least two weeks to begin to see some significant effects from just a movement or performance standpoint. And then from an anatomical standpoint, usually a good four to eight weeks before you start to see things, let’s say aesthetic benefits.

That’s one of the reasons a lot of people drop out of an exercise program. They don’t see their body change if they don’t stay with it for at least four weeks. And some people get frustrated because they’re like, “I’m lifting more weights.” Or, “I’m getting stronger. I’m getting faster. But my body isn’t changing.” That’s what a lot of people want. They want to see the changes in the mirror. That’s one thing to bear in mind.

As far as the speed with which someone can get more fit, it really varies. It varies on everything from how quickly you’re going to build blood volume to increase your stroke volume.

And part of that can be water intake, mineral intake, what kind of diet you’re consuming. Part of it can be, again, your increase in motor neuron development or recruitment of motor units. And again, part of that can be how you’re doing in terms of your intake of DHA and healthy fats, the strength and resilience of your nervous system, whether or not the diet that you’re eating is supportive of nervous system health, mineral repletion strategies like we started with. Those can come in as a pretty important factor as well.

So I’ve never seen any research, honestly, that there’s a specific number of days or an amount of time that you can generally paint with a broad brush and say that everybody is going to get fit in this period of time or whatever.

But usually, it’s two to four weeks in terms of really beginning to see something happen from a performance standpoint and then four to eight weeks before you start to see things from an anatomical standpoint when it comes to just getting fit.

So I know that that’s a vague answer. But it’s really tough. There’s not a ton of research on that.

DrMR: Sure. No, I get that. And then, of course, we outlined a number of tools people can use as they’re getting healthier and trying to ramp up their exercise that they can use to monitor to make sure that they don’t overextend or overstep or overtrain. And it seems like HRV is probably the biggest. But we definitely listed off a few. So I think we gave people some good tidbits there.

BG: Yeah, HRV is a biggie. Or Rest Wise if you’re a little bit more serious. You want to keep track of a whole bunch of variables. Honestly, the people I coach, what they keep track of primarily is HRV, sleep, food, and then, of course, just any notes that they have on their training. Those are the four biggest ones that I have found.

So everybody who I work with or who a coach that I train works with, they have a post-workout comments section—just how they felt during the workout or if they even fricking did the workout.

DrMR: Right.

BG: So they have the post-workout comments section. And I use this program called TrainingPeaks right now to deliver all my workouts. So TrainingPeaks just allows coaches to deliver workouts to clients or people to just manage their own workouts. And everybody is required to fill out some kind of post-workout comments.

But then in addition to that, everybody’s got an Instagram account. And they share with me their sleep data, whether they’re using Beddit or the Oura ring or SleepWise or whatever. They share their HRV data. And then they share their food.

As long as I can keep track of sleep, HRV, and food—and food also includes any supplements or whatever—and then I can see what they’re doing with their training—if they’ve done their training and how they felt during their training, that gives me enough to keep a pretty good finger on the pulse of recovery. Those are the variable I’ve found to be most important for tracking.

Episode Wrap Up

DrMR: Gotcha. Gotcha. All right, so where can people track you down and connect with you if they wanted to learn more?

BG: Just BenGreenfieldFitness.com is fine. I’m working on getting BeatDogsWithDeadChickens.com.

DrMR: Nice. Nice.

BG: But I might have to go with BeatDogsWithDeadChickens.it or .edu or something like that.

DrMR: Yeah, that’s got to be taken at this point.

BG: I would imagine. Yeah, especially after this podcast comes out.

DrMR: Yeah, right? And I’m looking at my calendar here. And I’m realizing that Paleo f(x), from the time of this recording is only about a week and a half away. So boy, I’m getting kind of nervous, Ben, that you may take the title for the strongest arm wrestling at Paleo f(x) back this year. But I guess we’ll have to see.

BG: I may indeed. I might have to pull out some of my stops though. I might have to just wait until some party, make sure you get a few extra drinks into your system and then sidle up and challenge you right then and there and just if may I could take advantage of liquid courage or something like that.

DrMR: Oh geez.

BG: I don’t know.

DrMR: Well, I guess it depends what spot on the liquid courage compendium you find me. You want to get me at the diminishing end of that return.

BG: That’s right. That, or I’m just going to do just a crap ton of sauna between now and then so I’ve just got EPO coming out my ears. And that, as we know, is the secret to being a good arm wrestler.

DrMR: Endurance, yeah. Oh, man! All right, my friend. Well, I’m looking forward to seeing you in Austin. And thank you again for taking the time.

BG: Cool, man. Thanks for letting me on.

DrMR: You got it.

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