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Snake Oil

Oh, Biohacking

I wrote here about the first company that the big VC firm Andreessen Horowitz has launched in the biopharma space, Nootrobox. They’re selling nutraceuticals to make you “smarter” and “faster” – so how are things going over there? The San Jose Mercury News has an update (forgot to add the link, sorry!), in the context of an article on “biohacking”:

Employees at San Francisco startup Nootrobox don’t eat on Tuesdays.

 The weekly fast isn’t an extreme money-saving move by a scrappy, bootstrapping company. Instead, Nootrobox team members swear withholding food for 36 hours — they stop eating Monday night — improves their workplace focus and concentration.
“We’re actually super productive on Tuesdays,” co-founder and CEO Geoffrey Woo said. “It’s hard at first, but we literally adopted it as part of the company culture.”
So look on the bright side: at least you don’t work there. This reminds me of the articles I saw a couple of years back about the companies (I believe a lot of them were in advertising, media, and fashion) where everyone in the office was doing some sort of “juice cleanse” simultaneously. And it wasn’t, y’know, written down anywhere that you had to be doing the juice cleanse to stay employed, but if you weren’t doing it, well, were you sure that you really were the right person for this position? Were you sure that you might not fit in better somewhere else?
One of the annoying things about this is that in the same way there’s no evidence whatsoever that a juice cleanse does anyone any good, there’s no real evidence that fasting for thirty-six hours makes your brain work any better. Yeah, yeah, ketosis and all that, but there’s no real evidence that it makes your brain work any better. There’s as much reason to think that it’ll make it work worse. The placebo effect in this sort of thing is just gigantic – I’m sure the Nootroboxers, many of them, do feel all focused and fizzy and productive on their foodless Tuesdays, but you could hand out powdered lemonade mix and get the same effect as long as people thought that it was the latest cognitive enhancer. Which, come to think of it, is more or less the business model for all the companies selling these things.
Fasting is the least of it. As that newspaper article notes, there are a lot of people, particularly out in the Valley, taking all sorts of CNS-active drugs to tune themselves up. There’s even less known about that stuff, as you can well imagine, and the thought of gulping down some Russian nootropic just because everyone else is ordering the stuff is enough to give me the shakes. Nootrobox isn’t selling anything like this, but a lot of people are buying:

Dr. Vinh Ngo of Smart Med in San Francisco specializes in nootropics and works with patients from Facebook, Google, Uber, and other tech startups. Ngo says his treatments — including amino acids, nutritional IV drips, prescription drugs and testosterone therapy for men — are intended to help clients become better versions of themselves.

“Instead of preventing illness, we’re actually optimizing health,” Ngo said.

George Burke, who runs a San Francisco nootropics and biohacking meet-up group called Peak Performance, says he takes one-tenth of a hit of LSD every few days to treat his diagnosed ADD. It helps him visualize creative solutions to work-related problems, he said.

“Until it becomes legal, then I certainly have to be careful,” Burke said. “However, I’m working in an industry and a culture where many professionals understand how to get ahead, how to supplement, and how to optimize their performance.”

Ah, the professionals understand how to do these things, do they? Excellent. One thing’s for sure: there are plenty of people who do know how to market to all the professionals who are so sure that they know how to optimize their performance. And it’s in their best interest – the sellers – that people take enough pills to be walking piñatas. “Nutritional IV drips” surely don’t come cheap, either, although you do wonder what kinds of nutrients these are that don’t get absorbed from an oral dose.

There’s a credulity problem here. I’m sure that many of the people doing this stuff think of themselves as very good scientists and engineers or clear-headed business dealers, but if you believe that (a) we know enough to “hack the brain” and (b) that these pills and shots you’re taking are the way to do it, then you have a problem with weighing evidence and probabilities that might possibly extend to the other ways you do your work. I would be worried, for example, if I heard that before sending in an NDA that people at Genentech took care to ritually pour a vial of restriction enzyme over the outstretched foot of Herb Boyer’s statue. But that has about as much chance of working as some of these biohacking ideas do.

The history of biohacking is a actually long one, as a glance at one of those reprint Sears catalogs from the 1890s will make clear. I doubt if the Silicon Valley folks would care to trace the lineage back through the early 1900s food faddists and decades of raving quacks, but I’m apparently too unoptimized to see much of a difference. For my part, I’m going to try to come up with an especially good lunch for Tuesday in honor of the Nootrobox folks, which will doubtless give me all the amino acids I need.

Update: Nootrobox CEO Geoffrey Woo (on Twitter) mentions this page on the company’s site as something to check for more details, and says that they’ll be registering a clinical trial for one of their products soon.

52 comments on “Oh, Biohacking”

  1. Glen says:

    What these companies really need is the Graham Diet. Away with impure thoughts, in with clear eyed creativity!

  2. anon says:

    What does this have anything to do with Russia? Am I missing something?

    1. anon says:

      No link to the article yet, but here’s a quote from it for context:
      “Others have a more expansive view of brain-enhancers, taking off-label prescription drugs, small doses of LSD or Russian pharmaceuticals not approved for consumption in the U.S.”

    2. Anon says:

      Probably has something to do with phenylpiracetam.

    3. SSG says:

      Not sure of the historicalcontext, but a relaively large % of nootropics were developed in Russia and/or are legal there.

    4. Adam Hallett says:

      Google racetams.

  3. luyisii says:

    Well it will if you believe it. A great study showed that cognitive training improved fluid intelligence by 5 – 10 points if people were recruited by aids for cognitive training. If they were recruited to make some money by submitting to some experimental psychology study nothing happened. For details please see —

  4. AGMMGA says:

    CEO Geoffrey Woo… nomen omen?

  5. Stu West says:

    I sort of think things like extreme diets, skinny dipping in ice pools etc. are in a different category to medical treatments. I mean, if half the people who try them feel great and the other half feel terrible I suppose that would make them fail a clinical trial but I wouldn’t particularly tell the people who enjoy them to stop. Extreme diets seemed to do pretty well for Steve Jobs until he tried to use them to treat pancreatic cancer.

    On a related note, sucks to be diabetic if you’re working at a place whose company culture includes 36-hour fasts every week.

  6. janex says:

    I’d like to see an actual genuine placebo controlled clinical trial on the microdoses of LSD. In theory it could work. There are multiple internet reports of people successfully using this. Placebo effect or actual brain chemistry changes? It would take a clinical trial to sort it out. I also don’t think we really understand the brain at all. And I don’t think we really understand the underlying biology of ADD. The pre-clinical models have lousy translation, like virtually everything else in neurochemistry. Also, it’s not uncommon for something to be a poison in high doses and a medicine in low doses.

  7. biotechtoreador says:

    “We’re actually super productive on Tuesdays,” co-founder and CEO Geoffrey Woo said. “It’s hard at first, but we literally adopted it as part of the company culture.”

    If fasting 1 day increases productivity, wouldn’t it be logical to fast ever day?

    1. Absolute Fast Fad says:

      Grocery Stores Hate Him: Learn how a revolutionary biohacker in silicon valley has turbocharged his productivity while zeroing his diet. If you’re 18+, try this one trick to enhance your thinking.

    2. Sam P says:

      If fasting 1 day increases productivity, wouldn’t it be logical to fast ever day?

      The (non-)dose makes the poison?

  8. Tuck says:

    Biohacking’s a very vague term. There’s a big difference between intermittently fasting and taking small hits of LSD.

    There’s pretty good evidence at this point that fasting and higher ketone production offer real benefits neurologically, although most of the scientific evidence is in the context of people with impaired neurological function, and it’s entirely possible that this effect (to your point) does not appear in non-cognitively impaired people. However, as cognitive impairment seems to go along with the metabolic syndrome, and a majority of Americans have some aspect of the metabolic syndrome, that’s a pretty large target market!

    In general I agree, most biohacking is likely snake oil. It’s incredibly unlikely that we’re going to find new therapies that actually improve function. But therapies like intermittent fasting and the resulting ketosis have a long history of proven benefits in both improving neurological function and mitigating aspects of the metabolic syndrome. Harvard’s Joslin Diabetes Center, for instance, is named for a man who was advocating fasting for diabetes management 100 years ago, and John Hopkins has been treating (and in some cases curing) epilepsy using ketogenic diets for quite a while.

    I’d argue that regimens like intermittent fasting and ketosis aren’t a “hack” at all, but are returning the body to the regime it evolved to operate in.

    Interesting place to start:

    “Time-restricted feeding and risk of metabolic disease: a review of human and animal studies”

  9. Imaging guy says:

    I can’t believe those who call themselves scientists taking drugs/nutraceuticals with little or no evidence of effectiveness. In the last week issue of Science there was an article about a double blind randomized trail showing ineffectiveness of EPO (erythropoietin) in athletic performance which seemed to surprise many.

    “Cyclists’ favorite drug falls flat in trial” DOI: 10.1126/science.353.6296.206 (PMID: 27418482)

    1. CH says:

      Then why was EPO banned, if it’s not effective? Should all the EPO cases in cycling be overturned?

      1. MTK says:

        I believe that it was both a performance and safety issue. Or at least was thought so at the time. I’m sure there were no hard studies, but there was a number of cardiac incidents amongst cyclists who were, presumably, using EPO. The theory was that the abnormally high hematocrit resulted in thickening of the blood putting more stress on the circulatory system.

        At the time there was no validated test for EPO use so the UCI instituted a hematocrit limit of 50 and justified it as a safety issue, not a PED test. Over that and you couldn’t compete. Of course, that just meant that cyclists would dial-in there EPO dosage to be as close to the limit as possible.

        1. JG4 says:

          “better dead than second”

      2. Imaging guy says:

        According to the article, “but Catlin and other doping researchers applaud the team for subjecting EPO to a rigorous trial. Such studies are rare; critics have argued that the ever-growing list of banned substances in sports—and the international testing industry that enforces it—have no firm basis in science”.

        1. Ursa Major says:

          As an amateur athlete, former runner now cyclist, I once knew someone who was on an EPO trial, I think maybe a phase I for therapeutic use. Anyway, he claimed to have been running his fastest times ever during the trial.

          My first thought on reading the story is to wonder if they controlled properly for the type of cyclist, e.g. even on EPO a heavy sprinter is never going to beat a light-weight climber up Ventoux, all other things being equal an athlete who lives in a hilly region will perform better on the climb. Also “trained amateur cyclists” probably still covers a wider range of ability than you get across elite athletes, which would need to be controlled. The conditions (cold and windy) would also have had a big influence.

      3. Anon says:

        In athletics, intentions play a large role in terms deciding what should be banned. If athletes are taking a drug substance with the intention of having it improve their performance, it is considered cheating and that substance gets considered for a ban. Whether that substance is actually effective in enhancing performance is secondary.

    2. Erebus says:

      The Science article doesn’t go into much detail. It’s very likely that the doses the trial employed were far lower than the doses athletes would typically use.

      …In that sense, this trial would thus be analogous to the studies out of the 1970s that claimed that anabolic steroids don’t build muscle in healthy individuals. Springer’s book “Anabolic Androgenic Steroids” (Kochakian, 1976,) reviews these in detail, and ends its paragraph on steroid use in athletics with this ridiculous note: “In brief, a careful review of all these reports leads to the inescapable conclusion that in spite of the claims that have been made by some of the investigators that the use of anabolic steroids by athletes in conjunction with progressive resistance training will afford a greater increase in muscle bulk and greater strength, there is, in fact, no substantial evidence that this is so. On the contrary, there is a substantial body of evidence that, even upon very close scrutiny, indicates that anabolic steroids will not contribute significantly to gains in muscle size or strength in healthy young males. “

      …Oh, come on…
      See, here’s the thing: At 300mg/week, maybe anabolic steroids don’t do very much. At the doses that bodybuilders and athletes were, and are, taking — 1500mg/week and often much more — they work very well indeed! Studies and trials on performance enhancement typically don’t go far enough, for ethical and other reasons.

      1. tangent says:

        Now that’s a nice moment in the history of scientific fallibility. Hadn’t heard that one!

    3. Zenboy99 says:

      Were they using EPO the same way pro cyclists were? I ask as a former pro who didn’t use, but frequently saw abuse.

  10. anon says:

    Investors: Andreessen Horowitz, Marissa Mayer (CEO, Yahoo!), Mark Pincus (Founder and CEO, Zynga), Dr. Connie Chen (Co-founder and Chief Medical Officer, Vida Health), and Kevin Chou (Founder and CEO, Kabam).

  11. Jalfrezi says:

    There’s a mutinous rumble if a meeting goes on much past noon here. I’m not sure what would ensue if someone suggested not eating for 36 hours.

  12. Random Scientist says:

    As a scientist working in the SF Bary Area, I have come across a number of people who live in an interesting dichotomy where they are perfectly logical, rational individuals when it comes to matters of work, but for some reason do not apply those same reasoning skills outside of their job. A few examples:

    Juice (or other) cleanses and fad diets
    Acupuncture and other “traditional” healing techniques
    The belief that anything Monsanto is involved in is evil

    I have never understood this behavior, and it leads to awkward situations at parties where I’ve learned that I need to be careful about what I say in certain settings. I just accept that they are making these decisions based on emotion rather than logic since they certainly possess the mental tools to learn more about these areas if they made the effort. They have chosen to not make the effort, and it makes them feel good about themselves, so is it my place to pour some rational rain on their personal parade?

    Now if they start working for a company like Nootrobox I’m sure I would feel obligated to be a bit more vocal.

    1. anon says:

      I flat out tell those people they are stupid and stop being friends. I have lost MANY friends, but I really couldn’t care less.

    2. X≠Y says:

      Yeah, I always found it interesting how many anti-vaxers work at Microsoft and Google. I guess that the formal logic needed for coding doesn’t translate very well into run-of-the-mill critical thinking…

      1. tangent says:

        I think (from working at a tech company like that) that it’s intellectual arrogance. If since childhood it’s your identity to be smarter than other people (some figure out that’s a dumb identity, some don’t), then it’s easy to convince yourself you’ve figured something out that other people haven’t.

  13. soylent green says:

    Food is so yesterday. Perhaps they’ll start spiking soylent green with nootropics… ummm good!

  14. Foodie says:

    They’re more productive on Tuesdays because the entire company doesn’t take lunch.

    1. A says:

      12.5% more effective.

  15. So, two comments, one light, one less so.

    First, there’s a documentary that is just entering wider release called “Nuts” which is about Dr. John Romulus Brinkley, who built an empire based on the initial idea that implanting goat testicles into impotent men as a cure. A friend saw it and raved about it and I’m planning to see it as soon as I can. So, Snake oil and other animal parts have indeed always been part of the medical landscape

    Second, this discussion of a kind of dichotomy between work and external thinking on the part of people in SV perhaps helps explain somewhat the naivete that seems to exist on the part of many (but not all) such entrepreneurs who decide to enter health fields and disrupt things. I’ve wondered a bit about this. Code is code, and while building software can lead to unexpected and emergent behavior, one can almost always track issues down and fix them. I think this may lead to a mental view that everything is ultimately known and knowable, and also may lead to an emphasis on individual knowledge and expertise. Which, having been in biopharma for a while, I know is probably not the best way to approach drug development and health interventions.

    1. Derek Lowe says:

      A fellow Arkansan, I believe Dr. Brinkely was, goat glands and all. . .

    2. Olivier Galibert says:

      I think a massive issue is that people who are used to work with, or even reverse-engineer systems designed with compartimentalization and complexity isolation in mind don’t get what it is to work on one that isn’t…

  16. Boot the chemist says:

    I’ll think over their proposition while eating my bacon, mushroom and avocado breakfast sandwich and drinking a full cream latte 🙂

    My favourite (local) version of this, is the MLS lady, who I consider one of the smartest people around here, but really likes Bach flower remedies.

  17. Truro Park says:

    No mention of that old education standby, amphetamines? How far has science come on the wings of ritalin. How many a tenure has been granted with the help of that glorious goddess.

  18. Anonymous Researcher snaw says:

    Firewalking, anybody? No joke, a number of companies have organized firewalking sessions.

  19. Not bob says:

    at the tisk of getting political, one of the primetime speakers at the Republican convention is an “entrepreneur” associated with “youngevity” – a nutraceutical company. Name of Michelle van etten.

    1. drsnowboard says:

      the sad thing is the article still maintained the greatest failure was the non-glowing plant, rather than the concomitant suicide of the pump priming investor.

  20. LiqC says:

    The rigor of formal medical studies spills over into “whatever market can bear” prices. And people’s desire to make decisions for themselves (as opposed to jumping through hoops to get a prescription), as well as craving for attention to their bodies and minds then spawns all the alternative approaches.

    We will never find out formally if they work or not. They seem to make people happy, otherwise hey wouldn’t be around…

  21. It’s actually possible that Fasting Day boosts productivity simply because it reduces the amount of time these bozos spend wandering around gaping thoughtfully at the Free Snacks Buffet.

    Having spent a lot of time at startups, I can attest that huge amounts of time are consumed by gaping at Snack Buffets, getting and drinking coffee, peeing, gossiping, and generally mucking around. Productivity is actually very very low at these places, but since it’s so easy to throw together some sort of glittering demo in these degenerate times, nobody seems to notice.

  22. Dave says:

    Well, just remember that:

    “The brain typically gets most of its energy from oxygen-dependent metabolism of glucose.”

    So, it would seem that depriving the brain of it’s energy source (glucose), by fasting, would be a non-optimal thing to do. 😉 Maybe they’d do better if they had a sugar dispenser in the office? Maybe dispense it with a CNS stimulant, such as Caffeine (perhaps in coffee)?

    Don’t like that idea? Well, how about his one. Ethanol is a CNS depressant, so it slows down the brain. But, you don’t want your brain overheating, especially at night when you don’t need to be your most creative. So, maybe you should give is a nice dose of Ethanol at night to keep it cool. That will allow you to push it to maximum capacity during the day, without fear of it overheating. Right? Err, umm, right? 😉

    Now, watch. There’ll be some fool group that will believe these, and will actually try them.

    1. Erebus says:

      Hah! Well…

      In his book “Superintelligence,” Nick Bostrom of Oxford posited an interesting theory: The only nootropics which might prove truly effective are those which might plausibly and consistently reduce evolutionary fitness. All other avenues have been, as per his theory, already thoroughly tapped due to evolutionary pressures. He cites two examples: Larger head size, and increased brain glucose uptake/utilization.

      …So, yeah, the more glucose you’re getting, the better.

      A 36 hour fast likely isn’t long enough to deplete glycogen stores, besides. Very unlikely that they’re getting into ketosis. Makes no sense.

  23. ben sears says:

    in SF and silicon valley, there’s a significant percentage of libertarian-influenced workers. given high levels of income and progressive thinking, i believe the concept of biohacking is a logical next step after consuming both legal (artisanal coffee) and illegal substances (marijuana, lsd).

    however, my primary concern involves the risk of consuming counterfeit “brain-hacking” drugs with the potential for tragic outcomes. given the lack of regulatory oversight, i’m not sure how geoffrey woo and his staff safeguard employees’ safety, not to mention the liability aspects.

  24. Dan Gerszewski says:

    Wait, their CEO is *literally* a “woo merchant”… wow.

    That said, there’s some science mixed in here, usually in the form of prodrugs and off-label uses. I blame the government, myself, there’s a HUGE market for human enhancement and there’s no reason “shift mood disorder” should be a good enough reason for a Modanafil prescription and “doing better at my first shift job” should not be. So instead people have to turn to a Modanafil prodrug instead, which are oddly enough totally unscheduled.

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