You know those tiny little green bottles that you're seeing popping up around the world tour like Mads Patterson has them in all his Instagram stories. The world tour riders will tell you that it helps them push a little bit harder without as much burn that it delays the onset of lactate production. Well, is that true?
Well, that's what I wanted to find out today. So, today I'm sitting down with the physiologist behind it all, Dr. Philip Larson.
We're going to find out the real science behind these tiny little shots and we're going to design a testing protocol so I can figure out if it actually works on me. You're going to enjoy this episode. Let's jump in.
>> Philip, welcome to the Road Podcast. >> Thanks for having me. Glad to be here.
>> I'm excited for this one. There's a lot of hype about this. If anyone's watching on video, you'll see what I have in my hand.
It's a little bottle called Nomio, and it claims to reduce lactate buildup and improve performance. I started hearing about this before they were involved with the show at all. Before I ever met Oscar, like friends in the world who were started talking about they were trying this new supplement.
It seemed to be kind of the next iteration after the beetroot juke storm came along and people were whispering about this but I wasn't I wasn't seeing it like pushed in the heavy marketing campaigns like we've seen ketone with this huge marketing campaign but very little real world on the ground use from what I could see Nomio was very different everyone seemed to be using it very few people seem to be talking about it so today I'm really excited to dig into the science about if this works, how we use it, should we be using it, and maybe if it's plausible to set up a experiment where I can actually test this myself and if you were up for it, maybe we'll do this as a two-part interview where I'll today we can establish the protocol and I'll go off and I'll test it and report back if it actually worked or if I was just on the toilet for six hours a day. We'll find out. >> Yeah, hopefully not.
No, it will be interesting. That's just the way it should be tested in real life with real athletes. >> Uh before we jump into the questions, what's your role in Nomio at the moment?
>> So I'm um I'm a scientific advisor. Uh so I mean this is a spin-off from uh the research uh we've been doing for a long long time. Um and yeah for transparency uh when we found this uh like really interesting findings how it worked in the body we decided to patent it and we continue to uh like improve the product make it more stable and it was a lot of you know development going on and then we decided to so we need like this needs to be out on the market.
So we started a company uh together with three entrepreneurs and you know I'm continuing to do research and they are taking care of the day-to-day business. So I'm still a co-founder there. So I have my conflict of interest.
So like with that said, I think you know you're a scientist of notable credentials and you know we'll I'll link some of your uh work below and maybe we'll get a chance if the podcast goes on to talk about some of your other work which is you know amazing and groundbreaking in sports physiology but just in plain English because I'm not a science guy like this is a 25 it's a 6 bottle it's a small bottle for anyone who can't see it like what's in this like what's the active pathway how's it working? >> Yeah. So I mean uh the active part is broccoli sprouts uh and they contain a substance called isotiocyanate which is a whole group of uh different molecules.
So there's many different isotiocyanates but that's a compound that's really uh abundant in broccoli and or like all cabbage uh like all plants from the cabbage family but especially in sprouts. And this has been known for quite some time. So since the late 90s and it was first seen as a you know something that could potentially inhibit cancer growth and be used to uh to like to lower oxidative stress, reduce inflammation and stuff like that.
So broccoli sprouts is that's the main part. I think it's like 80%. So, it's an extract of the broccoli sprouts that we stabilized >> because it tends to be quite unstable in at room temperature.
So, we stabilized it and then it's like lemonade uh citrus juice and a little bit of sugar. >> Yeah, there's not there's only three ingredients in this. Broccoli 80% lemon 15% sugar 5%.
So, I'm guessing they're greater than the sum of their parts. and they come together, how does it go about reducing lactate production at a given workload? >> Yeah, like like the mechanism there, how it actually works, it's like we haven't we don't really understand it fully, I must I must say.
So, and it was a completely unexpected finding when we did the studies. Um so and there's a lot of you know they they try to dissect the mechanism how it fully works in the cancer studies but it's it's still out there uh you know how what is the actual mechanism we know that it's inducing a like a signaling pathway in the muscle called nerf two that's like how it was invented um so and nerf two is like really important for your training adaptations. So when you train uh nerf two signaling goes up and that sends like downstream signaling for creation of more >> mitochondria.
Sorry for my ignorance around this topic but so what's nerf two? >> Yeah. So Nerf 2 is a protein complex and a signaling pathway.
So it's um you it's sometimes it's called a master regulator. So, and what it does is uh that it's when Nerf 2 is uh turned on, it tells the body to start to detoxify itself from harmful chemicals, for example, and to increase the body's own antioxidative defense. So, it's trying to increase its own defense against external stresses, you can say.
on what are the ways that I we typically used to turn on nerve 2. >> Uh yeah, the most the most common or the most well-known one I would say is uh exercise. So when you do a normal training session uh you expect nerf to to increase.
>> And by taking this shot what observationally have we seen as the effect on nerve two production with the shot and without the shot? >> Yeah. So what we done is in in our study uh we took recreational cyclists and they train really hard for one week.
Then we measured nerf two expression. So this is we take a mus biopsy from the muscles. We go into the muscles, take out a small piece of the muscle and then we measure uh the how much of the protein nerve two that's in there and >> is nerve two sorry to jump in.
Is nerve two a way of measuring an adaptation to the training in this sense? >> Yeah, you can say it's an adaptation u in some way. So it's I mean it's the master regulator.
So it's something that should be turned on but there's like it's a little bit like turning a key. So when you turn the nerf 2 key you start a lot of different processes in the body. So it activates like several hundred uh different genes that's important for the body to handle oxidative stress to produce more mitochondria to make the mitochondria more efficient.
>> Interesting. Interesting. It's what's that uh that I did the Dunning Krueger effect.
The the more you know, the less you know. I have conversations with people like you and I think I know something about sports physiology and then it's like oh my god I know so little about sports physiology. >> I mean we dove straight into like the detailed uh biochemistry signaling pathway there.
So um and I mean it's really comp just if you forget about isotiocyanates for a while and just look at how is nerf two activated during exercise like if you do a training session you expect nerf two to increase >> but it's it's quite complicated. It's not like you it's not not enough to do a light exercise. So it needs to be quite hard and some groups have shown that it's really transient increase.
So it increases for a few minutes up to maybe an hour after a training session, but then it goes down again. So it's this like turning the key to start other processes in the body. And I would say that it's still still quite unknown exactly how this works.
>> Interesting. I'm going to definitely dig deeper into it. So sorry I interrupted you and you're talking about the findings of this study.
the the group of amateur athletes who were training uh on was it a oneweek training phase? >> Yeah, exactly. So they trained trained really hard for one week.
Uh and it was a randomized double blinded crossover study. So they trained like a one week super hard training. So it was basically 4 minute or 8 minute build to max intervals every day for one week.
And I mean the intent was to uh to get them tired, slightly overreached and uh then let them recover for a few days and see how they bounce back. So they did that with the nomial or a placebo. Um and the and the main findings on the whole body that was unexpected was this lowering of lactate.
So when they trained really hard and but they got the placebo, the training was too hard. Meaning that when we measured lactate around the lactate threshold, it was actually so say the cycle at 250 watts or something if they had a threshold there. So after this tough week, they actually had a higher lactate level at the same workload when they got the placebo just because they didn't adapt to the training.
>> But when they got the isotyanates in the normal drink, it was lower. So it was a big big difference there uh between how they responded. >> This is really interesting because I've had a lot of my conversations recently.
Uh I talked to the head of performance at Chico Olua around this around absorption and adaptation when I used to race in France France my director call it absorption of training and it's I guess we just call it adaptation of training now. So was the findings you had that it wasn't that athletes could produce more power at V2 max, it was that they were able to assimulate or absorb that training better. >> Yeah.
I mean the outcome was that they produced less lactate. Uh they had a higher power production when they we did a ramp test. Um but I mean they had done this like really hard week of training before that.
So what we measured was actually the interaction between really hard training and the isotienates. So it seems like you know they adapted better to the to the hard training. They could tolerate it better and the outcome of that was a lower lactate, better power production >> and also lower oxidative stress.
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Because I know for me and for probably anyone balancing conflicting demands on their time, work, family, and trying to balance training, there's a different lens we view training through. It's like, yeah, maybe the best physiological adaptation I'll get from a session today is 4x4 V2, but maybe I have a podcast to record this evening, and I'm just not going to be cognitively that sharp if I do 4x4. It'll be interesting to see the subjective feedback on post session fatigue levels and alertness with and without Nomio.
>> Yeah. Yeah, definitely. Um you know like after this study we just you know of course we communicated with our participants but we we asked them so how did you feel you know after doing this the two different blocks one with placebo one with nomio and a lot of them I wouldn't say everyone but a lot we got the feedback that they felt that the training was easier to yes to get through the training sessions and to recover for the next on.
So remember it was hard intervals day after day back to back to back for one week and that's really really tough to do and uh yeah so they had some kind of subjective feeling that the body you know it just absorbed the training better. >> It's like obviously we're going to go through and set up a protocol for test and formally on me but I've been using uh Nomio before. or we have this session called the Thursday chop.
We've run it all summer where it's an old school chain gang just threwing off hard for one hour on a Thursday evening and it's my hardest session of the week. I've taken Nomio for the last four weeks, but I was traveling last week and I didn't get a chance to take Nomio before the session because I came straight through the session without going home. I it's so hard to, you know, with, as I say, a busy person who's balancing multiple things.
It's so hard to say, was that I was on my feet all day and I had a different lifestyle, that's why I felt bad. Was there a placebo element to it? But I definitely didn't feel as good during the session.
And it's that's why I'm super excited to set up this testing protocol to see if that's imagined from me. If it's a result of, you know, I had a chicken curry the night before and I didn't have a chicken curry the night before the other two sessions. I don't know how we control for that in the ultimate study, but it was just very interesting.
Be before we dive on to setting up protocols and stuff for me. What's the kind of dose response curve that you're seeing? like is more Nomio better?
>> Uh yeah. So maybe before I answer that maybe I can comment on what you just said about you know this the interaction between I think that's super interesting and maybe that's a little bit how we can think about compounds like this something that you know it increases your body's resilience or like your the how you can tolerate oxidative stress or different kinds of stresses. So, and and that's a super interesting qu questions.
You know, when you are stressed out, you have a full-time work, you have kids, whatever, why can't you train as hard as a professional athlete, if you have the same nutrition, say that you manage to get the same amount of sleep, but you're doing something that stresses you out mentally. >> Yeah. It's like willpower is like a it's like a diminishing resource throughout the day.
Like I am, as I get older now, I'm more aware of protecting that kind of spark I have in the mornings, that spark for creativity, for sharp exchanges, because as the day goes on, I'm less sharp, but I also feel like my willpower is gone. If I'm going to eat bad foods, it's in the evening. If I'm going to skip a training session, it's because I've left it till the evening.
If I'm going to, you know, have a fight with Sarah, it's because it's going to happen in the evening. Everything bad happens as you slide towards, you know, lack of willpower. >> Yeah.
But but it's not only uh a psychological thing. It's it's a really close interaction between physiological processes processes and psychological ones. So there's a really interesting study um I think it was uh dentist students.
So they were they were given a like a small like a small experimental scar like in the like in the mouth somewhere. >> Yeah. >> And they they done did that twice.
So once was uh during you know summer break or whatever and once was before final exams. So the only difference was the same scar, but you got it either when you were like not stressed or super stressed before the final exams. And they looked at the healing like physical healing.
How fast did that wound in the mouth close? And they found out, okay, so during the exam period, the wound actually healed much slower than when you were not stressed. And that is, you know, so it's your mental stress levels, they will affect your physiological ability to recover.
And >> and I've experienced this on stage races. I've crashed on day one of a stage race, had quite minor road rash or cuts to my knees and been eight days later with very little healing in the middle of the stage race, still on that cut. And I could swear to myself, and I'd say it to my girlfriend, I'd be like, "I've had way worse cuts than this on the mountain bike on training and it's healed in like two days, >> but it's still seeping during a stage race.
" >> Yeah. So, it's something, you know, adaptation energy. I don't know what you want to call it.
Something that's, you know, you just depleted and that will make you recover slower and uh you will feel depleted too. So, >> yeah, it's interesting. It's very super interesting area.
Uh look, I'm really enjoying the kind of we spoke about this uh last week when we were just chatting. It's these studies are great. You know, 200 person, 500 person double blind placebo test.
But when I talk to the best coaches, the best sports physiologists who are working with world tour teams, they actually give very little like importance to these studies because all they really care about is the case study of one. Does Nomio work for Primos Rugglitch? Does ketones work for Primos Rugglitch?
That's all they care about because it doesn't matter if it works for 500 people, but it doesn't work for Primos Rugglitch if they're optimizing for results for Primos. So that's why I'm super excited to actually test this and not just with our protocol but observationally for myself. Uh it's a great hack for anyone listening.
I'm not even sure if you've started doing this Philip. It's really interesting. When I spoke to Derek Freel who's the founder of Training Peaks.
I was asking him what's the ways that the power users like the best athletes in the world interact with the platform that amateurs don't. And he said notes. like you put in personal comments after your sessions to give context to what's going on.
He said they use it like a diary. So I started using it like a diary, but I set up a custom GPT inside chat GPT. So every day I'll take my diary feedback and my data from the day including sleep data, HRV, training data, put it all into chat GPT.
Now you start building this body of data. So in those notes there will include hey I used Nomio before the Thursday chop this week. Now when you fast forward two, three months rather than me thinking, "Oh, it didn't go that well because I didn't take my Nomi over because I had a busy day, it can start to pull out like AI has its, you know, brilliant use cases, but also quite well doumented limitations around AI hallucinations.
" But what it's really good at is like uncovering data relationships. And I found some brilliant results already with this where it's able to parse through massive amounts of data that would just be totally unworkable for me to come back and say, "Hey, now I haven't got any reliable data yet on the my little Nomio study, but to come back in two, three months time and say, hey, actually, every time you've had, you know, your best power figures, every time you've had higher HRV, higher sleep quality, no meio seems to be one of two or three commonalities in this that for he starts to get really really interesting and if you start putting your blood panels and stuff in there with that >> oh boy your own physiologist on the side >> yeah I mean this is uh precision medicine in a nutshell right so you need to like you need to what works for you and not for like someone else but the hard thing with that is I mean so maybe it's that by carb doesn't work for you or that no me doesn't work for you and that something else is like really beneficial. Uh, and it doesn't matter how many double blinded studies there's out there.
If it doesn't work for you, it doesn't work. But how do you know? And that's the tricky part with, you know, being n equals 1.
You only care about yourself. So you need to I mean there's a lot of different protocols for that you know like ABAB design for example that you try you know standardized training sessions with and without something or with different kinds of >> preparations >> but it's I mean this is I I built my uh research career on learning from athletes and coaches because u I would say that in a lot of cases athletes know stuff about their body that is not explained by common physiology and coaches have they know about individual differences what do different athletes respond to and it's not as simple as taking a muscle biopsy and knowing the fiber type it's much more yeah >> deep than that >> and it's the the one bit I would caution on my kind of chachi PT personal physician that I'm creating is I spoke to Dr. Sam I impy around this and that quote of which I love it's not what you don't know that hurts you it's what you know for sure it just isn't so so with AI you can easily go down a silo so a great example he gave me was an athlete who is cramping so he queries his little personal GPT around why he's cramping and the first result that comes back is electrolyte imbalances now you fast forward two three days later when he has a consultation with this athlete this athlete knows everything about potassium levels, magnesium levels, optimum sodium rates.
He's done a sweat analysis, but he's just grasped at the wrong straw. He's gone down a totally wrong direction. It's just that, hey, the opening of the race was too hard and you didn't clear that lactate fast enough.
That's why you cramped. You It's the simple answer. It's not the answer AI gave you and then you went chasing this to the exclusion of all other alternatives.
H yeah it's uh that kind of I don't know like with chat GPT it's it's really great to talk about training and talk about physiology but it's not based on I don't know like there's something missing that it's a difference between talking to a coach someone a researcher someone who's really knowledgeable and talking to ship they it's still missing something it's probably going to get there in a few years but right now it's I mean trying to use it to you know summarize research like I want to know look at all the training protocols out there summarize the you know highest improvement in power output for different uh training intensities whatever and it will just completely hallucinate everything is my experience it it creates like really nice table with all this data but then you go into the different references and it's just it's not there. So, it's but hopefully it will get there and then it will be super useful. >> Also, if you're drunk and you start talking to it about trying to find a flaw in the matrix, like how would I know if I'm in a simulation, it creates a protocol for you to understand >> and defeat the simulation.
Blink really fast on front of a mirror and see if there's a lag between the blink and the mirror reflection. >> Yeah, >> it gets dark. it gets dark.
So just circle back to that question that we put a pin in. Is the dose response curve is more nomio better or is there a law of diminishing marginal returns? >> Uh there is an optimal dose.
So and that was the next question. So we did this training study. Uh it's two years ago now.
Um so and that was as I said they trained for one week and got drinks on a daily basis and then we measured before and after. So the next question was first is there an acute response or do you need to like train and like get this adaptation or if you just take one drink and wait a few hours and then we measure lactate again we measure blood glucose again uh will it be you know is there acute effects and the second question is there an optimal dose so we did that study or a colleague of mine Michaela here at the same institution um and so we tried a placebo and then like equivalent to one Nomi drink or two Nomu drinks and we just we came to the lab fasted in the morning got a drink and then 3 hours later that's when it peaks in the in the blood. uh we did like a simple lactate threshold test more or less and we found that okay so there is an optimal dose so one no drink was better than two actually >> so yeah you can't take too much >> and yeah so we've been playing around with mathematical uh estimations of the optimal dose so it seems to be you know >> is it mass dependent body weight dependent >> yeah I mean it should be uh it wasn't in that study we had 15 subjects and we didn't see a significant correlation to body mass but it makes sense to adjust it to body mass.
Um another interesting finding we have is that it seems to be um more effective with uh more trained subjects. So if you're untrained or you're not like you don't have any know training stimulus to like in the body it's the response is smaller and uh the more fit the person is and the harder he trains um the better response and that's really really interesting. >> Yeah and I know that was the experience that I believe Mads Patterson had when he tested Nomio.
I think he was quite shocked with the earlier results of it and that's why we've seen him, you know, maybe as the most high-profile athlete using it this season. >> Yeah. I mean, and that's the, you know, as a researcher, you do stuff in the lab, you take sub like try to find recreational athletes or students uh for this test and then it's quite, you know, quite often when you go to elite athletes, you don't see a response.
So, but we started to, you know, from our network trying this on elite athletes. You just handed it out and they had to, you know, just as you are supposed to do here, uh, try it on standard training sessions. And the response we got from quite a few of them were like this is more than we what we have seen in the studies.
Of course, like it wasn't placebo controlled or anything. They just got to try it out. But so many reported like subjective feelings of like I feel fresher.
I can complete my like the next if I do a hot session the next one will feel better. I will sleep better. We have um feedback that they have higher HRV during night if they measure that stuff like that.
That's you know it's anecdotal but it's uh very interesting and now now we are building actually so we are we're designing the studies that we are going to do based on the elite athlete feedback that we got. So for people that are skeptical about this, there's a saying in Ireland, like if you go into the barber and ask him for a haircut, he's obviously going to tell you you need a haircut. People are listening to this at the moment and maybe saying this isn't good science because of the conflict.
Is there independent replications under peer review? >> Uh so not yet. Uh so no one so so I mean this is really early.
So our study was published. So yeah, end of 2023 the training study and the other one we got so the acute response it's still on uh it's on by archives it's on open access so it's not uh peer-reviewed published yet um so but I know that we are I mean we got requests from other research groups and they want to look into it uh some have gotten quite far with it already so it's it's underway um and then there's you know there's uh parallel studies there's a Japanese group for example they've been using it together with uh heavy strength training so eccentric strength training that it gives you muscle soreness and quite high inflammatory response if you're not used to that kind of training and they gave uh the isotypes like before different sessions um and and what they found was like it dampened this inflam inflammatory response and the muscle soreness that you got. So, it's not exactly the same thing as we do, but it's quite similar.
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And an interesting part is known like a lot of physiologists inside these teams. Teams conduct their own research, but they have no interest in making those results public. If they find an edge, they don't want to share that edge.
>> Yeah, exactly. And the feedback we've gotten is I mean it's really it's uh super encouraging, but it needs to be replicated in like from other stud like other research groups independent and as you said like I completely agree with people that don't believe in stuff at first sight. It's a very very healthy response because 99% of all the supplements out there it's just it's it's not based on like it doesn't work and uh yeah so but yeah so so it's it's very you know it's a very good uh starting point to be super skeptical.
So with that uh attitude of healthy skepticism, how do I design a protocol for myself to test this at home? And if you're up for it, maybe to check back in on the results of this protocol in a couple of weeks time. >> Yeah.
So I would suggest you to do hard hard and standardized sessions because the way it this seems to work is that it improves your body's ability to absorb training. So if it activates nerve two, it will protect protect you from too much oxidative stress. It will lower like inflammatory responses.
Um, so I would do like standard sessions that you're used to. Try to do hard days back to back where you feel that okay, so now my recovery is really challenged. I'm, you know, slightly overreached.
I'm I'm I'm performing slightly worse all the time because like if you take this and it just uh you go on a twohour easy ride, I don't think like it does no it doesn't make sense that you would feel anything or see anything. But if you challenge yourself and challenge your system, that's how it's supposed to work. So what say we go uh 4x4 uh V2 max efforts.
Would you set that up as with Nomio I do two days of 4x4 and then I do two days of 4x4 without Nomio and monitor heart rate power HRV in the mornings. >> Yeah. So yeah uh everything that you are used to measuring where you know your baseline.
So if you're sleeping with a your Garmin watch on or with a ring or some something like that and you know your this is my typical HRV, this is my typical resting heart rate, monitor that. Um and uh then also the the timing. So if you do uh 4x4 uh back to back, I would suggest you take uh like one nom shot 3 hours before the session and one more before you go to sleep on both days.
So in total four nomials >> and then maybe you know because you will probably adapt a little bit to that training. So maybe a week or two wash out before you repeat it again. >> Okay.
>> Without the nom or if you do the other way around. >> Yeah. So that would be I mean yeah that would be a sensible protocol to try it out.
>> And is it worth trying to do blood lactates with this or is there too much of a just collection of data being bad because I'm not a professional at collecting lactate readings risk. >> Yeah I mean lactate is one of the primary outcomes that we've seen. So we've seen it in the training study, we saw it in the acute study and uh I feel that it's a robust and easy to measure outcome but then like if you are used to me measuring lactate you will be aware of daily variations that can be quite substantial um and the way the way to handle that from now it's n equals 1.
So we can't add more anonies into this uh pilot it needs to be you. So ideally you should do this uh protocol several times just to increase the power um get the daily you know daily daily variations down try to standardize everything try to do the session at the same time of day uh same fueling before have the same breakfast before uh because everything that's different will introduce a noise in the measurements. Interesting.
Uh, Philip, thank you so much. I know you're super busy with your studies hard in the lab, so I do appreciate you taking the time out to kind of, yeah, help me understand why this is getting whispered around the world tour and everyone seems to be using at the moment. So, thank you so much for your time.
>> Thank you very much. Good luck with the protocol. >> Thank you.