Into the Impossible With Brian Keating - Andrew Huberman’s Guide to Eye Health

Episode Date: April 10, 2025

Andrew Huberman and Brian Keating dive deep into optimizing astronomical vision and the physiological challenges faced at high altitudes. Huberman shares insights on nose breathing, creatine supplementation, and adapting to extreme environments like the South Pole. The conversation also touches on eye health, offering practical advice for dealing with jet lag, light adaptation, and conditions like dry eyes and glaucoma. Learn more about your ad choices. Visit megaphone.fm/adchoices

You had a couple questions for me, which is a first on this podcast. Turn the table. Usually I just offer up information, even if people don't want to hear it. But I'm happy to answer any questions that I'm able to answer. So I do a lot of visual astronomical observation, a lot of people on my podcast, listen to my podcast. I'll also do it too. So curious about a couple of your opinions as an expert. Visual defects, artifacts, are there ways to improve astronomical vision?

Are there ways to impair it? So first thing I want to ask you about is oxygen. We operate very high altitudes for most observatories. We want to be above as much atmosphere as possible because that absorbs light. Are there any tools or trainings or ways you can improve your physiology to be better as an optical astronomical observer? At high altitude? Yeah. I mean, there are certainly tools to feel less crappy when you get up there for the first couple of days while you're trying to get a job.

Just your oxygenation, right? I mean, there's less air up there, right? There, believe it or not, is solid evidence. People will probably try and fight me on this, but I'd be happy to fight back with references, that breathing through your nose not only improves memory for odors, but improves memory and cognitive function more generally.

Really? Which is not all that surprising. It actually turns out that during the inhale phase of a breath, were actually, loosely speaking, sharper, able to retain information presented to you during an inhale better than at during an exhale. I had to... I should be good. I'm sobel on the podcast.

He was formerly at Berkeley, Stanford, then Berkeley, and now at the Weissman Institute, we talked a lot about olfaction is not just about smelling things. It's about bringing oxygen into your system and the brain's very oxygen-dependent system. So if you're headed up there, I would say the nose strip and the nasal breathing emphasis is probably going to be helpful. Now, if you're talking about oxygen and the functioning of the eye, I'd have to consult with one of my colleagues in ophthalmology, but even better, somebody from NASA, because there are a lot of data about kind of in low oxygen, low gravity environments. Yeah.

That vision is severely impaired. Degrade, yeah. Yeah. You know, there's a whole program, or there was at one point anyway, looking at ways to offset some of the visual damage done by people going up in space. It's not great for the visual system, glaucoma-like effects and things of that sort. So an oxygenation of the retina is exceedingly important. I mean, it's one of the most heavily vascularized systems in part for that reason. So, you know, there are fun and interesting data.

I would call them more fun and interesting than kind of cornerstone data around good old creatine, we think about for muscle building, but most of the data on creatine are cognitive effects of creatine. Right, or muscular. Right. Right, and because of the use of the creatine phosphate system for the forebrain at altitude. Wow. Things like supplementing with creatine for people that are moving to altitude.

Yes, a lot of data on muscular performance, athletic performance, strength, et cetera, a lot of data also on cognition. Wow. And off-saying some of the negative effects of altitude. In terms of being able to see better up there, you know, people vary tremendously in terms of their sensitivity to light. You probably notice this, like, if you sit outside on a day, a bright sunlight in San Diego and you're like a metal surface to the cafe table,

some people, like you have darker eyes than I do, are you pretty comfortable in bright light? Yeah. Yeah, I'm not. So for light-eyed folks, even though you've got your Scandinavians, right? Your light-eyed folks could probably step through a series of sunglasses that, like, I wouldn't stay with very dark sunglasses. You can actually adapt to those brighter, brighter environment.

pretty quickly over the course of a few days starting with darker glasses and then transitioning to lighter ones or using transition lenses, things, that sort. Yeah, but in general, you know, your ability to see at high altitudes, provided you get enough oxygen you've adapted to the higher altitude shouldn't be impaired, except unless if you're out on like a snowfield, as you were describing the South Pole, I was thinking about the brightness of the snowfield. Like as you were saying that, I was like as an aversive. property to it because I'm just so sensitive to light.

It's horrible. You know, and that was my next question. We have a lot of listeners that are at the South Pole right now listening to us have this conversation. And, you know, when you're there, it's sunlight 24 hours a day or it's dark 24 hours a day. You know, the sun's below the horizon. It's actually only pitch black just as when the sun goes, you know, sets here. It doesn't get pitch black instantly.

It takes an hour before what's called Civil Twilight ends and it becomes dark enough to not be able to read something outside. But at the South Pole, it's literally when I'm there for three months or whatever. It's blindingly bright, and you're in every time zone, right? You're in every single time zone. They happen to run off Christchurch, New Zealand, but, you know, getting adapted to, you know, it's the ultimate and, like, daylight savings, right? It's always, it's always screamingly bright or, you know, maddeningly dark.

So we actually put the only kind of window shades you can use is, like, thick aluminum foil to cover the sliver. Because when you wake up in the middle of the night, if you get one photon in your eye from the screamingly bright light, reflecting off an ice cap. So how, you know, are there ways that people can adapt in that, like astronauts? We have, I have some astronauts I've had on the pocket. How can they, you know, in their extreme environments, first of all, sleeping when you really need to sleep, astronomers have to sleep during the day and it's bright out, right? So are there any tips for, you know, like conquering that and adapting to weird time zones?

Well, first of all, as a general tool for jet lag that everyone, regardless of if you're traveling the South Pole or not. If you are traveling and you suffer from jet lag, we have a whole newsletter about this. It's available. We can put a link to it. We zero cost. You don't have to sign up for anything, et cetera. I've done an episode on jet lag and shift work.

But there's two things to just keep in mind. If you're traveling, especially if you're going eastward, know the time that you normally wake up back home. And for the first two days that you're in your new environment, let's say San Diego to London or wherever, really avoid getting bright sunlight in your eyes for those first two days at the time corresponding to sunrise and your wake up time back home. Makes perfect sense, right? Because that wakes you up.

So if, you know, the beautiful sunset in London, you know, it happens every once in a while or wherever you happen to be, and it corresponds to your morning back in California or New York, you would be wise to wear dark eye glasses and a brimmed hat for those first two days only during that phase corresponding to sunrise back home. Makes perfect sense why it's going to wake you up. You'll likely be able to fall asleep after a nice meal in your new location that you're going to wake up a few hours later. And if it doesn't happen the first night, it tends to happen the second night.

This is also true for people traveling in the South Pole. The reason it doesn't happen the first night is typically there's a travel fatigue associated with travel itself that's independent of circadian shifts and jet lag. But that second night is when people fall asleep and then they're up in the middle of the night, probably got too much light in your eyes at a time corresponding a sunrise back home. And then also hop on the local meal schedule. And if you're somebody who doesn't eat breakfast, you don't have to eat breakfast. If you don't eat lunch, you don't have to do it. But eat whatever one to three meals you eat in this new location, they eat in that new location, hop on their schedule even if it feels a little

bit difficult. You're quickly in train. Okay. And then when you want to be awake, exercise and caffeine are actually going to offset some of the negative effects of sleep deprivation. This is very interesting data for brain longevity too. Most of the positive effects of exercise on brain longevity and cognition are mediated by sleep. So you want to make sure you're getting your sleep, et cetera. But if you are a little bit sleep deprived, provided you're not fighting back an illness, you're better off exercising than not exercising.

You'll offset some of the negative effects of sleep deprivation. Okay. Now, for people traveling to the South Pole or Scandinavia, if you're in that direction, Right. It's very, very bright. I mean, I would just get a blackout eye mask. It is true that it takes probably no fewer than five seconds of very bright light exposure like off a snowfield to quash your melatonin. If you're going to these places in winter and it's dark all the time, you absolutely should invest in a, they cost about $100 a portable, excuse me, 10,000 lux light and just look at that first thing in the morning. I don't have any financial relationship to any company that sells these, but there are a number of them that now are in like a paper-sized eight-and-a-half-11 tablet form and get in front of that thing for 15, 20 minutes in the morning. You don't have to like stare right at it. And then at night, if you can get even like a Christmas red light bulb, I'm not talking about red light therapy. That in the evening will really help taper down your cortisol levels or offset cortisol

increases by bright light. Bright light can increase the circling levels of cortisol by like 50%, which you want early in the day. And you don't want later. Now, when, it's too bright, you're just going to have to fight to get that darkness, which is a little bit easier and a bit more fun than trying to get light when it's really dark. Okay. So I think that that probably covers it. And then if people wanted to get into the pharmacology, there are some, there are things like magnesium three and eight, theanine epigenin, which I've talked about before. Again, people can go to our sleep newsletter. I don't sell supplements there. That's not what this is about. You can get these from any reliable source. I will. A little bit. A little bit.

bit of melatonin if you're really struggling, a low-dose melatonin, like one milligram to fall asleep, it won't keep you asleep. And then if you're really adventurous, I have talked about on this podcast that there's a peptide, which is legal, called pinealin, which has pretty remarkable effects in extending the amount of rapid eye movement sleep that is out. Is that OTC? You can get it, I would not get it on the gray market. You can find sources out there on the internet. I would just find an MD that works with peptides. And it certainly can help every once in a while if you're really struggling to get back on. And alcohol, cannabis, and any other sedative are going to be the absolute worst thing.

They're going to rob you of the kind of sleep you want. And then the last point is that if you have an MD that will prescribe it, there is a new class of sleep drugs. One goes by the brand name, Quivivic. I have no financial relationship to this, that acts to suppress the wakefulness system, works to this hypercretinoract. system that's also involved in narcolepsy that's mutated in narcolepsy. Okay. And this new class of drugs, they're called the D-O-R-A-S. Many people find that it helps them sleep without the sedative effect of sedatives.

And Matt Walker was the one who initially talked to me about these. So you have a lot of options. I would say get your behaviors right. Then if you need to explore the supplementation route, that's usually a pretty, I mean, magnesium is pretty, you know, I mean, I suppose there are risk check with your doctor, but then, and then prescription drugs, pinealinealine and peptides and things that sort. By that point, you're, you're maxing out the number of tools that you could possibly use. Yeah. Last question. Is there any prospect on the horizon for dealing with

floaters in the eye, not in the toilet, but in the eye, is there any hope? I mean, I have some and they're just persistent and obviously contrasting bright light seems to affect it the worst of all. Anybody working on that to like zap them or, you know? I need to ask Jeff Goldberg, my chair of ophthalmology at Stanford. I'm not aware of any treatments for floaters. Usually people ask about dry eye. That's very interesting. A lot of people suffer from dry eye.

I have it in one eye. Dry eye and floaters are, and visual snow are three things that I get a lot of questions about. I'll just quickly say, a floaters, I'm not aware of any treatments, but the ophthalmologists out there can put something in the comment section. And I'll certainly ask our chair. He did a really wonderful episode with us all about things that people can do for their eye health, offsetting disease, treatment and disease and things of that sort. In terms of, so we had visual floaters. Oh, for dry eye. I mean, drops are obviously what most people go to. By the way, if somebody wants to solve a really great biological problem that's not a lethal problem and get very, very wealthy, solve dry eye. I have heard, and by the way, this is purely anecdotal, but I feel comfortable sharing it because I don't have any financial relationship to any company that sells NMN, which is the precursor to NAD.

Oh, yeah. Many, a fair number of people who take sublingual NMN, just pure form NMN, not NR, not mixed with anything else, have reported to me that their dry eye has been greatly assisted by that. Now, whether or not that's a direct effect of lubricating the eye or whether or not it's because of the known anti-inflammatory effects of things in the NAD pathway isn't clear. I have no financial stake in this. I don't have dry eye, so I can't run the experiment. But it might be something worth trying if one is adventurous and wants to try something. Because dry eye is actually very uncomfortable for a lot of people.

But if somebody can actually fix this with an eye drop that really works and lasts, then you're going to be a very wealthy person. You will have helped a lot of people. I had it after. I had LASIC only in one eye because I had 20-20 and the other eye. But that's the eye that gets dry. And then they give you drops and prescriptions. I want to name the names.

But then they have all sorts of weird. Like I have a taste like a tobacco-type taste from the eye drops. It's just like your-drops. People don't like using their drops. People with glaucoma don't like using their drops, even though if you have glaucoma, you should definitely use your drops. You do have nice eyes, Brian. Oh, thank you.

That's really good. Yeah. I'm taking, Andrew. Okay. That wasn't why I told you that. Eye health is something that I think we don't place enough emphasis on and until people start to have problems. And everybody get your eye pressures checked. You can get it the optometrist with an air puff test.

You can get it from the ophthalmologists. Get your eye pressures tested because there are good treatments for glaucoma, even though the drops are a bit uncomfortable. You do not want glaucoma. There's the second leading cause of blindness. More than 70 million people worldwide go blind because of this. It is second only to cataract. It is treatable in most cases. And there is something called normal pressure glaucoma,

but most of the time elevated eye pressure is an indication that you need to lower your eye pressures. And for you pot smokers who are immediately going to say, well, it doesn't cannabis help? Yeah, it can in certain instances, but that wouldn't be the way to go. So get your eye pressures check. Take care of that vision. Thank you, Andrew. Thank you for these tips that will undoubtedly be able to allow my audience to peer even deeper into the heavens. Thank you very much.