2022's Top Questions Asked - with Answers! Boulder Longevity Institute

At BLI, we look forward to all the learning and discovery that lies ahead of us in 2023. As we prepare to kick off the new year, we’re taking a quick look back at some of our favorite questions from 2022.

Plasmalogens—What Are They & How Often Should You Be Taking Them?

Plasmalogens are a special type of phospholipid present in almost all forms of human tissue with high concentrations in the brain, heart, lungs, kidneys, and eyes. Most abundantly found in the brain, plasmalogens play a critical role in memory, focus, and cognitive functions. Our level of plasmalogens peaks in our 30s and then steadily declines with a significantly decreased level by 60 -70 years of age. Research shows that this decline has significant effects on brain performance, especially in plasmalogen-deficient seniors. The body’s ability to make plasmalogens becomes impaired as peroxisome function is compromised with age and by chronic diseases such as autoimmune disease, covid, and more. Plasmalogens are degraded from inflammation and oxidative stress.

Unfortunately, there are no adequate food sources that contain and can restore our plasmalogen levels. After years of extensive research, Dr. Goodenowe designed plasmalogen supplements as a plasmalogen precursor that survives the gut and is then converted to the target plasmalogen molecule independent of peroxisomal function. Dr. Goodenowe also discovered that by making plasmalogen precursors with specific fatty acids at the sn-2 position, he could selectively enhance specific types of plasmalogens. Dr. Goodenowe’s plasmalogen supplements are the only plasmalogen supplements that can do this. Ideally taking at least a baseline dose daily is critical as we get to be 60 and over when levels really decline. But higher doses or earlier treatment is needed after illness, diseases, toxic exposures, etc.

Plasmalogens are a stronger risk factor for dementia than genetics. A systemic deficiency in plasmalogens is notably present in Alzheimer’s and levels are significantly lower in people with all stages of dementia. The lower the plasmalogen levels, the more severe the disease. Levels decrease years before any clinical symptoms.

What Is the Best Overall Peptide for Cellular Energy (Mitochondria)?

At BLI, we are big believers in the idea that optimizing your mitochondria is the key to optimizing overall health. Mitochondria play a huge role in the anti-aging battle! Mitochondria have been closely examined in aging because of their roles in cellular energy production, calcium homeostasis, apoptosis, and cell signaling. For example, mitochondrial dysfunction is linked to metabolic and oxidative damage pathology in Alzheimer’s disease and Parkinson’s disease. This is not entirely surprising because the brain is one of the most mitochondria-rich tissues and is particularly sensitive to changes in mitochondrial function. Similarly, mitochondrial dysfunction is also linked to diabetes and obesity. Likewise, mitochondrial dysfunction and mitochondrial DNA instability are highly associated with cancer. So mitochondrial peptides are of extreme interest in aging! (https://doi.org/10.1172/JCI158449)

Small open reading frames in circular mitochondria DNA can encode multiple microproteins, which are referred to as mitochondria-derived peptides (MDPs). Currently, eight MDPs have been published: humanin (the smallest micro-peptides known to date), SHLPs 1–6 and MOTS-c—a peptide that should be added to your anti-aging fight. 

A staple in the longevity world, MOTS-c regulates metabolic functions throughout the body, including turning glucose into usable energy. Studies show that this peptide may also help: 

  • Fight weight gain
  • Normalize metabolism 
  • Improve blood sugar control for those with obesity and type 2 diabetes
  • Further fatty acid metabolism in the liver
  • Control mitochondrial energy
  • Promote metabolic flexibility and balance
  • Improve resistance to metabolic stress
  • Prevent osteoporosis

Which Peptides Are Best for Gut Health?

BPC157 is kind of a wonder peptide that improves blood flow to the intestines, thus accelerating healing. Because of its gut-healing properties, BPC-157 has been used to improve digestion and treat conditions such as irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), Chron’s disease, and leaky gut syndrome. BPC-157 is also known as a “stable gastric pentadecapeptide” primarily because it is stable in human gastric juice. This means, unlike most peptides for gut repair which can only be administered subcutaneous injection (SQ), BPC-157 can be taken orally as well, resulting in healing free of side effects.

Not only can BPC-157 cause an anabolic healing effect in both the upper and lower GI tract, it can also:

  • Have an antiulcer effect
  • Produces a therapeutic effect on inflammatory bowel disease (IBD)
  • Protects against NSAID and steroid-induced gut disease
  • Cures and heals stomach ulcers
  • Improves wound healing
  • Increases cellular regeneration
  • Boosts bone and joint healing
  • Heals organ damage
  • Reduces muscle wastage
  • Promotes growth and muscular development through angiogenesis

Other peptides that can help gut health include:

Collagen: The most abundant protein in our body, collagen makes up 70% of our skin and 90% of our connective tissues and bones. In addition to its skin and hair benefits, collagen is hugely beneficial for the gut. As we age, our collagen stores naturally decline with the majority of our collagen completely depleted by our 60s. Producing less collagen each year, we can attribute these depleting collagen levels to environmental factors, nutritional deficiencies, genetics, stress and other factors that correlate with the aging process. Collagen depletion is associated with skin wrinkles, saggy skin, and joint pain. For this reason, it’s important to consume plenty of collagen-rich foods. When it’s appropriate, supplementing with collagen in powder or capsule form can also help hold the body together. The building block for the villi that line our intestinal walls, collagen can help heal, seal and repair the gut lining. With 80% of our immune system being hosted in our gut, collagen can result in improved overall health. 

Another reason collagen is so helpful for the gut is that it contains glutamine, which studies have shown to be the most important amino acid for preventing inflammation of the gut wall. It also improves intestinal permeability. Glutamine inhibits inflammation and oxidative stress that is associated with the gaps or openings of tight junctions along the connective tissue of the intestinal lining. Studies even prove that there is a direct correlation between decreased collagen levels and digestive imbalances. More specifically, there is an association between low levels of serum collagen levels in individuals with Crohn’s disease, colitis, Celiac disease, and inflammatory bowel syndrome. For this reason, supplementing with collagen might be a missing link and key to providing relief for those with digestive diseases. 

KPV: A naturally occurring peptide with antimicrobial and anti-inflammatory powers, KPV is an MSH analogue that interacts with mast cells in your immune system, which, when dysfunctional, can result in an overactive immune system resulting in inflammation. KPV has the miraculous ability to:

  • Treat a wide variety of inflammatory conditions & decrease inflammation in the body
  • Strengthen the immune system
  • Act as an anti-microbial
  • Improve skin health
  • Aid in healing wounds & injuries
  • Reduce SIBO infections, IBS, Ulcerative Colitis, and IBD symptoms 
  • Minimize tumors

What Are Your Thoughts on NAD+?

NAD+ is a vital coenzyme that functions mainly in the mitochondria of our cells and has been shown to influence processes relevant to osteoporosis and immunosenescence. Our NAD+ supply declines as we age, reaching a pivotal downward trend between the ages of 40 and 60. We should be concerned about this decline because, as studies show, low levels of NAD+ is linked to mitochondrial inefficiency, one of the nine hallmarks of aging. 

Broadly speaking, the effectiveness of direct NAD+ supplementation is in question. This large, phosphorylated molecule cannot permeate the cell wall directly but rather must be taken up by cells in order to participate in pathways relevant to aging and other age-related conditions.  According to a Harvard Medical School study, NAD+ IV therapy has a proven success rate of 87%. However, the study speaks only about the use of NAD+ precursors, not the actual use of intravenous administration for NAD+. So, to date, there are no published studies showing NAD+ given IV or otherwise can enter into the cell. A published study from the Journal of Biological Chemistry shows that your body breaks NAD+ down into smaller precursors before absorbing it into the cell. Once through, your cells may be able to convert the precursors back to NAD+. This arduous process denotes that direct NAD+ supplementation, whether through intravenous methods or oral administration, may not be the best solution to elevating NAD+ levels. 

It remains to be robustly determined as to whether oral or intravenous administration of NAD+ produces benefits. Comparatively, little work has taken place to characterize NAD+ transport into cells. Therefore NAD+ supplementation is recommended based solely on anecdotal evidence of people attesting to feeling better. However, NAD+ IV treatments often contain other nutritional supplements, like amino acids mixed with NAD+, so it’s difficult to attribute the success of the therapies to NAD+ alone. 

Although natural methods like caloric restriction and moderate exercise can increase your NAD+ levels, supplements prove to be an easy way to replenish the necessary nutrients for maintaining NAD+. Lately, NAD+ IV therapy has received a lot of buzz as a new way to boost this critical molecule with NAD+ IV therapy providers claiming that an intravenous solution is more effective than oral because it bypasses the digestive system, which in turn, allows your body to feel the effects quicker. 

Simply put, the scientific community doesn’t know enough about NAD+ IV therapy to make conclusive recommendations. At BLI, we prefer NMN or the novel 1MNA precursors. We would also need to lower CD38 to stop degradation-apigenin.


How Does Long-Term, High Caffeine Intake Affect Adrenals and Estrogen Metabolism (16oh2)?

The liver detoxifies caffeine using the CYP1A2 enzyme system, which is also responsible for the initial metabolism of estrogen during Phase I clearance by the liver. This is one reason caffeine is likely metabolized more slowly in women taking oral contraceptives or postmenopausal hormone replacement therapy. While research showing the effects of chronic caffeine consumption on circulating levels of estrogen isn’t yet available, researchers have suggested that caffeine consumption may lower the risk of breast cancer by upregulating the CYP1A2 isoenzyme and thus improving estrogen metabolism.

Studies in humans have shown that caffeine increases cortisol and epinephrine at rest and that levels of cortisol after caffeine consumption are similar to those experienced during acute stress. Drinking coffee, in other words, re-creates stress conditions for the body. While scientists have some ideas about how caffeine increases HPA hormones, the exact mechanism still remains unclear. Compounding the problem, people tend to consume more caffeine during stressful periods (as nearly every student during exam season knows well). They add stress to stress, potentially making things even worse.

Rat studies have shown that caffeine consumption during chronic stress increases cortisol, blood pressure, and other negative hormonal events. Chronically stressed rats who consumed caffeine ended up sicker and died sooner than rats experiencing chronic stress without caffeine consumption.

However, again, chronic caffeine consumption leads to a degree of physiological tolerance, and thus among people who drink coffee regularly, blood pressure, heart rate, excessive urination, epinephrine production, and even anxiety and stimulation were not really affected.

How Can Caffeine Withdrawal Symptoms Be Minimized During a Detox?

Typically, the onset of caffeine withdrawal symptoms starts 12 to 24 hours after caffeine cessation, peaks at 20–51 hours, and may last up to two to nine days. Some signs of caffeine withdrawal include: impaired behavioral and cognitive performance, decreased or increased blood pressure, decreased motor activity, increased heart rate, hand tremors, increased diuresis, skin flushing, flu-like symptoms, nausea/vomiting, constipation, muscle stiffness, joint pains, and abdominal pain. 


The best ways to help minimize and/or alleviate the symptoms of caffeine withdrawal is to:

  • Hydrate with up to 189 oz of water. 
  • Lions Mane mushroom helps alleviate headaches and increase your focus and energy.
  • L-Tyrosine 500mg to improve dopamine which lowers caffeine withdrawal – this will help mood and energy.

Would You Mind Sharing Flexibility Recommendations?

Exercise, stress/anxiety (mental, emotional), muscle tension, and pain, are associated with the Sympathetic Nervous System (SNS) and the stress response. With the stress response being triggered during adverse situations (physically, mentally, and emotionally), it is the constant activation of the SNS that is responsible for a further breakdown of the body and needs to be disengaged. In order to counteract this response processes need to be activated that engage the parasympathetic nervous system (PsNS),  mitigating the release of stress hormones (i.e cortisol, adrenaline) that contribute to inflammation, increased heart rate, blood pressure, muscle tension, and quickening of brain waves. One way of activating the PsNS is through the use of low-intensity stretching (LiS) (i.e., microStretching) that is not associated with the generation of pain (SNS response), and the use of deep breathing activating both the vagal nerve and the PsNS.

Stretching may even help prevent and treat cancer! A study in 2018 on mice in a breast cancer model showed immune responses were activated and levels of Specialized Pro-Resolving Mediators were elevated in the stretch group. These results suggest a link between immune exhaustion, inflammation resolution, and tumor growth. Stretching is a gentle, non-pharmacological intervention that could become an important component of cancer treatment and prevention.

Most stretching techniques are designed to place a “stress” on the musculoskeletal unit that will increase its resting length and range of motion (ROM). Twenty-four adolescent dancers participated in a six-week intervention program that compared low-intensity stretching (micro-stretching) with moderate-intensity static stretching on active and passive ranges of motion. Micro-stretching is a new modality that reduces the possibility of the sympathetic system being activated. Repeated measures analysis indicated changes in ROM over the intervention period (p < 0.05), with the micro-stretching group demonstrating greater increases in passive and active ROM than the static stretch group (p < 0.01). There were no noted bilateral differences in ROM. The results from this study agree with past studies that have found that stretching increases the compliance of any given muscle and therefore increases the range of motion. One main finding of the present study was that throughout a six-week training program, very low-intensity stretching had a greater positive effect on lower-limb ROM than moderate-intensity static stretching. The most interesting aspect of the study was the greater increase in active ROM compared to passive ROM by the Microstretching group. This suggests that adaptation has occurred within the muscle itself to a greater extent than in structures of the hip joint. 

Micro-stretching is a specialized evidence-based system of low-intensity gentle stretching. It is based on some research from Dr. Apostolopolous focused on stretch intensity, the inflammatory response, and muscle function. Apostolopoulos was the first to examine human subjects, blood biomarkers (hs-CRP) and stretch intensity as published in his book, Stretch Intensity and the Inflammatory Response – A Paradigm Shift. 

Micro-stretching technique:

  • Intensity: 30% – 40% of a maximum perceived stretch (very light gentle stretch)
  • Volume: Each stretch should be held for 60 seconds
  • Density: Each stretch should be repeated 3 times per muscle group a minimum of once per day

Should you stretch before or after exercise? In general, stretching before exercise will reduce the speed and strength of a muscle. While there may be reasons to stretch before you exercise, such as an injury, you are otherwise better off stretching after exercising or at a separate time.


Can a Nap Be Counted in With My Total Restorative Sleep Time Each Day?

Naps of 10-20 minutes place you in the correct sleep state to reap the maximum energy boost – sometimes up to 2.5 hours. While naps don’t provide the full benefits you get from a proper dose of solid sleep, they can be useful.

Sleep is essential for life, including daily cognitive processes, yet the amount of sleep required for optimal brain health as we grow older is unclear. Poor memory and increased risk of dementia are associated with the extremes of sleep quantity and disruption of other sleep characteristics. While the optimal sleep has been said to be 6-8 hours, a recent study examined sleep and cognitive data from the UK Biobank (N = 479,420) in middle-to-late life healthy individuals (age 38–73 years) and the relationship with brain structure in a sub-group (N = 37,553). Seven hours of sleep per day was associated with the highest cognitive performance, which decreased for every hour below and above this sleep duration. Several brain regions showed a quadratic relationship between sleep duration and volume while other regions were smaller only in individuals who slept longer. These findings highlight the important relationship between the modifiable lifestyle factor of sleep duration and cognition as well as a widespread association between sleep and structural brain health.

How Much Deep Sleep Should You Be Getting?

In healthy adults, about 13 to 23 percent of your sleep is deep sleep. So if you sleep for 8 hours a night, that’s roughly 62 to 110 minutes. However, as you get older you require less deep sleep. During deep sleep, a variety of functions take place in the mind and body:

  • Memories are consolidated
  • Learning and emotions are processed.
  • Physical recovery takes place.
  • Blood sugar levels and metabolism are balanced out.
  • The immune system is energized.
  • The brain detoxifies.

Without deep sleep, these functions cannot take place and the symptoms of sleep deprivation kick in. On the other hand, there doesn’t seem to be any such thing as too much deep sleep.

To increase deep sleep:

  1. Sauna before bed or a warm bath
  2. Pink-not white noise. Pink noise differs from white noise in that it has more intense lower frequencies, making it deeper than white noise. Examples of pink noise in nature include steady rain, wind, and rustling leaves.
  3. Research has found that pink noise has the potential to improve deep sleep. You can incorporate pink noise into your sleep routine by buying a sound machine or playing a pink noise track on YouTube.
  4. Exercise.
  5. No food within 3 hours of sleep


How Much REM Sleep Should You Get?

Your first REM cycle of the night begins about 90 minutes after you fall asleep and recurs every 90 minutes. Your eyes move around quickly behind your eyelids and your brainwaves look similar to those of someone who is awake. Your breathing, heart rate, and blood pressure rise to near-waking levels.  REM sleep, often referred to as stage 5, is when you are most likely to dream.

Your arms and legs become temporarily paralyzed during this stage to prevent you from physically acting out your dreams.

Although there’s no official consensus on how much REM sleep you should get, dreaming is most common during this stage. Experts believe that dreaming helps you process emotions and solidify certain memories. For most adults, REM takes up about 20 to 25 percent of sleep. So if you get eight hours of sleep, one to two hours should be REM, which seems to be healthy during average sleep cycles. However, sleep research is raising some interesting questions. One recent study suggested that higher amounts of REM sleep may be associated with depression. But don’t go making sudden changes in your sleep habits — it is not clear which is the cause and which is the effect.

Because the quality of your sleep matters to us, here are seven tips that will help you get more REM sleep: 

  1. Take magnesium or gaba before bed.
  2. Avoid alcohol, drugs, sleep aids and benzodiazipines.
  3. Use rose, lavender, vanilla, and chamomile scents. Avoid peppermint or lemon scents.
  4. First morning light and dusk light. No blue light after 5
  5. Sleep cold. Set your thermostat between 60 to 67 degrees to foster the best REM sleep.
  6. Since most of REM occurs shortly before awakening, stay in bed longer. 
  7. Consider using an alarm clock that is synched with your sleep cycle and can wake you just when you’re coming out of REM.

What burning questions do you have for 2023? As an Enhanced Human Optimization Academy Member, you get the chance to ask Dr. Yurth your health-related questions every month during her LIVE Ask Me Anything events. Consider becoming a member today!

Visit the Human Optimization Academy - BLI's Educational Arm


Published January 2, 2023
Categories: Cellular Medicine

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