by Dave Asprey
The next year, a study out of Harvard Medical School and Boston University School of Medicine showed that patients with dementia experienced significant improvements in cognition when treated with laser therapy. For this small human study, five patients with mild to moderately severe cognitive impairment received twelve weeks of transcranial laser treatment. After the twelve weeks, they saw a significant improvement in brain function, slept better, experienced fewer angry outbursts, and felt less anxiety with no negative side effects.8
There is an affordable laser treatment device that can be used at home with a headset that emits near infrared light through diodes placed on the scalp and inside the nostril called Vielight. They are conducting a clinical trial with 228 participants across North America to see what it does for Alzheimer’s. If someone I love was suffering from Alzheimer’s right now, I wouldn’t want to have to wait for this trial to be over before getting the device. The risk of allowing Alzheimer’s to progress is much higher than the risk of trying it out. Devices that use light on the brain range from $200 to many thousands of dollars.
FEED YOUR BRAIN
Anything you eat that causes inflammation is going to hurt your brain function—period, end of story. But there’s more you can do to protect your brain than just avoiding inflammatory foods. As you get older, it’s important to eat a diet that consistently keeps your blood sugar low, avoids spikes, and keeps ketones present in your blood. In the last ten years, studies have consistently demonstrated that insulin resistance is at least partially responsible for amyloid plaque formation in the brain.9 As you read earlier, the latest research connecting brain degeneration with insulin resistance has led many experts to begin referring to Alzheimer’s as type 3 diabetes.
Remember, insulin’s job is to lower blood sugar levels by moving sugar out of the bloodstream and into your cells, where your mitochondria burn it for fuel. If you eat too much sugar, your body produces more and more insulin to move it all out of the bloodstream, but it has nowhere to go because your mitochondria can’t burn it fast enough. This is the beginning of insulin resistance, which you know is a major precursor to type 2 diabetes. That high blood sugar also leads to the creation of AGEs and amyloid plaques, which are two of the Seven Pillars of Aging.
In order to ensure that your blood glucose levels don’t drop too low when you have an abundance of insulin, your body produces insulin-degrading enzyme (IDE) to break down excess insulin. Interestingly, IDE also helps destroy the amyloid plaques that cause Alzheimer’s in the brain and aging throughout the rest of the body. But it cannot break down excess insulin and destroy amyloid plaques at the same time. If IDE is constantly busy breaking down insulin, there is not enough left to fight your amyloid plaques, creating the opportunity for them to build up in the brain.
So when you eat a lot of foods that spike blood sugar, your body produces tons of insulin, and your IDE has to constantly break down insulin to get that sugar out of your bloodstream. This leaves the gates wide open for amyloid plaques to develop and for you to age rapidly and potentially develop Alzheimer’s. This means that one of the easiest and most effective ways of reducing your risk of Alzheimer’s is to simply stop eating sugar. This way, your IDE can focus on breaking down amyloid plaques instead of constantly working to break down excess insulin.
A powerful intervention is to take 400 to 1,000 mcg of chromium picolinate daily with 25 to 100 mg of vanadyl sulfate, ideally at the same time you eat carbohydrates. These minerals lower the blood sugar spike that occurs after meals, even if you have healthy blood sugar levels. In diabetic animals, vanadyl sulfate lowers blood glucose, cholesterol, and triglyceride levels.10 And chromium reduces glucose levels and insulin resistance to help prevent type 2 diabetes.11 These supplements are quite affordable, but evidence suggests taking higher doses than the government recommends.
You can also make sure that when you do consume carbohydrates, especially sugar, you pair them with foods that contain plenty of fiber or even with some saturated fat because this helps you avoid a blood sugar spike. To be clear, the combination of sugar and fat is bad for you, but sugar alone is even worse. For instance, ice cream raises blood sugar less than drinking a soda that contains the same amount of sugar.
In 1998, as I struggled with low energy and obesity, my doctor looked at my blood tests and said, “Maybe you have high blood sugar.” The next day I bought a $200 blood sugar monitoring device at the drugstore; it enabled me to prick my finger to get a reading. When I returned to my doctor’s office two weeks later with sore fingertips and two pages of data from dozens of tests per day, it was pretty clear that my blood sugar was a little high but not high enough to cause my symptoms. The doctor thought I was crazy. He said, “Those blood glucose meters are for diabetics. You’re not diabetic [yet], so you shouldn’t use it.” I may have been crazy, but I learned these techniques to avoid big blood sugar spikes by monitoring my blood sugar.
Today you can buy a blood glucose meter for about $20 at a drugstore; the meter enables you to prick your finger and know what your blood sugar is doing. If you’re really into living a long time, you can invest more by purchasing a twenty-four-hour continuous blood glucose monitoring system like I use. It’s a painless coin-sized device that sticks to your triceps for up to two weeks and shows you your blood sugar level on your phone at any time. You can see what your blood sugar does when you sleep, after exercise, and after meals.
The first time I tried this device, I stuck it on my arm and hopped on a plane to New York to be on Dr. Oz’s show. I was wearing my Oura sleep tracking ring and the glucose monitor on the same arm, and when I got to the TV set, the producer asked if I could take off the weird metal dot on my triceps. When I explained what it was, she said, “It will look interesting on camera—like you have a robot arm.” My brain is worth it.
Reducing blood sugar is the easiest step to reducing your risk of Alzheimer’s, but cyclical ketosis is even more powerful. This allows your body to alternate between fat and glucose as fuel for maximum resilience. This metabolic flexibility is important for brain cells that will otherwise become insulin resistant and unable to burn glucose efficiently, and it provides your neural mitochondria with their preferred source of fuel. In my personal quest to live to a hundred and eighty, I make sure to always have some ketones present in my bloodstream, even when I do eat carbs.
You simply follow a high-fat, low-carbohydrate meal plan for five or six days a week. Then on day seven, you increase your carbohydrate intake to roughly 150 grams. On these days, focus on carbs like sweet potatoes, squash, and white rice. For reference, one sweet potato has roughly 115 grams of carbohydrates. If you are always in ketosis, your cells get “lazy” because they never burn glucose, and you actually develop insulin resistance.12 To get the many benefits of ketosis without developing insulin resistance, sometimes eat a low-carb, ketogenic diet and other times eat a moderate carb diet.
After years of following a cyclical ketogenic diet, I now spend a lot less energy counting carbs. Instead, I use Brain Octane Oil because studies show it raises blood ketones even in the presence of carbohydrates. This way I can eat more veggies, enjoy a few carbs, and still have the benefits of ketosis. I put it in my Bulletproof Coffee, add it to my salad dressings, and drizzle it on meat so I get a small, steady dose of ketones throughout the day. My cells are always prepared to burn glucose or fat, and I avoid blood sugar spikes. As a result of eating this way, my insulin sensitivity score was a perfect 1 on a scale that goes up to 160 based on a combination of four laboratory values.
Cycling in and out of ketosis this way retrains the mitochondria in your brain to become resilient and metabolically flexible and gives your IDE a chance to stop breaking down insulin and work on cleaning house of cognitive-impairing plaques. Having ketones present in the bloodstream also reduces your levels of progranulin, the damaging protein released by your microglial cells when you are chronically inflamed.13
If you want to take your brain hacking
up a big notch or you’re dealing with early Alzheimer’s, you can use insulin intranasally for cognitive enhancement. A compounding pharmacist pours a vial of injectable insulin into a nasal spray bottle, and you take one squirt in each nostril. I do this once or twice a month when I’m working on a project that requires an intense focus, like this book. It is useful as a cognitive enhancer in a healthy brain. There is also clear data supporting its use for Alzheimer’s, as it improves delayed memory and keeps general cognition from declining.14 It works for men and women, but the benefits top out for women at 20 IU, while men benefit from a larger dose of 40 IU. Check with your doctor about this biohack. Nasal insulin does not normally lower blood sugar—it just makes the brain better at using glucose as fuel.
Let me be clear: You do not want high levels of insulin in the brain for long periods of time because that will lead to insulin resistance, but quick bursts of insulin can be helpful to drive glucose metabolism. The supplemental insulin shunts glucose out of the bloodstream and directly into your neurons, giving them a hit of energy. The long-term consequences of having chronically high levels of insulin in the brain probably outweigh the benefits.15 But I’d like to see more research on the effects of quick bouts of insulin. At this point it’s safe to say that it’s much more efficient to avoid dementia and Alzheimer’s by keeping your insulin levels low through eating properly and exercising than it is to try to halt or reverse the disease later by adding exogenous insulin to your brain.
YOUR BRAIN ON DRUGS
In 1997 I stumbled upon a newsletter called Smart Drug News that had been around since the 1980s. Steven Fowkes, a biochemist, wrote and edited the newsletter. He hailed the benefits of a certain class of smart drugs called racetams, which includes piracetam, phenylpiracetam, and aniracetam. These drugs, which have been around since the 1960s, raise oxygen in the brain and improve mitochondrial dysfunction after oxidative stress.16 The first positive studies came out in 1971, yet these pharmaceuticals were almost entirely absent from the United States. My doctor didn’t know what they were, even though a major pharmaceutical company manufactures them. They weren’t banned in the United States, but they weren’t embraced, either, putting them in a “gray zone” where they still reside today.
Since I was desperate to get my brain back, I decided to take a risk and order $1,000 of these so-called smart drugs from Europe. When they arrived in a sketchy-looking unmarked package, I wondered if I was going to have a day as a genius or if I’d been conned out of a thousand bucks. Given the research, I considered it a good bet. I was right. Twenty years later, I still use these drugs every day.
Since that first dose, I have been experimenting with all kinds of smart drugs (also called nootropics) and supplements to boost my cognitive function. Some of them have had a huge impact on my brain function, and others have done very little. But I am grateful that I’ve had the opportunity to try them all and hope we reach the point soon where these drugs come out of the shadows and into the mainstream. We use coffee to perk up, glasses to see better, and all sorts of other tools every day to enhance our performance. There is no reason why smart drugs should be any different, especially the ones that make you smarter now and keep your brain working better for longer.
There are plenty of pharmaceuticals and supplements that can help you enhance cognitive function as you age. Some of the most promising anti-aging drugs trigger your body’s production of naturally occurring chemicals (brain-derived neurotrophic factor, BDNF; nerve growth factor, NGF; and neurotrophin-3 and -4) that tell your brain to grow new neurons. Increasing levels of these chemicals can help treat degenerative brain diseases and boost your cognitive performance right now.17
It’s hard to say which nootropics will provide you with the greatest return on investment, in part because everyone’s brain is different and in part because we don’t yet know everything about how they work. The most cautious approach is to simply try them one at a time. The bad news is that if you try each one for only sixty days, you’ll be dead from old age before you try them all.
A far more effective strategy is to choose a result you’re looking for and take several supplements at the same time that will likely provide that result. If you get it, you win. Then you can back off from some of the supplements to see if you still experience the same benefits. With pharmaceuticals, including the piracetam family, it’s better to try them one at a time because pharmaceutical interactions are far more likely than with supplements.
Here’s an overview of some of the smart drugs that can help keep your brain running well at any age. You don’t need to run out and buy any of these, but it’s worth your time (and money) to find one or two that provide the most benefit.
PIRACETAM
I first took the piracetam that arrived in that first unmarked package for two weeks and didn’t feel much of a difference in my brain. I was mad. Those drugs were expensive, and I expected to see results. So I stopped taking the piracetam, and the next day in a meeting I found myself scrambling to think of a word. I suddenly realized that for the last two weeks, I hadn’t fumbled like that. It felt so natural when the drugs were working that I didn’t notice it. I had felt more like myself, and everything was just a little bit easier. There was no dramatic thunderbolt and I didn’t gain superpowers. I just had a slightly greater capacity.
There are about a dozen other derivatives of piracetam, and each works differently. Try them individually, not as a “stack,” until you know how your brain responds. One favorite is aniracetam, the only fat-soluble racetam, and the only one to increase memory I/O (in animals),18 which is the ability to get things into and out of your memory. It is also a mild antidepressant.19
Another favorite is phenylpiracetam, which is banned in professional athletics because it increases physical performance. It is arguably the most stimulating of the racetams, and I wash it down with coffee when I want to really get something done. There isn’t much evidence that phenylpiracetam makes young people smarter, but there is good evidence that it reduces cognitive decline in aging.20
I have taken aniracetam and phenylpiracetam on a regular basis for almost twenty years and plan to continue for at least the next hundred years. Normal doses are 500 to 750 mg of aniracetam twice per day, and 100 to 200 mg of phenylpiracetam two to three times a day. Ask your doctor about any possible drug interactions. Some people require extra choline, a B vitamin, with these compounds.
MODAFINIL
The next drug I tried was modafinil in 2002, and this time I felt the effects right away. It was like someone turned on the lights in my brain. It simply didn’t take as much effort to use my brain as it did before. Modafinil helped me finish my MBA despite cognitive dysfunction while I simultaneously worked full time. It also improved my meditation practice. Without it, I don’t believe I would have been able to start Bulletproof while working full time and being an effective husband and father of two young kids.
Very few entrepreneurs used smart drugs or even believed it was possible until a few years ago. The handful I knew would not admit to it publicly. But I was open about it from the beginning. I never wanted someone to talk about it later and accuse me of “cheating,” so I made my use of smart drugs well known. At Wharton, I once lined up my nootropics on my desk before taking an exam. I even mentioned it in my LinkedIn profile, which led more than a few Silicon Valley friends to open up to me about the fact that they had used smart drugs, too.
Because I was the only guy willing to talk about it on air, ABC’s Nightline came to my house to film a special on modafinil. Since then, modafinil has become more and more well known among entrepreneurs, executives, and even college students looking for an edge. The last part makes me sad—I don’t think it’s a good idea for healthy people under twenty-five to use modafinil because the prefrontal cortex isn’t formed fully until that age, and there are no studies showing the effects it might have.
Today there’s a good deal more evidence to back up the effects of modafinil, though th
ere are reports that it increases alcohol sensitivity, so please don’t drink while using it. Modafinil has been shown to increase your resilience and improve your mood. In healthy adults, it improves fatigue levels, motivation, reaction time, and vigilance. It even improves brain function in sleep-deprived doctors.21 And it certainly helped me reverse my cognitive dysfunction.
I stayed on modafinil for almost ten years, until my brain was working so well that I felt I didn’t need it anymore. In that time, I became a bit of a modafinil evangelist, constantly singing its praises to anyone who would listen. To write one of my very first blog posts, I sat down with some friends, including a successful television producer, a top artificial intelligence researcher, a published author, and a hypnotherapist. I shared some info about how much modafinil had helped me, and they all decided to get some with prescriptions or legal mail order. The next week, as I expected, I received some excited phone calls.
In one night, the TV producer finished a proposal for the Dalai Lama Foundation that he had been procrastinating on for months. He believed the proposal was far better than it would have otherwise been. The AI expert said he was able to make new connections he hadn’t made before and suggested modafinil should be widely available. The author powered through his writer’s block and made more progress on his current book than he had in months. And my hypnotherapist friend felt she had huge breakthroughs in cognitive performance and made new connections in her mind on a technique she was perfecting.
Honestly, these responses were not unusual. The only reason you don’t hear about them in mainstream outlets is that people are worried they will be seen as “cheating” or somehow weird. Well, I admit it. Like our caveman friend who learned how to make fire and keep his family warm, I cheated. And I’m weird, too. Those are common Super Human traits!
