There are a lot of really cool longevity conferences coming up this year

1. Life Summit Berlin is giving away 10 free tickets to the Nina’s Notes community in a raffle. Everyone who participates but does not win, receives a 50% discount. Enter here: lifesummit.berlin/giveaway-nina-patrick

2. Longevity Day at NFC Summit Lisbon — June 4, 2026. Join me as I host a day all about Longevity.

3. Longevity Summit Dublin — June 24–26 at Trinity Business School, Trinity College Dublin, Ireland. Grab your tickets here.

4. Longevity Show — June 26 & 27 in London. My podcast co-host Phil will be part of the event! Grab your tickets here.

5. 2060 Longevity Forum — September 2 & 3, 2026, one of the best conferences dedicated to longevity investment. Use code LONGEVITYDAYXYZ for a special discount (valid until May 15) at forum.2060.life

Cheers,

Nina

💬 In this note:

• 📱 How A Text Message Changed US Drug Policy

• 📚 New To Reads

• ⚡️ IKEA Inflatable Furniture, round 2

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#179: 📱 How A Text Message Changed US Drug Policy

On April 18th, Bicycle Day weekend, no less, the anniversary of Albert Hofmann’s first LSD trip, US President Donald Trump sat in the Oval Office and signed an executive order to accelerate research into psychedelic drugs and expand patient access.

According to Joe Rogan, who was standing right there in the room, here’s how it happened: he texted Trump some information about ibogaine.

Trump texted back.

“Sounds great. Do you want FDA approval? Let’s do it.”

Rogan described it as “literally that quick.” CNN

Policy by text message.

Welcome to 2026.

What The Executive Order Actually Does

The executive order directs $50M from the Department of Health and Human Services to match state investments in psychedelic research.

It also calls for the FDA to give expedited consideration to certain psychedelics that meet specific criteria.

More specifically: the order directs the FDA Commissioner to provide National Priority Vouchers to psychedelic drugs that have received Breakthrough Therapy designations for treating serious mental illnesses.

The National Priority Vouchers essentially fast-track regulatory review to weeks instead of the standard year-long timeline.

It also instructs the FDA and DEA to establish a pathway for eligible patients to access investigational psychedelics, including ibogaine, under the Right to Try Act.

Trump, for his part, seemed genuinely enthusiastic. Before signing, he pointed to early research on ibogaine’s potential, then joked, “Can I have some, please?” “I’ll take it. Whatever it takes.” to which the audience laughed.

Ibogaine, derived from a shrub native to West Africa, is named explicitly twice in the executive order. It has been championed by veteran organizations and psychedelic advocates as a promising treatment for hard-to-treat conditions including opioid addiction, PTSD, depression, and traumatic brain injury.

Why ibogaine, and why now

Ibogaine has been building momentum, quietly, while the rest of the mainstream psychedelic conversation centered on psilocybin and MDMA.

Ibogaine was classified as a Schedule I substance in the United States in 1970. Due to this illegality, in recent years, US veterans have reported benefiting from ibogaine after travelling to clinics in Mexico to access it.

That grassroots pressure, combined with backing from veterans groups and former Texas Governor Rick Perry, who co-founded a group called Americans for Ibogaine and made the case for reducing federal limits on the drug on Rogan’s podcast, twice in two years, led to a law providing $50 million for ibogaine research in Texas.

Trump’s executive order appears designed in part to match and amplify exactly that kind of state-level momentum.

The clinical trials are preliminary and limited on Ibogaine due to the Schedule I classification, which makes it almost impossible to study the compound domestically in the United States.

One of the only recent studies conducted by US researchers was done by a Stanford research group who enrolled 30 veterans who then received Ibogaine in Mexico. They found that veterans treated with ibogaine showed improvements in PTSD, depression, and anxiety symptoms.

Ibogaine is known to cause irregular heart rhythms and has been linked to more than 30 deaths in the medical literature.

That is a significant safety concern that has stalled research for decades. The FDA has resisted ibogaine research partly due to concerns about heart-related risks, and most research has been conducted abroad.

What the executive order does is create the conditions to finally study it properly, in the USA.

Frederick Barrett, director of the Johns Hopkins Center for Psychedelic and Consciousness Research, says: “It’s been incredibly difficult to study ibogaine in the US because of its known cardiotoxicity. If the executive order can pave the way for doing objective, scientific research with this compound, it would help us understand whether it is truly a better psychedelic therapy than others.”

While the executive order is a symbolic act signalling unusual openness to scheduled substances as potential treatments, it doesn’t fundamentally change the evidence on safety and efficacy the FDA would need to see.

There’s also a real risk of moving too fast. And, then there’s the access question.

Even if ibogaine clears FDA approval someday, clinic owners note there will be no insurance coverage, and it will still be considered unapproved, non-covered care.

Access will initially remain a privilege of the wealthy.

The people who need it most, veterans, people with treatment-resistant depression, those without the means to fly to Mexico for treatment, will still be waiting.

Whatever you think of the currently political circumstances, and I have thoughts, the framing shift on psychedelics matters.

The stigma around Schedule I drugs is significant, and this gives political cover for Republican governors and legislatures to step into the ring and fund research programs at their universities. States that might have been fence-sitting may now feel safer moving forward.

For those of us who have spent years watching rigorous psychedelic science get dismissed, defunded, or simply ignored, the idea that ibogaine is being discussed by name in the Oval Office is genuinely surreal.

📘 Thinking of diving deeper? Check out my guidebooks.

Over the past three and a half years of writing Nina’s Notes, I’ve turned the research I trust most into free, downloadable guidebooks, no fluff, no supplement brand agenda, just the science and the protocols.

1. Age-Fighting Drugs Guidebook

2. Breathwork for Longevity Guidebook

3. Exercise for Longevity Guidebook

4. Men’s Health After 40 Guidebook

5. Nutrition for Longevity Guidebook

6. Sleep for Longevity Guidebook

7. Stretching for Longevity Guidebook

8. Supplements for Longevity Guidebook

9. Thermal Therapy for Longevity Guidebook

You can download all 9 and more at ninapatrick.xyz/guidebooks.

Or if you want everything in one place, the guidebooks, the full deep dives, and early access to events, just upgrade to a paid subscription. Paid subscribers get the complete guidebook library included.

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📚 Book of the Week

Alright readers, I’m a bit behind on my reading, but I bought two new books from the bookstore this weekend and can’t wait to read them.

Have you read Big Swiss by Jen Beagin or The Deserters by Mathias Enard?

What did you think?

Drop it in the comments - but, no spoilers please!

⚡️ Check This Out

IKEA is trying inflatable furniture again.

Yes, really.

After their famous 90’s fail - where their inflatable range turned out prone to dust, delation and being destroyed by a passing vacuum cleaning.

Now they’re back, and apparently they’ve cracked it.

The new easy chair, designed with Mikael Axelsson, has a foam cover, a carbon steel frame, and it is…full of air.

But the textile cover means no squeaking, no sliding and actual back support. It looks surprisingly solid.

And honestly, I have to admit, it’s kind of cute.

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🗣️ Looking for the Nina’s Notes Podcast?

You can also find the Nina’s Notes podcast on 🔴YouTube 🟢 Spotify, 🟣 Apple Podcasts, 🟠 Substack Podcasts where I interview entrepreneurs and have an archive of 100+ voiceovers of previous Nina’s Notes.

I also co-host Longevity.Technology UNLOCKED!

🎙️ Mondays: LT UNLOCKED interviews with leading longevity innovators, clinicians, and scientists

📰 Wednesdays: Nina’s Notes in your inbox with interviews, deep dives on longevity & neuroscience

🎙️ Fridays: LT UNLOCKED News, a weekly news roundup of the latest in longevity

Find Longevity Technology UNLOCKED on Spotify, Apple Podcasts, and YouTube.

Did you know I’m curating a Longevity Stage within the NFC Summit in Lisbon on June 4, 2026?

It’s going to be 8 hours of dedicated longevity talks, panels and workshops.

I’d love you to join if you are in town.

Grab your ticket here!

Nina

💬 In this note:

• 💪 My Accidental Workout Stack

• 📚 The Hallmarked Man

• ⚡️ Robots Are Running Half-Marathons

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#178: My Accidental Workout Stack

Nobody handed me this workout routine, I ended up building it by following what felt right to my body. And…somewhere along the way, I accidentally ticked almost every box the longevity research says matters.

I’ve been active my whole life, cheerleading and track in high school, cheerleading in college. I fell off when I no longer had a coach pushing me, then found my way back in grad school through CrossFit-style workouts and dance classes.

After that I had to figure out how to sustain it on my own, which took a while. What I learned about myself: I like being told what to do. I want to show up, do the workout, and leave without having to think too hard about it. That’s not laziness, that’s knowing yourself.

So I chased classes. OrangeTheory, hot yoga, power pilates in San Francisco and Berlin, Beat81, Barry’s Bootcamp.

As I learned more about longevity, I got more intentional about balance. The research is clear: you need strength training, cardio, and mobility work, ideally all three, consistently.

Which meant I was trekking all over Berlin or San Francisco to hit different studios for different things.

When I landed in Lisbon in the winter of 2022, I found Amplify. And I’ve been going ever since.

In the beginning of my time in Lisbon in that winter of 2022, I was living in Baixa, so getting to the Amplify studio meant a 20-minute uphill walk. I’d do a bootcamp class and walk back home. Between the walks, the workouts, and eating well, I genuinely think I was the healthiest and happiest version of myself that winter. I came back to Berlin tan and fit, having lost about 10 lbs, and tried to carry that momentum forward.

When I moved to Lisbon permanently in 2023, I signed right back up to Amplify. The bootcamp classes became my anchor - 10 minutes on the treadmill, 10 minutes strength, repeat. I did this three or four times a week, no question.

Resistance training is one of the most important things you can do for longevity. After 40, you lose 1-2% of muscle pass per year if you’re not actively fighting for it.

Muscle is protective, metabolically, structurally and for independence later in life. Bootcamp class is my prescription for that.

Then a friend told me I hadn’t even scratched the surface of Amplify if I hadn’t tried Miki’s cycling class. I went. The man has a gift.

It was the hardest class I’d ever done, the energy was through the roof, and at one point Miki was literally on the ground with his fist down, giving us a full motivational monologue about being in our bodies, becoming our best selves. You walk out of that class feeling like you can do anything. I was hooked.

Cycling at that kind of intensity is exactly what longevity literature calls for.

Your VO2 max, your body’s capacity to use oxygen, is one of the strongest predictors of all-cause mortality. The research shows that moving from “low” to “above average” VO2 max cuts your risk of dying more than quitting smoking.

For me, that means Miki’s cycling class is basically a longevity drug.

After a bad ankle injury eventually took running off the table, I went deeper into cycling and then yoga. A year or two in, Amplify opened a new location in Santos, where they have a bigger studio and added Barre classes.

Now my routine is a mix of everything: two or three bootcamps a week, one cycling class, and barre or yoga on top of that.

Flexibility and stability work isn’t just recovery, it’s core to your longevity too. The ability to balance on one leg for 10 seconds is an independent predictor of survival in your later years. Barre and yoga are my way of working on that.

I’m at Amplify four times a week. I hit 250 classes recently, and I’m still going. One thing nobody tells you about Amplify: people bring their dogs. This is, objectively, one of the best parts of my day.

Post-workout, I grab a smoothie. My order: the Boogie Matcha. Everytime. This helps me get my protein in right after a hard workout. Protein matters more than most people realize, and your muscles are most receptive to protein in that window right after training. Getting protein in after a workout is one of the easiest optimizations you can make.

Beyond Amplify, I dance. Pop dance once a week at Jazzy Saldanha, and high heels dance twice a week, which is as much work as it sounds and connects me to something completely different.

In 2017, researchers found that dance was more effective than traditional exercise at reversing brain volume loss in the hippocampus. This is because dance requires constant new learning, new choreography, new spatial awareness, and new timing.

That’s a cognitive challenge on top of a physical one. High heels specifically trains proprioception and balance in ways that flat-footed dance training doesn’t.

I also play padel once or twice a week for the social aspect. Longevity research has also identified social connection as a strong predictor of a long, healthy life - equally powerful to exercise and diet. Padel is a great way for me to get in extra movement and my social time.

My workout framework, if you want to steal it:

- Amplify is where I build the foundation: strength, cardio, mobility, all under one roof

- Dance is for my brain: neuroplasticity, body awareness, learning something new

- Paddle is for my social health: connection, fun, lateral movement

I designed it by following what I enjoyed. The fact that it maps almost perfectly onto what the research recommends is either a coincidence or proof that your body knows something.

Either way: it’s a life I love.

📘 Thinking of diving deeper? Check out my guidebooks.

Over the past three and a half years of writing Nina’s Notes, I’ve turned the research I trust most into free, downloadable guidebooks, no fluff, no supplement brand agenda, just the science and the protocols.

1. Age-Fighting Drugs Guidebook

2. Breathwork for Longevity Guidebook

3. Exercise for Longevity Guidebook

4. Men’s Health After 40 Guidebook

5. Nutrition for Longevity Guidebook

6. Sleep for Longevity Guidebook

7. Stretching for Longevity Guidebook

8. Supplements for Longevity Guidebook

9. Thermal Therapy for Longevity Guidebook

You can download all 9 and more at ninapatrick.xyz/guidebooks. Or if you want everything in one place, the guidebooks, the full deep dives, and early access to events, just upgrade to a paid subscription. Paid subscribers get the complete guidebook library included.

📚 Book of the Week

The Hallmarked Man by Robert Galbraith

Rating: ★★☆☆☆

You may have noticed there wasn’t a book of the week the last two weeks. One reason was…I’m still reading this long damn book. Another reason was #176 was an emotional essay that needed to stand alone.

While I’m still not done with this book, I’m ready to rate it, or give it up.

It’s an 18 hour read according to my kindle, and I’ve dragged myself through over 50% and I can say that it’s a frustrating amount of “Cormoran loves Robin, and Robin loves Cormoran” but neither of them have the confidence to say so and are therefore living unfulfilled lives.

The main plot line moves along at a glacial place - Cormoran and Robin are investigating a mysterious body found inside of a silver shop’s vault. Meanwhile, balancing a few other clients and Cormoran has to face a public scandal.

I’ve read all seven books in this series so I feel I owe it to myself to finish this one too, but it’s truly the most boring one thus far, and it only gets 2 stars.

⚡️ Check This Out

A humanoid robot just ran a half-marathon in 50 minutes and 26 seconds, a new robot record.

The human half-marathon record, on the other hand, is ~57min held by Jacob Kiplimo.

The 2025 half-marathon robot winner finished the race in 2 hours, 40 minutes and 42 seconds.

I’m not going to lie. I don’t really want us to make them any faster, it’s starting to feel a little to I, Robot to me.

But although the winning robot from Chinese smartphone manufacturer, Honor, is faster than the humans…another robot started the race by falling on its face.

🗣️ Looking for the Nina’s Notes Podcast?

You can also find the Nina’s Notes podcast on 🔴YouTube 🟢 Spotify, 🟣 Apple Podcasts, 🟠 Substack Podcasts where I interview entrepreneurs and have an archive of 100+ voiceovers of previous Nina’s Notes.

I also co-host Longevity.Technology UNLOCKED!

🎙️ Mondays: UNLOCKED interviews with leading longevity innovators

📰 Wednesdays: Nina’s Notes in your inbox, personal essays, interviews & deep dives

🎙️ Fridays: LT UNLOCKED News, a weekly news roundup of the latest in longevity

Find Longevity.Technology UNLOCKED on Spotify, Apple Podcasts, and YouTube.

Edited by Wright Time Publishing

I gave a talk at the HotColdClub in Lisbon last week titled “Altered States, Extended Lives” where I gave a recap of all the latest research linking psychedelics as longevity medicines.

Xo,

Nina

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I’ve been working on something.

Over the past few weeks, I pulled together the five areas of longevity science where female biology diverges most from the standard advice, and where getting it right actually changes your trajectory in aging.

The result is The Women’s Longevity Starter Kit, a 14-page guide covering estrogen and cognition, creat…

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A super special thanks for those of you who upgraded to a paid subscription.

I write these newsletters every week, and maybe you read some, not all. I get it. Inboxes get full. There’s cool info coming from a lot of awesome writers, and of course I write about whatever I want to write about - it’s NINA’S notes after all ;)

There are weeks when…

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Dr. Yi Song has spent her career bridging Eastern and Western medicine.

What she’s found is that most people are already losing the health game before they feel a single symptom.

In this conversation, Dr. Song breaks down why treating symptoms is not the same as healing, what stem cell therapy can actually do (and what the industry gets dangerously wrong), and how meditation and energy flow aren’t just ancient metaphysics - they’re measurable, teachable tools for longevity.

If you’ve ever wondered whether regenerative medicine is real or hype, or how to find a clinic you can actually trust, this episode will sharpen your thinking.

Key Topics:

• Why early prevention is the most overlooked lever in healthcare

• Stem cell types, functions, and what mesenchymal stem cells can treat

• How stem cell production declines with age — and what to do about it

• Navigating the unregulated stem cell clinic landscape safely

• The six principles of natural longevity from The Regeneration Effect

• Meditation, energy flow, and metaphysical states of consciousness

Timestamps:

• 00:00 The Intersection of Eastern and Western Medicine

• 08:05 The Importance of Early Prevention in Healthcare

• 13:19 Exploring Stem Cell Therapy and Its Benefits

• 16:18 Understanding Stem Cells: Types and Functions

• 19:56 Applications of Mesenchymal Stem Cells in Treatment

• 22:39 Preventative Measures for Joint Health and Aging

• 28:05 The Decline of Stem Cells with Age

• 29:17 Skepticism and FDA Approval in Stem Cell Therapy

• 30:58 Quality Control in Stem Cell Treatments

• 33:45 Identifying Reputable Clinics for Stem Cell Therapy

• 35:21 The Importance of Personalized Treatment

• 38:12 The Regeneration Effect: Principles for Longevity

• 40:46 Six Principles for Health and Longevity

• 46:24 Rapid Fire Longevity Questions

• 49:52 Myths and Realities of Stem Cell Therapy

RESOURCES MENTIONED:

The Regeneration Effect Book — https://book.regenerationeffect.com

StemCell Therapy Experts — https://stemcelltherapyexperts.com

Cell Therapy Experts Podcast — https://youtube.com/CellTherapyExperts

Free Regeneration Effect eBook — https://gift.regenerationeffect.com

Connect with Dr. Song: https://regenerationeffect.com

ABOUT DR. YI SONG: Dr. Yi Song is a regenerative medicine physician and author of The Regeneration Effect. Drawing on decades at the intersection of Chinese medicine and modern science, she guides patients through personalized stem cell protocols and holistic longevity frameworks at StemCell Therapy Experts.

ABOUT NINA’S NOTES: Nina’s Notes explores the intersection of longevity science, neuroscience, and human optimization. Hosted by Nina Patrick, PhD in pharmaceutical sciences and longevity researcher, each episode translates cutting-edge research into actionable insights for living longer, better.

CONNECT WITH NINA’S NOTES

LinkedIn: https://www.linkedin.com/in/ninapatrick/

Website: https://www.ninapatrick.xyz

Key Words

holistic health, early prevention, stem cell therapy, meditation, longevity, Chinese medicine, regenerative medicine, energy flow, aging, biohacking

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While I was taking my Dad to visit his cousins in Australia, I was hustling in the shadows.

I launched a second podcast, Longevity.Technology UNLOCKED, with co-host Phil Newman, one of the leading voices in the longevity space.

Now you can hear from me three times a week!

• 🎙️ Mondays: LT UNLOCKED interviews with leading longevity innovators, cl…

Read more

In this episode of the Nina’s Notes Podcast, I speak with Danny and Sarah, founders of Behold Retreats, who have guided more than 1,500 people through plant medicine ceremonies around the world.

Their participants range from professional athletes and high performers to people seeking deep emotional healing.

We explore what actually happens inside a psychedelic retreat, how medicines like ayahuasca, psilocybin, and Bufo are used in ceremonial contexts, and why these experiences are attracting people interested in healing, personal growth, and expanded consciousness.

Danny and Sarah also explain the concept of ego dissolution, the importance of integration after psychedelic experiences, and the difference between using these medicines for healing versus expansion.

Subscribe now

Topics we discuss:

• What happens during a plant medicine retreat
• The meaning of ego dissolution (sometimes called “ego death”)
• The biggest misconceptions about psychedelics
• Why athletes and high performers explore plant medicine
• Healing versus expansion in psychedelic experiences
• Why integration is essential after ceremony

Plant medicines have been used for thousands of years in indigenous traditions. Today, they are becoming part of a growing conversation around mental health, consciousness, and human potential.

Learn more about Behold Retreats: https://bit.ly/4rwJszz

Most longevity conversations focus on labs, supplements, and biomarkers. This week’s guest, Roderick Lambert, goes deliberately upstream of all of that.

After 15 years of struggling with obesity and a doctor warning him at 35 that he could have a heart attack within five years, Roderick overhauled his life, lost 24kg in seven months, and never looked back. Today he coaches people aged 40–60 on the root causes of metabolic decline and accelerated aging.

The calories in, calories out model isn’t just bad advice. It’s physically inaccurate.

You’ll discover:

• Why mitochondrial dysfunction is the root cause of most chronic diseases

• How fat produces up to 6x more usable energy than glucose

• Why the 40–60 window is your last real chance to turn back the clock

• The role of light, circadian biology, and coherence in cellular health

• Why “you can’t get well in the environment you got sick in”

• How to build habits that stick, without willpower

Cheers, Nina

Timestamps:

• 00:00 Roderick’s Journey: 15 Years of Obesity

• 05:30 The Doctor’s Warning That Changed Everything

• 12:00 Why Calories In/Out Is Inaccurate Physics

• 18:00 Mitochondria: Far More Than the Powerhouse of the Cell

• 25:00 Accelerated Aging and the 40–60 Window

• 31:00 Food First: Fat vs. Glucose as Fuel

• 38:00 Light Diet and Circadian Biology

• 44:00 Fasting, Movement, and Building Habits

• 50:00 Accountability as the Missing Link

ABOUT RODERICK LAMBERT: Roderick Lambert is a metabolic health coach and founder of Midlife Metabolic Health. After reversing his own metabolic syndrome in his early 40s, he now works with clients aged 40–60 to address the root causes of accelerated aging through first principles nutrition, light biology, movement, and mindset.

ABOUT NINA’S NOTES: Nina’s Notes explores the intersection of longevity science, neuroscience, and human optimization. Hosted by Nina Patrick, PhD in pharmaceutical sciences and longevity researcher, each episode translates cutting-edge research into actionable insights for living longer, better.

CONNECT WITH RODERICK LAMBERT

Website: https://midlifemetabolichealth.com

Facebook: https://www.facebook.com/MidlifeMetabolicHealth/

LinkedIn: https://www.linkedin.com/in/rodericklambert/

I’m obsessed with sleep.

Recently, my sleep has been suffering - world travel, jet lag, altitude…I’ve been rough on my body.

But now that I’m back in Lisbon - my peaceful sanctuary, my sleep has been some of the best I’ve had in years.

But because I keep coming back to this idea that we are wildly underestimating what happens to the brain during those unconscious hours.

We think of sleep as passive. That our body goes quiet, and the mind goes offline.

But the more I dig into the research, the more I’m convinced that sleep is the most active thing you can do for your brain’s long-term health.

This week I want to take you inside one of the most fascinating and underappreciated systems in the human body: the glymphatic system.

Never heard of it? It’s the brain’s own sewage network!

and…you can hack it.

Enjoy,

Nina

💬 In this note:

• 🧠 The Glymphatic System Hack: How To Detox Your Brain During Deep Sleep

• 📚 Why We Sleep: Unlocking the Power of Sleep and Dreams

• ⚡️Watch The Brain’s CSF Pulses During Sleep

Subscribe now

Want to improve your health and wellness in 2026?

I’ve written 9 guidebooks to help you get started. They are included when you upgrade to a paid subscription of Nina’s Notes

Upgrade to Paid

Or get the individual guidebooks here: Grab the guidebooks.

#171: 🧠 The Glymphatic System Hack: How To Detox Your Brain During Deep Sleep

Every hour you are awake, your brain is accumulating metabolic waste.

Proteins, cellular debris, and neurotoxic byproducts are building up in the space between your neurons, called the neural interstitium, every moment you are awake.

And the only way to flush them out is through deep sleep.

Deep sleep activates your glymphatic system which carries that waste out.

What Is the Glymphatic System?

The glymphatic system is your brain’s waste clearance network.

The name is a mashup of “glial” (the support cells of the brain) and “lymphatic” (the body’s wider drainage system).

The glymphatic system was only identified in 2012 (!!!) by neuroscientist Maiken Nedergaard at the University of Rochester.

Before Nedergaard’s discovery, neuroscientists were puzzled. The rest of the body has a lymphatic system to remove cellular waste. But the brain sits behind the blood-brain barrier, sealed off from that conventional drainage network.

So how was it clearing the cellular waste and garbage from the brain?

It turns out the brain has its own hydraulic system which moves the cerebrospinal fluid (CSF), a clear liquid that surrounds and cushions the brain, along channels formed by astrocytes which fill the spaces between neurons, providing scaffolding and physical support to the brain.

Astrocytes are essential caretakers of the brain and spinal cord.

As the CSF flows through them, it flushes the waste dissolved in the interstitial fluid out of the brain, draining it into the lymphatic vessels that run alongside the neck.

It gives a new definition to “brainwash,” huh?

Why Does It Only Work During Sleep?

When you are awake, your brain is busy.

Neurons are firing constantly, astrocytes are actively supporting neuronal function, and the glymphatic system runs at only about 5-10% of its sleep capacity.

But during slow-wave sleep (the deep, dreamless stages of non-REM sleep), the brain’s glial cells actually shrink up to 60% in size.

This dramatically increases the space between cells, allowing cerebrospinal fluid to flow much more freely and efficiently through the brain tissue.

That means that the glymphatic system kicks turns on full blast. The CSF floods through, waste gets swept up, and the brain is rinsed clean. (ohhhh ahhhh 🧖🏾‍♀️)

One of the key waste products cleared by this process is beta-amyloid, the protein that clumps into the plaques strongly associated with Alzheimer’s disease. Studies in mice show that beta-amyloid clearance is twice as fast during sleep as during wakefulness.

Data like this show us why sleep is not a passive luxury.

It is important and acts as active neurological maintenance.

How to Optimize Your Glymphatic System

So if we know the glymphatic system activates during slow-wave sleep, can we do anything to maximize it?

YES! We can.

Two of the most evidence-backed interventions are surprisingly simple.

Your sleeping position and core body temperature.

Sleeping Position

A 2015 study published in the Journal of Neuroscience led by researchers at Stony Brook University, found that sleeping on your side (lateral position) significantly enhances glymphatic transport compared to sleeping on your back or stomach.

Why is side sleeping the best?

It comes down to gravity and fluid dynamics.

On your side, your brain’s drainage pathways are aligned in a way that maximizes CSF flow and minimizes resistance.

Laying on your right side appears to offer the best glymphatic clearance, though the research is still emerging on whether right vs. left makes a meaningful difference for most people.

Interestingly, many animals that sleep, from dogs to elephants, default to lateral positions. It may be one of the most evolutionarily conserved behaviors for brain health.

Core Body Temperature

Core temperature is a powerful regulator of sleep architecture, and by extension, a powerful regulator of your brain’s glymphatic activity.

Your body’s core needs to cool by roughly 0.5–1.5°C (1–3°F) to initiate and maintain deep slow-wave sleep.

Deep sleep is most abundant in the early part of the night, coinciding with the natural drop in core body temperature that begins a few hours before sleep.

You can support your body’s natural cooling process by keeping your bedroom cool (18–20°C / 65–68°F) to accelerate your core temperature drop and make falling asleep easier.

Taking a warm bath or shower 1–2 hours before bed works because the warm water draws blood to the skin’s surface and accelerates heat loss once you step out, rapidly dropping core temperature.

You can also try cooling mattress pads (like ChiliPad or Eight Sleep) which have shown meaningful improvements in slow-wave sleep in several studies.

There is also emerging interest in deliberate cold exposure earlier in the day (cold showers, cold plunges) as a way to regulate the circadian temperature rhythm and prime deeper sleep at night.

But the key here is that cold exposure needs to happen earlier in the day (before 4pm or so). Cold plunging at night (and this is really my personal experience here) spikes adrenaline too much which makes falling asleep more difficult.

Listen to 40Hz To Hack Your Glymphatic System

Before I get to the full protocol, I have to share something I covered recently on Longevity.Technology UNLOCKED with Phil Newman because it fits this topic almost too perfectly.

The rest of this note, including a breakdown of a brand new PNAS study on sound therapy for brain detox, and the full glymphatic protocol, is for paid subscribers.

Read more

On a roadtrip to Nazaré back in December, yes, to watch humans voluntarily surf 30-metre waves, which is its own kind of madness, a friend turned to me and asked something that’s been stuck in my head ever since.

“Should we migrate like birds and chase the sun, or should we go with the seasons? Is it possible that our bodies are actually optimal in the habitat where we were born?”

I grew up in Las Vegas. 360 days of sun a year. Desert heat. A sun that is trying to kill you.

And every winter when I lived in Berlin, I’ve had the same quiet breakdown when November hits. The light disappears, my mood tanks, and I spend three months wondering why anyone voluntarily lives in the dark.

So yes. Guilty. I chase the sun. (I wrote this from Australia. No regrets.)

But is this just a personal preference, or is there something deeper going on biologically?

Something that predates me, my choices, even my lifetime?

That’s what I wanted to find out.

💬 In this note:

• ☀️ Chasing the Sun

• 📚 Being You

• ⚡️ Do Your Parents Know What You Do For Work?

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#170: ☀️ Chasing the Sun

Photo by Florian D. Bazac on Unsplash

Your body has a blueprint

Humans have spent tens of thousands of years adapting to the specific environments their ancestors called home, extreme cold, high altitude, low light, desert heat.

That creates what you might call a biological blueprint.

Your native habitat is often the environment where your body experiences the least friction, because it’s the one your genes were shaped for.

Take high-altitude populations in the Andes or Himalayas. Their hearts and lungs are genetically adapted for thin air. Move them to sea level and something might feel... off. Heavy. Wrong.

The same principle applies to temperature and light.

Our genes for thermogenesis, the way our bodies generate heat, were sculpted over 30,000 years by the climates our ancestors inhabited.

Populations from colder climates have genetic variations that enhance brown adipose tissue (BAT) function, which plays a key role in metabolism and energy balance.

If someone genetically optimised for cold moves to a tropical climate, it can create a metabolic mismatch, increasing risks for obesity and diabetes, because the body is programmed to store energy in a way that no longer matches its environment.

Unfortunately, your genes don’t update when you buy a plane ticket.

So what are snowbirds actually doing to their biology?

Quite a lot of good things, it turns out.

Longer daylight hours strengthen your circadian signals. Better alertness during the day, deeper sleep at night.

In winter, lower solar angle means less UV-B radiation reaching your skin, and less vitamin D production as a result.

In Berlin in the winter, you synthesize 0% vitamin D.

The figure above plots the sun’s elevation for Berlin for every month of the year.

The data reveals a hard truth that Berlin is a Vitamin D dead zone in the winter.

When the sun sits low on the horizon, like in winter,the sun’s rays travel a long diagonal path. The light travels through a thicker part of the ozone which absorbs 99.9% of UVB radiation.

You see visible light, of course, but the beneficial biological signals are filtered out. No matter how much time you spend outside in December (or even March) in Berlin, your Vitamin D synthesis is effectively 0.

Vitamin D deficiency weakens your immune system. And the expanded darkness of northern winters is linked to increased inflammation, fatigue, and higher risk of seasonal affective disorder (SAD).

Chasing the sun doesn’t just feel good.

For many people (like me!), it genuinely prevents these seasonal declines.

Want to read the rest?

Upgrade to paid to get the full breakdown including: why constant migration might actually hurt your biology, the concept of “circadian load,” how to figure out if you’re fighting your own genetics, and tools to track your circadian alignment.

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I just got back from a month in Australia with my dad and I have a story I need to share with you.

It’s personal. It was stressful. And it completely changed how my 78-year-old dad manages his type 1 diabetes.

As a pharmacologist, I’ve spent my career understanding how drugs work in the body. But this was the first time I applied that knowledge to someone I love, in real time, on the road, with no safety net.

The results blew us both away.

💬 In this note:

• 🩸 How I Fixed My Dad’s Diabetes Crashes in 4 Weeks

• 📚 Men Explain Things To Me

• ⚡️ Year of the Rabbit, or Cat?

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#169: 🩸 How I Fixed My Dad’s Diabetes Crashes in 4 Weeks

My dad is 78 years old and has type 1 diabetes.

He started as a type 2 diabetic, which eventually developed into insulin dependence.

He does multiple insulin injections a day and wears a continuous glucose monitor (CGM).

I got him on a CGM about a year and a half ago, and that alone was hugely transformative.

Before that, he was doing finger pricks, giving himself way too much insulin, and going into diabetic comas, episodes where his blood sugar would drop so low that his brain essentially stopped functioning.

This. was. terrifying.

He wouldn’t fall asleep exactly.

He’d be in this zombie-like state, kind of there, processing information, but nothing really working.

It’s similar to watching someone who’s had way too much alcohol.

We’ve had to call the paramedics multiple times. They give him a glucose injection and he snaps back. Then he’s on a sugar high because he was just given a ton of glucose. And the roller coaster starts again.

Getting him on the Abbott Libre 3 continuous glucose monitor (CGM) relieved a lot of stress for my mom, for him, and for me.

It sends his blood sugar reading to his phone, my phone, and my mom’s phone in real time.

I absolutely love this device. It is brilliant, easy to use app.

(@Abbot if you want to sponsor my newsletter, please reach out! 🤩)

But it was only step one.

The Deal

Before we left for Australia, I set a rule:

“We’re not going unless you haven’t had a diabetic coma in the last six months. It’s too high risk, something could happen on the plane.”

He was managed that. No crises in a year and a half.

So we went.

And on the flight from Las Vegas to LA before our long-haul to Brisbane, I sat my dad down and said:

“Will you do an experiment with me? Everything we try on this trip, we can change. We can go back to how you were doing things before. But will you be on board and try some of the things I suggest so we can better manage your blood sugar?”

He said yes.

The Roller Coaster Problem

Before our experiment, my dad’s daily blood sugar reading looked like a stock market crash, spike to 300, crash to 60, back to 300, down to 60. A violent roller coaster.

I imagine the feeling was horrible.

What I wanted to see instead was slow, rolling hills as his readings from the CGM.

A flat line would be nearly impossible, but something stable, that was the goal.

His doctor had prescribed 14 units of slow insulin in the morning, 14 at night, and 3 units of fast insulin with every meal.

Based on what I had seen, the crashes, the paramedic calls, the collapses on his walking trail and as a pharmacologist who understands pharmacokinetics, I knew he was taking too much insulin.

⚠️ Disclaimer: I am a pharmacologist, not a medical doctor. This is not medical advice. This was an experiment with an N of 1, my dad, and the results we saw. If you’re going to change medications, you absolutely need to talk to your doctor. I told my dad the same thing: when we get home, we talk to the endocrinologist about every change we made.

The First Test: A 13-Hour Flight

We sat down for a bowl of ramen before the flight. I watched his blood sugar start to skyrocket. We did some fast insulin and brought it down.

Then I said: no more insulin for the rest of the flight. And we’re not eating anything on the plane.

My dad, who has been doing this routine for decades, pushed back.

“I need to do my slow insulin.”

I said, “

Why don’t we just wait and see?”

What happened over those 13 hours was beautiful.

We saw a slow, steady curve decreasing from about 200 down to 100. The fast insulin caught up with the food. The slow insulin from the morning was still working.

No crash.

No panic.

No emergency.

I had proved my first point: the slow insulin lasted longer than he thought.

What 9 Things I Changed (And Why It Worked)

1. Eliminating the Nighttime Insulin Dose

Here’s what I discovered: my dad’s 14 units of slow insulin taken in the morning lasted a full 24 hours.

When he was doing that second dose of 14 units at night, he was stacking insulin

…and crashing in the middle of the night.

He’d wake up stressed, sweaty, disoriented, fumbling around for a soda to bring his blood sugar back up.

That meant terrible sleep, which affected his stress levels, which affected his blood sugar the next day. A vicious cycle.

I said, let’s try just the 14 units in the morning and see what happens.

We did it for the entire month. According to the CGM, how he felt, and how he was sleeping, it was perfect. No more middle-of-the-night crashes.

2. Reducing the Fast Insulin Dose

His doctor recommended 3 units of fast insulin per meal.

I said, let’s be cautious, let’s try 2 units and see what the CGM tells us.

Two units worked for most of the meals we were eating. We avoided those terrifying straight-down arrows on the CGM that signal a rapid blood sugar drop.

3. The Golden Rule: Never Take Insulin Without Eating

This was a non-negotiable.

Before the experiment, my dad would sometimes skip breakfast, take his fast insulin, and go for a three-mile walk carrying weights.

He believed exercise was bringing his blood sugar down. But it was actually the fast insulin on an empty stomach.

This is why he had collapsed on his walking trail, more than once. People found him and had to contact us to get him to the hospital.

New rule: insulin always, always, always goes with food.

Food with slow insulin and fast insulin. No exceptions.

Want to read the rest of this story?

Upgrade to a paid subscription to get the full breakdown of the 9 specific interventions with the science behind them, the insulin adjustments, the diet overhaul, the “emergency bedside banana,” and the dramatic results (reducing 85 blood sugar alerts to only 6 alerts, 15 lbs lost) after 4 weeks and the actionable takeaway summary.

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Want this newsletter in podcast form? Find it on Spotify or Apple Podcasts.

It’s also on my YouTube channel. If you like it, please subscribe and I’ll keep making videos :)

Xo,

Nina

P.S. I recorded this episode on my YouTube Channel, watch it here:

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Hey friends,

This week’s conversation takes us into the future of preventative healthcare.

I sat down with Emilian Popa, founder of Expand Health, who’s on a mission to democratize access to longevity and preventative care for the middle class.

“Prevention is number one. You can always tweak afterwards.”

Emilian shares his journey from selling goods across …

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In this episode, Nina sits down with Emilian Popa, founder of Expand Health, for a candid conversation about democratizing longevity and preventative care. From his early days as an entrepreneur in Romania to working in venture capital and finally building his own healthcare company, Emilian reveals the critical gaps in our current healthcare system and how technology can bridge them.

This isn’t about boutique longevity clinics charging $10,000 for annual memberships. It’s about making evidence-based preventative care accessible and affordable for the middle class, the people who need it most but are currently priced out of the market.

Emilian explains why behavior change is the hardest part of healthcare transformation, how AI is revolutionizing patient experience and cost structures, and why the fundamentals of nutrition, movement, and sleep remain non-negotiable. You’ll discover what’s actually stopping people from accessing preventative care, how healthcare will evolve over the next decade, and why brain health deserves more attention in the longevity conversation.

Timestamps:

00:00 Emilian’s Entrepreneurial Journey

05:47 Building Expand Health: A New Approach to Healthcare

12:11 Behavior Change and Health Span

20:24 Innovations in Preventative Care

25:43 Scaling Preventative Health Across Continents

30:57 The Cost of Healthcare and Access to Testing

32:31 Democratizing Healthcare: Bridging the Gap

34:59 Behavior Change: The Key to Health

37:16 The Future of Work: Balancing Productivity and Health

41:05 Foundational Health: Nutrition, Movement, and Sleep

43:33 Emerging Technologies in Health and Longevity

48:15 Advice for Individuals in the Longevity Space

52:58 The Importance of Brain Health and Future Innovations

Where to find Emilian Popa:

• Expand Health

• LinkedIn

Where to find Nina Patrick, PhD:

• Newsletter

• LinkedIn

• Website

Why do we demand absolute perfection from AI while accepting human error as inevitable? When an LLM hallucinates or cites fake sources, I get frustrated. But when a colleague misspeaks or misremembers, I give them grace. Why the double standard?

I walk through the reality of human error across industries:

1. Diagnostic mistakes happen in 5-20% of doctor visits

2. 80% of aviation accidents trace back to human error

3. 20% of Big Four audits have significant deficiencies

4. Even elite professionals only achieve 90-95% accuracy.

The thread tying all of this together is simple but uncomfortable: our imperfections are what make us human and interesting. AI-generated content feels soulless. You can sense it. It lacks emotion, depth, playfulness, and personality.

I believe we’re heading toward an age where we’ll pay a premium for human-generated content, art, and music. We think we can scale the human experience with AI, but what we’ll find instead is an overly perfect, emotionless dark age of art and culture.

The choice isn’t between perfect AI or imperfect humans. It’s about deciding which imperfections we’re willing to live with.

TIMESTAMPS

00:00 Hello from Australia!

01:16 We Expect Perfection out of AI and Not in Humans, Why?

06:41 The Paradox of Perfection in AI and Humanity

07:05 Mentoring Opportunities

07:26 The Book of the Week

08:34 Grab My Guidebooks

08:51 Check this out

Links

https://www.who.int/news-room/fact-sheets/detail/patient-safety

https://www.sciencedirect.com/science/article/pii/S2666691X23000246

https://tax.thomsonreuters.com/news/audit-deficiency-rate-drops-in-2024-in-sign-of-improvement/

https://www.researchgate.net/publication/1907590_Thinking_is_Bad_Implications_of_Human_Error_Research_for_Spreadsheet_Research_and_Practice

CONNECT WITH ME

Newsletter: https://www.ninasnotes.xyz

Longevity.Technology Unlocked Podcast: https://longevity.technology/unlocked/

Longevity Guidebooks: https://ninapatrick.xyz/guidebooks

Mentoring: https://ninapatrick.xyz/startup-mentor/

LinkedIn: https://www.linkedin.com/in/ninapatrick/

Website: https://www.ninapatrick.xyz

I’m writing to you from sunny Australia, where I celebrated my birthday and the new year with my BIG AUSSIE FAMILY 🐨🦘.

That’s right, something you may not know, is that I’m an Australian-Italian-American. 🇦🇺🇮🇹🇺🇸

My paternal grandmother was Australian and my Dad grew up in Brisbane and later California.

While my maternal grandparents were…

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In this episode, Nina sits down with Ariel Garten, neuroscientist and founder of Muse, for a deep dive into how neurofeedback technology is revolutionizing the way we train our brains. From her early work making buildings light up with brainwaves at the 2010 Winter Olympics to creating a headband used by half a million people worldwide, Ariel reveals how accessible brain training has become.

This isn’t science fiction, it’s neuroscience made practical. Ariel explains how three to five minutes of daily brain training can improve focus, enhance sleep quality by 20%, and even help you fall asleep 55% faster. You’ll discover what your brain really looks like during sleep, why most of us aren’t getting “textbook” sleep, and how emerging technologies like deep sleep stimulation could change how we age.

Timestamps:

00:00 Introduction to Muse and Neuroscience

01:50 The Journey of Muse: From Concept to Reality

04:29 User Experience: Feedback and Interaction with Muse

06:54 Training the Brain: Techniques and Processes

09:44 Understanding Calmness: EEG Insights and Metacognition

12:12 Evolution of Use Cases: Meditation to Sleep Optimization

14:52 The Muse S: Enhancing Sleep Quality

17:35 The Complexity of Sleep: Insights from EEG Studies

22:10 Transforming Sleep Through Mindfulness

24:33 Understanding Calmness and Anxiety

26:06 Enhancing Focus and Productivity

27:52 The Role of Muse in Daily Life

29:19 Exploring ADHD and Focus

31:30 The Future of Brain Diagnostics

34:01 Innovations in Brain Measurement

36:34 The Limits of Brain Training

39:30 Best Practices for Brain Training

CONNECT WITH ARIEL GARTEN

Website:

https://choosemuse.com

Linkedin: https://www.linkedin.com/in/arielgarten/

Twitter: @choosemuse

Instagram: @choosemuse

CONNECT WITH NINA’S NOTES

Newsletter:

Nina’s Notes

A weekly, digestible, non-technical read on health & science.

By Nina Patrick

LinkedIn: https://www.linkedin.com/in/ninapatrick/

Website: https://www.ninapatrick.xyz