Dear Mark: Trauma and PTSD, Cans vs Pouches, Psychedelics, Long Term Ketosis, HRT for Older Women, Current Supplements, Balancing Strength with Flexibility

While I have no idea what specifically you’re dealing with, I can tell you that the common notion of what causes PTSD may not be entirely accurate. The popular idea is that exposure to extreme combat, explosions, death and dismemberment, and loss levies a combined physical and psychological toll that is too much to bear. Once they’re back in civilian life and no longer in survival mode, the trauma manifests.

One problem with this theory is that PTSD afflicts many soldiers who never even see combat.

What seems more likely? There’s a great book called Tribe by Sebastian Junger which explores a “new” theory of PTSD. It goes like this: Soldiers spend every waking moment of their time serving alongside each other. They eat, sleep, laugh, fight, and survive together. They work toward common goals against a shared enemy. They lean on each other and in many cases save each other’s lives. They establish bonds that you can’t fake or design in a lab. And even if there’s little to no combat, you’re still in it (whatever it is) together. These are real connections almost tribal in nature. Life has meaning.

And then they come back home, and all that gets cut off. They’re trying to work a normal job. They’re often living alone, isolated from other people. They go from living a tight-knit tribal community existence with people who would literally die for you to living in the isolated atomized sprawl of modern society. Rather than living a life where meaning is implicit (like the battlefield), they find themselves navigating a world bereft of obvious meaning.

That’s when the traumatic experiences rear their heads. It all comes rushing in without meaning and connection to buttress its effects. You’re left alone.

I really think meaning is the key all this stuff: PTSD, anxiety, trauma, depression, etc. We need a reason to get up in the morning, to keep taking those steps forward through life. To face fears and push through resistance. To focus on the present rather than imagined worries. Something higher to aspire toward. A mission. I don’t think that’s enough, but it is required to deal with and perhaps prevent a lot of these issues. Necessary but not sufficient.

I hope this helps. My guess is that fixing the “meaning” deficit is a potential solution for anything kind of trauma, PTSD, etc, whatever the source. If you want to be more specific, feel free to reach out.

I think the can has more of an environmental connotation. I think nobody cares about portability and durability. The can arose because people didn’t have freezers and you could keep stuff shelf-stable. You don’t need a refrigerator to keep something in a can.

But if you’re out and about also, you open up a can, and it hasn’t gotten smaller. You still have the same size can that you have to deal with now. It’s bulky.

Pouches can be sealed back up with the ziplock. With cans, you have to finish the contents because every can is one serving. You can’t close it back up and save the rest for later.

With a pouch, you can fold it up, you can store it, you can rip it open quickly. You can’t do that with a can. Even if it has a pull tab, it often splatters you with the contents when you pull it off.

And just in terms of the economics of processing on a line, cans are much more difficult than bags.

Pouches lend themselves to more graphic representation of the food that’s inside. Easier to print on and they can be clear if you want to show the interior.

I think there are a lot of reasons that you’d pick a bag or a pouch over a can. Conversely, I can’t imagine one reason to pick a can over a pouch.

If you’re the type to already introspect as a baseline, if you are a person who plums the depths of your psyche who overthink and over analyzes, be careful.

Just like I am suspicious of people who claim to have minimized or destroyed their ego through meditation I don’t trust when people say that they used powerful psychedelics to obliterate it. That the opposite is often true: extreme amount of meditation or psychedelic usage can actually strengthen the ego and reinforce it. There’s even a study I remember reading where mindfulness meditation increased ego rather than reduced it. This is the classic case of the holier than thou guru (dime a dozen in Southern California).

Don’t become a DMT guy or a mushroom guy or an acid head. Anytime you start identifying as the substance that you use, you are ascribing too much power and prominence to that substance.

The classic case that I just saw recently is Bryan Johnson doing a mushroom trip, several, I think, in order to enhance longevity and reduce inflammation and all these other things. It appears to have worked on that level, at least acutely while he was taking it. A number of biomarkers improved. But he also started writing very differently. He began talking about his connection to some nonspecific transcendental sensation of connection and an overwhelming sense that he had figured it out.

Now, what was it? No one can quite say. You can never really define it, and having that feeling is certainly powerful, but I don’t know that it gives you anything actionable, and I don’t know if it comes with hidden costs. Although, he did have a couple subsequent posts where he appeared to be questioning his obsession with biohacking and tracking everything, so maybe it did work.

The thing I go back to is something that we probably all experienced. You’re at a party and some guy insists on talking your ear off about this Ayawaska trip he did or this DMT retreat. You come away, knowing that whatever the person did really affected them and was a big Monumental experience in their lives, but you don’t quite know what the experience meant or what they even experienced. They really can’t say. It’s ineffable

Just know what you’re doing. The problem is that these things can be very unpredictable, so it’s often impossible to “know what you’re doing.”

I have this suspicion that there’s “ancestral” priming occurring that might change how you react to different psychedelics.  The guy with Western European ancestry might want to be extra cautious when venturing into the Amazon for a five day ayahuasca session with some sketchy shamans. Our brains are all affected by genes, and genes have different distributions across populations. I’ve heard about a few individuals adjacent to my circles who upended their lives after a trip to one of these retreats. Divorces, personality changes, career shifts. Maybe for the better, they’d argue. But maybe not. He might do better with psilocybin (native to Europe as well as other regions) or LSD (invented by a Swiss guy). Or, hell, a bottle of good wine.

I had a friend who did a 5-MAO-DMT retreat and it took her two years to recover from the demonic thoughts that arose during her experience. They called it "night school" as if it were a positive thing that she suffered for two years as a result of her fighting, or not letting go during the experience.

And that’s another thing that really pisses me off. All the experts all the people were so convinced that she had just done it wrong but the problem with her that she messed something up during the experience and it wasn’t with the substance.

Regarding personal experience, the closest I have come is 10 mg of mushrooms embedded in chocolate. TBH, nothing hallucinogenic, just like a weed high. I am content enough in my status in this world, happy with my current mindset, not searching for any Godlike or transcendental experience.

I have always been an over-thinker. A high-stress, type A guy. Just comes with the territory. It’s part of the reason why I’ve been able to excel at what I do. I would be the guy who then relived or at least re-accessed the demons on a regular basis after a bad trip. That is the main reason I have refrained. I am not willing to risk long-term psychosis for a short term visit with "God.”

I am not religious or spiritual, but I would also caution against “instant spirituality” in the form of psychedelics. Church might be a safer, more effective and long-lasting bet. Certainly has lots of evolutionary precedent.

Check out this X thread I did on it. Read from the start.

As for long term ketosis, I don’t recommend it for most people. Ketosis works better as a tool for boosting fat burning capacity, training your mitochondria to utilize fat, and ultimately increase metabolic flexibility. Once you get in the sweet spot, you should be drifting in and out of mild ketosis just from living normally. Fasting overnight (from dinner to whenever you eat breakfast) will increase ketones. A good long hike or easy run might generate ketones. Simply not eating snacks between meals might even generate ketones.

Most of the long term high-fat low-carb populations we’re aware of, like the Inuit, actually have genetic mutations that limit ketosis. They are great at burning free fatty acids, not ketones. It appears as if we aren’t designed to run indefinitely on ketones (although we certainly can do it).

All that said, long term and even perpetual ketosis can be therapeutic for specific populations, like those with treatment-resistant epilepsy.

That’s been the conventional wisdom for decades now: that starting hormone replacement “too late” after menopause has already happened  will increase mortality and the risk of various cancers and diseases. A 2002 study suggested that women who took HRT after the age of 65 had an increased risk of cancer and heart disease, but the problem with that study was that it used oral hormones rather than transdermal/vaginal and horse estrogen and synthetic progesterone rather than bioidentical hormones.

More recent studies find that both the route of administration and form of hormone matter. Transdermal and vaginal hormone replacement therapy appears to lower mortality in women over 65 compared to women who never used HRT or stopped using it when they hit 65. The same study found that bioidentical estrogen appears much safer than synthetic estrogen.

I’d say as long as you’re experiencing symptoms, you should think about hormone replacement. You might also ask about a very small dose of testosterone, which can really have a beneficial effect on women (especially libido). It’s not as common, but it’s worth exploring.

Bare minimum, if anything.

I’m just doing vitamin D on occasion, more like acute hyper-supplementation than a daily routine. I might go four days and take 10,000 or 15,000 IU a day and then not take any for a while, because it’s fat soluble, it accumulates, and I’m just not good about compliance. Never have been. In a way, it sort of mimics sun exposure: some days more than others.

For the most part, it’s vitamin D, collagen, and vitamin C sort of sporadically. I don’t take fish oil anymore. I don’t take multis. I don’t take magnesium.

If you want to call LMNT a supplement, then I do a glass of LMNT every day. And based on my schedule, sometimes I’ll do whey isolate protein powder. I don’t call it a smoothie. I just put protein powder in water and slam it down. Very simple and bare bones.

That’s about it. Bare minimum. Nothing elaborate, nothing exotic, nothing requiring a spreadsheet or a tackle box full of pills. No urolithin A.

Train through full range. Combine strength with stretching.

Say you’re on the cable machine doing single arm rows. Get in a stagger stance, let the weight really pull you toward the machine, feel the stretch in your lats, rotate your trunk, and then do the row.

Pullups? Hit full stretch at the bottom.

Romanian deadlifts are fantastic for this: lower the weight until you feel the hamstring stretch at the bottom and then drive your hips forward to complete the lift.

When you’re doing full range “stretch” lifting like this, you really want to be deliberate and careful. Don’t just drop into end range. Make sure your joints are all stacked and aligned.

If you still want more flexibility, do a simple routine at night whenever you’re watching TV or relaxing. Just focus on the areas that seem to be lagging or giving you the most trouble.

As for soreness, drop the volume. Keep the intensity high, or even higher, but reduce the number of reps and sets you do. Stay fresh each workout and stop short before failure. Recovery gets slower and harder the older you are. Training this way (intensity over volume) will maintain your strength and function without making you overly sore or requiring a week of recovery.

Thanks for reading, everyone. Next Q&A coming up soon.