Rejuvenation biotech is a new industry forming around the theme of life extension technologies. This episode provides a broad look at the state of the industry, its most promising life extension technologies and their potential timelines.

Life extension – this is something I’ve wanted to spend time on for a while.

In this episode, I interview 5 thought leaders from the life extension movement. Consider this an introduction to the current status of life extension tools and technologies, as we look at most areas with a broad first-look.

You will learn where things are and what the risk profile of those life extension tools and technologies is today.

All interviews took place at RAADfest in San Diego. This is one of the larger life extension technology conferences today. It stands for Revolution Against Aging And Death and then fest for the festival.

I would encourage you to skip around this episode. It’s long, and there might be a specific topic that you’re interested in. So check out the notes below and pick the area that you’re most interested in first and start there. If you get through the whole thing it will give you an overview of where things are currently at.

“At the moment we’ve got this burgeoning of the rejuvenation technology industry with more and more investors realizing that this is the next big thing”

-Aubrey de Grey, PhD

“Our life is code and I think that we can modify that. First, we’ll look for human health and then we’ll look to enhance your life for where you want to live, who you want to be and what you want to achieve.”

-Liz Parrish, CEO of BioViva

“Basically what we’re trying to do is reproduce the young physiology that you had when you were younger [by replacing your old plasma with younger plasma]”

-Dr. Howard Chipman

“It’s not entirely crazy to think that some point soon, we can turn some of these senescent cells back into healthy cells.”

-Brian M. Delaney

“Not all biohackers would call themselves quantifiers. […] In the quantification side, well instead of taking 20 things, if there are two or three I can do that I get 90% of the benefit from, I’ll do that. That’s efficiency.”

-Bob Troia, “Quantified Bob”

The episode highlights, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know what you think in the comments!

itunes quantified body

What You’ll Learn

  • Start of the first interview at RAADfest with Aubrey de Grey. Presentation of SENS Research Foundation. (9:32).
  • The actual state of SENS Research Foundation. (12:22)
  • Therapies to target the seven types of aging damage. Some of the diseases linked to them. (14:18)
  • Companies associated with SENS and the variety of startups that have sprouted from it. (16:57)
  • Aubrey’s particular views and interests in life extension. (28:10)
  • Start of Liz Parrish’s section and the introduction of BioViva. (33:50)
  • The new focus of BioViva, using a meta-analysis of public data to find promising drugs and genes (38:30)
  • The scale and patients of BioViva’s potential gene therapy treatments. (41:30)
  • The biomarkers Liz and her group work with, where they come from and how they are detected. (44:00)
  • The process of receiving a specific gene therapy (1.0 vs 2.0 human) (46:00)
  • Self-experimentation, data collection and associated biomarkers (48:41)
  • What drove Liz Parrish to investigate riskier and more experimental medical areas. Her initial experiences in the area. (53:00)
  • The process and the legal loopholes that were necessary for Liz to be treated with gene therapy (56:00)
  • The current treatments and products BioViva offers. Future prospects for genomic counseling, new genes, and methylation testing. (59:48)
  • Ending of the interview and Liz’s conclusion on the potential of gene therapy (1:00:50)
  • Start of the interview with Howard Chipman, from Young Plasma (1:02:15)
  • The basis and origin of the Young Plasma Project. (1:05:08)
  • The positive and negative effects of using Young Plasma and the protocols associated. (1:07:21)
  • The Ambrosia study and the biomarkers that are generally used in Young Plasma (1:08:30)
  • The cost associated with participating in Young plasma and the mechanisms of the process. (1:11:34)
  • Howard’s own experiences in the area and ending (1:13;40)
  • Start of the interview with Brian M. Delaney. His experience with Young Plasma. (1:18:20)
  • The introduction of Brian M. Delaney and his work in the LEF (Life Extension Foundation) (1:22:37)
  • The repurposing of old drugs for new anti-aging purposes and new treatments and research. (1:24:20)
  • Brian’s objectives in LEF and life extension (1:30:00)
  • How Brian got involved in the area of life extension. (1:32:43)
  • The current state of Brian’s research. (1:36:00)
  • Brian’s health, tests, and biomarkers. His experiences with Calorie Restriction. (1:41.10)
  • Further experiences of Brian with CR, insomnia and other physiological parameters. (1:51:10)
  • Brian’s experience with Rapamycin, nicotinamide riboside. (2:02:01)
  • Brian’s experience with Metformin and senolytics. (Dasatinib and Quercetin). (2:08:32)
  • The effects of senescent cells in our body and the off-target effects of senolytics. Senomorphics. (2:13:59)
  • The DNA methylation testing at Zymo Research Program. (2:19:39)
  • End of the interview with Brian M. Delaney. (2:23:34)
  • Start of the interview with Bob Troia (Quantified Bob). Presentation and opinion of RAADfest. (2:24:44)
  • Bob’s activities, tracking during the last few years. Recent changes in the landscape of life extension. (2:28:39)
  • Which consistent data in Bob now regularly collecting about himself. (2:38:12)
  • Ketone testing and Bob’s experience with KetoneAid. (2:40:11)
  • Recent advancements and curiosities in the area of life extension and supplementation. (02:46:57)
  • End of the interview with Bob Troia. Invitation to contact him through social media and his web. (2:50:10)
  • Damien’s conclusion and some questions to take home about the main themes of the podcast. (2:51:13)

Thank the interviewees on Twitter for the information they shared and let them know you enjoyed the show.

Thank them here: Raadfest (the conference), Aubrey de Grey, Liz Parrish, Brian M. Delaney and Bob Troia (Quantified Bob).

Interviewees in Order of Appearance

Aubrey de Grey, PhD

Liz Parrish

  • Background: Parrish is the CEO of BioViva, an advanced life extension center. It aims to develop new gene therapy based health testing and analysis techniques for the betterment of your health.  They offer help navigating the details of genetics and family history. They can also assess how they impact your health and well-being.
  • Self-experimentation: She was the first person to undergo gene therapy. In particular, one targeting life extension. This took place three years ago. She’s known as patient zero in some circles for this reason. Check Liz’s journey as a test subject of gene therapy here.
  • Research: As CEO of BioViva, she recently presented the results from her telomere lab. Telomeres are DNA pieces we can look into to assess aging.
  • Follow Parrish on Twitter.

Dr. Howard Chipman

  • Background: Dr. Chipman is the medical director at Atlantis Clinic. He oversees the Young Plasma section. Their approach is to transfuse all the regenerative and healing factors present in young blood. This is done by transfusing the plasma (blood minus the cells) of young donors into an older patient. This was first tested in the 1920s in Russia. He is also involved in Aurora Aerospace. It is a space training company for jet fighters and zero-gravity flights.
  • Research and experience: He specializes in emergency medicine. He has treated patients with life-threatening conditions. These include heart attack, drug overdose, shock, or massive bleeding. You can check Dr. Chipman’s Pubmed articles here.
  • Find Dr. Chipman on Facebook.

 Brian M. Delaney

  • Background: Brian is an advisor for the Life Extension Foundation.  LEF is a nonprofit organization. Their long-range goal is to extend the healthy human lifespan. This will be done by discovering scientific methods to control aging. They have been proficient in the supplements area. They have produced many well formulated and effective supplements. Before his involvement in the LEF, he was a philosopher and translator. He is based in Stockholm, Sweden. He is also a founding member of theCalorie Restriction Society.
  • Books: The Longevity Diet is Mr. Delaney’s most popular book. In here he and Lisa Walford explain in practical terms the concept of calorie restriction. They consider CR “a life-extending eating strategy with profound and sustained beneficial effects”.

Bob Troia (Quantified Bob)

  • Background: Bob appeared in episode 22 way back in the Quantified Body. He quantifies a lot of n=1 experiments and publishes them on his blog.
  • You can find him on Twitter.

Tools & Tactics

Interventions

  • Stem cell treatments to combat cell loss. Stem cells are undifferentiated cells capable of generating many different cell types. They substitute the ones lost through aging1.
  • Mitochondrial mutation treatments to combat aging. Still in the early stages. Mitochondria are cellular organelles responsible for energy production. The accumulation of mutations throughout life can impair them. It can even stop their correct functioning. The reversal of these mutations might partially stop the aging process.
  • Telomerase induction therapy. Telomeres, the protective ends of linear chromosomes, shorten throughout an individual’s lifetime. Telomere shortening is a hallmark of molecular aging. It is associated with the appearance of age-related diseases. Several scientific articles, including María Blasco‘s 2 have been recently published. They suggest that telomere growth can reduce the phenotypes of aging.
  • Myostatin inhibition therapy. The inhibition of this protein can increase muscle mass and strength. These results apply to mice3 and possibly in humans. It is believed that it could be successfully employed in cases of muscular dystrophy.
  • Intravenous fluid therapy. Intravenous fluid therapy. It is the introduction of a fluid (plasma, serum, antibiotics) in the vein of a patient. It is generally for employed for purely medical purposes. In the case of Young Plasma, it is the method used to introduce the plasma in the patient’s system.

Tech & Devices

  • 10,000 Lux Lamp: Lamp that replicates strong sunlight. Damien has been using this in the morning to reset the circadian rhythm. this has the result of improving sleep quality. These lamps are designed for use by people with Seasonal Affective Disorder (SAD). They provide sunlight in dark months of the year.

Supplements & Drugs

Drugs (Typically More Potent/ Require Prescription)

  • Senolytics: They are small molecules capable of inducing the death of senescent cells. They are still under research. Senescent cells are non-functional ones. Dasatinib is a compound generally used in cases of leukemia. As of late, experts think it can be repurposed as a Senolytic along with Quercetin. Brian mentions taking 5.0mg of Dasatinib and 50 of Quercetin per kg of body weight.
  • Metformin: A drug used to improve blood sugar regulation in diabetes. Researchers are looking at its wider applications with cancer treatment. It can inhibit insulin secretion. Brian mentions taking up to 500mg.
  • StatinsThey are lipid-lowering medications. They can reduce illness and mortality in those who are at risk of cardiovascular disease.

Supplements

  • Rapamycin: A compound that has been researched for its life extension properties. According to Brian, it is potentially senomorphic (capable of restoring senescent cells). It is believed to work by stopping certain responses to nutrients that can accelerate aging.
  • Nicotinamide ribosideBrian mentions that it is useful for raising NAD+ levels. This happens in particular in the blood and in the cells. NAD+ is used in many redox reactions, including the ones needed to get energy. Brian mentions taking up to 500mg daily at some points of his fasting cycle.
  • Nootropics: They are drugs, supplements, and other substances.  They might improve cognitive function in healthy individuals. In particular, they may improve executive functions, memory, creativity, or motivation4.
  • KetoneAid: It is a series of ketone esters (beta-hydroxybutyrate). They possess a great energetic performance. Generally used by elite athletes to achieve great bursts of power.
  • Ketosports KetoForce: KetoForce contains the endogenous ketone body beta-hydroxybutyrate (BHB). It is in sodium and potassium salt form. The compound BHB can be used as an energy source by the brain when blood glucose is low. Ingesting KetoForce raises the levels of blood ketones for 2.5-3.0 hours after ingestion. (Note: A similar product from the same company is Ketosports KetoCaNa). Damien expresses his preference for KetoCaNA.

Tracking

Biomarkers

Inflammation Markers

  • High Sensitivity C-Reactive Protein (hs-CRP): Elevated hs-CRP levels show inflammation. That is damaging to inner artery walls. If your level is below 1 mg/L then you do not have a cardiovascular disease risk. Liz mentions this as an example of a classical biomarker.
  • Homocysteine: High levels can be predictive of increased risk of inflammation of blood vessels. Low levels are generally not indicative of anything in particular. Anything over 150 μg/dL is generally considered an elevated concentration.

Blood Sugar Regulation Markers

  • Fasting Glucose Levels: A biomarker used to understand blood sugar regulation. Optimum levels are between 70 and 90 mg/dL. Higher ones show some level of blood sugar dysregulation. That lack of regulation increases the risk for diabetes II. Liz mentions this again as a classical biomarker.

Cholesterol Based

  • Low-Density Lipoprotein (LDL): The traditional measure of ‘bad cholesterol’. That is the type that causes heart disease. Less than 100 mg/dL is considered an optimal level. Levels between 160-189 mg/dL increase the risk of cardiovascular disease. Research has shown that LDL alone is not the best predictor for cardiovascular risk. LDL particles with the smallest sizes are most damaging to the cardiovascular system. Still, as Liz says, people with high LDL might never have a heart attack.
  • Testosterone: It is the primary male sex hormone and an anabolic steroid. Testosterone is used as a medication in several cases. Some of them are low testosterone levels in men and breast cancer in women. Normal levels are between 264 to 916 ng/dL from 19 to 39 years old males, and they decline after that.

Associated to neurodegenerative diseases

  • Amyloids: Amyloids are proteins that can arrange into fibers and plaques in the brain. They give origin to diseases like Alzheimer’s. The presence of visible aggregations has been associated with the origin of the disease. Still, recent studies might show that it is not the plaques that are responsible. Individual free proteins might cause the disease. Several complex methods that use specific ligands are used to detect them5.

Associated to cancer

  • Carcinoembryonic antigen (CEA): It is a set of proteins that are mainly present during the fetal stages of development. This is why their presence in normal blood is usually very low (about 20 ng/mL). Still, these levels increase in some types of cancer, which is why it is used as a tumor biomarker.

Lab Tests, Devices and Apps

  • Magnetic Resonance Imaging (MRI): Mainly used to provide information on the inner workings of the body. Liz used MRI throughout her gene therapy to view any changes in muscle mass and white fat.
  • Telomere length testing: Telomere shortening is associated with many health conditions. These lengths can be altered in response to social and environmental exposures. These two discoveries have underscored the need for methods to quantify telomere length. Terminal restriction fragmentation is one of the main methods used as of now for this purpose6.
  • Methylation testing: Methylation is a series of modifications that your DNA can be subject to. They play an important role in many chronic diseases. Through tests you can more effectively understand the diseases you might develop. BioViva aims to include this test to their list. This will enhance its predictive capabilities.
  • Ketone testing: The different approaches to measuring ketones provide different perspectives on your ketone metabolism. These can be looked at as the ‘window of snapshot’ that they represent. Some methods have a snapshot of a longer duration. These provide more of an average reading. Others might provide a direct status of that exact moment. Moving from the more average-based value end of the scale to the more direct status end you have:
    • Measuring ketones via the urine (via the ketone body acetoacetate). They have the longest snapshot with it representing your ketone values over the last 5 to 6 hours.
    • Measuring via the breath (the ketone body acetone). It has a smaller snapshot window of the 2 hours leading up to the measurement.
    • Measuring via the blood (via the ketone body beta-hydroxybutyrate). It provides you a snapshot of your ketone level at that exact moment.

    The various devices available for glucose/ ketones testing and mentioned include:

    • Urine Ketone Strips: Several parameters can interfere with the measurement values provided. They include both hydration status and becoming keto-adapted. They are the cheapest and starting with them is recommended.
    • Ketonix Breath Meter: Currently the only breath acetone meter. If you are moderate to high on this meter you are in ketosis (i.e. typically over 0.5 mmol/L). This device is recommended in epilepsy cases.

Other People, Books & Resources

People

  • William Faloon: The actual president of the Life Extension Foundation. Check his twitter here.
  • Dean Ornish: An American physician and researcher. He is the president and founder of the nonprofit PMRI. That stands for Preventive Medicine Research Institute in Sausalito, California. You can check his website here.
  • James Clement: The founder of Betterhumans, a transhumanist bio-medical research organization. They run open-label, non-randomized simple controlled trials

Organizations

  • SENS Research FoundationFoundation for the research of “Strategies for Engineered Negligible Senescence”. Founded by Dr. de Grey as an offshoot of The Methuselah Foundation. They work to develop, promote, and ensure widespread access to therapies. In particular, those that cure and prevent the diseases and disabilities of aging. This is done by repairing the damage that builds up in our bodies over time.
  • Ichor therapeutics: It is a vertically integrated pre-clinical contract research organization. They focus on the study of aging and aging pathways. It was set up to work on macular degeneration, which is the number one cause of blindness in the elderly.
  • Covalent Bioscience: It sprouted out of the work that SENS funded on amyloidosis. Amyloidosis involves waste products accumulating outside of the cell especially in the heart. They aim to develop and create affordable, better antibodies and vaccines. These will aim to solve a range of unmet medical needs.
  • Unity Biotechnology: Flagship company in the area of removal of senescent cells. Their mission is to extend human healthspan, the period in one’s life unburdened by the disease of aging.
  • Juvenescence: It is a drug development and artificial intelligence company. It focusses on aging and age-related diseases. It was created by Jim Mellon and his colleague Greg Bailey. Juvenescence AI combines advances in artificial intelligence with classical development expertise.
  • Andreeseen Horowitz: It is a venture capital firm in Silicon Valley, California. It backs bold entrepreneurs building the future through technology.
  • Y Combinator: It is an American seed accelerator, started in March 2005. They select and fund startups with great potential to allow them to grow as fast as possible.
  • BioAge: A company started by Christian Foley. It focuses on using a unique computational platform that explores a universe of proprietary and public data. The main aim is to identify and target molecular factors that influence longevity. Their target is to slow and stop aging.
  • Insilico Medicine: A company run by Alex Zhavoronkov. It specializes in the field of deep learning for drug discovery. It is also invested in personalized healthcare, and anti-aging interventions.
  • Integrated health systems (IHS): A company focused on advancing the healthcare industry. They do this through the latest Gene Therapy techniques used in longevity research. By pulling from public sets of biomarkers they aim to select some to identify patients. These patients will then receive the gene therapy treatments.
  • SpectraCell: A group of laboratories specializing in personalized disease prevention and management solutions. They were used by Liz Perrish for the MRI imaging and the telomere length testing.

Resource Links

Here are the links to each individual interview on our facebook page. On top of that, there are other interviews that weren’t included in the podcast:

Full Interview Transcript

Click Here to Read Transcript
[Damien Blenkinsopp]: Hey there! Damien with episode 52 of The Quantified Body podcast here. This one’s a bit of a test episode. It’s a little bit different in format. It is longer and it is taken from a conference that I went to on the topic of longevity, and more to the point, life extension and the now growing market, growing industry around the topic of life extension.

You may know that that’s been a personal interest of mine for quite a while. This podcast is basically looking at topics of life extension, longevity, performance and general wellness and how we can quantify and ensure that we’re getting those types of results.

So this is something I’ve wanted to spend some time on for a while and you could look at this as an introduction to the current status of life extension tools and technologies and where things are and what you could do an experiment with today and what the risk profile of those tools and technologies could be today. Or actually the potential quantified benefits, if any.

So this is a test episode because basically it’s based on some live videos that I recorded with people attending RAADfest 2018 which was held in October in San Diego. RAADfest is one of the larger life extension technology conferences today. RAADfest stands for Revolution Against Aging And Death and then fest for festival.

So pretty much everyone who is active in this new industry, companies like Life Extension Foundation, the hosts and the leaders of this conference, Coalition for Radical Life Extension, investors, biotechnology startups in this new industry which is called Rejuvenation Biotechnology. That’s the name it’s starting to get for itself. All of these people were here at this conference so you’ll see there are a number of different profiles that I interviewed and that you can find in this interview.

So I think it’s a good episode to get an introduction into these topics to start understanding where life extension is and start getting an idea of where you may want to look into more and learn more about one of these topics. If you want to go check out the live videos, those are all on the Facebook page. So you can go to Facebook and just search the Quantified Body and you’ll find all of these interviews in the live videos there.

I would encourage you to skip around this episode. It’s long, as I said. So if there’s a specific topic that you’re interested in, you may want to check out thequantifiedbody.net blog and check out as always, we have the highlights, the times, who’s talking about what subject at what time in the episode so you may want to just jump to one hour or two hours in. Pick the area that you’re most interested in first. However, going through the whole thing will give you an overview of where things are at.

So with that, just let me give you some brief introduction into the topics and the people who are going to appear in this episode.

The first one is Aubrey de Grey from SENS Research Foundation. I interviewed him in episode 14 of The Quantified Body podcast. Really in this episode, he gives us an update on how life extension has moved from the fringe, basically something that was looked at as a fringe science, to becoming a new biotechnology industry where you know have a lot of funding coming in and a lot of startups becoming active.

As I said before, this is now starting to become labeled, rejuvenation biotechnology. I just went to another conference on this in London just a few weeks ago where there were a lot of prominent people and investors. So you can really see that this is growing into an industry all of itself more credible. So that was a good discussion on the progress of the tools and the funding and everything that’s going to bring it alive and make it happen in the longer term.

The next person I interviewed here was Liz Parrish from BioViva. Liz runs a biotechnology company focused on life extension and she was the first person to undergo gene therapy targeting life extension and this took place three years ago. She’s known as patient zero in some circles for this reason. She just presented the results from her telomere lab. Telomeres are something that people are looking at to measure how we age.

The idea is that telomeres get shorter as we age so you can have an idea of someone’s biological age based on measuring the length of your telomeres. So hers were actually shorter than average when she first tested before her gene therapy and now they are longer than average three years down the line using the same test from SpectraCell Labs to measure that. So with Liz, we talked about plans for her company to support the development of life extension therapies and of course her own experience with gene therapy to extend life.

The next person we have on the show is Reason from Repair Biotechnologies. So this is one of the new biotechnology companies that has emerged and been funded in this area already and they’re working on life extending therapies. He’s also the author of the blog Fight Aging which has been around for a really long time.

I’ve known about this blog for a very long time and he’s constantly been covering the science, the updates and how things are progressing; the ideas, tools and so on. So it was interesting to talk with him about his own self-experiments with senolytics, which you’ll learn about is probably the newer term tools that people will be using to aim to extend or rejuvenate themselves and also just an overview of where he’s focused and the science he has covered and some of the more interesting things.

The next person is the episode is Brian M. Delaney from Life Extension Foundation. So Life Extension Foundation, you may know of, is a company that has been very active in the supplements area and they tend to have better formulated supplements than the average company and they’ve always written pretty good articles with in depth references and citations. So Brian is sort of chief guinea pig for the life extension which is his new role he has taken on. He has been an advocate and someone who has practiced caloric restriction for a long time.

So we talked a little bit about that and then we talked about his new job with Life Extension Foundation and the things and the tools he has been testing which include senolytics and Rapamycin; two potentially newer term tools that can be used for longevity purposes to try and extend your life. Also go into depth in both of those and his own experiments on what he has been up to.

Next person on the show is Quantified Bob, Bob Troia. So Bob appeared in episode 22 way back in the Quantified Body. He does a lot of n=1 experiments and he quantifies those so obviously he’s a good fit for this podcast so you might want to go back and check that. Basically, we had a chat about what he found interesting at the RAADfest, which of the life extension topics he’s most interested in and also his other recent quantified experiments that he has done since we last spoke to him.

And finally, the last person in this episode is Howard Chipman from Young Plasma. Now Young Plasma is providing transfusions today of young blood so blood from young adults to people who are older in order for them to benefit from rejuvenating properties. This was first tested in the 1920s in Russia in fact.

Since then, there have been mice experiments and there has also been some allozymes as human studies which have shown benefits from basically just transfusing younger blood into people with older blood. So he talks about that service, he talks about the latest study , Ambrosia, and how he got involved with it and what patients are doing and who’s using this currently. So that’s obviously interesting therapy right there also.

As per usual, there are extensive show notes for this episode. They may be more useful than usual. There’s links to everything mentioned in the show including the studies and easy listed takeaways. There are summaries of the biomarkers, the tracking, the tools and the tactics we discussed in this longer episode.

So please reference those especially if you’re not sure about anything. I know some of the topics get a little bit deep in this episode because some of the topics like senescent cells are actually complex. So I think you might find some of the show notes useful to get up to speed there.

Also if you want to receive in future, updates on episodes and so on, go to thequantifiedbody.net forward slash newsletter and from then on and henceforth, you will get an email from me in your inbox whenever a new episode comes out with all of the details of that episode. So you won’t even have to go to the blog.

That’s it for me. I’m now going to leave you to delve into these episodes and get a broad introduction into the topic of life extension.

[MAIN INTERVIEW TRANSCRIPT]

(00:09:32) [Damien Blenkinsopp]: There we go. We’re live again. We’re at RAADfest again and we have Aubrey de Grey sitting next to us which is fantastic. If you’ve been watching the podcast, you’ll probably know that we spoke to Aubrey de Grey in episode 14 which was about three years ago I think. So we’re not going to go over all of that stuff. If you want to get up to speed on the basics and what he’s doing, check that out later and then you can come back to this. That’s probably the best way to go about it.

We want to talk about what’s going on now, what you’ve been achieving and then how it’s all going. So first of all, we didn’t talk a lot about the SENS Research Foundation; how it’s structured and basically what the mission is and how it’s structured to achieve that. So I thought that would be a good place to start.

[Aubrey de Grey]: Yes it is. If you [check 10:12], first of all, just generically, but also because that has been changing over the past couple of years. So we are based in California and we’re a charity. We’re a 501c3 as it’s called in the U.S. and that means that people can give us money with tax advantages. We also incidentally have an affiliate charity in the U.K. so that U.K. taxpayers, ID taxpayers from most of Europe can do the same.

But our goal is not only to get work done internally on the basis of money given to us, but also to be the engine room of the industry. Of course you might think well what is this industry? There has been this thing called the Anti-Aging Industry for quite some time, but it doesn’t have a very good repute. That’s no surprise because it’s fundamentally based on things that don’t work or hardly work. We are creating. We’re the new industry; the Rejuvenation Biotechnology industry [unclear 11:05].

[Damien Blenkinsopp]: You renamed it.

[Aubrey de Grey]: Things that do work. That’s right. Now that has really only happened over the past couple of years. There have been investors coming to us saying, “What can I do? How can I get involved in this? But I don’t like giving money away so please give me an investment opportunity.” Historically, we would not have been able to help them because the projects that we were working on were too early a stage for us to be able to make a case that really joined the dots all the way to eventual profitability.

That is no longer the case. We’re now up to about half a dozen projects that we gestated for, in some cases several years, and that we eventually were able to spin out and to start up companies and every one of those companies is doing pretty well in terms of bringing in money. In some cases, money that is the equivalent of multiple years of our entire annual budget.

The foundation is still very small. We only survive on something like five million dollars per year. Some of these companies are getting twenty or more and that’s fantastic because it means the science can get done faster. It’s also fantastic in the sense that we can focus on the projects that are lagging behind and still have not reached the point where they can be spun out and made interesting to investors.

(00:12:22) [Damien Blenkinsopp]: Yeah. So is that transformed over the last three years?

[Aubrey de Grey]: Really, yes. Until, I’m going to say four years ago, we had never done this. Not only we had never done it, but at the moment we’re in a position where we’ve spun out six companies I believe now, but actually we’re also working closely with at least a dozen or more other companies.

They’re not spin-outs, but they’re doing very closely aligned work and the people are very much looking to me and the foundation as source of introductions to investors for example. So for me personally, it’s extremely gratifying. I’m able to maintain this position of influence in the emerging industry that I historically had in the non-profit world.

[Damien Blenkinsopp]: So this is fantastic. So you listed several companies, the twelve companies that you spun out yesterday and also the SENS aligned. How many are there in total now that you consider within the right parameters?

[Aubrey de Grey]: Yeah. It’s a continuum. It depends how much [unclear 13:19] but at least a couple of dozen.

(00:13:22) [Damien Blenkinsopp]: Wow. Wow. We’ll get into some of the specifics of that. So one of the things I wanted to talk about is when you published your book. Was that 2008? The first year?

[Aubrey de Grey]: 2007.

[Damien Blenkinsopp]: 2007 and you published the seven types of damage of aging?

[Aubrey de Grey]: That’s right. I had been talking about that for at least five years before that.

[Damien Blenkinsopp]: Yeah. Last night, you said that basically that hasn’t changed. That model has withstood time.

[Aubrey de Grey]: It has withstood the test of time, that’s right. Always though was the risk that there could be some new type of damage that had not been discovered.

[Damien Blenkinsopp]: Yeah.

[Aubrey de Grey]: Of course there still might be, but every year that goes by when it’s not discovered is increasing circumstantial evidence that it’s never going to be.

[Damien Blenkinsopp]: Yeah.

[Aubrey de Grey]: Similarly with regards to therapies, it’s very important also to recognize that we have not had any bad news of the form of this or that approach that we thought we would be able to take to succeed in repairing this particular type of damage is not going to work for some reason.

[Damien Blenkinsopp]: It’s not dead end.

[Aubrey de Grey]: That has not happened either.

(00:14:18) [Damien Blenkinsopp]: Excellent. Excellent. Ok so if you got these seven areas, where are we making progress with this portfolio of companies now? Are there specific areas where we’re making progress now?

[Aubrey de Grey]: So that’s a much better finding. Really all of them, the progress is really encouraging; much faster than it used to be. So there is a possible big spectrum in terms of how far along they are. In fact, there has always been that spectrum.

So one of the areas is stem cell therapy to repair cell loss; cells dying and not being able to be magically replaced by cell division. That’s an area which was already sufficently established when we began a decade ago, but we have always deprioritized it with just an occasional little thing in the stem cell area. But other people with good money and from other sources are doing it so that’s [check 15:04] there. But pretty much all the other areas we have worked in, we have done quite a lot and yes they’ve all moved forward.

So the only one that is entirely within the foundation still is mitochondrial mutation. Even there, it’s probably not going to be all that long before we can [check 15:23]. Because after maybe ten years of working on it without anything really to show for it even before we were publication, we started making breakthroughs. We had our first real groundbreaking breakthrough publication two years ago now and we’ve made massive progress since then. We are universally recognized in the field as the world leaders in that area now and we believe that it’s going to be ready for private sector prime time fairly soon.

Now, that doesn’t necessarily mean that we can shut up shop and declare victory at the foundation. Because first of all, we are obviously doing other stuff in addition the research. We have this very vibrant education arm and also we do regular outreach. But also, even though some examples within these seven things are already out there in the private sector, it’s been out, nevertheless there are other examples that still need to be gestated for a bit longer before they can really be of any proposition.

(00:16:16) [Damien Blenkinsopp]: So some aspects of that damage hasn’t been spun out yet. So you said some of the mitochondrial mutations are looked at internally. When you’re saying internally, does that mean that you’re funding internal research or you’re funding external researches that you think are appropriate, but it’s internally funded?

[Aubrey de Grey]: In that case, it’s actually literally internal. We do the work in our own facility in Mountain View, California. We have a couple of other projects in Mountain View, but most of our work I think will be [check 16:44] about two-thirds is funded extramurally. In other words, we support professors in laboratories and institutes and universities.

(00:16:52) [Damien Blenkinsopp]: Wow. Ok, cool. Ok so if we look at the timeline, this is the kind of stuff people are going to be really interested in. If we look at the timeline of where these companies are and where you think they’re going to get to some commercial or even clinical trials or something that people could actually get involved in, could you paint a rough picture or maybe something we can expect?

[Aubrey de Grey]: Sure, absolutely. Absolutely. So let’s take Ichor. I would say out of all the actual spin-outs that we’ve had, that’s probably the poster child in the sense that it’s the one that has attracted the most funding so far and it has also grown in terms of the diversity of things it works on. Ichor was set up to work on macular degeneration which is the number one cause of blindness in the elderly. It’s an example of what we call LysoSENS. It’s caused by the accumulation of waste products inside the cell in a particular part of the cell called the lysosome.

We developed a method to fix that in house in our Mountain View facility. For several years, we couldn’t quite get there. We ran into the sand for a long time and we were a bit frustrated and one of our employees decided that he wanted to run with it. He felt he had a solution to this last problem. He was right it turns out [check 18:02]. He formed his company; fine with us.

We only took a very small nominal percentage of the company in return for the intellectual property. The technology went forward, they’ve got good money and there and then, they’ll be doing clinical trials next year or possibly even by the end of this year. That’s just one example.

Another company Covalent Bioscience which is in Texas. It’s a company formed out of the work that we funded on amyloidosis which involves waste products accumulating outside of the cell especially in the heart. It’s a very important phenomenon in terms of mortality and the [check 18:38]. That went well enough that the two main academics who were spearheading that work have now quit and gone full-time with the spin-out company. They are again hoping to be in clinical trials in the very foreseeable future so it’s happening.

[Damien Blenkinsopp]: Yeah. It’s starting to get to meet the road. Which do you think is going to be, I guess it’s the mitochondrial mutation which is going to be the last thing.

[Aubrey de Grey]: I don’t like to say. At this point, I would say the mitochondrial mutation strand is probably moving as fast as for example, the extracelular crosslinking strand; the [check 19:14] problem. The [unclear 19:15] problem is being spun out right now. It will be out within the next month. It just came together a little bit more quickly.

But I wouldn’t necessarily go on a rant in terms of how far along they are or how soon they’re going to be in the clinic. It’s all neck and neck. That’s how it should be. We have always been very careful to prioritize the ones that are at the most difficult, most challenging, most neglected so that they’ll catch up.

(00:19:43) [Damien Blenkinsopp]: So I was thinking about the seven types of damage. Liz Parrish, she has done one type.

[Aubrey de Grey]: Well two really.

[Damien Blenkinsopp]: All right, two types of [check 19:52] so that covers two areas of damage?

[Aubrey de Grey]: Yeah.

[Damien Blenkinsopp]: Ok. Basically you’re going to have people which are covering some of the damage, but not some of the other damage and it’s a bit difficult to understand what that may look like.

[Aubrey de Grey]: We have to give our finger on the past [check 20:07] very carefully because you’re right, but the utility of this taxonomy, the seven-point plan that we have must never be lost sight of. The utility comes down to the fact that for each strand, even though there may be many examples of a problem within the strand, for each strand there is a generic therapy. So if you have cell loss, it’s just stem cell therapy.

Now, different organs have different cell types and they need different stem cell therapies. So if you get one working, that’s not the end of the story, but it is kind of halfway to the end of the story because the stem cell therapy, even though they’re different, they have an awful lot in common. That means that once you’ve got a couple of them working then getting the next one working is going to take much less effort and much less time. There’s much fewer unknowns so we can push that forward.

It also means that it’s easier to make a case whether to scientists or to investors that this is something that they can make money out of in a timeframe that they’re comfortable with.

[Damien Blenkinsopp]: So in a sense once you’ve made progress in one of these areas, you’ve gone to clinical trials and you prove that even if it’s one-tenth of the actual end-output you need for that area, you’re validated, you’ve got credibility and that will make it a lot easier.

[Aubrey de Grey]: Let me also emphasize that you don’t necessarily even need to get as far even as clinical trials. So the strand of SENS that has been most in the news in the past couple of years is definitely senescent cells; removal of senescent cells. In that case, the company that’s really the flagship in this area, Unity Biotechnology, which is somewhat associated.

We could not describe them as a spin-out from us, but some of the founders have worked with us and have been funded by us. That company was able to attract its first [check 21:48] respectable enough like mid seven digit money on the basis of ridiculously preliminary data. Not just that it wasn’t clinical. It was only in mice, but also it was genetic models of mice that gave no particular reason to expect that one would actually be able to create drugs. It was even accelerated aging model which are always unreliable and they still were able to make a lot of money.

Since that time, their data has improved. They’re now worth nearly a billion dollars so this is a big deal. They’re not going to start clinical trials until later this year.

(00:22:18) [Damien Blenkinsopp]: Wow! This kind of leads on to some of the names you have in terms of the investing companies were quite big. You’ve got Juvenescence and you’ve got Andreeseen Horowitz, some huge names in the BC world and also Y Combinator. Has that made a difference? Why did these companies or these funders come in?

[Aubrey de Grey]: It’s beginning to. So some of the, well really all of the really early investors when the industry just was starting to begin three or four years ago, were private individuals using essentially, well starting with their own money. Juvenescence is an example. Jim Mellon and his colleague Greg Bailey, both very successfully invested in other areas and decided to get really into this. Other just private individuals decided to start their own thing.

It wasn’t so much a movement at the investor side of things at that point. But then after a year or two of that, things started to change. So Andreessen Horowitz, obviously as you said an extremely established name in BC, doesn’t do much Biotechnology. They still don’t. They decided to get into this area just because they’re with this one company, BioAge. Which again is not technically a spin-out from us, but we work very closely with them, that was doing bioinformatics. So Andreessen Horowitz is very heavily involved in informatics in general.

So it was just something that they felt that they could understand really and do well. They felt a bit comfortable with it, it looked promising and of course, they were right. The company’s doing extremely well. Then Y Combinator has got into this whole field more recently, just really in the past year. They have again, not had much influence on Biotechnology until recently. They decided to do that and furthermore, they’ve done it in a proper way.

They’ve done in a way that recognizes that Biotechnology just takes longer to get going than IT. So the typical deals that they would have had for IT companies would be more like three months to get to demo stage and then we’re only going to give you a few hundred thousand to create.

[Damien Blenkinsopp]: More effective products.

[Aubrey de Grey]: Yeah. Whereas when you get to Biotechnology, they recognize the difference in its order of events to mobilize the time and the money.

Yes, they are very much very clear that aging is a major preoccupation of theirs. They want to get into a startup landing in the biology of aging as quickly as possible. They’ve already got a few companies which again of course we’re talking to. They are [check 24:34]. They’re literally on the same street of us. They’re literally two blocks away.

[Damien Blenkinsopp]: Well that’s useful.

[Aubrey de Grey]: Yes.

(00:24:41) [Damien Blenkinsopp]: Ok so you just mentioned bioinformatics and BioAge. I don’t know if you’re allowed to talk about BioAge. I heard they’re more of a stealth mode.

[Aubrey de Grey]: They’re not really stealth, no. In fact, they share about what they know quite a bit, but what they have done as a result though actually of successful fundraising is they have been able to go broaden beyond the bioinformatics side. So Christian Foley who started BioAge is… she made a name at Stanford in bioinformatics. But the predictive ability that she was able to demonstrate with her original very small team of people was so good.

It mainly focused on metabolomics, but now spreading out to other onyxes. It was so good that the funding came in that was sufficient to be able to do their own lab work as well as to validate some of the drug candidates that they were identifying in silico. So now I’ve heard that a number of very good lab scientists are working at BioAge as well; again, friends of us.

It’s an extremely mission-oriented company. They’re very, very strong on making sure that they don’t get diverted by short-term investors into doing the wrong thing. That’s not true only of BioAge. It’s true across the board of the companies we work with.

Lessons have really been learnt here. A decade ago, you had a few cases of very well meaning, very smart gerontologists going out and forming companies and getting investment to actually take things forward. Even though it was earlier days in terms of science. A great example would be elixir, a pharmaceutical study by Cynthia Kenyon and Lenny Guarente. Complete waste of time, but it became a waste of time because they got the wrong investors. Because they got people on board who were much more interested in short-term [check 26:13] than they were in actual long-term success and the whole thing ended up being a total clusterfuck. That’s not happening these days.

[Damien Blenkinsopp]: Is it because you’re advising?

[Aubrey de Grey]: It’s a bunch of reasons. Firstly, it’s because the founders of these companies recognized that risk and they’re very careful of what money they take. But secondly it’s because the opportunity exists to take money from people who are not going to do that; people who really are high-risk high-rewards type investor types who are very comfortable with long-term strategies and yet who also have sufficiently deep pockets to be able to be the major investors for a long time.

(00:26:54) [Damien Blenkinsopp]: Yeah. Great. So you mentioned bioinformatics and I was wondering how important is that to the overall strategy? Because we especially saw [check 27:01] some of the data and the stuff they’re doing and I’m hearing more about that data. It’s obviously something that we talk about here for validation. Does that also have to be an area of investment to push this forward by being able to validate the discovery you were talking about with BioAge?

[Aubrey de Grey]: It certainly does and it’s not just validation either. Well a lot of it is, but the sheer ability to make predictions so that you don’t have too many things to validate is the key really. Another great example in our space is Insilico Medicine who also received a load of money and mostly from Juvenescence in that case. Again, run by a longtime and very ardent mission-oriented guy, Alex Zhavoronkov; great friend.

They are usually state of the art machine learning techniques to achieve really fantastic results in terms of prediction of not only new drugs, but also new activities of old drugs that could be repurposed and their aftermarket is shorter in that case. Yeah and they’ve been able to get very good investment.

I believe that bioinformatics will never do everything You’re always going to have to do a lot of bench work and everybody knows it, but it definitely has its place.

(00:28:10) [Damien Blenkinsopp]: All right, great. So I’d like to pass a little bit on to you actually because we chatted last time just about what you do. Do you do any tracking for yourself? Are you interested in any of these life extension? One of the things I’ve heard about quite a bit here is senolytics because some people see this as something short-term they can do to enhance their health spans and they can get to these technologies. What’s your view to this for yourself? Are you doing anything or are you interested? Do you think it’s not really worth it because you’re just waiting for the big stuff?

[Aubrey de Grey]: Everybody’s different in this. I always tell people, “Don’t do as I do; do as I say.” The reason I say that is twofold. First of all, I’m just well-built. I’m a really lucky guy. Well first of all, I’m lucky in that because of my providence in the field, I’m able to get for free the kind of really top of the range analysis of my metabolic state that would normally cost ten thousand dollars and I’ve done that maybe five times over the past fifteen years.

(00:29:04) [Damien Blenkinsopp]: What kind of analysis?

[Aubrey de Grey]: They measure 150 different things in your blood and all manner of physiological and cognitive tests; you name it, they do it. I always come out insanely younger than I actually am like fifteen years younger. What that means in terms of what I should do is I have to be very conservative. Respecting how little we really understand about metabolism. It’s a case of if it isn’t broken, don’t fix it.

So the fact that I actually eat and drink what I like and I don’t even do much exercise, nothing happens. I’m doing fine and so I might as well, but that doesn’t mean that I’m going to do fine forever. I always have to pay close attention to any early signs of something going downhill.

The other way in which I recommend people not do what I do is because of my position and my advocacy role, I’m constantly on the road. I definitely don’t get nearly enough sleep and that’s definitely bad for me. But I figured it’s probably [check 29:57]. I’m hastening the defeat of aging, but I’m [check 30:00] in my life.

[Damien Blenkinsopp]: Absolutely. Yes it’s really interesting because I’ve spoken to a variety of people here and they have got very different strategies. One person I spoke to, he’s basically stacking everything that you’ve seen here. Some of his markers, he actually isn’t in such great shape so the higher risk is worth it to him. But if you’re starting from a great place then as you said, until they’re proven, it’s not worth taking these things.

[Aubrey de Grey]: Precisely. Senolytics, for an example, the [check 30:27] is definitely one of the things in my seven point list and so I’ll definitely be willing to do that at some point. But at the moment, it makes sense for me to wait and see and let these therapies become more effective and more, you know, more tested. That’s happening so fast now that in one or two years down the road would make more sense to me.

(00:30:50) [Damien Blenkinsopp]: Yeah. It’s a very strategic unit. It really fits with what you’ve done with SENS Research Foundation. So this is the last thing. Where can people, I mean two things. Have you got an ask for the audience? Anything that you’d like to tell them?

[Aubrey de Grey]: Sure, totally! At the moment, as I said we’ve got this burgeoning of the rejuvenation technology industry with more and more investors realizing that this is the next big thing and it’s starting to come in too. But there is still this residue of projects that absolutely vitally need to be taking fold as well and yet are not yet quite at the point of investability even from the visionary end of the spectrum of investors. That’s why the foundation still exists.

Now the unfortunate part is that your average investor is not totally keen on giving money away. They got wealthy by not giving money away indiscriminately. Therefore if anything, the burgeoning of the industry side actually makes that much harder for us to bring money in philanthropically.

As such, we are still way short of what we need in order to go as fast as the difficulty of the science allows. I think we could still at least double the rate at which we make progress on the hardest and therefore the most essential aspects of this work. Absolutely I haven’t asked. I say anything you can do to help. We have a nice friendly donate button on our website, sens.org and if you want to give us more than that then you know where and how to contact us.

Other than that, if you’re not wealthy, you can still give us ten dollars, a hundred dollars a month; these add up. But also advocacy; very, very important. People who are not billionaires and not scientists may feel that they can’t do anything, but that’s not true at all because the quality of debates, the quality of understanding and discussion of this area is still being unbelievably strongly held back by the desperate need for most people not to get their hopes up about this.

This is what drives what I’ve called [check 32:47]. They hear rationalizations that allow people to trick themselves into thinking that aging is some kind of blessing in disguise. I get so frustrated that people just refuse to open their eyes because it’s holding us back. That lack of enthusiasm is making people not support this work financially. When I say people here, I don’t mean just individuals, I also mean companies and governments.

So shunting the course of debates just as you’re doing right now by having me on camera, this is what needs to be done.

[Damien Blenkinsopp]: Perhaps more of these conferences. More people attending the conference, getting more involved, more engaged.

[Aubrey de Grey]: Totally. RAADfest is growing. Yeah it’s a fantastic event. We also have our own event in Berlin every year, every March. The emphasis is a bit different. It’s more exclusively science at that conference, but the crowd is the same. The kind of connections you have, it’s across the whole spectrum from the hardcore scientists who are getting the work done at the lab through to all the advocates, the investors.

[Damien Blenkinsopp]: Aubrey, thank you so much for your time.

[Aubrey de Grey]: My pleasure.

[Damien Blenkinsopp]: It’s great to have you again. Yeah.

[Aubrey de Grey]: Thank you.

[Damien Blenkinsopp]: Can you go first? We were just talking about how we we’re going to talk and it just failed.

[Britton Schneider]: I’m Britton Schneider. I work with Liz at BioViva.

[Liz Parrish]: My name’s Liz Parrish and I’m the CEO of BioViva.

(00:34:15) [Damien Blenkinsopp]: You know me or you should do by now so I’m not going to introduce myself. This is going to be a great little chat based on some of the stuff I learnt yesterday from your presentation. Just talk about what BioViva is doing and also what you personally have done yourself which is one of the highlights. So first of all, just for the audience because many of them probably don’t know who you are and what you do. What do you do? Who are you?

[Liz Parrish]: I’m the CEO of BioViva. I’m considered the woman who wants to genetically engineer you. I want to create humans that are healthy and don’t die of the diseases of aging and therefore bring treatments back to children who are dying of critical diseases now that will cure them of their diseases.

[Damien Blenkinsopp]: That’s a really good introduction.

[Liz Parrish]: I’ve been doing it for a few years.

(35:00) [Damien Blenkinsopp]: So Aubrey de Grey just called you patient zero so you apparently have several names. Are there any others?

[Liz Parrish]: Well depending on who you talk to.

[Damien Blenkinsopp]: Good ones! Well if you get any bad ones. Any bad ones?

[Liz Parrish]: I don’t know of any bad ones actually. I don’t think that I get too much right now.

[Damien Blenkinsopp]: That’s good. Does Brit call you something? Does she have a pet name for you?

[Liz Parrish]: She calls me “you’re late.”

[Damien Blenkinsopp]: Ok.

[Liz Parrish]: That’s how I know myself.

(00:35:21) [Damien Blenkinsopp]: That’s the main thing there. Ok so what does BioViva do and what is its mission?

[Liz Parrish]: BioViva is a bioinformatics platform now. We’ve changed our gears. For two years, we tried to be a program that actually treated patients directly with gene therapy. We’re looking at regenerative medicine gene therapies; gene therapies that reverse the biological clock, gene therapies that create upregulation of regeneration in the body, gene therapies that increase muscle mass for the aging population and therefore creating cheaper cures for kids with muscular dystrophy.

So every one of the therapies that we talk about today, there’s an aspect that can be used in childhood disease. But we wanted to do that. We wanted to treat patients correctly, but we found out we couldn’t do that. There was not a regulatory framework for us to be a U.S. company and do that, but the most important part of treating patients is the data; what happened when a patient was treated.

So we actually became in partnership with an exclusive partnership with a company that’s offshore of the U.S. It can broker deals between patients and doctors to do gene therapy and we get access to all the pre and post data. We find out exactly what’s been done to the patient and then we look at the biomarker panel that we’re developing with our bioinformatics program and we see where gene therapies work and where they don’t work.

In research and development, we are actually starting to design our first viral vector that will get multiple genes in at one time.

[Damien Blenkinsopp]: So you are doing R and D still?

[Liz Parrish]: Yeah, we are.

[Damien Blenkinsopp]: Then you license that out, but you just don’t clinically deliver it?

[Liz Parrish]: No. The thing is you never want to fall in love with your hypothesis. So we don’t want to be a telomerase inducing gene therapy. We don’t want to be just a [check 37:06] inducing gene therapy, PCG-1 alpha, FGF21, Folistat. If you fall in love with your hypothesis, you’re going to try to prove that it works.

We’re a testing platform to see what works. We’re going to bring other companies through that have therapeutics that we will actually give them their first human data. So why would we do this? Why would we do medical tourism? It’s a multi-pronged approach.

Number one, you give patients access to therapies they couldn’t get otherwise. Often, these patients are in dire need of something and the regulatory system and their doctors would just let them die rather than treat them, rather than take the risk because we’re very risk-averse. So number one, you’re helping patients.

Number two, you’re helping biotechnology companies get the first data on whether their drugs work in patients and where they work and where they don’t work.

Number three, de-risking investment in biotechnology. Right now, biotechnology has a 94% failure rate through phase studies. Investors don’t want to invest, but if you plop down the data on ten, twenty, a hundred patients and what happened, we’ll know what drugs will work before we start to run them.

Do we think that drugs should go through a regulatory service? Absolutely. They should go through a regulatory service so they can be sold widely to a wider audience and help more people, but people need access now. The human model is the best model organism to work in to find out if drugs work for humans.

(00:38:30) [Damien Blenkinsopp]: So you completely pivoted the company. So before you were actually developing them and now you’re, just to get it straight, you’re not doing any R and D and development at all? Or you’re doing a bit, but mostly you’re going to be sourcing the R and D from other companies?

[Liz Parrish]: Instead of actually trying to run one gene to find out how well it works, we use the meta-analysis so it’s called bench to bedside. Where we are doing the development and research and development is the driver, the vehicle; what gets the genes into the cell. So we’ll let other gene companies and research institutions run all that expensive pre-data, but then we want to see what happens in patients when we look like we do have a promising drug.

[Damien Blenkinsopp]: So you’re going to select the most promising ones?

[Liz Parrish]: Yeah, that’s right. So the reason we would look at telomerase induction is it actually has decades of research done on it. Nobel prizes have been given out and fantastic, very inclusive research papers have come out. Maria Blasco just put out an exhaustive scientific paper about how telomerase induction does not cause cancer, it may actually protect against cancer. These are the things that we need to see, but if we don’t apply them to humans, they have zero value.

(00:39:42) [Damien Blenkinsopp]: So basically what you’re doing is you’re saying the regulatory environment is not going to let us do any of this and it’s very expensive to do the clinical trials. So we’re going to let less risk-averse people or maybe they’re in a situation where they’re at high-risk of dying or they have a very damaging condition already and so it’s in their interest to reduce risk. So they can do it for medical tourism then you can get the data and then fast forward and validation.

[Liz Parrish]: Fast forward those drugs. Actually, I think that our platform in the next two years, we’d like to prove ourselves and then we’d like to have the regulatory service look at our platform. If we actually ran drugs like we’re designing to run drugs, this is actually what we want. Don’t hide any of the data, show the data; where does it work, where does it not work.

That way we have a clear picture of what’s going to happen. We already take drugs that aren’t necessarily safe, but we’re none the wiser. We get a pamphlet, you get a bottle of statins, you get a pamphlet, but if you look at the Cochrane Report, a statin will save one in 164 patients from getting a stroke, but one in ten will get Type 2 Diabetes and one in 50 will get dementia from taking the drug.

We don’t understand our risks to begin with, but we’re looking at gene and cell therapies, we’re looking at just upregulating a beneficial protein that has decades worth of data on it in the human body to push regeneration. Not only may these patients actually recover from their disease if we’re lucky, they will be spearheading the technology for the future.

Our risk aversion just has developed so many myths around living as if we’re not actually going to die, but how is anyone actually going to solve the problem. Taking a gene therapy is the type of people who want to buy an experience, but they are also health investors; they’re investing in their future.

(00:41:30) [Damien Blenkinsopp]: You probably are talking to a lot of people who are interested in taking gene therapies, what type of people is this? Just to get some on the ground information. i’m sure these kind of people contact you. What kind of population are interested in this?

[Liz Parrish]: We get thousands of people who contact us and are interested in taking a gene therapy and they really span the gamma and some of them were excruciatingly heartbreaking earlier on because we didn’t have ways to treat patients. We had people come through with sick kids who have probably died since then because there was no option. People with muscle disorders, heart disorders and various really sick people. But also we get some pioneers. Some people that hands down would take any therapy to be part of the experience of spearheading technology for the human race.

[Damien Blenkinsopp]: Like some healthy people?

[Liz Parrish]: Some healthy people.

[Damien Blenkinsopp]: Like you?

[Liz Parrish]: Yeah, some not so healthy. Well if you look at biological aging, by the time I was 40, I’m not very healthy. These therapies will be used in sick people. We’ll see if we can regenerate a kidney, we’ll see if we can regenerate a liver, we’ll see if we can create some more beneficial cognitive effect in patients with Alzheimer’s. But then we’ll work them back to people in less disease state and soon, we’ll be using them as immunizations. How soon that happens is how fast we start working towards that data.

(00:42:52) [Damien Blenkinsopp]: So what is the timeline for this model you’ve put in place? Is it just started? Is it 2019 you’re going to have some clinics in specific countries in the world that’s run by this organization called IHC?

[Liz Parrish]: IHS?

[Damien Blenkinsopp]: IHS.

[Liz Parrish]: Yeah, Integrated Health Systems. Yeah so we’re starting now and already patients are signing up to talk to doctors. They are very interested in therapeutics so we’re hoping to start generating our data in 2019, but how clean that data is and what that data means is going to take us a little bit of time to generate. So we’re looking at a huge biomarker set. We’re looking at a multi-comeback…

[Damien Blenkinsopp]: There are four monstrous slides. I think I’m a data geek. It was ridiculous.

[Liz Parrish]: Yeah. So we’re going to pull from publicly available data sets, but we’re going to be analyzing, the first company in the world that analyzes what happens when you do regenerative gene therapies in humans.

(00:43:44) [Damien Blenkinsopp]: So you’re going to ask the clinics to collect this data? Because it was a very extensive amount. So do you need equipment like special MRIs?

[Liz Parrish]: Well we actually work with the doctor. So the doctors who are exclusive to IHS are actually exclusive to giving all of the data to BioViva.

[Damien Blenkinsopp]: That’s the new agreement?

[Liz Parrish]: Right, and there is protocol. So to every gene therapy, there’s a protocol, there’s a list of markers that have to be taken before a patient can be treated.

[Damien Blenkinsopp]: Ok.

[Liz Parrish]: It is pretty broad.

[Damien Blenkinsopp]: It wasn’t all of those though, was it?

[Liz Parrish]: Remember a lot of it is done in blood work. So a lot of those biomarkers come from blood work, DNA testing, methylation testing. Other markers come from imaging. So imaging is really important when you’re talking about brain health, when you’re talking about muscle health. When we’re talking about whole body health, we want to visualize what’s happening.

(00:44:38) [Damien Blenkinsopp]: Are you going to basically standardize the definition of the type of data and also how to record it?

[Liz Parrish]: Yeah, absolutely.

[Damien Blenkinsopp]: But who’s going to actually collect the data? Are you going to collect the blood samples and send it to a U.S. lab or a centralized lab? Or are there going to be labs all over the place or just the local ones?

[Liz Parrish]: So that depends on what labs the doctors work with, but they’re all the big companies. We work with generally the standardized labs.

[Damien Blenkinsopp]: Like [check 45:01]?

[Liz Parrish]: Yeah. Exactly. But we also work with some smaller companies that have some protein discovery methods, proteostasis, demethylations.

[Damien Blenkinsopp]: This specific test is more advanced.

[Liz Parrish]: Yeah so we’re not only looking at the old biomarkers that we used to look at c-reactive proteins and a blood glucose level, but we’re looking at these markers that will be really important in five years that really will be more specific than the other biomarkers in the coming years. That’s how we’ll find the real true biomarkers of aging that can give us a close date to the biological age of what your due date might be on your body and how we could actually change that.

But by doing regenerative therapies, we might be able to reverse engineer some biomarkers of aging as well.

(00:45:50) [Damien Blenkinsopp]: What does that mean?

[Liz Parrish]: It will give us a new view, a new insight of reversing pathology in the body and regenerating certain [check 45:58]. So for instance, even when you’re young, you’re actually generating damage. Your cells are degenerating in a slow form way. This isn’t just something that happens as you get older. Your body is developing so we have the illusion that we’re not accumulating damage, but in fact we’re accumulating damage over our entire lifespan.

We’ll be looking at bodies hopefully with regenerative medicine in these gene therapies that actually start to restore damage. That’s a reverse process of damage. Therefore we’ll get the insights of what that actually means with biological age. First, we’ll start pinpointing it back to a healthy body. A healthy what I call 1.0 body with a 2.0 body may have different biomarkers that give us insight to how to adjust to what is happening with aging in the body right now in the 1.0 body.

[Damien Blenkinsopp]: I’m not 100% following with this.

[Liz Parrish]: Sorry.

[Damien Blenkinsopp]: Sorry guys.

[Liz Parrish]: It’s probably me.

[Damien Blenkinsopp]: So 1.0 is someone.

[Liz Parrish]: 1.0 is a human who has not been given the gene therapy.

[Damien Blenkinsopp]: Ok. All right. So you’re saying once you get a gene therapy, you may not be normal? You might be something different, but it’s also healthy?

[Britton Schneider]: Ideally, yes.

[Damien Blenkinsopp]: Or it might be healthier?

[Liz Parrish]: You’ll be regenerating, well that’s what we’re hoping, is to put the body into a homeostasis; stronger, smarter, faster, healthier.

[Damien Blenkinsopp]: So that’s the 2.0?

[Liz Parrish]: Yeah. That’s any person who has gone through a regenerative gene therapy who has an upregulation of a protein that is designed to actually reverse damage in the body.

[Damien Blenkinsopp]: Ok so I’m following you now I think.

[Liz Parrish]: I nerded out.

[Damien Blenkinsopp]: The same way we’re upregulated with many detoxifications.

[Liz Parrish]: I went too far.

[Damien Blenkinsopp]: You talk fast. Not as fast as Aubrey, but he’s hard to keep up with. So for instance, we have many detoxification processes and enzymes in our body, you could upregulate some of those and then you could drink alcohol all day and not worry about it for instance, like Aubrey does.

[Liz Parrish]: Yeah, that’s true. That’s one use of our time.

[Damien Blenkinsopp]: Well I’m not saying it’s the best, but basically that’s what you are saying. We would have these abilities.

[Liz Parrish]: Yes of course. I’m all for people enjoying their life and living the life that they want to live.

[Damien Blenkinsopp]: We’ll go to the gym less and be stronger.

[Liz Parrish]: Yeah exactly. Well that was one of the things with my therapy. I worked out five days a week, I ran about 25 miles a week and after my therapy, I got on plane after plane, I had jet lag, I wasn’t working out. When we did my second MRIs, I was really worried because I had not been exercising, but the muscle mass was bigger, the white fat was down and my insulin sensitivity was up.

[Damien Blenkinsopp]: Ok Liz.

[Liz Parrish]: So that’s fantastic!

(00:48:41) [Damien Blenkinsopp]: I did want to talk about this of course I did. So on this podcast, on this show, we’re into self-experimentation so you’re a good fit and tracking data on it so that’s one of the key things. But I wanted to make sure we covered all the business and what you’re up to there because we’re also excited about the data. Because my belief and probably most of the people following the show which includes BCs, entrepreneurs, software experimenters and biohackers, is that data is one of the keys to everything because it will stop us running around in circles.

[Liz Parrish]: Yes, exactly and boy did we learn a lot about data. When we started this company, I found an investor. He said I’ll invest in you taking this therapy to embark on this and show that we can reverse biological aging. We have really big plans, but we didn’t really have a list of things that we really needed to do. So all I did was a lot of blood work, I did MRI imaging then I did telomere length. But today what we know is there’s so much more that we could do.

[Damien Blenkinsopp]: So you wish you knew probably more?

[Liz Parrish]: Of course, but that’s how you get there.

(00:49:38) [Damien Blenkinsopp]: What exact baselines did you take?

[Liz Parrish]: That’s when you saw my biomarker list, it’s extensive; it’s exhaustive.

[Damien Blenkinsopp]: Well because we don’t know which ones it’s going to affect.

[Liz Parrish]: No, we really don’t and we actually still don’t know what biomarkers [check 49:48] that we look at now. We’ve hunted LDL cholesterol like a witch hunt and yet people with high LDLs sometimes never have heart attacks.

[Damien Blenkinsopp]: I have high LDL, but I’m not worried about it because my particle count is low.

[Liz Parrish]: There is the group in Italy that have a gene. They never develop atherosclerotic plaques, but amazingly they have really high LDLs and then people with high HDLs and low LDLs die of heart attacks.

[Damien Blenkinsopp]: So it’s a perfect example.

[Liz Parrish]: So we have a long ways to go.

[Damien Blenkinsopp]: Because this biomarker is used everywhere and we don’t even know what it is.

[Liz Parrish]: Everywhere. Yeah.

[Damien Blenkinsopp]: It’s called bad cholesterol, but we really don’t know what it is.

[Liz Parrish]: So we need more data. We need to look at phenotype, we need to look at anatomical, physiological data. We have a long, long ways to go. So even before BioViva came along and started throwing regenerative gene therapies into people, we had a problem with biomarkers and we’re just pointing out that problem.

(00:50:40) [Damien Blenkinsopp]: Ok. So you’re going to collect a lot of data, but how are you going to get the value right because there are a lot of biomarkers. Are you going to put AI on it or what are your plans for this leverage?

[Liz Parrish]: Yeah, right now we’re using machine learning algorithms so our computer scientists and the PhDs that are working on that are trying to collect all of the best data and they’ll do a little bit of light machine learning as the data goes in. The most important thing is that the data is clean because garbage in, garbage out, we’re screwed. AI can’t solve a problem if we have no data.

AI is really fantastic for old drugs because we have a lot of data on how those work and it’s helping us understanding protein to protein interaction because we have some data on that. But regenerative gene therapies, we need human data then we can plug that in then we can start to get some meaning.

The microbiome, very interesting; changes as you age. If we are actually able to regenerate parts of the body, will the microbiome change? But we still don’t know most of the microbiome and we have issues.

[Damien Blenkinsopp]: Well I can tell you that I’ve done 40 different microbiome tests and I’ve never gotten actual information because you have to combine it Liz to get the real picture and assay islands.

[Liz Parrish]: Well it changes with what you eat.

[Damien Blenkinsopp]: It’s up and down all the time.

[Liz Parrish]: Yeah.

[Britton Schnieder]: We still have to identify what’s good and what’s bad. It’s still so much we don’t know.

[Damien Blenkinsopp]: Yeah, but we don’t know. There is a lot of “don’t know” basically so I think bioinformatics, it’s interesting. I’m always like, “Wow!” That’s what bioinformatics, and I’ve been thinking for a long time, we need to focus more on that. Because the more I get into, I’ve got into data just from this show and really it’s not accurate. A lot of this stuff is inaccurate. The more I’ve tested, the more I’ve spent on it, I’m like is this useful?

[Britton Schneider]: It’s the results.

[Liz Parrish]: Actually the arguments within the field. So in 2015, I took the two gene therapies that we’ll talk about. I did the telomerase induction and I did the myostatin inhibitor. Immediately people flew up and they were like, “Telomerase induction!” or they were like no, you should have tried this other thing. Well we have to get out and try these things. Without the data, we can’t say something doesn’t work.

(00:52:44) [Damien Blenkinsopp]: Could you talk about, I’m interested why did you take that decision to do it? Was it because you were frustrated the company wasn’t making progress?

[Liz Parrish]: No, no. The company actually was just starting. So in 2013, my son was diagnosed with Type 1 Diabetes. I was thrown into children’s hospital. I had been volunteering my time for two years working with stem cells and that advocacy and trying to figure out why the funding for stem cell had dried up and people weren’t interested when it seemed to show such promise.

So I had this regenerative medicine education that I was going through, I’m thrown into this hospital situation and I started asking them can you do something with stem cells. Could you biobank some of his pancreas so we can use it later and they looked at me like, “Lady! That’s experimental medicine.” They said kids are dying here. Your son has a treatable disease and I looked around and I saw that kids were dying and it was so unacceptable to me.

[Damien Blenkinsopp]: But your point is if they’re dying, let’s do something riskier.

[Liz Parrish]: Let’s do everything. Let’s do everything. So I left the hospital and I never really went home. I started getting on every board that I could get on as far as information on the internet, looking up what was going on and I found a SENS conference happening in England. That was 2013 and I got on a plane and I went over there and I said, “Ok what is what you’re doing, how does that help kids?” Because I was looking for treatments for kids.

I got there, they said, “Look, we’ve got all this great technology, we just need funding.” So if you look, I went home and I created a funding company. It was called BioTrove Investments. I started BioTrove podcast thinking that people just needed education. I’d get a call on the phone, I’d get to go fly around with fancy people who have a lot of money asking me a lot of questions about the technology. They said, “If you prove it works, I’ll put money into it.”

[Damien Blenkinsopp]: The investors?

[Liz Parrish]: So I said well ok two of my favorite things were telomerase induction and myostatin inhibitors because myostatin inhibitors were already working in humans. So I thought they will like this. So I found an investor and I said, “Let’s start this company and if you want to, I would take these gene therapies.” It will be my contribution to the world, it will be my contribution to my children and it will be my contribution to a world that I hadn’t really given much back to. He said, “Let’s do it. I think this will work.”

Of course we hoped to cure aging in one therapy, but we didn’t, but we got some really interesting data. We found out ok now we have to build the platform to make this a reality. Test every gene therapy that we can and see what combination is needed to actually achieve what we originally started.

[Damien Blenkinsopp]: So they gave you your start?

[Liz Parrish]: Yeah.

[Damien Blenkinsopp]: So how long ago was this?

[Liz Parrish]: That was in 2015.

[Damien Blenkinsopp]: So we’re three years on.

[Liz Parrish]: Yeah.

[Britton Schneider]: September makes three years.

[Liz Parrish]: Yeah, I took the therapy in September.

[Damien Blenkinsopp]: So it’s exactly three years.

[Britton Schneider]: Exactly three years ago.

[Liz Parrish]: Yeah, but the company was started January eighth 2015. The investor came in right away and then it took a long time to get that gene therapy. Then the gene therapy was delayed twice. So here I was ready and anticipating ok we’ll do it. We had considered treating a patient with it, but we couldn’t find any legal way to do that.

(00:55:57) [Damien Blenkinsopp]: How were you allowed to do it? I don’t really understand the regulatory.

[Liz Parrish]: There are some loopholes in regulations where if you are educated, you understand the product of your company, you can participate in the product of your company

[Damien Blenkinsopp]: It’s your personal company, that’s the view.

[Liz Parrish]: It’s not an actual law, but it’s a bit of a loophole and so the FDA never sent us…

[Damien Blenkinsopp]: But you have to be the owner of the company. Is that the thing?

[Liz Parrish]: Yeah and actually people have looked at ways to use that in order to sell shares in their company for people who want to participate in what their company is doing. So yeah spoiler, some people do that. It’s called making an educated decision. I’m a major shareholder in a company, it’s developing technology that will treat patients.

[Damien Blenkinsopp]: You needed that credibility to move forward.

[Liz Parrish]: I don’t know if it offered us credibility, but it sure ignited the industry. We were the first company to treat a patient for, or a person, in this case myself, for biological aging.

(00:56:57) [Damien Blenkinsopp]: Ok. So what baseline labs did you take?

[Liz Parrish]: We did all of the standardized blood tests that you would get at your doctor when you’re doing one of your uber health exams. We did MRI imaging, we did the telomere length testing.

(00:57:11) [Damien Blenkinsopp]: Which company was that?

[Liz Parrish]: We used SpectraCell. We actually used both SpectraCell and Life Length, but the Life Length one that we sent, they said they got it on the wrong day so they couldn’t analyze it.

[Damien Blenkinsopp]: You know what? One of my friends has the same problem. He stopped using them.

[Liz Parrish]: Yeah I was really like, “You are kidding me.” Actually, they were our company of choice. So at the last minute, we had to do a SpectraCell because they would take a 24 hour delivery at that point and we had to get it in within 24 hours because I was about to embark on the test.

[Damien Blenkinsopp]: That’s a shame you didn’t know.

[Liz Parrish]: Well what is great is one year after I took another SpectraCell and I went ahead and did Life Length again because they sent me a free kit because the first one got messed up. Guess what? They had the same value.

[Damien Blenkinsopp]: Exactly?

[Liz Parrish]: They pegged me at about 45 years old.

[Damien Blenkinsopp]: So the same as the SpectraCell?

[Liz Parrish]: Yes.

[Damien Blenkinsopp]: So the two labs coincided; that’s good.

[Liz Parrish]: They totally coincided. So the third one that we did this year, we used SpectraCell because it was the one that we had consistency with and they showed that they lengthened a little bit again. We don’t know if they lengthened all within maybe an 18-month period and they’ve stopped or if they continue to lengthen. Remember, this is only my T-lymphocytes so I can’t tell you that my whole body has been changed by it.

[Damien Blenkinsopp]: The test only looks at one specific cell.

[Liz Parrish]: Yeah. So gene therapy has a lot of obstacles that we have to get over. One thing, what genes do we need to use to create really healthy humans. The other thing is how do we target a lot of cells in the body without creating a immune response. Those are two really big things.

So a lot of people, they either go one way or another. They’re like, “This is so great that you’re doing this” or “Why isn’t this working yet?” We have a ways to go and so by analyzing this data and patients, we’re not only going to learn what happens with gene therapies, but we’re going to learn about titration. That means the dose that you give.

Here’s a really interesting thing. Hemophilia B, they just found in studies if they give 20% of the dose, they had a better outcome in patients; completely unexpected. We don’t expect that with something like telomerase induction that’s not shared outside the cells, but we can expect that with other genes. That’s cost savings. What that means to you is a lot less cost.

[Damien Blenkinsopp]: There’s a lot of those U curves in dosage. I’ve seen that talked about in other areas as well.

[Liz Parrish]: But generally in gene therapy when we look at myostatin inhibitors with the primase, the more they got, the bigger they were, but all genes are not the same.

[Damien Blenkinsopp]: Yeah. Ok. The other one you did was the MRI for the muscle?

[Liz Parrish]: Yes.

[Damien Blenkinsopp]: The myostatin?

[Liz Parrish]: The myostatin inhibitor.

(00:59:48) [Damien Blenkinsopp]: Ok. Thank you very much. Where can people follow what you’re doing, stay in touch with you? Twitter, Facebook or the company?

[Liz Parrish]: Yeah. We are in several places. Actually Brit probably knows. We’re bioviva-science.com. That’s the website. You can see what we’re doing. In October, we’re going to be offering genomic testing, but more importantly, genomic counseling because a lot of people have already got their genes run, but what does that mean?

So we want you to be able to talk to live specialists. Then we will be working over the next year to turn that into longevity counseling. We’re looking at the 59 genes in the human body that drive longevity. We want to see if in people and their family lineage, if these are actually creating longer, healthier lives by the upregulation of these proteins.

[Damien Blenkinsopp]: So they will come to you for that?

[Liz Parrish]: Yeah.

[Damien Blenkinsopp]: So you’ve got a [check 1:00:38] just like a data service basically.

[Liz Parrish]: So the genomic counseling, the genomic products, we’re hoping to offer some of the methylation testing that you can get from other companies, but offering it through our platforms so you have the availability to share your data with our company so we can solve the problem sooner. Then other than that, we’re just analyzing data and doing research and development in BioViva research and development for the larger load viral vector in order to pump you up in one treatment.

[Damien Blenkinsopp]: Ok.

[Liz Parrish]: Fifteen years give us.

(01:01:11) [Damien Blenkinsopp]: Great. If you had one ask to the audience that would help your mission, what would it be?

[Liz Parrish]: I would ask you to go and read some scientific papers. I would ask you to go look at what we’ve achieved in science, look at model organisms and how we’ve extended lifespan. I’d ask you to look at organisms that are already in the planet that have specialized genomes. The extremophiles, they can handle hot, radiation, extreme cold. Axolotls, they can regenerate their limbs. The pentachromat species that can see in billions of colours and I want you to get really excited about your future.

Our life is code and I think that we can modify that. First, we’ll look for human health and then we’ll look to enhance your life for where you want to live, who you want to be and what you want to achieve.

[Damien Blenkinsopp]: Thank you so much both of you; Brit also. Bye.

[Liz Parrish]: Thanks. Bye.

[Damien Blenkinsopp]: See you guys.

(01:02:15) [Damien Blenkinsopp]: Ok we’ve still got the lovely background noise. We’ve been running away from it, but it’s here and it’s following us so we’re just going to persevere now. So I’ve got Dr. Howard Chipman from Young Plasma with me here. We’re at RAADfest 2018. There’s basically an exhibition here. It’s an exhibition hall with lots of companies doing interesting things.

So I’m going to be talking to a selection of these people that I find more interesting and Dr. Howard is one of the more interesting people we’ve met. So first of all, could you just introduce yourself. You just gave me some great highlights of your background so I think that’s a pretty cool way to introduce yourself to they guys.

[Howard Chipman]: My name is Dr. Howard Chipman. I’m the medical director at the Atlantis Clinic in Oldsmar here in Tampa, Florida. I’ve been an emergency physician for many years and also done family practice and walk-in clinic. But I saw a lot of my patients were getting older and needed some other type of anti-aging treatments so I started doing the young plasma treatments. That’s what I’m here for to promote and also to learn about other anti-aging things that we can add to our protocols to help our patients stay alive and healthier and myself too of course.

(01:03:25) [Damien Blenkinsopp]: Yeah. So in a nutshell, what is Young Plasma and how long have you been doing it?

[Howard Chipman]: Young plasma is basically the blood minus the cells which is the plasma from younger people 16 to 25 years old. The idea is to get the healing and growth factors that you had when you were younger and replenish your body with those for anti-aging and healing of degenerative processes.

[Damien Blenkinsopp]: So you’re actually giving people basically a transfusion?

[Howard Chipman]: Yes.

(1:05:00) [Damien Blenkinsopp]: Of how much blood?

[Howard Chipman]: We customize it for the patient, but typically patients get seven units of fresh frozen plasma. The plasma comes from a certified blood bank so it’s tested for all infectious diseases.

[Damien Blenkinsopp]: This is the stuff you would get if you had an accident in a hospital?

[Howard Chipman]: Yes, this is the exact same blood you’d get in a hospital.

[Damien Blenkinsopp]: It relates to your emergency medicine background.

[Howard Chipman]: Except the donors are young.

[Damien Blenkinsopp]: So you make sure they’re young. So yesterday you were telling me that you mix up seven units of blood.

[Howard Chipman]: Actually we just start an IV and we just run the units in like an IV fluid basically over about two hours and that’s it. It’s very simple and painless.

[Damien Blenkinsopp]: Great. Well it’s very interesting. You said you’ve got a few other things just in your background.

[Howard Chipman]: Well my goal is eventually to fly into space. I love airplanes so I have a space training company also called Aurora Aerospace and we take people out for military jet training flights and also zero gravity flights. We do have a microgravity research as well as. We’ve had artists go up and do zero-G painting.

[Damien Blenkinsopp]: Cool. You’ve got an eclectic mix of interests. I like that.

[Howard Chipman]: I just can’t decide what I want to do when I grow up. With the young plasma, hopefully I won’t grow up too fast.

(01:05:08) [Damien Blenkinsopp]: Exactly. All right with the young plasma, I like to give people a little bit of background where this came from if they haven’t been aware of it. It has been in the press for the few years. So could you start from [check 1:05:19] study and then [check 1:05:20] here?

[Howard Chipman]: Well I’ll go back a little bit further. Actually, there was a Russian physician called Bogdanov in the 1920s who started giving himself transfusions of blood from young people to see if it would have an anti-aging effect. He reported many beneficial effects from it, but unfortunately he died after a transfusion.

[Damien Blenkinsopp]: He did? Of what? A bad transfusion?

[Howard Chipman]: Well they’re not sure because back then they didn’t know about blood types. So he may have had a transfusion reaction, but the patient that he got transfused from had malaria and tuberculosis.

[Damien Blenkinsopp]: Ok that could have had something to do with it.

[Howard Chipman]: An interesting note, Dr. Bogdanov was actually a communist and he was highly involved with the communists of Russia. He actually treated Lenin’s sister with young blood. So that’s the first reported instance that we know of in modern times of people using young blood or young plasma.

After that, some experiments were done where they took mice and they interconnected their circulation system called parabiosis where they took an old mouse, young mouse, stitched their blood vessels together so that their blood circulated freely between them. What they found was that the old mouse, his health improved. He became younger and basically everything they could measure or dissect out of him improved.

[Damien Blenkinsopp]: Yeah and what happened to the young mouse?

[Howard Chipman]: The young mouse, he went downhill. Other studies have corroborated this that not only is there a lack of good stuff in your old blood, but there’s actually bad stuff in there as well that actually causes bad things to you. If you take out old plasma and inject it into a younger individual, it causes damage.

[Damien Blenkinsopp]: So don’t do that guys. If you do end up in the army, if you want to ask for younger blood, i don’t know if that’s possible.

[Howard Chipman]: I don’t think so. Typically if you’re getting blood in the ER due to hypovolemic blood loss, what you really need are those red cells to provide the oxygen so that doesn’t really matter. Of course if I was dying and needed blood, I’d rather have younger blood, but if you need those red cells, it doesn’t really, that’s doesn’t matter so much.

(1:07:21) [Damien Blenkinsopp]: All right, cool. So are there any downsides to this? You’ve done this yourself.

[Howard Chipman]: Yes. I’ve been doing it for two years and I feel the difference. I feel more energetic and more youthful. I find myself acting more in ways that I did when I was younger that I had kind of forgotten.

[Damien Blenkinsopp]: How old are you?

[Howard Chipman]: Fifty-six.

[Damien Blenkinsopp]: I don’t think you look 56.

[Howard Chipman]: I used to jump up two stairs at a time. Over time, you get older and you act differently. You don’t really realize it, but after doing these treatments for a couple of years, I find myself doing things that I did when I was younger.

(1:08:00) [Damien Blenkinsopp]: Ok. What is your protocol? How frequently are you doing it? What dose?

[Howard Chipman]: I’m taking seven units every three months.

[Damien Blenkinsopp]: Ok.

[Howard Chipman]: Again, that’s not based on any hard science. It’s based on the study that we performed; the Ambrosia trial where we used seven units.

[Damien Blenkinsopp]: You are mimicking the study?

[Howard Chipman]: Yes. That dose was come upon by a high dose of plasma because we use plasma for many other things in the hospital. Basically, we just took the high upper-level dose of that and do it every three months.

(1:08:30) [Damien Blenkinsopp]: Yeah. So you said you worked on the Ambrosia study. What was the Ambrosia study?

[Howard Chipman]: The Ambrosia study was a trial where we took a number of individuals and gave them one dose of seven units of plasma and then measured the biomarkers before and after to see if there was any change in there.

[Damien Blenkinsopp]: And?

[Howard Chipman]: The study is not published yet.

[Damien Blenkinsopp]: So you’re not allowed to talk about it.

[Howard Chipman]: I don’t have the data because I was a sub investigator, but my understanding is that the amylase and the CEA showed significant improvements and there were several other biomarkers that showed that as well.

[Damien Blenkinsopp]: So reduction in amylase. Is that amylase did you say?

[Howard Chipman]: Amyloids, sorry. Amyloid.

(01:09:07) [Damien Blenkinsopp]: Amyloid plaques in the brain. How do they measure the amyloid?

[Howard Chipman]: They weren’t measuring the plaques. They were measuring blood levels. They send off a huge panel of 100 different tests.

[Damien Blenkinsopp]: Ok. Those were the only things you know that came back with a difference?

[Howard Chipman]: Correct. Correct.

[Damien Blenkinsopp]: Because you might have expected more basic things like CRP. A lot of people get elevated as age goes on.

[Howard Chipman]: It’s possible. Like I said, I haven’t seen the data yet.

[Damien Blenkinsopp]: Do you know when it’s going to be published?

[Howard Chipman: No, I don’t.

[Damien Blenkinsopp]: Ok.

[Howard Chipman]: I keep asking, but I haven’t gotten a straight answer yet. Hopefully soon.

[Damien Blenkinsopp]: Ok. We’ll look forward to that.

[Howard Chipman]: But the patients that we treated in the study and the patients I have treated subsequently have all reported subjective significant improvements in their wellbeing and health.

(01:09:50) [Damien Blenkinsopp]: Ok. Great. So now you’re providing this as a service to other people?

[Howard Chipman]: Yes.

[Damien Blenkinsopp]: By the way, are you tracking any biomarkers yourself?

[Howard Chipman]: No.

[Damien Blenkinsopp]: Have you noticed anything personally?

[Howard Chipman]: I’m not checking any real biomarkers. I do routine labs upon myself and my glucose and cholesterol and all those things improved, but it might have been due to, I started going to the gym too. I figured if I’m doing this young plasma, I might as well make the best of it and do it as a regimen of improving your lifestyle.

[Damien Blenkinsopp]: So you see improvements. That often happens with me. I do two or three things at the same time.

[Howard Chipman]: It could be from something else.

[Damien Blenkinsopp]: I don’t know, in like, ten years. So I’m going to do several and then I’m like I don’t know which one did it, but it’s something.

[Howard Chipman]: The main thing I look at is, “Does it work?” The efficacy, and I think we’re eventually going to find the cure for aging, but that’s going to be a while off. So what we need to do now is to stay alive as long as we can with the best tools that we have now. That’s what my goal is, to try and find things that we have available now that we can use to keep ourselves.

[Damien Blenkinsopp]: Extend health span.

[Howard Chipman]: Yeah extend our lifespan until maybe something better comes along.

[Damien Blenkinsopp]: Cool. You’re doing this now as a service.

[Howard Chipman]: Yes.

(1:11:02) [Damien Blenkinsopp]: How many people have you had in your clinic?

[Howard Chipman]: We’ve treated over a hundred people with this so far.

[Damien Blenkinsopp]: Are they one-time users or are they frequent? What’s the way people have been using this?

[Howard Chipman]: About half of them were in the study and they came just for one-time; some of them. But many of them have since come back. I’d say probably 80% of the people that do one treatment continue to do them because they feel improvements.

[Damien Blenkinsopp]: Are they doing the similar protocol to you? The three months?

[Howard Chipman]: Some are, some aren’t. Some can afford it.

(01:11:34) [Damien Blenkinsopp]: Let’s talk about the cost. How much is one dose?

[Howard Chipman]: The treatments are eight thousand dollars and that’s for seven units. That includes everything. If people want less units, we have a prorated scale. We have a couple patients that come every month and get five units for example. We have a patient with dementia and we’re trying to see if it can help with that. Because there are some animal models and studies that show that it might be beneficial so we’re trying to help this woman. She comes every month and we give her five units, for example.

(01:12:05) [Damien Blenkinsopp]: Ok. All right. Cool. Do you have any idea of the mechanisms? It sounds like it’s probably way off for me to understand what might be going on.

[Howard Chipman]: There are many, many things going on and we’ll never know the details exactly. Basically what we’re trying to do is reproduce the young physiology that you had when you were younger by replacing all those healing and growth factors that are present in young blood and just basically replenishing the people who are older.

There are many different mechanisms going on. The body is very complex; the process. I think over time, we’ll be able to better understand these mechanisms, but I’m not a basic research guy. I don’t have a billion-dollar lab to figure all this stuff out. So what I’m trying to do is help people today and help myself with what we have right now until we figure it out.

(01:12:53) [Damien Blenkinsopp]: Great. So one of my first questions when I met you was how are you getting this blood? Is it legal? I’m sure that might be a question some people have in their heads. So what is the answer to that?

[Howard Chipman]: Of course. It comes from a certified blood bank so yes it’s completely legal. We’ve been using plasma treatments for over 50 years in hospitals. Every hospital in every country gives plasma every day pretty much. It’s usually given as a preventative or to treat bleeding disorders. It’s an FDA-approved treatment.

[Damien Blenkinsopp]: You’re just using it off-label.

[Howard Chipman]: We’re just using it off-label for something else.

[Damien Blenkinsopp]: So it’s quite straightforward really.

[Howard Chipman]: Absolutely straightforward; no problems at all.

[Damien Blenkinsopp]: You’re just saying basically you have to be a practicing doctor.

[Howard Chipman]: Yeah, you have to be a physician because it has to be ordered and administered by a physician. There you go.

(01:13:40) [Damien Blenkinsopp]: Ok, great. So that’s Young Plasma. The other thing I would just like to know a bit more broadly what you’re up to in terms of your activities. You said you’re going to the gym and you’re tracking markers. What are you doing in terms of your own health and life extension?

[Howard Chipman]: I’m using young plasma. I’m also taking Metformin as well. It’s a Diabetes drug. There seems to be pretty good evidence now showing that it’s helpful. They did a study where they took people who are diabetics and put them on Metformin and measured their insulin, heart attacks and strokes and they actually had lower incidence than non-diabetic people who were not on the medications. I think Metformin’s a no-brainer so it’s probably a good idea to take it.

[Damien Blenkinsopp]: Did you ever raised glucose or anything like that or you’re just taking it for the longevity?

[Howard Chipman]: My hemoglobin A1C was measured at the time was borderline. It wasn’t diabetic.

[Damien Blenkinsopp]: Was it six?

[Howard Chipman]: It was 5.7. I used to joke and tell people I was one doughnut away from being borderline, but it’s all back to normal now.

[Damien Blenkinsopp]: Where’s it at?

[Howard Chipman]: I don’t remember what it was last, but it dropped. It dropped. It was almost in the abnormal range and now it’s well in the normal range.

[Damien Blenkinsopp]: So do you think that might be the Metformin?

[Howard Chipman]: I tested it before I started the Metformin so I just started. I haven’t checked my blood. I just started on the Metformin recently.

[Damien Blenkinsopp]: It’s probably the young plasma and your exercise.

[Howard Chipman]: Yes. Yes, but the Metformin will bring it even lower. Sorry, what were you asking about?

[Damien Blenkinsopp]: I don’t know. It skipped my mind there. This is the problem with live. I got into what you were talking about.

[Howard Chipman]: You asked me what I do for other treatments. So firstly, I take Metformin, I do the young plasma, take an aspirin a day; that’s a no-brainer.

[Damien Blenkinsopp]: Ok aspirin.

[Howard Chipman]: I also take cholesterol medication. I take a statin.

(01:15:31) [Damien Blenkinsopp]: Are you concerned about the potential negatives of some of those?

[Howard Chipman]: I don’t see statins as a problem. It’s overblown. A lot of my patients are 400 pounds, their cholesterol are through the roof, “Oh they can’t take a statin.” I do not see many problems with statins. Rarely, people get some muscle pain and you have to stop it.

[Damien Blenkinsopp]: Like fibromyalgia.

[Howard Chipman]: In some people, it will raise their liver enzymes slightly.

[Damien Blenkinsopp]: The things I have seen are its potential interactions with mitochondria. I was thinking that might be the connection with the muscle pain and fibromyalgia.

[Howard Chipman]: It’s possible.

[Damien Blenkinsopp]: The connection there.

[Howard Chipman]: But I don’t see too many side effects from it. Most people don’t have any problems at all. So I take that because my cholesterol was a little bit high. There are studies suggesting that even normal people take statins significantly to reduce their risk of heart attacks and strokes. My father had coronary artery disease.

[Damien Blenkinsopp]: You’re focused on that one.

[Howard Chipman]: Yeah. My dad didn’t believe in eating vegetables. He lived to be 90.

[Damien Blenkinsopp]: He would’ve gotten along with, have you heard of th carnivores? The zero-carb? There’s a whole tribe of them on the internet now.

[Howard Chipman]: Really?

[Damien Blenkinsopp]: They just eat pure meat. That’s a thing, yeah. Great. So you’re exercising, you’re taking Metformin, baby aspirin; you’re doing quite a range of things.

[Howard Chipman]: And the statin.

[Damien Blenkinsopp]: And the statin, yeah. That’s quite a bit.

[Howard Chipman]: The other thing I’m looking into is Rapamycin as well. I’ve seen some potentially good studies and evidence on that. It is an immunosuppressant, but some studies show if you take it once a week, you don’t get the immunosuppression, but you still get the anti-aging effects. I have a couple of my young plasma patients that have dementia. I have them on Rapamycin.

[Damien Blenkinsopp]: Is it quite expensive?

[Howard Chipman]: It’s not cheap and it’s not very expensive either. You’re only taking it once a week.

[Damien Blenkinsopp]: How much does it cost on a monthly basis, for example?

[Howard Chipman]: Can I just throw a number out like 50 bucks, 100 bucks. It’s not cheap.

[Damien Blenkinsopp]: That’s pretty cheap.

[Howard Chipman]: I thought a four dollar Wal-mart prescription, but it’s not expensive. It’s not expensive. It has been out for a while. That’s something I’m not taking, but may consider taking soon because it looks like it does actually work.

(01:17:43) [Damien Blenkinsopp]: What will lead you to the decision to take that or not?

[Howard Chipman]: Maybe I’ll see how my patients do on it.

[Damien Blenkinsopp]: Ok guinea pig; the guinea pig approach.

[Howard Chipman]: Usually, I use myself as the first guinea pig.

[Damien Blenkinsopp]: That’s good to know. It has been great to chat with you about all of this. Is there anything we missed?

[Howard Chipman]: Not that I can think of. I think you asked me to give my contact information. Anybody has any questions, they can contact me at any time. I’m at the Atlantis Clinic in Oldsmar, Florida. That’s next to Tampa. Our website is young-plasma.com and if anybody wants to call me for a consultation, I’ll give you my cellphone number 813-476-2321. If you have any questions about Young Plasma or any other anti-aging, I’m glad to answer for you.

[Damien Blenkinsopp]: Thank you so much for your time. It has been great to have you here.

[Howard Chipman]: Nice talking with you.

(01:18:37) [Damien Blenkinsopp]: Hey! We’re here with our second interview. There’s a little segway here actually. We happen to have one of the guys who’s using

[Brian M. Delaney]: Young Plasma.

[Damien Blenkinsopp]: Young Plasma which I didn’t know.

[Brian M. Delaney]: From Dr. Howard Chipman. I got that six, seven, eight weeks ago and I didn’t know what to expect. I read some of the research results. There are actually many and there’s lot for umbilical cord plasma which is really young plasma, but for less young plasma, there aren’t a lot of results out there, but I wanted results. For theoretical reasons, I expect there to be some benefit because I’m 55 and the plasma comes from someone between the ages of 16 and 25.

I did some before and after biomarkers and saw small changes, but it’s hard to know because I’m always changing my diet and exercise routine so I can’t really say much about that. What was amazing was the subjective effect which sadly didn’t last too long, but for about 36 hours I was Superman. It was amazing.

(01:19:35) [Damien Blenkinsopp]: What did it feel like to be Superman?

[Brian M. Delaney]: I have sleep problems and I’m not as young as I used to be. I think I do have a lot of energy and I’m in pretty good shape, but I walked towards my car from the clinic after having plasma. During it I had, some get hives so I had some Benadryl so I was a little tired from the Benadryl, but that had worn off. I got in my car, turned on the radio and the music sounded more beautiful. It didn’t matter if it was Abba or Beethoven, the whole thing from the bass.

[Damien Blenkinsopp]: Life is more beautiful.

[Brian M. Delaney]: Yeah, it was amazing.

[Damien Blenkinsopp]: There were more colours in the world.

[Brian M. Delaney]: Yeah it was incredible. I’m driving across the Everglades and it’s just wow.

[Damien Blenkinsopp]: It was a bit psychedelic.

[Brian M. Delaney]: It was almost. I happen to be a birdwatcher. You can fool yourself into imagining and experiencing it better than it is. So I’m looking at all these passing raptors and identifying them really quickly as if my vision worked better. I knew obviously my vision is not better. Anyway so for about a day and a half, I really felt physically, I felt, you could even say I had more energy. That’s such a stupid marketing term, but I really did have more energy.

I slept better that night which is unusual for me. Normally I have to take sleep medications which is not good. The next day I woke up and I felt amazing. I did, this is one slightly more objective measure, I do decline pushups and I changed my diet and I tried to see if it would have an effect so I measured the height of my feet on the chair exactly, it’s 47 centimeters, arms are set a certain distance apart and I could do about 15% more that morning.

[Damien Blenkinsopp]: So how many?

[Brian M. Delaney]: Normally, it would be about low forties and it was somewhere around 50 I think.

[Damien Blenkinsopp]: It pushed you to the maximum?

[Brian M. Delaney]: That was just maximum, yeah. Next day, I was exhausted, yeah. Unfortunately, the subjective effects and partially objective.

[Damien Blenkinsopp]: Did they decline as well? That change during the week?.

[Brian M. Delaney]: It did start to go back to normal after about a week. So the 36 hours was just an amazing experience and then it started to fade and within five to seven days, I felt like I was back to normal.

(1:21:42) [Damien Blenkinsopp]: So when did you do that?

[Brian M. Delaney]: I can’t remember exactly. I think it was maybe two months ago. It was seven weeks.

[Damien Blenkinsopp]: You just did it once?

[Brian M. Delaney]: Just once although I’m going to do it again in a couple of weeks.

(01:21:50) [Damien Blenkinsopp]: So do you have a plan? Are you going to stick to it?

[Brian M. Delaney]: Here’s what I’m going to say. Money is an object for me, but if money were no object, I felt so good that I would do this every three or four days. That’s how good I felt, but it’s just too expensive. Dr. Chipman knows that and he would love to bring the cost down. He has a contract with the blood bank which is hard to get that enables him to buy small quantities of plasma.

[Damien Blenkinsopp]: I think he’s going to be limited. He was telling me it’s quite tricky at that place.

[Brian M. Delaney]: Yeah so I would love to do it every few days. That’s how good it felt, but it’s just impractical.

(1:22:37) [Damien Blenkinsopp]: Ok. Now Brian M. Delaney, let’s introduce you. Who are you? What do you do?

[Brian M. Delaney]: I am currently the president for the Society for Age Reversal. It’s a group that Bill Faloon founded.

[Damien Blenkinsopp]: Bill?

[Brian M. Delaney]: Bill Faloon of Life Extension.

[Damien Blenkinsopp]: One of the founders of Life Extension Foundation or supplement maker?

[Brian M. Delaney]: Exactly. He put me in charge of it. Lots of people, fortunately more and more all the time, are working on finding cures for aging or at least treatments to reverse parts of aging. It’s great that lots of money is coming in from increasingly conventional sources.

For example, Jim Mellon, the British millionaire was a very good, but more or less conventional investor. He slowly started turning towards Biology and then now he’s turning towards anti-aging. I’m sure it’s probably because he has charitable donations and he wants to save himself and his immediate family, but also because he has realized it’s a great investment.

So lots of money is going into anti-aging, but typically this is going to result in cures or effective treatments maybe a decade from now. The typical drug development path takes that long; maybe seven years, maybe fifteen years. What we’re trying to do is find what one could describe as the low-hanging fruit of age-reversal treatments. That’s not entirely accurate, it’s just easy to pluck. It’s not always easy to pluck, but you can pluck it soon.

So this involves things that have been investigationally orphaned because there’s no easy way to make a profit from it. For example, Metformin that has been studied for a long time for Diabetes, but now there are people trying to raise money during these trials to try to test it in humans as an anti-aging treatment, but how do you make a profit from a drug like Metformin? It’s not so easy. You can do it as a clinician, but that’s just patient fees so it’s not going to be too profitable.

[Damien Blenkinsopp]: [Check 1:24:39].

[Brian M. Delaney]: Yeah. Rapamycin is another example and of course senolytics. Senolytics are substances that will destroy senescent cells; these zombie cells that spew out injurious cyclin molecules.

[Damien Blenkinsopp]: The idea is we accumulate senescent cells as we age and it’s the signals they’re sending out or the metabolites or whatever they’re sending out which is damaging and accumulates over time.

[Brian M. Delaney]: That’s exactly right. Worse still, these senescent cells can turn other non-senescent cells into the senescent cells. So it almost is like The Walking Dead. So a TV show where zombies can turn non-zombies into zombies by just being near them and getting close and biting them metaphorically speaking. So it’s great tool to use if you can do it safely. Some would say that’s a big if. The category of senolytics spans both the traditional [check 1:25:37].

[Damien Blenkinsopp]: So senolytics are things that kill senescent cells?

[Brian M. Delaney]: Yeah. “Seno-” from the Greek “old” and “lytic” for “lysis” to split apart or break so yeah that’s what senolytics do. There are all kinds of them.

[Damien Blenkinsopp]: Are these compounds or molecules?

[Brian M. Delaney]: Yeah. Even now, there are new strategies using enzymes, but the standard approach that has existed upon not only Big Pharma, but also the stuff that we’re trying to find, involves either something like natural substances like fisetin or old cancer drugs that can be repurposed like Dasatinib.

So that has been tested in rodents several times now specifically a combination of Dasatinib and Quercetin. Synergistic is a word that is often abused, but it describes them correctly. You put them together and the effect is more than the sum of the individual effects of the two. I don’t think there has been a lifespan study done yet or even underway, but what we see in the rodents is regression of atherosclerotic plaques. for example.

[Damien Blenkinsopp]: Regression?

[Brian M. Delaney]: Yeah, actual regression which is astonishing which we normally think they can’t do. Dean Ornish I think has shown that a radically low-fat diet combined with other aspects of his program, meditation and exercise can regress them actually, but aside from that, it’s really hard.

[Damien Blenkinsopp]: How do they measure that?

[Brian M. Delaney]: I think it was just x-rays.

[Damien Blenkinsopp]: [Check 1:27:09]?

[Brian M. Delaney]: With the rodents, I think they actually just looked. They just x-rayed them, I think. I’m not sure. There are actually two studies I believe that showed that.

(1:27:19) [Damien Blenkinsopp]: So when you say you going about looking for these compounds, what does that actually mean? Are you looking for the research? Are you talking to people?

[Brian M. Delaney]: We’re talking about senolytics alone, but this is the same strategy for lots of other drugs.

[Damien Blenkinsopp]: You’re doing several areas. This is just one you’re focusing on at the moment?

[Brian M. Delaney]: I’m focusing on many, but it’s one that I’m particularly interested in. So I think we can actually save people’s lives now with senolytics. I’m convinced. I’m trying to get my mother to try this and she’s a little scared because Dasatinib is a cancer drug and if you Google it, you see the side effects. That’s from people taking it daily for months who are really sick because they have cancer and are taking other drugs.

My approach partly is I just read research. My formal academic training is in the Humanities, but I’ve gotten up to speed as fast as I can on research. I try to make executive decisions about what areas our group needs to focus on and then I contact the real experts which I’m not, and try to form collaborations and try to see if what they’re doing in researching Quercetin alone or in combination with something else is redundant. Then we try to find funding. We might fund it ourselves. Bill Faloon has funded lots of projects; he’s incredibly generous. And or we find other people who want to fund some of this research.

At conferences, the talks are always great, but you go to the poster presentations and you find some mad scientist graduate student at the University of Lund in Sweden. He has got some cool idea and it may be something that hasn’t even been published yet. That’s what I really want to do. I want to find these things that no one knows about.

(1:29:10) [Damien Blenkinsopp]: Yeah. So just for the people out there, posters at conferences are typically studies in progress or maybe just finished by PhD students. Maybe it’s part of their PhD so they’re not going to do a full talk on it, but they’ll have this poster explaining that whole study and what they found or they’re finding. So I actually have PhDs working for me who present this kind of stuff at conferences so it’s a way to fund the edgier, earlier stuff.

[Brian M. Delaney]: Exactly. Yeah. Then there are small startups or we call them pre-startups. Scientists with ideas who are sitting somewhere. There’s a guy Harold Catcher who’s actually an American, but he’s got a collaboration with some people in Mumbai and actually he’s spent about half a year.

At this point, unfortunately, I can’t talk about much of his research, but they have a polyherbal formulation that has got some amazing results. It can look like it does what this calorie-restriction diet does which apparently slows aging even in humans according to biomarkers. That research has been done for a century. They have some other amazing products and they’re forming a company.

[Damien Blenkinsopp]: So it’s like a calorie restriction mimetic?

[Brian M. Delaney]: Yeah, possibly even more. It’s not clear yet. So people like that I try to identify and then maybe that would be a case where if they’re forming a startup and they’re looking for investors as opposed to funding from charitable sources that just want to give away their money to help resources then I might connect them with investors who want to help actually found the company. If the company’s already started then I’ll help it grow.

(01:30:57) [Damien Blenkinsopp]: So your goal is basically to find opportunities and help push them on?

[Brian M. Delaney]: Yes.

[Damien Blenkinsopp]: You help give them what they need to grow and to make more progress faster?

[Brian M. Delaney]: Faster! That’s really the key. If you don’t have that part about the timescale, you’re really focused on the short-term. We had a group that was named previously “The Society for the Rescue of Our Elders.” A long and exotic name, but the concept was it was based on this group, the name itself, this group in Holland that existed two and a half centuries ago where people would fall into the canals and drown. If you did it quickly enough, you could pull them out and save them so it was a society for the rescue of drowned persons.
The idea was there are people like my parents who are about 83 who don’t have a lot of time left. My dad’s in good shape, but my mother is not. Jim Mellon is doing this amazing work, Juvenescence, but a lot of what he’s investing in is not going to come in time for my mother; probably not even my father who is still in good shape. So the idea with this society for the rescue of our elders, I thought of it internally as the society for the rescue of my mother. That is what really motivated me.

[Damien Blenkinsopp]: That gets you up in the morning.

[Brian M. Delaney]: Exactly. So it’s really trying to find treatments that can be made available in a very, very short timeframe. If you saw my mother sitting down, she’s sharp, but if you saw her walk, you’d realize she may not have a lot of time left. It actually does worry me so that’s part of why. I had a fine life teaching Philosophy in Sweden. I gave that up entirely to work with Bill because I really want to.

(1:32:43) [Damien Blenkinsopp]: Wow! I’m just really curious. How did you get involved in this?

[Brian M. Delaney]: Life Extension itself, I was involved in the Calorie Restriction Society and that goes way back.

[Damien Blenkinsopp]: I saw that, yeah.

[Brian M. Delaney]: I was making money doing other things. I was in graduate school as a philosopher.

(01:32:59) [Damien Blenkinsopp]: So you practiced calorie restriction?

[Brian M. Delaney]: For a long time. I’ve gone at least half of it which I’ll explain in a moment. What happened was a long time ago in 1992, I was diagnosed with Crohn’s Disease. It’s an inflammatory bowel disease. It was not clear at first. We thought it might have been food poisoning, but until that point, I really ate horribly. I exercised a lot. I had this notion like a lot of people do that the virtue of exercise can make up for the vice of bad eating no matter how badly you eat and that’s not true of course. It helps to exercise, but you have to eat well as well.

Back then, research online was useless so I went to the medical library when I was in graduate school in Phiolosophy, but I would go to the medical school and read about nutrition. That’s when I found what [check 1:33:45] were and calorie restriction. I called them up and said, “This looks miraculous! Why aren’t human beings trying this?” They said well I’ve written two books trying to get people to do it. A few people are, but let’s start a non-profit. That was my beginnings of my interest at Life Extension.

But back then, because I was so focused on things one can do now, then as now, and then it was only CLR. Vitamins couldn’t help with certain disease states, with aging cells so CLR was the only thing I wanted to do. So I did that, but meanwhile I’m in graduate school. That was my main way to make money; not much.

Then I accidentally moved to Sweden 18 years ago and continued making money teaching all the while trying to keep the CR Society going. But what happened about seven, eight, nine years ago was there really were better options or options other than CR (Calorie Restriction) that seemed promising; that seemed either available or soon to be available.

So that posed two challenges for me. One, do I even want to keep the CR Society going given it’s clear [unclear 1:34:53]?

[Damien Blenkinsopp]: It has less potential.

[Brian M. Delaney]: Exactly. But then secondly, do I want to shift gears and put more of my own energy into something else? So I oscillated for quite a while and then just by chance, I was in Florida a year ago only visiting my parents and helping them move actually and called up Bill Faloon thinking that I might maybe write an article for a magazine about CLR. I think what I wanted to pitch was, “Is it still worth it?” He said, “Where are you?” I said I’m in Florida. “Hey I’m in Florida, let’s have dinner.” We had dinner and we talked. We had another dinner and we talked.

He had already started this Society for the Rescue of Our Elders. He said if you want to become Project Manager, leave your life in Sweden and just really commit to this, I’ll bring you on retainer and we’ll be off and running and I said yes.

[Damien Blenkinsopp]: Excellent! I bet you were like man, this will be fun.

[Brian M. Delaney]: It was generous of Bill and great for me. Not that I minded teaching Philosophy to hungover Vikings.

[Damien Blenkinsopp]: So remind me. Is this now two years? How long?

[Brian M. Delaney]: One year.

[Damien Blenkinsopp]: One year.

[Brian M. Delaney]: A little bit more.

[Damien Blenkinsopp]: Where are you at with this? Are you basically working some leads or have you actually completed some funding?

[Brian M. Delaney]: Where we are now is what’s going to be announced here at RAADfest by Bill Faloon in a few hours and then in a little more detail in his second presentation on Sunday which is that we now have a pretty good idea of some concrete steps people can take today to slow aging.

[Damien Blenkinsopp]: This is under senolytics?

[Brian M. Delaney]: It involves a number of steps. I feel like I don’t want to go into it in too much detail because Bill wants to.

[Damien Blenkinsopp]: Yeah, open it to the world.

[Brian M. Delaney]: Yeah, be the one to present it. We have a little publication that you can grab where it’s laid out. None of this has been verified and done in phase three or even phase two trials. This is just stuff that we have either put together using other people’s research that others have funded or research that we have helped fund through this group called Better Humans. This guy, James Clement started a non-profit, Better Humans where he runs these open-label, non-randomized simple controlled trials. They call them phase zero trials; exploratory trials. So some of the data from his work.

[Damien Blenkinsopp]: So it’s on humans, but it’s non-randomized. So you basically just give ten people something and see what happens?

[Brian M. Delaney]: Yeah.

[Damien Blenkinsopp]: You take a baseline?

[Brian M. Delaney]: Exactly. In some cases, one can say well that doesn’t really say that much, but in this case he designs them very well. Give me a moment, I have to remember what I’m allowed to say. You know what? Wait until Bill gives his talk. I don’t want to screw this up. James doesn’t really care, but it’s all pre-publication and he has a whole bunch of papers that are about to be accepted I assume for publication. I am allowed to say that the results from most if not everything he has done look positive in two ways. They’re safe and at least a bit efficacious.

(1:38:07) [Damien Blenkinsopp]: So what could this mean? Would it mean there’s a supplement someone can take with these compounds?

[Brian M. Delaney]: It will mean yes supplement or drug in a particular order. Actually I should just back up. This has nothing to do with Better Humans.

[Damien Blenkinsopp]: This is a senolytics area?

[Brian M. Delaney]: That is part of it, but something that is important here to back up and note. It has nothing to do with Better Humans or any research that we’ve done recently, but it’s almost common sense. I’m going to to express broadly that the most fundamental first step that people should do is to get the body in basic shape using things like Vitamin D supplementation if your Vitamin D is too low or get out in the sun, exercise if you’re overweight, eat better. These things are actually more effective than a lot of people realize.

I’m still President of the CR Society and I still want to wear that hat occasionally and tell people even if they don’t want to do extreme CR like I did for years, that can help a lot. Then take these steps that involve some of these off-path drugs.

(1:39:16) [Damien Blenkinsopp]: So build your foundation first with the basics that we know. All right let’s talk about the structure though because that’s interesting and maybe it relates to what you do. I don’t know.

[Brian M. Delaney]: For my own personal health?

[Damien Blenkinsopp]: Have you implemented all of this stuff already?

[Brian M. Delaney]: Absolutely!

[Damien Blenkinsopp]: So let’s just talk about you as a case study. So what do you do?

[Brian M. Delaney]: What I did for a long time was calorie restriction as you know.

[Damien Blenkinsopp]: How many calories we’re talking per day?

[Brian M. Delaney]: I’ve got weird inefficient metabolism. This is going to sound like a lot, but I exercised a lot. At my most extreme, where I really looked like I shouldn’t have survived; it was really extreme.

[Damien Blenkinsopp]: Very thin.

[Brian M. Delaney]: Very thin. I looked in the mirror and I thought that’s not me even though I felt great. At that point, I exercised a lot. I was eating 1,900 calories per day and that doesn’t sound so little.

[Damien Blenkinsopp]: What is it? Like 10% now?

[Brian M. Delaney]: No, it was more like 35% to 40% below what I’m eating now. I’m still trim, but not like [unclear 1:40:18].

[Damien Blenkinsopp]: You’ve got quite a high metabolic rate.

[Brian M. Delaney]: Yeah which is actually bad because that tends to be one of the things correlated with rapid aging. It’s just burning through like stepping on a gas pedal and the engine is not quite in tune so that’s unfortunate. Anyway I did that for a long time and looked at my biomarkers which improved dramatically.

[Damien Blenkinsopp]: What kinds?

[Brian M. Delaney]: Just like HDL through the roof, LDL really bottom down. When I did the measuring particle count and size, the few LDL particles I had weren’t noticed.

[Damien Blenkinsopp]: Great. So that’s what you want basically. You probably don’t remember the numbers.

[Brian M. Delaney]: No.

(1:40:57) [Damien Blenkinsopp]: It would be well below 800 for the small particles. But based on what you’re saying well below 800 so really good. We’re talking about the nuclear magnetic resonance lipoprofile which is a test which looks at the particle size of your LDL and your HDL to really understand that versus just looking at LDL cholesterol total which is normally what people look at. The idea is that it’s a lot more accurate because if you’re looking at total LDL, you could have some really big particles which we don’t really care about because they’re not very atherosclerotic.

[Brian M. Delaney]: We think.

[Damien Blenkinsopp]: We think. It’s a better assumption than LDL is bad for you.

[Brian M. Delaney]: Absolutely.

[Damien Blenkinsopp]: It’s progressing slowly is what we’ll say. But if you combine that with a bunch of biomarkers then it starts to paint a realistic picture. So your homocysteine, your CRP, did you look at those?

[Brian M. Delaney]: Yeah. CRP was just perfect; it couldn’t be better. I do have genetically high homocysteine so I didn’t get below seven. Seven is very good.

[Damien Blenkinsopp]: Seven is actually good.

[Brian M. Delaney]: It’s good, but I a lot of people have below five. I have familial high blood pressure so mine never got without having orthostatic hypertension which is fainting when they stand up. They would have 85/57 and feel great. Mine was more like 102/60 which is great, but it’s not the typical extreme CR value. My fasting glucose was, my doctor would say, “Do you feel weak?”

[Damien Blenkinsopp]: How much was it?

[Brian M. Delaney]: It was like 60; usually sometimes even high fifties.

[Damien Blenkinsopp]: Yeah, that’s pretty low.

[Brian M. Delaney]: So it was great. I felt great. Unfortunately what happened was about three years ago, two and a half years ago I had hernia surgery and they screwed up so then it was three surgeries. I had to eat more to recover. You have to eat more. I don’t know if it had to do with mTOR signaling, but I had to get out of the famine stage which doesn’t make growth easy. But I have to confess when I started eating more, I felt good in a way that made me think wow.

[Damien Blenkinsopp]: Alive! Just some empty calories after all.

[Brian M. Delaney]: Leucine, the protein that makes the mTOR signaling go up and testosterone. Suddenly, I was a man again.

[Damien Blenkinsopp]: Did you test your testosterone? Because I thought it would go down while you’re fasting.

[Brian M. Delaney]: It did.

[Damien Blenkinsopp]: Which is similar to caloric restriction I would think.

[Brian M. Delaney]: It’s two things. People on really extreme CR have low serum total testosterone, but really low free testosterone because the sexual hormone binding is really high.

[Damien Blenkinsopp]: It does?

[Brian M. Delaney]: Yeah. On CR, that took place. We joke that men on CR, we are functional eunuchs. When I started eating more, I realized that there is perhaps more of a sacrifice to being on CR than I realized. Being hungry was not a problem for me. Feeling cold is not a problem; you put on a sweater.

[Damien Blenkinsopp]: You were starting to realize also that CR may not be as impactful compared to all these other things.

[Brian M. Delaney]: That too.

[Damien Blenkinsopp]: So you got double whammy.

[Brian M. Delaney]: Yeah. Exactly. So that got me thinking about alternatives. At that point, I started, well I had to recover from my surgeries. That took a while. So then I started going back to research in my off hours and then that’s when I started to realize how much else is out there. I looked into Rapamycin and some new [check 1:44:21] that appears to be a partial calorie restriction that I’m now on by the way.

[Damien Blenkinsopp]: You’re on Rapamycin?

[Brian M. Delaney]: Yeah.

[Damien Blenkinsopp]: Let’s get your stacks.

[Brian M. Delaney]: So to answer your question, I got off CR, had a bunch of testosterone and had fun with that. Then I realized ok I had to get serious about not dying.

[Damien Blenkinsopp]: How old are you by the way?

[Brian M. Delaney]: Fifty-five.

[Damien Blenkinsopp]: Fifty-five.

[Brian M. Delaney]: I was more knowledgeable about diet than anything else. What I started with was time-restricted eating. I didn’t want to go back on CR the way that I had been. I wanted some of the benefits of a CR-like diet so I was interested in Valter Longo’s work and I tried the Fasting Mimicking Diet for a while.

[Damien Blenkinsopp]: How many cycles did you do?

[Brian M. Delaney]: I did it once already for five or six weeks for about four months. It’s hard to know. You get these immediate benefits after and then they start to fade. It’s not clear. He hasn’t done the experiment which is really important which is to do daily CR with an amount that is the average amount that someone on fasting would have done would end up eating. If you eat 2,500 calories per day normally and then you ate 500 per day for five days of every month. You average that out and what is that per day for the month?

Then you do the study with normal daily CR eating the same total amount averaged over the month. He hasn’t done that.

[Damien Blenkinsopp]: So you want to compare?

[Brian M. Delaney]: Because we don’t know if it’s fasting per se.

[Damien Blenkinsopp]: You’re saying it might just be the calorie reduction because five days you reduce your calories?

[Brian M. Delaney]: We don’t know that. He needs to do the experiment.

[Damien Blenkinsopp]: I’ve done an experiment with fasting [check 1:46:02] last week. Your immune system goes down. It’s going to go down further because there’s more autophagy than with caloric restriction.

[Brian M. Delaney]: We don’t know that.

[Damien Blenkinsopp]: No?

[Brian M. Delaney]: We don’t know that actually. With mild CR, maybe not. But certainly daily CR, at least moderate CR, there is autophagy. There are all kinds of things that happen at slower levels than during a fast or a fasting on your diet.

[Damien Blenkinsopp]: What I do know is just your white blood cell count is halved on day five. Then you test again seven days later after refeeding and you’ll actually be higher than your baseline and that’s what I’ve seen several times now.

[Brian M. Delaney]: In yourself?

(01:46:43) [Damien Blenkinsopp]: Yeah. So I’m using as a proxy for autophagy which isn’t great, but it’s difficult to get autophagy and get a biomarker. So I’m continuing to look into that, but it gets me hopeful. I’ve also seen some effects in my mother who is now doing cycles of these to combat cancer. It looks promising from that. For her type of cancer, you have immunoglobulin M which grows over time. So the maximum reference [check 1:47:10] because basically over the years, it has grown.

What we’re trying to do is knock it down by doing a fasting mimicking diet once a month. We’ve seen it now two times in a row now boom boom. That suggests to me autophagy because that’s the idea behind why I wanted to implement it with her is that she’s getting that autophagy, it’s clearing up some of the senescent, well cancer cells in this case, not just senescent, but evil cancer cells. We’re hopefully replacing with some of the good cells. But I understand it’s hard to get that autophagy that’s actually going on.

[Brian M. Delaney]: I was trying to figure out do I want to keep doing this? I was confident I didn’t want to do daily CR because that was just horrible.

[Damien Blenkinsopp]: It seems like you’re taking some of the fun out of life. Your testosterones are always going to be low.

[Brian M. Delaney]: Although what I argued before I experienced this surge of testosterone after my surgery which doesn’t matter because I was able to have normal relations with women and I was able to fall in love.

[Damien Blenkinsopp]: For the first time in my life.

<b[Brian M. Delaney]: No I mean before.

[Damien Blenkinsopp]: Ok. No. Good.

[Brian M. Delaney]: Finally, at the age of 52, I fell in love and had sex.

[Damien Blenkinsopp]: I realized why.

[Brian M. Delaney]: Exactly. But on the other hand, love does have a component that is obviously physiological and a lot of it is lost. What we told ourselves was that we have a more sublime form of love like what Socrates describes in Plato’s Symposium. The character Socrates; I don’t know if everyone knows that. You start with the body and then Diotima is the character that Socrates himself talks about saying that we become more sublime as we love in a less corporeal way. We had all these notions of how we were in some ways still able to love and it was better. That’s absurd. It has to be sexual and plunge more directly.

Anyway so I knew I didn’t want to do daily CR. I experimented with it fasting mimicking diet before. I may still do that periodically. It’s not something you have to choose one way of doing and stick to it. Then I tried this restricted eating window daily, but that was too difficult because I exercised.

[Damien Blenkinsopp]: Which hours?

[Brian M. Delaney]: This is the problem. This very controversial, but there is some evidence to suggest that we do need to eat our first meal not too late in the day. That’s controversial.

[Damien Blenkinsopp]: Actually I have seen such in Panda’s work. He’s really pushing that we shouldn’t be eating late in the day. I have been using that template since seeing his work.

[Brian M. Delaney]: Now there’s also this, there’s a lot to work on, which genes turn on and off in the normal circadian cycle. A lot of it based on work with rodents which are nocturnal so it’s hard to know if you can flip that to the diurnal pattern for humans, but it seems clear that there are changes in genes. We don’t know in humans what they are, but there are these go, have sex during the day.

[Damien Blenkinsopp]: What you’re saying is we have a genetic clock basically? The circadian clock.

[Brian M. Delaney]: Then at night, you get into this repair mode that could be interfered with if you have a belly full of food. This is why we’re all different and we can’t come up with general rules that everybody follows. My problem, and some other people have this, is that I have horrible sleep problems. They got worse around seven or eight years ago. That’s another reason why I had to go off CR. Somehow the low blood glucose at night was causing an increased cortisol.

[Damien Blenkinsopp]: You get a cortisol spike, yeah.

[Brian M. Delaney]: Maybe that was happening all along and I became more sensitive because I got older or maybe the spike went higher. I don’t know, but something changed. That’s another reason why I just cannot be on CR unless I’m going to take really powerful probably brain-damaging sleep medications which I don’t want to do.

[Damien Blenkinsopp]: It defeats the purpose of the whole thing.

[Brian M. Delaney]: Yeah so I make it 80 and I’m just drooling and I don’t know my name unless I’m [check 1:51:16] before I become drooling. At first, I tried a time window that was late because of my sleep problems and I just was too scared that I’m screwing up this cycle of genetic changes. So then I tried an early window, but then I couldn’t sleep.

I was trying to find some safer sleep medications than the so-called “Z” drugs. They have these non-Z like names such as Ambien which is zolpidem, but there is one with a short half-life called Zaleplon which I think is Sonata. I always forget the easy to remember names. I think it’s Sonata that I would take because I have sleep maintenance insomnia. My head won’t go to sleep and I wake up after four hours and I can’t go back to sleep so I’ll take Zaleplon then, but that’s still not so safe so I gave up on that because I woke up too early.

[Damien Blenkinsopp]: So do you wake up early?

[Brian M. Delaney]: Yeah, I wake up too early and I can’t get back to sleep.

(1:52:06) [Damien Blenkinsopp]: I have problems with that too.

[Brian M. Delaney]: It’s horrible unless I stuff my face before I go to bed.

[Damien Blenkinsopp]: Have you tried CBD oil?

[Brian M. Delaney]: Yeah. I haven’t found really pure CBD oil is my problem.

[Damien Blenkinsopp]: I think that might be part of the problem. I managed to get a whole bottle from this person I knew and it did seem to help, but only if I took it once in a while. If I start taking it every night, it stops working. It doesn’t do the trick.

[Brian M. Delaney]: All right, but that’s a whole other topic; how to manage sleep. What I’m now doing is I’m suffering the different types of damage. I cycle through different things that are useful, but damaging in different ways. So I’ll eat late a couple times a week then I might get reflux which is another problem and I might screw up the genes that are supposed to turn on. That’s only couple times a week.

I’ll take the CBD oil. The reason I asked about the purity is not so much about the strength, but typically there will be a little bit of THC mixed in even though it’s illegal. I need a huge amount of CBD to have an effect, but this means a huge amount of THC. So I do that a couple times a week and wake up half-stoned I think. Maybe it’s the CBD that’s making me feel that way. Then a couple times a week, I’ll get [unclear 1:53:17].

[Damien Blenkinsopp]: It feels like it if I take more. I’m quite sensitive to it. I don’t need a lot.

[Brian M. Delaney]: You’re lucky.

[Damien Blenkinsopp]: I’ll wake up really drowsy in the morning and I need two coffees to wake up. It avoids the purpose.

[Brian M. Delaney]: I’ve tried this Suvorexant from Belsomra which works on this new system discovered; the orexin receptors. It works, but it feels like it has a long half-life.

[Damien Blenkinsopp]: I don’t know if this would be helpful, but one of the things that helped me a lot is I found a Parkinson’s study because I have the same night-waking problem. They did this experiment where basically they gave them a strong light source, 10,000 watts SAD lamps; the Seasonal Affective Disorder lamps, that are medical lamps. You put one of those in front of you and you expose yourself to that for an hour in the morning. I think it was actually half an hour, it wasn’t that long, but I’ll leave mine on for an hour sometimes.

I bought one of these and just put it next to my laptop when I’m working in the morning and you’re just given that stronger relative signal because we don’t get outside. I’m in London and it’s terrible. You actually don’t even know if it’s daytime sometimes when you look out the window.

[Brian M. Delaney]: It’s like that in Stockholm.

[Damien Blenkinsopp]: Whereas here we don’t have that problem at all. That has seemed to help. I do it every morning because it’s right next to my computer.

I knew it was working because at first what I tend to do is have my coffee and then I’ll feel alive and I would switch it on and just check the usual business stuff. Has anything blown up while I was asleep. So I’ll do that and really wanted to have my coffee, but I actually don’t need it. I’m already really awake. So I started to notice that and then on the other end of the spectrum, I was getting more sleepy in the evenings because now you’ve increased the relative distance. You have a strong light in the morning and now when it gets dark in the evening, I was starting to feel drugged and I’d start going to sleep at 9 o’ clock, no problem.

Then the other thing that has really made a difference is getting to bed earlier. If I can get to bed at 9:00, I’ll still wake up at 4:00, but I’ve had seven hours of sleep.

[Brian M. Delaney]: Your body is smarter than mine because if I go to bed early, the whole problem just shifts to the east. I’m in Florida, I’ll I go to bed at 9:00, I will wake up 1:00 and then I’ll try this other method of not taking a power nap so that you can have all your sleep compressed. I will fall asleep at 8:00 and I will wake up at midnight and then suddenly, I’m just back on Stockholm time living in Florida then I’m on Mumbai time. It just keeps going to the east or earlier.

[Damien Blenkinsopp]: Maybe it would be interesting if you do a CTM to see if there’s something going on; something that spikes or drops at a specific time.

[Brian M. Delaney]: That’s a good idea.

[Damien Blenkinsopp]: Then you can be like look I woke up at that time and it’s tanked like you say. Or maybe it’s not. Some people see spikes sometimes. I wonder if that’s an infection or activity during the night.

[Brian M. Delaney]: That’s a good idea.

[Damien Blenkinsopp]: Yeah.

[Brian M. Delaney]: That’s a really good idea.

(1:56:23) [Damien Blenkinsopp]: Anyway sorry. So getting back to your stack.

[Brian M. Delaney]: So I did this time-restricted, various forms of it and I’m going to keep doing that because I really do think that that can have a huge effect on health. I don’t know what my ultimate plan will be. I know I’ll do the periodic multi-day fasting or fasting periodically.

[Damien Blenkinsopp]: So just on the fast mimicking diet, you decided that you’re not sure about the research? Is that why you dropped that or is it just inconvenient?

[Brian M. Delaney]: I haven’t dropped it. To be honest, I haven’t decided yet. There’s going to be a huge conference in early November that Valter Longo is putting on at USC. November 9th and 10th that I’m going to be going to [check 1:57:00]

[Damien Blenkinsopp]: What’s that called?

[Brian M. Delaney]: Something like Fasting, CR, Longevity. It can be Googled. Valter Longo, Fasting, November, USC.

[Damien Blenkinsopp]: There we go.

[Brian M. Delaney]: I’m going to go to that and probably there will be some new results to be announced at the “Poster” sessions perhaps. So I haven’t given up on it. It’s just that I’m not convinced that it’s better than any of the other restricted eating diet. I do think it’s beneficial, but is it better than daily restriction, is it better than time-restricted window per day, is it better than every other day partial fasting? I don’t know. So that’s one thing

That was my thinking too about that up until a year ago. It was really until I met Bill and got this new amazing job. Now I can wake up and read research. That’s what I started doing and then traveling and going to conferences, talking to researches. So at that point, I realized that there were some senolytics worth looking into. How one combines that with a restricted eating is very complicated. Do you want to have two ways of getting these genes to be activated too much? Is that too much? Who knows? But Rapamycin became particularly intriguing to me. I only started it three months ago.

(01:58:15) [Damien Blenkinsopp]: Is that easy to get?

[Brian M. Delaney]: Yeah, it’s pretty easy to get. We have a relation with this group called International Aging Systems (IAS). They have a booth here and I think they’re based in London. So one can get Rapamycin of high quality source made in the EU for a reasonable price. The FDA here in the U.S or the DA, whichever it is, permits I think a three month personal supply. It’s a prescription drug.

[Damien Blenkinsopp]: So as a consumer, you can order it?

[Brian M. Delaney]: Yes and you can do it from any country. It’s just that the border controls might be tougher in some countries, but in the United States, it’s pretty open. Otherwise you can get a prescription. It’s not cheap, but it’s not like exaggerate that’s very expensive. So I’m taking now 7.5 milligrams once a week which is much higher or somewhat higher than what anyone else is taking. Typically, people take between 3.0 and 6.0.

[Damien Blenkinsopp]: Ok. Why are you taking more?

[Brian M. Delaney]: I decided it’s part of my job. I want to push the envelope a little bit. Not because it’s going to be scientific, but mostly when it comes to the side effects so that I can then report to people what I felt during that.

[Damien Blenkinsopp]: Have you noticed something?

[Brian M. Delaney]: Nothing negative.

[Damien Blenkinsopp]: How long have you been taking it?

[Brian M. Delaney]: I started at 4.0 milligrams per week about three months ago. Then I went up to 5.0 then 6.25 because I was scoring the tablets.

[Damien Blenkinsopp]: Are you taking labs or do you have a tracking routine? Or did you just take labs?

[Brian M. Delaney]: I am terribly embarrassed to say I’m sloppy on that front and it’s partly laziness, I have to confess. But mostly it’s that as part of my work, I really have to try a lot of these things and it would be so hard to isolate the relevant intermittent variable when I’m trying so many things all the time. It doesn’t add a lot of value to get labs done and to draw conclusion about any one treatment.

It’s not useless and I have done some labs and I will report on our blog at society for rescuetheelders.org. I’m going to report some results that I think I can attribute to one treatment and not some of the other ones I did a little bit earlier, but it’s complicated scientifically so I really do have to.

If I go to a conference and there’s an exhibit booth with someone I’m offering something, I feel like I have to try it. It is my job. Or if I’m traveling around the world and I meet some mad scientist who has got exosomes and I think they’re safe and he’s just, “Hey, you want some?” I’ll try it. It’s what it seems. That seems like part of what I need to do.

[Damien Blenkinsopp]: For sure, you’re training you. Every now and again, you’re using labs just to see what’s going on?

[Brian M. Delaney]: Yeah.

[Damien Blenkinsopp]: Just in case you sabotage your whole anti-aging plan?

[Brian M. Delaney]: Exactly. That I’m certainly doing. Another shift that I made in my diet aside from energy intake level was the foods that I eat. I want to radically high fat, low carb diet like almost 80% calories from fat; mostly nuts.

[Damien Blenkinsopp]: Macadamia?

[Brian M. Delaney]: No. I used to. I’m convinced that saturated fats of any chain length are probably not so great. Macadamia nuts have more saturated. It’s not like steak or lard. If I’m at a party, I’ll grab quite a few, They’re delicious, but no. I try to stick with walnuts, almonds, pistachios are really good. What else? Pecans; those are not so great, but I love them. A little bit of olive oil which also has a lot of saturated fat compared to some of these other nuts. That shift has led to higher LDL.

Just to speak, I generally track my biomarkers. The one thing I’m worried about that doesn’t look good is I haven’t done my NMR; this wave measure particle size of the LDLs. I haven’t done that in a while. The last time I did it, it looked good, not great, but good. I have to do it again so I’m eating even more nuts now. I wake up, I eat nuts and broccoli or kale. That’s pretty much it.

So now back to Rapamycin. I started increasing the amount I was taking and really I’ve had no side effects. I had cankers; a canker sore once which people get. Only once.

[Damien Blenkinsopp]: So one of the side effects of Rapamycin is immunosuppression so that’s one of the concerns. That’s why you’re not taking it every day because you’re going to get some immunosuppression, but you’re hoping that that’s just a momentary downside and possible canker sores.

[Brian M Delaney]: Yeah, almost everyone reports that. I would not recommend 7.5. That’s quite high. But on the other hand to be honest, if you scale up from the rodent studies that showed the maximum lifespan benefit, the equivalent would be something between 10.0 to 12.0 milligrams for a human once a week. That’s part of why I bumped it up to 7.5. I may even go higher. We’ll have to see.

It has a really long half-life. Usually some people say I think between 62 and 67 hours. So one can do 7.5 and maybe do it every eight days instead of every seven just to give some period for letting it to taper out.

It has probably, as you said, the immune risk, but also there seems to be a risk of glucoregulatory dysfunction. It’s not clear.

(2:04:05) [Damien Blenkinsopp]: In terms of it’s more variable?

[Brian M. Delaney: No. Actually glucose goes up.

[Damien Blenkinsopp]: That’s the general level trend?

[Brian M. Delaney]: Yeah it goes up in some studies, not all. But then there’s this other weird phenomenon where it seems to disappear after a while after a few months. That’s why there’s this problem. We’re pretty sure we have to pulse the dose, but is the pulsing done once a week or once a day? Or take it once a day for a few months, let the side effects taper off which they do, according to some studies and then stop it.

[Damien Blenkinsopp]: Then restart?

[Brian M. Delaney]: Then stop it. We don’t know.

[Damien Blenkinsopp]: So even pulsing once a week, you’d still get that rise? Is that a chronic dose?

[Brian M. Delaney]: We don’t know yet. We don’t know yet. Actually, here I do have some data. This is something that I can say it’s the Rapamycin. It’s a good [check 2:04:54]. Now I’m eating very early in the morning and a smaller amount fairly late in the evening. So my big gap is actually between breakfast. So I take my fasting glucose at 8:00 p.m. and it is typical these days, so not on extreme CR.

It’s in the mid-seventies. On Rapamycin, it has been typically 70 or 71 so it has not gone up, it has gone down. The margin of error is pretty large, but it certainly hasn’t skyrocketed upwards which is what some of the mice research indicated it would.

So I’m not worried about that effect, but I haven’t had my lipids measured recently, but I am going to do that soon. I’ll do a full NMR and see what it looks like. That’s part of my stack. We could go one for hours here.

[Damien Blenkinsopp]: So we have time-restricted eating?

[Brian M. Delaney]: Of various forms, yeah.

[Damien Blenkinsopp]: Of various forms. We have ketogenic diet?

[Brian M. Delaney]: Yeah.

[Damien Blenkinsopp]: We have Rapramycin.

[Brian M. Delaney]: 7.5 milligrams.

[Damien Blenkinsopp]: 7.5 milligrams.

[Brian M. Delaney]: Probably will go higher.

[Damien Blenkinsopp]: What else?

[Brian M. Delaney]: The next would be nicotinamide riboside; oral nicotinamide riboside.

[Damien Blenkinsopp]: Is that Niagen?

[Brian M. Delaney]: That’s one of the brands, yeah. This is to raise NAD levels in the blood and more importantly in the cells.

[Damien Blenkinsopp]: Have you done any testing of that? Because I saw people are doing more tests now. I haven’t seen any results

[Brian M. Delaney]: Of NAD levels?

[Damien Blenkinsopp]: Yeah.

[Brian M. Delaney]: No I haven’t yet. This is a complicated topic. Do blood levels matter so much or is it the levels in the cell?

[Damien Blenkinsopp]: Red blood cells. Yeah, exactly. Well, yeah.

[Brian M. Delaney]: So I’m not really sure, but we do know that nicotinamide riboside will raise blood levels. It will double blood levels. I’m not sure how much we know the extent to which it will raise levels in the cells, but it certainly does raise levels. This is something in the cells which is where it matters.

Because Rapamycin is a partial CR mimetic, it’s probably going to increase my own production of NAD to some degree. So I have this complicated weekly cycle of when I first take the Rapamycin, I’ll only take 250 milligrams of nicotinamide riboside those first two days per day and then I’ll go up to 500 and then towards day six or seven, I’m taking 750. Then when I’m doing a fasting mimicking diet, and by the way I may skip a week of Rapamycin, I may adapt that pattern. So once a week, four to six weeks, do a five day partially near fast and then don’t take Rapamycin because that would be too much; little bit too much going on at one time.

[Damien Blenkinsopp]: You’re doing the fast anyway.

[Brian M Delaney]: Then I wouldn’t take any nicotinamide riboside for a few days. So time-restricted eating, ketogenic diet, high-fat, low-carb, Rapamycin, nicotinamide riboside. Maybe I’ll do the occasional NAD patch or infusion. I don’t know. I’m not really sure about that. But then finally, of the big things exercise of course which you know of exercise.

(02:08:00) [Damien Blenkinsopp]: What kind of exercises do you do?

[Brian M. Delaney]: Strength training. I have so many old baseball injuries, there’s not a lot I can do. I do pushups. I have a chin-up bar. I certainly don’t have time to go to the gym so I’ve got my backpack with different sized rocks I put in it and do overhead pull-ups. I do everything at home so I just can’t think [unclear 2:08:21]. Then I run and walk briskly.

I always exercise after meals to knock down those blood glucose and lipids. People don’t realize postprandial lipids can be a problem too. So always. If I’m at a restaurant with a billionaire that I’m trying to get financing for a project, maybe I won’t exercise and I will take Metformin.

(02:08:46) [Damien Blenkinsopp]: Are you taking Metformin as well?

[Brian M. Delaney]: Only if I cannot exercise after eating and I’ve had more than a tiny amount of carbs.

[Damien Blenkinsopp]: Ok. Interesting.

[Brian M. Delaney]: Five hundred milligrams.

[Damien Blenkinsopp]: Is that based on any study or anything?

[Brian M. Delaney]: Well it’s based on what we know for Metformin and Type 2 diabetics. It will actually knock down those [unclear 2:09:04].

[Damien Blenkinsopp]: Some people are just taking it chronically.

[Brian M. Delaney]: Lots of people.

[Damien Blenkinsopp]: Yeah.

[Brian M. Delaney]: Lots of people.

[Damien Blenkinsopp]: More and more.

[Brian M. Delaney]: Tons of people. I’m actually an outlier here where I’m actually not convinced that for healthy, trim people who eat well and exercise that it really is worth it. I know some clinicians who have tried it. This is actually worth noting. Two clinicians who are anti-aging doctors, really smart people who have tried Metformin in elderly and the elderly say, “I feel like crap” because it lowers their energy levels. That’s part of how it works.

So now the next thing I have to talk about is the senolytics. A lot of people think that we shouldn’t try any of them; that we need more human research. Not that I can’t understand. It’s not strange for a physician to say let’s wait until phase one, phase two, phase three trials are out. That’s why we have not recommended that anyone tries these. I can just say that I personally want to and have tried them. I want to try them and have tried them and would like my mother to try them.

The combination of the Dasatinib and Quercetin, if one is going to try it, the conservative thing would be do it once every few years. You just take the dose, knock out a whole bunch of certain classes of senescent cells. It doesn’t target all. Each different type of senolytic agent has a different target. So this is mostly preemptive sites that it knocks out and a few other types of cells, but mostly senescent cells. Do it once every few years and then they go back.

I’m doing a much more aggressive approach where I’m taking it every four or five months. I should stick to a strict schedule, but I just get too busy. I’m traveling. There can be side effects for this during the 12 to 24 hours after you take it.

[Damien Blenkinsopp]: What’s the name of those?

[Brian M. Delaney]: This is Dasatinib which is cancer drug.

(02:11:10) [Damien Blenkinsopp]: How do you get your hands on that?

[Brian M. Delaney]: Metaphorically speaking, sometimes it’s a researcher pal in some way.

[Damien Blenkinsopp]: Some connections?

[Brian M. Delaney]: Yeah. You can get it various ways, but the proper way to get it which I’m now going to use is me to go to a doctor. I mean researchable. I’m not talking about anything illegal. You become part of the study and there are lots of studies now going on; not lots, but a few. But the standard way that I would recommend would be go to your doctor, your healthcare practitioner, say you want to do this, show the doctor the studies and get a prescription and then pay for it.

The ways to get this through various overseas sources where it’s a little bit less expensive, but still high-quality, usually through India. The amount you take is per round which you can divide in half and then take one week and then the next, but per round would be 5.0 milligrams per kilogram of body weight.

[Damien Blenkinsopp]: Ok.

[Brian M. Delaney]: So that would be 750 milligram tablets. It’s actually hard to get a bottle of 750 milligram tablets. So I usually have to buy too much and then give some to a friend or go halves on it.

Quercetin is a natural substance it is a supplement. You take ten times as much of that so it would be 50 milligrams per kilogram of body weight. So what we now think is that it’s better, and Bill Faloon will be describing this, we meet lots of people. It’s better to divide that in half per what you call round you do once every three years or once every four or five months.

[Damien Blenkinsopp]: So it’s not very frequent.

[Brian M. Delaney]: No, no.

(02:13:04) [Damien Blenkinsopp]: So what about all these vegans eating [check 2:13:05]?

[Brian M. Delaney]: They’re not eating as much.

[Damien Blenkinsopp]: Not as much as they need.

[Brian M. Delaney]: No, not even close to what you get from this protocol. So you take that and you might get muscle cramps. The one serious risk which is theoretical, never heard it happening to anybody, is anaphylactic shock

[Damien Blenkinsopp]: Ok.

[Brian M. Delaney]: The smart thing to do is to go to your healthcare practitioner and talk about it and if it’s ok, he or she will say no don’t do this because it’s crazy.

[Damien Blenkinsopp]: You would think a lot of cells are getting killed off.

[Brian M. Delaney]: So the theoretical risk of the dangerous side effect is anaphylactic shock. The more long-term theoretical potential downside is the off-target effects because the mechanism is such that it could kill some healthy stem cells.

(2:13:59) [Damien Blenkinsopp]: I’ve got a silly question. If we’re killing off all those senescent cells, let’s say they’re doing something, but they’re just not doing it very well and as stem cells are declining, are we able to rectify that? Do we end up with enough cells to do the job?

[Brian M. Delaney]: What the senescent cells are doing, mostly they’re doing really bad stuff, but there are some positive roles with tissue remodeling.

[Damien Blenkinsopp]: They’re trying to do their job.

[Brian M. Delaney]: No, it’s not that they’re trying to do their job and they’re kind of doing it, they’re not doing it at all except possibly the tissue remodeling and sending out these extracellular matrix proteins that some of them are dangerous, but some of them are actually useful. They’re useful in tissue remodeling. So I don’t think that’s the problem.

The theory behind why this helps with osteoarthritis in particular; that’s another thing seen in rodent studies and I think I can say there’s some human data. Yeah, I will say that we have some human data that it really helps in osteoarthritis. The way that it works is it actually frees up existing stem cells to do their job. But in theory, we really don’t know. I see the results in the humans and I see the results in the rodents.

I had a kidney stone a year ago; more than a year ago. It was diagnosed with a CT scan. I discovered I have calcification. Not much, very little, but that really shocked me.

[Damien Blenkinsopp]: So you had the calcium scroll?

[Brian M. Delaney]: No, I just discovered. They saw that in the CT scan. The guy asked me, “Do you smoke?” No. You have some calcification in here, not much. It was a shock. That’s one of the reasons why I was motivated to go on an aggressive Dasatinib and Quercetin treatment protocol because it seems I have some calcification. So theoretically I could be doing some harm.

So reason someone who is really young, I would say, “My God! Don’t be absurd to do this.” Having anyone under 40, certainly it seems foolish.

[Damien Blenkinsopp]: Something to do later.

[Brian M. Delaney]: Yeah, and that’s partly because the potential off-target effects. We really don’t know. We have to do those studies. Bu there’s another reason. It’s not entirely crazy to think that some point soon, we can turn some of these senescent cells back into healthy cells.

[Damien Blenkinsopp]: Turn them back; fix them.

[Brian M. Delaney]: Yeah. Exactly. People are now talking about senotherapy is this new term. Basically you deal with the senescent cells in various ways, not simply with senolytics which destroys them, but there is a new term that I think now rightfully could be applied to Rapamycin, called a senomorphic. It changes the senescent cell. It doesn’t make it perfectly healthy, but there is evidence that Rapamycin will lower the amount of these injurious paraben factors that the senescent cells are letting out. So they’re morphing; they’re changing.

[Damien Blenkinsopp]: They’re less antagonistic.

[Brian M. Delaney]: Yeah, basically. So Rapamycin actually has that effect. Presumably CR does as well.

[Damien Blenkinsopp]: Is that damaging them in some way maybe?

[Brian M. Delaney]: Damaging the senescent cells?

[Damien Blenkinsopp]: Yeah.

[Brian M. Delaney]: Probably not. Probably not. We don’t know, but I would imagine it’s more of an epigenetic change in the senescent cell itself that’s actually changing.

[Damien Blenkinsopp]: [Unclear 2:17:27]

[Brian M. Delaney]: Yeah. Have these injurious [check 2:17:31].

(2:23:00) [Damien Blenkinsopp]: Great.

[Brian M. Delaney]: That’s it.

[Damien Blenkinsopp]: That’s full stacks for you?

[Brian M. Delaney]: For now. We didn’t mention the biologics. We did; we opened with the biologics. The next categories would be the biologics. The newer “Living Medicine” as some people are calling it which doesn’t apply to plasma, but does to cells. If I had the money, I would get, people are now saying MSCs which used to stand for Mesenchymal Stem Cells, but now they’re saying let’s call them Medicinal Signaling Cells.

[Damien Blenkinsopp]: I heard that last night.

[Brian M. Delaney]: Because it’s not clear that they’re stem cells. [Check 2:17:59] mentioned that Mesenchymal Stromal Cells, but anyway MSCs from birth-associated tissue. I have not done that yet, but if I could afford it, that would be my next step.

[Damien Blenkinsopp]: It looks interesting.

[Brian M. Delaney]: And young plasma as young as possible from umbilical cords. Cord blood would be great. What Howard Chipman’s offering is also very good as I mentioned earlier. I felt like Superman for a day and a half; tragically short, but it was great. So that would be the thing that I would really want to put a lot of energy into for my own treatment next if I go forward.

(2:18:32) [Damien Blenkinsopp]: Great. Wow. So are you doing any consistent tracking? Is there a lab panel you do once a year or once every six months?

[Brian M. Delaney]: What I’m going to start doing is…

[Damien Blenkinsopp]: Or am I encouraging you?

[Brian M. Delaney]: You are and lots and lots of people think I’m being an idiot or lazy or both by not getting more blood work done. I track simple things like pulse and blood pressure and body temperature at home. Body weight obviously; I’m doing that for years. Bill Faloon and I and our team came up with this age management profile that you get at lifeextension.com. I think there’s a discount. Let me see. I will make this available.

[Damien Blenkinsopp]: It’s a set of panels?

[Brian M. Delaney]: A huge set of things. I am going to do that every six months and it has got a whole bunch of relevant markers. It has got a lot of inflammatory markers. The other thing I’m doing is DNA methylation testing; Zymo Research Program.

(2:19:43) [Damien Blenkinsopp]: DNA methylation?

[Brian M. Delaney]: Yeah.

[Damien Blenkinsopp]: So epigenetics.

[Brian M. Delaney]: That may be new to some of our viewers.

[Damien Blenkinsopp]: That’s really new. I’ve been talking to a couple companies doing that. There’s one in the U.K. It looked interesting, but I was like it’s the early stage. I got into the whole microbiome area. I’ve done so many tests from all the companies, nothing actual. The test results were varying between companies. I was like you know what this is too early stage so I don’t know if this is actually usable at all.

So now I take my time, talk to a lot of people, try to get into it. It’s easier if I take two labs and I put them together, am I going to get some similar results or what am I going to get here?

[Brian M. Delaney]: With epigenetic testing, you will get varying results sometimes.

[Damien Blenkinsopp]: They’re changing off.

[Brian M. Delaney]: Exactly. Steven Horvath at UCLA is the one who came up with this idea, I think. He’s the one that came up with it. He selected, they’re called CpG sites. They’re a particular area between a C and a G in a DNA chainwork. You’ve got potentially a methylation, you’ve got a group covering over the DNA so that it can’t be expressed. I think he based on actuarial data and or data from the [unclear 2:21:08] study, but they had tons of data and it is very accurate way of predicting someone’s chronological age.

[Damien Blenkinsopp]: Chronological or biological?

[Brian M. Delaney]: Chronological.

[Damien Blenkinsopp]: So no matter what you’ve done during your life.

[Brian M. Delaney]: Oddly enough.

[Damien Blenkinsopp]: It will still say you’re 50.

[Brian M. Delaney]: Well no, it will vary a little bit, but the goal is chronological age. Now, he has now come up with something called a phenoage. It’s the new selection of CpG sites. That’s going to measure biological age. That would be more useful. Zymo, this company that had a license with Horvath, they have a blood test, a urine test and I think a saliva test. For each one, I think it’s a slightly different selection of CpG sites.

[Damien Blenkinsopp]: So you have to do all of them?

[Brian M. Delaney]: One could do all of them. I am doing all of them. I am doing all of them.

[Damien Blenkinsopp]: That would give you a more complete picture? You plug this into an algorithm?

[Brian M. Delaney]: No, they don’t do that. Well they could, maybe they will, but this is off the books thing that we’re doing. They’re helping me and I’m helping them, I hope by giving them more data.

[Damien Blenkinsopp]: Are they early stage in this business?

[Brian M. Delaney]: I would say it would be somewhat early stage.

[Damien Blenkinsopp]: But it’s based on Horvath’s work?

[Brian M. Delaney]: It’s based on Horvath’s work and their own. They’re now doing their own research. So I think they’re going to eventually move towards their own selection of CpG sites that they think will be the most useful. They may have several different tests. One that may be useful for measuring chronological age license to insurance companies. One that would be a measure of phenotypical age; your actual biological age of people like you and me and a lot of people watching this.

That I’m doing. I believe in the idea. I agree with you that it’s somewhat early, but only somewhat. I had my last results when I was 54. Came out as 50 which is ok as a guy who started CR too late, kind of went off CR for a while because I enjoyed the testosterone. Ok that seems like four years. I’ve done strict CR earlier even though it’s supposed to be chronological and not biological, it does change with increased production and aging. So maybe it would’ve been 47 instead of 50. I don’t know. Yeah, but it was nice that it was younger than.

[Damien Blenkinsopp]: Validation that it wasn’t all a waste of time.

[Brian M. Delaney]: Exactly.

[Damien Blenkinsopp]: That’s what we’re trying to get out it. Some really good biomarkers to tell us that the stuff’s working.

[Brian M. Delaney]: Yeah.

[Damien Blenkinsopp]: Man, this has been a great chat.

[Brian M. Delaney]: Yeah it really has been. Thank you.

[Damien Blenkinsopp]: Thank you very much. We’ve covered so much stuff and it has been great to hear your personal experience and what you’re up to. Your personal journey really, you’re constantly modifying stuff and looking into new stuff. So where can people get in touch with you or reach out to you or learn more about what you do?

[Brian M. Delaney]: We have a new website with a tragically long URL, but it’s not too hard to remember. It’s scoietyforagereversal.org and there’s a blog there. If you click on that, I haven’t started it yet. I’m going to start it tonight.

[Damien Blenkinsopp]: So tomorrow there’s going to be an awesome post.

[Brian M. Delaney]: Yeah, I hope. I hope.

[Damien Blenkinsopp]: Depending on how long it goes on this evening.

[Brian M. Delaney]: Exactly. Excatly. It may be somewhat a little bit drunken depending on the party tonight. Actually alcohol is not something one should partake in too much if one wants to live a long life. That’s where I’m going to be updating people on what I’ve discovered and side effects of my own experimentation [check 2:24:31]

[Damien Blenkinsopp]: Great.

[Brain M. Delaney]:Thanks a lot.

[Damien Blenkinsopp]: Thank you so much for your time.

[Brian M. Delaney]: You bet. Thank you.

(2:24:44)[Damien Blenkinsopp]: Third time lucky. Hey guys! We’ve been messing around with the equipment here, but we’re now ready to chat. So right now, we’re at RAADfest. This is [check 2:24:53]. We’ve got today and tomorrow left and we’re going to be doing some more interviews. Right now we have Quantified Bob. You know Quantifed Bob if you’re a superfan of Quantified Body because he was in episode 22 talking about intermittent fasting and blood glucose dysregulation and his experiments in tracking around that.
So you met Bob and we had a great conversation before. So if you haven’t listened to that, you might want to go and listen to that before you relisten to this or rewatch this because we’ll just cover new ground basically. We’re not going to go over the old stuff. So Bob, how are you doing?

[Bob Troia]: I am doing great. This is the third day of this RAADfest event. So we’ve had so many conversations just over the last three days because to see some of the talks about some of these advancements and some of the therapeutic work that’s being done around stem cells. I think when I was on your podcast, it was three years ago.

[Damien Blenkinsopp]: It was a long time, yeah.

[Bob Troia]: We were talking about it on a very macro high level certain dietary things and interventions, getting into maybe some data around glucose tracking, but now we’re getting down to the cellular level and subcellular level and seeing how rapidly these advancements are happening. It’s really cool. Just in those past few years, I think we’ve gained so much additional knowledge and insights. I looked back on even when we spoke and I was like, “Wow” some of it is actually cool. It’s relevant.

[Damien Blenkinsopp]: It’s still relevant.

[Bob Troia]: We talked about [check 2:26:17] testing, but then there was a whole new wave of science and things that are coming out.

[Damien Blenkinsopp]: Yeah. What have you thought about the event so far? Are you enjoying it? Are there great points? Would you recommend people come here?

[Bob Troia]: Yeah! I haven’t been to this event before. That was my main curiosity about it. I wanted to come last year and I didn’t so I came this year. I didn’t know what to expect. I’m a long time subscriber of the Life Extension. You get the magazine and some of their supplements. It’s a really cool, interesting crowd.

There’s a real sense of community around this. We talked about longevity and even this conference is called Revolution Against Aging and Dying and I’m just like ok. I like to make it a little positive. Instead of saying revolution against, I would make it something for living longer and better and more productive lives.

But the talks have been great. I like conferences where the presentations get into some science, not being a sales pitch. So we’re getting to see some really cool talks. I’m actually learning some more. Often when I go and I see talks, it’s like I’ve read about this, I’ve already read that and read that. Yeah I’m coming away from these talks with notes and mental notes and things I can go follow up on because it really piques my interest.

(02:27:34) [Damien Blenkinsopp]: Yeah. So I’ve also found that the people we met here, I’ve met so many cool people here and talking with people. We hung out with people last night from some of the startups that are being funded in order to bring some of these anti-aging therapies eventually to market. So there are really interesting people here doing interesting stuff so I think that’s one of the great things. This is my first Life Extension conference. What about you?

[Bob Troia]: Yeah, same. The other thing I was going to say was that what we’re seeing is this general idea, in the general space of this whole wellness and longevity, the overlap because I’m running into friends and people. I was like, “What are you doing here?” From whether it’s a quantified self conference or a biohacking conference or a biohacking conference, all these worlds are just overlapping now. It’s really interesting.

[Damien Blenkinsopp]: You’re meeting the same people.

[Bob Troia]: Yeah. Well new people, but also you’re seeing everyone’s interests are cross-pollinating. It’s all becoming around this whole concept of overall self-optimization and figuring out all the different ways to make ourselves as best as we can be.

(02:28:39) [Damien Blenkinsopp]: Excellent. All right, let’s talk about what you’ve been up to since we last spoke. So it has been three years, what’s the most interesting tool or tactic you’ve tested or you’ve used consistently because you actually see it’s making a difference?

[Bob Troia]: Sure. If you want to talk about just insights, I feel I’ve gone from again that macro level of tweaking my diet, trying to heal my gut and those types of tactics. We talked about concepts like intermittent fasting and now you’re seeing proliferation of things like types of fasting protocols and fasting mimicking diets. So if we’ve both done a lot of experimentation around that which was really cool and digging even a little deeper.

Ultimately everything we’re doing boils down to, for me at least, I’m seeing it as mitochondrial efficiency. So I look at tools and tactics and be like how is that helping or injuring that. So whether I’m using modality that reduces oxidative stress in my body or [check 2:29:42] in my diet, it’s all how about I can make it as efficient as possible. So it’s going back to as you peel back every layer of the onion, you’re going, “Ok, what am I really honing in on there?” Yeah so for me, that’s a really big part of it.

Some of the tools, we talked about wearables and getting data off all that and we’ve seen the big ship to that whole landscape.

[Damien Blenkinsopp]: A lot of companies are gone.

[Bob Troia]: They’re gone. Or the ones that were really open about letting you access data and have open access to it, they’re siloing themselves off because they’re trying to monetize it on their own which has been frustrating. But three years ago, everybody was doing 23 and me testing for genetics, but now whole genome sequencing is affordable.

(02:30:24) [Damien Blenkinsopp]: So we’ve seen a few companies talking about this; the whole genome sequencing thing. Liz Parrish’s BioViva, I’m doing that, Health Nucleus is doing it, but there are other companies as well. I told someone yesterday. He was saying there’s a huge movement in China for this whole genome sequencing so it’s available now. It’s actually the whole thing rather than the 23 and me is just a small part of it. So we’re getting to that step where we actually have better data.

[Bob Troia]: Yeah and it’s one of those things where five years ago, that whole genome sequencing was a million dollars and now it’s down to under a thousand dollars and a year from now it will be what you’re paying for 23 tests a few years ago. It’s pretty amazing. I think the fact that other people are doing this, that’s going to help bring this cost down because they’re all competing in a way now.

(02:31:09) [Damien Blenkinsopp]: I guess the other thing I liked about this here is this community. You see these companies, they’re competing against each other. Like stem cell companies, they’re in the same area so they’re competitors, but what you see here is everyone has a common objective which is to defeat aging and to defeat the damage of aging.

They’re working together a lot of the time in networks and in partnerships even though they’re actually competitors. So it’s really nice to see that because they’re so much focused on the objective, they’re like I don’t care who makes it. It’s like Elon Musk. He’s like I just want to let electronic cars be in the world so I’m going to open source the info.

[Bob Troia]: Even seeing the Life Extension Foundation, they fund a lot of research and they’re funding companies that are essentially viewed as competitors, but they’re going to get some innovation over here and we’re going to get some innovation over here and eventually it all will start coming together. Yeah it’s pretty cool to see. I’m also seeing companies are getting funded.

[Damien Blenkinsopp]: Yeah. It’s a lot of funding.

[Bob Troia]: Institutional money, big money and I was like wow.

(02:32:14) [Damien Blenkinsopp]: So we saw the SENS Research Foundation. Yesterday they had Y Combinator, part of Y Combinator had invested in one of their companies targeting aging. Andreeseen Horowitz so these are huge names in the BC incubator world.

[Bob Troia]: Yeah. I think they all see where this stuff is going and they’re putting their bets down now on some of these players. I come at it from I have technology background, I’m an entrepreneur as a UN so it’s interesting to watch how it all plays out because some of these are areas that maybe were more risk-averse to a few years ago. Now they’re seeing our studies and they’re seeing some glimmers of hope there in terms of wow they’re really on to something so there’s money going in there. For me, it’s about ok I want this company to be be successful and funded so they can make these things available to me at an affordable cost.

Yeah that’s pretty exciting, but back to your original questions about what I’ve been up to the last few years, I’ve gone through a lot.

(02:33:12) [Damien Blenkinsopp]: So what are you doing in a typical week now? You get up in the morning, what does a typical week look like now in terms of the tools and tactics and the tracking?

[Bob Troia]: So I look at it from the standpoint of no matter if one person’s data is more optimized than the other, it really comes down to we all have 24 hours in the day and how am I going to make the most of that time. I’ve been fortunate in that I’ve done a lot of this light work in terms of collecting some of my data, looking at data. I’m not doing it all the time.

There are moments where I might do continuous glucose monitoring for a period of two weeks, but I’m not always wearing that sensor because I got my insights for those two weeks. I maximize the time I’m wearing it to get my insights. Maybe six months from now or a year, I’ll use it again. So that’s not a burden on me.

I try to possibly collect as much data as possible. So even if I might not be using it today, but if I want to go back and look at what I was doing six months ago what actually happened back then, the data is there. It would require no effort on my part. I spent a lot of time in the few years back setting up some systems and tools and now it’s very much like a set it and forget it kind of thing where it can be on autopilot to some degree.

What I’m seeing now even on the consumer side is the frustrations where they’re getting access to their data and tools, but the insights they’re getting are not. You might say how your sleep is terrible, but hey your sleep is bad. I know my sleep is bad so what should I do and they’re not really being given that next step above what tactics and tools and what they could be implementing. There could be a whole slew of issues related to why their sleep is poor and really digging into that.

Things like training and recovery. I’ve been really big on exploring some of these devices and tools and modalities that help us. Instead of going to the gym six days a week for three hours a day, literally just 30 minutes here and 30 minutes there and be on with your day and you’re going to get just as much result out of this. It’s not about who can work out the longest and who can push the most weight. There are more efficient ways to do it.

In terms of supplementation and experimenting with different things whether it’s nootropics or just making sure I’m getting proper nutrient balance in my diet, I definitely cycled on and off things. Right now, I’m three months into taking this nicotinamide riboside product that’s basically a precursor to NAD. The body should be able to convert this into that. I’ll be getting some blood drawn shortly to see has it shifted. Has it increased my levels? Compared to what someone my biological age would have.

In terms of is it something I’ll be taking long term? I may not need it. It may be the result is actually your body doesn’t need that additional supplementation. Maybe if you were a different state or condition or older then it would be ok. Maybe ten years from now, you should consider starting to take it. But I’m seeing just other observations with it. It has a slight shift to my circadian rhythm. I was waking up about 30 minutes earlier a day, but not exhausted. It just seems it made me want to wake up earlier. Recovery from workouts and training definitely were a noticeable effect of it. That’s just one experiment.

I’ve been doing a lot of stuff around cognitive testing and understanding how to find tools that can help measure and assess whether you’ve got acute trauma or past trauma in your brain or fatigue, et cetera and then what can you do or take, what helps or hinders that. Because I had actually thought, I assumed from playing sports for years, getting hit in the head repeatedly, I’d have some issues. But it turns out some of the tactics I guess I have been doing over the past few years have kept my brain state at a good level.

When I did the assessments, it was actually I’m not saying disappointed, but everything was really good. There were like you don’t really need to make any changes or just keep doing what you’re doing.

So we’re seeing these cool assessment tools and devices are coming out of these labs and maybe they’re used by professional sports teams or the military and they’re being made accessible to basically anybody. Part of what I’ve done is I have all these different types of training and recovery tools.

About six months ago, myself and another person set up a facility in New York City because I was realizing friends were coming over to use a lot of the things I had. So instead of me just eating the cost of one of these devices, I was letting people get some benefit out of it so I said why not just put it into a space and let people come and share it without having to come to my home.

So it has been fun. It’s almost a little part-gym, part-lab, part-playground and so that for me is really exciting. From a business standpoint, really I just use it more as a place where I’m collecting data and I can do some really cool experiments around training and recovery and figure out how I can use these tools to effect based on biomarkers.

(02:38:12) [Damien Blenkinsopp]: Yeah. Is there anything consistently you collect and do daily or at least weekly, over time?

[Bob Troia]: Yeah. Daily, my routine would be as soon as I wake up in the morning before I even get out of bed, I do a hurry variability check. So about a two-minute check.

[Damien Blenkinsopp]: Are you correlating it with the aura?

[Bob Troia]: Yes, they do correlate. This is the new aura ring. So overnight while you’re sleeping, it’s taking heart rate variability readings throughout the evening and then it gives you an average number.

[Damien Blenkinsopp]: For the night?

[Bob Troia]: Yeah and it will vary.

[Damien Blenkinsopp]: It gives you the peak as well?

[Bob Troia]: Yes. So you might go from really low sympathetic state to a parasympathetic, but it’s just going to average it all out. So you may have had a really poor night’s sleep, but there might have been a part where you had really high HRD, good HRD so it hides the fact that you had a poor. Otherwise when you wake up in the morning, if you had trained really hard the day before or you’re jet lagged, you might see it’s suppressed today. They’re different, but they’re both important. They both give you a different insight into your physiological state.

If you go from that, you’re obviously sleep tracking. You can then start looking at the effects of that and I wear that with other types of data. If I’m home, I kind of understand my environment, my bedroom so air quality, temperature, humidity, light, sound and then things like body composition. The scales are not the super most exact body scales.

You can’t miss 4% body fat in a day, but if you just blur your eyes and stand back and look at the trend over six months, you will see the trend and you can point out where, “Yeah I changed my workout. I was lifting a lot more heavy weights during that month” and you can see the changes there.

Glucose tracking, I’ll do spot checks with a finger stick. You do a fasting reading so before you have any food or drink. Ketones as well, you can do that. Then I’ll play around throughout the week maybe if I actually want to see glycemic response to different foods. I can do spot checks with the finger stick. From the ketone measurement, for a while I was doing testing with the strips. I think if someone is more keto-adapted, actually it might make you look like you’re not in ketosis; you’re not doing it.

[Damien Blenkinsopp]: Blood ketones?

[Bob Troia]: Urine with the strips.

[Damien Blenkinsopp]: [Unclear 2:40:41] urine.

[Bob Troia]: Yeah because your body won’t be excreting it. Your body is keto-adaptive. You know this.

[Damien Blenkinsopp]: Some guys won’t know it.

[Bob Troia]: Yeah. Sure. Well basically with ketones, there are three ways to measure them. You can do blood, breath or these strips if you use urine. There are different proxies to basically the levels of ketones in your body, but blood is the best way to really measure them. I think you probably use the same meter. There’s a meter that you can use for the glucose measurements and the ketone measurements. Breath is an interesting one because it’s using acetone from your breath, but I can’t get it to get consistent readings.

[Damien Blenkinsopp]: I’ve got PhDs looking into this at the moment and it’s really tricky. The devices we have for tracking breath ketones at the moment, very, very tricky to use so we’re re-evaluating whether we should continue or not, but yeah we’ll find out. We keep on digging to try and find out. Because it appears that the meter actually measures other things and that can interfere. Basically you’re getting a combined reading of acetone and something else.

[Bob Troia]: Yes.

[Damien Blenkinsopp]: Depending on what you’ve eaten or your gut bacteria, potentially you get a signal and you think you’re in ketosis.

[Bob Troia]: Even if the force of your breath is not super consistent.

[Damien Blenkinsopp]: It’s really hard to control, yeah. The blood ketones actually go down over time as you get more keto-adaptive. So mine have gone down, not hugely, by about 1.0 millimolar. So I used to be nearly 4.0 sometimes in the afternoon. Now I’m being more 3.0 or even 2.5.

[Bob Troia]: Wow! That’s really good. I’m not going to say my diet is a keto-diet, but through just my normal diet and periods of intermittent fasting, I always wake up in the morning in a state of at least mild nutritional ketosis. So it’s fairly low, mild, but I can shift really easily into a higher state if I just fast for a day without taking exogenous sources of ketones.

So I don’t know if I mentioned that. I had done some experimentation with pure ketone esters. But most people, like athletes, Tour de France cyclists, are using these super big energy boosts.

[Damien Blenkinsopp]: Use the KetoneAid ones?

[Bob Troia]: There’s a product called KetoneAid that was pure beta-hydroxybutyrate. It is the worst-tasting. It is like rocket fuel so you have to chase it with a little bit or mineral water. It’s really crazy.

[Damien Blenkinsopp]: To wash your mouth out.

[Bob Troia]: Yeah. I approached it from all these athletes are doing it and reporting on benefits from athletic performance, I was like I want to see what it does to cognitive performance. So I did an experiment around just a whole battery of cognitive tests where I established, for two weeks, I just got my baselines. I got rid of any learning effects so the scores that couldn’t get any higher, I leveled out. I’m not getting any smarter, better or faster, my reflexes.

I took this product, it was a very small amount, but it was super, super powerful. Within 15 minutes, I used a blood ketone meter. They only go up to 8 milliomolars, the upper limit. I went, it had an error message. We were through it. So basically the dosage, I should have taken maybe half the amount.

[Damien Blenkinsopp]: How ddid you feel?

[Bob Troia]: It’s just a weird experience. Everything is brighter, your mind is lit up. I was nervous for a millisecond because I feel the gears shifting like an engine’s revving up, but then you’re just like whoa this is amazing. Your brain is never getting that sort of just flood. I mean it is pure beta-hydroxybutyrate getting right into your brain. You’re just like wow.

[Damien Blenkinsopp]: So what were the reults on that?

[Bob Troia]: We waited an hour before I did the tests. So I took it, went off the charts in the meter. Then we waited an hour so it got back down into the range of 6.0 to 7.0 millimolars as soon as it was therapeutic kind of zone and redid all the tests. The battery of every single one, I immediately increased in my scores over those baselines. These test everything from working memory to speed and reflex. It’s a battery of things, but all the scores across the board went up as high as 35, 40%. I was just like this is crazy. Then I go, “This can’t be.” Maybe I have adrenaline going.

The ketones didn’t last. The window of time is four hours.

[Damien Blenkinsopp]: For the ester?

[Bob Troia]: Yeah they tail off and you’re back to normal. So the next day, I was like let me go back and do them again with no esters, my scores were my baseline scores. So it was a temporary bump.

[Damien Blenkinsopp]: Ok. That’s interesting because one of my friends in the U.K., he got the DeltaG one which is the one that humans use. He did a weeklong test taking it every day and it was similar. The first day had all the anecdotal I feel different and the other days, it didn’t seem to make as much of an impact. He seemed tolerant.

[Bob Troia]: Oh really?

[Damien Blenkinsopp]: Yeah.

[Bob Troia]: I wasn’t taking any of the esters. I took them once. So it was almost I was going from zero.

[Damien Blenkinsopp]: I mistook you. I thought you were taking it the next day as well.

[Bob Troia]: No. I never took the esters.

[Damien Blenkinsopp]: So it’s not building your brain better. It’s temporary.

[Bob Troia]: It’s a performance enhancer I would call it. It’s very expensive so I think for athletes who they’re going to use it more often for performance, but if I’m going to go on Jeopardy, maybe I’ll pop it before I go on the show because I’ll be a little bit more on top of it.

[Damien Blenkinsopp]: First of all, if I’m going to do some speaking or some sort of cognitive task, I’ll take a ketone. KetoCaNa is my favourite from KetoSports. Those are the original makers. I get these kind of benefits I really think it is [check 2:46:20]. I haven’t done the battery of testing like you, but I should do that because just like anecdotally I’ve heard other people talk about it as well.

[Bob Troia]: You can even compare. There’s other tropics, you can probably stack them against each other and see how your performance compared.

[Damien Blenkinsopp]: It’s the best thing I’ve taken. A lot of the nootropics, I really don’t find they impact me and often they start affecting sleep if I take them so that destroys all values right away.

[Bob Troia]: It’s not a one size fits all. I know I don’t respond to or may respond to and you’re going to be very different.

(02:46:57) [Damien Blenkinsopp]: Yeah. Everyone has got a different brain chemistry so you have to be really careful about that. So we’re going to wind down because we’ve got other stuff coming. Is there anything you haven’t spoken about that’s really cool? Or anything you want to say?

[Bob Troia]: Anything cool? I think from the quantified aspect of things, I do think there are some cool advancements happening and some of what we can measuring today. I was just inside this event and I was getting my face thermal-imaged. It’s interesting to see how technology is always getting married with Chinese medicine. So we’re really going back to these things that have been around and they seem new because you couldn’t quantify them.

So imagine getting a thermal image like Predator. That movie Predator, you look like.

[Damien Blenkinsopp]: Predator?

[Damien Blenkinsopp]: Yeah and you’re lit up so you see hot spots and cold spots. So they did my face and they could tell I had just arrived off the plane and they could see that my throat was all irritated. They saw my nasal passages were [check 2:47:43]. Then they can map the Chinese acupuncture points and actually show you right here you have some poor digestion happening just by looking at the thermal camera. Now you can actually put this to data. These are things that are quick slot. It took literally 15 seconds to do this scan. You stand in front of the thermal imaging camera, it provides the data.

I’m experimenting with other modalities that are coming from Europe or maybe the Soviet Union that they’ve used for athletes for years. It’s cool to experiment on some of these things. Things are getting exciting. It’s all about being able to learn even more about ourselves in the least intrusive ways and getting actual insights on this stuff.

So for me, I’ve definitely gone and tested lots of things, there has been lot of dead ends and things that are cool, but is the benefit worth it? There might be things where it’s a hassle and I’m not getting enough out of it.

[Damien Blenkinsopp]: A lot of it’s you do projects, you add stuff, you retest it for a while and then you eliminate, you start cutting stuff. It’s this constant process of push forward, add some things, remove more things to get to the stuff that actually is worthwhile.

[Bob Troia]: So the analogy I made with biohacking and quantified self not all biohackers would call themselves quantifiers. I’ll try 20 things and I feel amazing and I don’t really care about isolating what worked. Maybe it was only one of those things that really contributed to it, but they’re not really interested in isolating it. They’re just like I’ll just do everything. Whereas the quantification side, well instead of taking 20 things or doing 20 different things, if there are two or three I can do that I get 90% of the benefit from, I’ll do that. Because 90% of the benefit with the least effort. That’s efficiency.

[Damien Blenkinsopp]: Yeah. It’s a more [check 2:49:34].

[Bob Troia]: Yeah absolutely. In structured experiments, you always do like a ABA test .

[Damien Blenkinsopp]: It’s repeat. I really find value in the repetition. You cycle on, you cycle off, you cycle on, you cycle off, you cycle on; you do that those four times and you can have a clear signal.

[Bob Troia]: Absolutely, yeah. We’re all seeing a subject experiment so you don’t have to worry about the scientific rigor.

[Damien Blenkinsopp]: As long as it works for you, who cares? It’s like in n=1 If ultimately that’s what we’re out for. So we’re not doing science for everyone. It may be useful as a case study for someone else, but then go and do some science, but there are more important things that actually just work for us.

[Bob Troia]: Yes. I agree 100%.

(2:50:20) [Damien Blenkinsopp]: Ok so where can people find you? Just a reminder where are you most active? Where would you tell people to go?

[Bob Troia]: Sure. So Quantified Bob, you can go to quantifiedbob.com. Any social media, Instagram, Twitter, Facebook, Quantified Bob. You can email me, Bob@quantifiedbob,com. If you’re ever in New York City or you want to start playing around with some cool tools and training and recovery tools, if you go to Optml O-P-T-M-L optml.co, you can see some of the things that I’m doing up there with the oxygen training and recovery tools and that will be built out over the next month or so.

[Damien Blenkinsopp]: Excellent. Thanks very much for your time and I’m sure I’ll be seeing you at another event soon.

[Bob Troia]: Yeah, it has been great. It has been so great hanging out with you and reconnecting and looking forward to the rest of the event.

[Damien Blenkinsopp]: Yeah, me too.

[Bob Troia]: Thanks.

[Damien Blenkinsopp]: Turning you guys off. See you later.

Hey there! Congratulations on getting to the end of a Quantified Body marathon episode. I don’t know about you, but I had a lot of questions coming out of this conference and on the discussions I had. It was a good introduction to get the lay of the land, but I have a lot of questions particularly before I would consider actually experimenting with any of these tools that were discussed.

So here are some of my first questions. I’m bringing them out there so that if you have any thoughts yourself, you can perhaps add your comments or your questions to the blog and we can have a bit of a discussion around this because I think there is a lot of uncertainty. There is a lot of different things to tackle and topics to explore in this area and it’s really for me, this is like a first episode of many future episodes. This is an important topic to me and I think an important topic to everyone and it’s going to be more and more interesting in the next years.

So here are some of my questions that I have after this episode. The first area is really understanding the risk profile of some of these tools. To make sure that there is no huge downside basically to the use of any of these tools that we are completely unaware of or some blind spots there. In particular, there are a couple of ones that I’m interested in trying to understand that risk profile better.

So that would be senolytics is number one. My questions are: How can we evaluate the risk profile of some of these different senolytics? Who should take them, who should not? At what age should you be? At what age does the upside become more useful than the potential downside? What is the track record in the use of some of these? Do we really understand them? Even the ones like some of the antibiotics or the chemo-based drugs that have been used for a while, potentially we don’t understand all of the long-term effects of these.

On my journey in the Quantified Body, I’ve learnt that we are still learning a lot about the body and we are learning our ability to quantify and get data on aspects of our biology is still very limited. I expect this area to be transformed in the next 50 years with just the amount of data and understanding that we can actually process. So for now, I consider that most of our biology is not being tracked. We don’t have data on it and it’s just a big black hole that we don’t know anything about.

My concern for these things are is there something going on which could present some long-term damage that we’re not aware of. How can we ensure that we are preferentially killing just senescent cells and not doing some other kind of damage? So that’s the topic I’m interested in understanding more before I potentially experiment with this myself.

The second one would be in the area of young plasma. I think this is very, very similar in my concerns. My main concern here is with blood transfusions in general. If you’re not in a critical state so if you haven’t just had a car accident and it’s really life or death, you need a blood transfusion to survive, then what is the risk profile of having a blood transfusion?

I believe that we aren’t able to screen for all of the pathogens in the blood currently. If you look at some of the more advanced labs which are trying to look into this area like Aperiomics which I discussed in the last episode, episode 51 for microbiome, Aperiomics does analysis against its database of pathogens which it’s still building for all types of samples; urine, blood and stool. They’re finding things that they didn’t expect.

So I do believe that the blood samples we have today, they are screened for some of the most important infections we know of such as HIV. But there are potentially many that we are not aware of that could lead to chronic disease later in life or chronic issues in the long-term and we’re just not aware of them.

So I feel like there is a risk profile there to establish on blood. If you’re going to have a transfusion of younger blood, then how do you ascertain that there’s nothing in there that could present some issues in the longer term and thus negate those young healing benefits from young blood? So that’s understanding the risk profile better in particular separating out any larger downsides rather that we may be exposing ourselves to and are unaware of.

The second area is really trying to understand the benefits and the upside of making an effort investing money in these treatments or these tools. So really understanding it area-wise. Is it worth our time?

The two which would fit more into that category now I think are Rapamycin because this is available now. You can get this. What kind of protocol could you put in place? What kind of experiment could you do? What biomarkers could you be testing in order to understand over a year, over two years, does this have any benefit to you? Is it worthwhile from a cost and effort perspective? Or potentially some of the side effect downsides? Also we have to take those into account. So would it be worth it to you?

Then the other one is NAD which has received a lot of press over the last couple of years because there has been nicotinamide riboside (NR) which have been on the market and popularized a lot by the company Elysium Health in the form of its supplement basis which you may have heard of. But how worthwhile is NAD supplementation really? There is a little bit of conflict around this in terms of the scientific discussion around it. How interesting is it? How beneficial is it given the cost of these supplements currently?

So someone who I did meet at the conference and I interviewed for the video live, but isn’t in this audio episode is Maria Entregus. Her grandson has worked with SENS Research Foundation a long time and has also just brought out a test for NAD levels which is a biomarker to help establish if taking nicotinamide riboside is having an impact on your NAD+ levels.

You could get a baseline an you could get some other tests down the line just to see if the value of that has actually changed. The name of that test is Life Bridge Test. By the time this episode is out, that could be out so that could be something worth looking at. Getting a baseline and then tracking that if you’re going to invest in taking NAD and trying to raise your NAD+ levels.

Those are some of the questions I have and some of the bigger questions I’m going to spend a little bit of time looking more into to understand if it’s worth doing any of these in the shorter term. I’ll be going to some other conferences in the near future. One in Berlin in March 2019 is “Undoing Aging” which I’m going to.

There are some others, some events, more events that are taking place so you can expect some more updates on these technologies and potentially some self-experiments if I decide one of them has a reasonable risk profile and I can track some of the upside benefits there.

So I’d love to hear your thoughts on these questions if you have any or if you have ideas, any clear ideas on them or references of course. We like references. Or if you have your own questions about these, please post them in the comments of this episode on the blog. I’d love to hear from you. So you can do that by going to thequantifiedbody.net and then pick out the episode there and comment on it. That’s it for me for this episode. I’ll talk to you again soon in Episode 53.

 

Research Study References

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Recent investigations have shown supplements to not always contain what they say they do. Or at other times to have unwanted contaminants such as heavy metals. Learn to use 3rd party lab testing to select supplements that contain the active ingredients needed to provide the results you seek.

Sometimes on this show, we discuss using supplements as tools to get desired results. Examples in past episodes included curcumin, activated charcoal, NT factor, Greens powder, oxaloacetate and many others.

I’ve been aware for a long time that not all supplement products are equal in quality. For instance, if they actually contain as much of the active ingredients as the label says on them, or if they are contaminated with heavy metals or pesticides, for example.

Last year this issue was given more publicity when the New York State Attorney General’s office investigated supplements found at GNC, Target, Walmart and Walgreens, and sent ‘Cease and Desist’ letters to each for some of their supplements that neither contained the active ingredients, and at times contained other undesirable ingredients that weren’t listed on the labels.

The unfortunate takeaway is if you truly want the results from supplements — so if we talk about results that can be achieved through a supplement on this show – then you can’t just take it for granted and buy any supplement. You have to make sure they contain what you want and don’t contain what you don’t want.

In practice, how do we do that? I’ve been using a lab service for a few years now that tests and reports on the quality of supplement products. So I can select the products that will achieve the results while minimizing the cost. Sometimes you don’t need to buy the most expensive brand to get the best quality, which is kind of cool.

The service was ConsumerLab.com, which is a subscription service, so unfortunately, you have to pay. However, the good news is that an open alternative is now available that has been publishing extensive lab testing data on popular supplement categories.

That company is Labdoor.com. If you have the internet available it will probably be useful to check out the rankings the company is publishing while listening to this episode to see what the end result is, and what they’re actually publishing.

“I think there are categories where 70 percent of products fail, there are categories like creatine where 10 percent or fewer products fail. And then there’s kind of the in-between zones where, with fish oil, about a quarter of the products have rancidity [fat oxidation] issues. And so we’re filtering that, and that’s a part of our [supplements testing] purity score.”
– Neil Thanedar

Today’s guest is Neil Thanedar, CEO and Founder of Labdoor.com, and Founder of Avomeen Analytical Services, which is a company that specializes in product lab analytics to see what they are composed of. Labdoor is now four years in the making and sets to start growing at a faster pace and covering more supplement categories now that they’ve got some sort of funding behind them.

In this interview, Neil walks us through the types of analysis they run on supplements to understand their quality and some of the most interesting and useful results they found in the supplement markets. It features highlights, such as we shouldn’t really be trusting user reviews that you find on the internet on places such as Amazon – because there doesn’t seem to be much of a correlation. And there are other big similar takeaways, which, I’m sure, goes against what we’ve all been doing.

itunes quantified body

What You’ll Learn

  • Neil’s research interests and orientation towards quality control supplement testing (3:57).
  • Labdoor is a spin-off business, diversifying lab testing services compared to what’s offered by Avomeen (5:40).
  • Labdoor and Avomeen are split in leadership between Neil and his father (7:50).
  • A consumer-aligned model and efforts to eliminate bias in producing objective information (8:03).
  • The major quality control issues with dietary supplements (10:04).
  • Defining supplement quality and criteria used for rating supplements (11:13).
  • The technologies used for testing supplements and the science behind interpreting results (12:19).
  • Customizing supplement ranking formulas and tailoring results to individual customers, ex. vegan or child categories (18:54).
  • Establishing accuracy in nutrient analysis and maximizing trust in results (20:25).
  • How Labdoor manages an active role as part of the supplement industry (22:54).
  • Dealing with testing newer or complex composition supplement products, where research is still accumulating (25:05).
  • Consumer demands and targeting of testing results to differing audiences (27:15).
  • Labdoor’s role in supporting an informed market (29:21).
  • Overview of tested categories of supplements (33:10).
  • Discovering products and prioritizing particular supplements testing (39:15).
  • A severe lack of price correlation in the supplement industry (40:58).
  • Cooperating with companies when Labdoor testing does not confirm producer certificate of analysis testing results (42:08).
  • Labdoor’s plans for reaching out to manufacturers more proactively (47:23).
  • The potential of re-testing for capturing trends in the supplement industry and increasing confidence in obtained data (48:30).
  • Case studies and key takeaways for particular categories of supplements (52:19).
  • Little brand correlation in same category products and guidelines for choosing supplements (54:21).
  • Caveats for non-scientific approaches towards choosing supplements (57:20).
  • Future prospects of wide-spread product testing aimed at empowering consumers to make science-based health decisions (1:01:44).
  • Reasons for re-organizing the supplement market, such that the best products are making the highest sales (1:03:59).
  • Scientific or practical business assumptions which Neil has changed his mind about (1:06:06).
  • The biomarkers Neil tracks on a routine basis to monitor and improve his health, longevity, and performance (1:08:21).
  • Recommended self-experiments for improving mental performance (1:14:07).
  • The best ways to discover the field of supplement testing (1:15:55).
  • How you can best connect with Neil or find out more about Labdoor (1:18:54).
  • Neil’s request for you – The Quantified Body audience (1:20:32).

Thank Neil Thanedar on Twitter for this interview.
Click Here to let him know you enjoyed the show!

Neil Thanedar, LabDoor

  • Avomeen: A chemical analysis lab specialized in failure analysis work (when products go wrong). Initially, it was started by Neil but is now run by his father – a scientist continuing his work and research in his retirement years.
  • Labdoor: A company currently run by Neil focused on providing scientifically-backed analysis and ranking of dietary supplement products. The company offers objective information on supplements and aims to empower people to make informed decisions. Check out Labdoor’s supplement rankings.
  • Labdoor’s Facebook & Reddit: The two fastest ways for you to reach out to Labdoor. Hundreds of questions have already been answered on these forums and Neil hopes new ones will spark lively debates on topics across the field.
  • Neil’s Twitter: Where Neil shares his ideas about testing and his opinions on how Labdoor touches other industries.

Recommended Self-Experiment

  • Tracking Time: Keep track of how you spend time for 10 days in a row with an app such as Hours. You should discover many useful takeaways such as areas where you waste the most time or activities you should cut. Neil suggests repeating approximately every 6 months to track improvements and optimize over time.

Tools & Tactics

Supplementation

  • B Complex: It contains Vitamin B12 – a molecule which is used in the metabolism of every cell and acts in DNA synthesis and regulation. B complex also contains folate which is needed for DNA repair and proper DNA methylation – see episode 5 with Ben Lynch. This product contains the active forms of B vitamins increasing their bioavailability.
  • Curcumin BCM95: The active ingredient of turmeric, also found in limited amounts in Ginger. Curcumin is a potent anti-inflammatory and cancer preventative molecule. Previously we have discussed this supplement in the context of lowering oxidative stress or inflammation in episode 4 with Cheryl Burdette and episode 25 with Josh Fessel.
  • Activated Charcoal: This is a medical-grade purified product which is highly absorbent of toxins. It promotes a healthy digestive track and improves brain functionality. Taking activated charcoal reduces the body’s toxic burden – a subject discussed in episode 23 with Kara Fitzgerald. This is a lower cost (value for money) Activated Charcoal option.
  • NT Factor EnergyLipids: A blend derived from soy lecithin extract specifically. This product is formulated and used for supporting memory and cognitive function. There’s also an NT Factor Energy Wafers option which is a chewable product packaged in pieces.
  • Greens Powder: A mix of alkalizing green foods, antioxidant rich fruits, and support herbs. This product is used as a dose of whole food nutrition – essentially aiming to supply a healthy background of nutrients.
  • Oxaloacetate (Aging Formula): A metabolite of the Krebs Cycle which improves blood sugar regulation, improves energy levels, and increase endurance. Previously we discussed oxaloacetate as an anti-aging supplement in episode 30 with Alan Cash and in the context of blood glucose regulation in episode 22 with Bob Troia.
  • Fish Oil: This supplement is useful against inflammation. Fish oil can be used post workout sessions or if inflammation is part of a disease state. Labdoor tests EPA and DHA content (beneficial Omega 3 fatty acids) in fish oil supplements. According to their data, often there are products which contain 50% Omega 3 instead of the labeled 90%.
  • Lypo-Spheric Vitamin C: These are liposome encapsulated vitamin C tablets and this maximizes the bioavailability of the active component. Previously we have discussed Vitamin C and its potential for preventing colds in a timely manner by tracking Heart Rate Variability (HRV) in episode 41 with Marco Altini.
  • Calcium: This supplement is aimed at improving the composition of bones. Calcium also plays a key role in muscle contraction thus this mineral supports neuromuscular health. The major benefit of calcium is lowering the risk of developing osteoporosis.
  • Magnesium : This mineral in supplement form is used to support nerve, heart and muscle functionality. See episode 17 with Dr. Carolyn Dean for testing and fixing magnesium deficiency.
  • Zinc: An essential mineral which plays a role in many enzymatic functions. Zinc supports immune system function and is an important component of the body’s antioxidant systems.
  • Creatine Monohydrate: This product is targeted for using after workouts to aid in the recovery process. Approximately 5-10% of these products are faulty, according to Labdoor supplement testing results data.
  • Garcinia Cambogia: A small fruit traditionally used to enhance the culinary experience of a meal and as an aid to weight loss. Garcinia cambogia was the worst category recorded by Labdoor. Up to 70% of products in this category do not actually contain the active ingredient (defined as less than 10% of the labeled ingredient quantity).
  • Ginseng: This supplement is effective for mood, immunity, and cognition. Examining the ginsenoside content is important in these products because Ginseng quantity is different from the active ingredient. This causes consistency problems because extraction processes differ. Neil advises patience before purchasing these supplements and, of course, waiting for Labdoor’s data on particular products.

Diet & Nutrition

  • Protein Bars: In the future, Labdoor plans to take on testing food beverages. For example, increasingly protein bars are marketed as a meal replacement, thus approaching the supplement (or functional food) category. Eventually, even well-known products such as a McDonald’s Big Mac, a Chipotle burrito, or liquid beverages such as Pepsi could be tested.
  • Baby Formula: Manufactured food products targeted for feeding infants under 12 months of age. Often, these are manufactured using methods similar to those used for the production of supplements.

Tracking

Labs Tests

  • Liquid Chromatography: Chromatography is a diverse set of laboratory techniques for the separation of mixtures. Detecting the concentration of specific substances out of a whole is key for objective supplement testing results. In liquid chromatography, the mixture is turned into a liquid phase which moves through a column or plane (solid phases used for detection). Individual chemicals can be detected based on a constant property, ex. by affinity for the solid phase coating material.
  • Gas Chromatography: This method is used for analyzing compounds that can be vaporized without decomposition. In vaporized form, chemicals travel through a column at different speeds and reach the detection surface at different times – known as retention time. This is a constant for individual types of chemicals and is the principle behind detecting particular types of chemicals in gas chromatography.
  • Mass Spectrometry: Mass Spec or MS as it is known is becoming increasingly popular for analysis of all types of samples from testosterone and other body metabolites or proteins to understanding the composition of any material.In a typical MS procedure, the sample is initially ionized by bombarding it with electrons. These ions are then accelerated by subjecting them to an electric or magnetic field. Individual substances are detected according to their mass-to-charge ratio. Ions of the same mass-to-charge ratio undergo the same amount of deflection on the detection surface. This is transferred into information about concentration.

    Liquid / Gas Chromatography is often used as a pre-analytical method for preparing isolated sets of chemical subgroups, before digging deeper using mass spectrometry to obtain accurate supplement testing results.

Apps

  • Headspace: A meditation, or mindful awareness, training app. It is useful for improving mental performance, to relieve anxiety, and increase endurance.
  • Lucid: An app focused on mental training for professional athletes.
  • Hours: An app used for tracking activities throughout the day, thus mapping time expenditure. This is useful for improving mental performance. Because tracking itself can be time-consuming, Damien suggests undertaking focused projects – one lasting a few weeks before moving to the next.

Other People, Books & Resources

Organizations

  • ConsumerLab: A company offering supplement testing service. Damien used ConsumerLab Reports until Labdoor appeared on the market and started offering supplement testing free of charge.
  • Thorne Research: A company manufacturing dietary supplements, separated in programs tailored towards health categories, ex. cardiovascular or immune support. Their products are usually sold through doctors, thus Labdoor has missed these in their initial supplement testing categories.
  • Life Extension: A manufacturing company producing supplements including vitamins, minerals, herbs, or hormones.
  • Elysium: A relatively new company gaining ground in the supplement industry, partly due to their science-strict operational and marketing model. Elysium is sponsored via venture capitalism investments – a business model different from Labdoor’s.

People

  • Gary Vaynerchuk: Recognized by Neil as an important voice in the understanding the link between marketing and consumer trust.

Other

  • Yelp: Neil draws a parallel between Labdoor and Yelp – a service specialized for ranking business of different categories ex. restaurants or shopping venues. This comparison demonstrates that Labdoor requires customer and manufacturer feedback to grow its business and to accomplish more ambitious challenges.

Full Interview Transcript

Click Here to Read Transcript
[Damien Blenkinsopp]: Neil, thank you so much for joining us.

[Neil Thanedar]: Yeah, absolutely. Thanks for having me.

[Damien Blenkinsopp]: You’re in a pretty niche area. There have been a couple of companies around which have been testing supplement products for a while. And of course there’s been a fair amount of news over the last year or so talking about the high variability in supplement quality, and whether we’re getting what we want.

So I was just interested in how you got into this whole area. Where did this start for you?

[Neil Thanedar]: Yeah, absolutely. I grew up in research, I grew up in science. My dad’s a Ph.D. Chemist. When I was two years old he quit his job as a researcher and started his own lab. And it was just him for a couple of months, and he slowly grew that lab all the way up until I was in college. So he had retired by the time I was in college.

When I was trying to figure out what I wanted to do with my career, the first thing I really wanted to do is, I had really thought about biotechnology or inventing new medicines. And those had been the first things I had thought of. And throughout the process, I found out that the existing process, the existing medicines and supplements just weren’t clean; they weren’t safe. And so I jumped right back into the same industry that my dad did, which is quality control.

And so right out of college I started a lab. It was a chemical analysis lab called Avomeen. We did product development and failure analysis work. We figured out for manufactures when something went very wrong: a pill had a black dot on it, your baseboards were yellowing, there was an odd smell coming from a multivitamin. Any sort of something going wrong, the company would come to us, we would do all of the testing required to figure out what they should go and fix.

(00:05:40) [Damien Blenkinsopp]: You just mentioned baseboards. What are baseboards?

[Neil Thanedar]: Literally the baseboards like in the floor, that connect the floor to the carpet. That little white strip? That’s actually a product that we did once. The white boards were turning yellow as soon as they were installed.

[Damien Blenkinsopp]: So you actually started from analyzing a broader spectrum of products, not just dietary products.

[Neil Thanedar]: Yeah. It was anything from that to household cleaners to a sunscreen to a multivitamin to even pharmaceuticals. Generic versus brand name medication.

And so we were doing it, but we were doing it in a very reactive way and we were doing it for manufacturers. And really one day I just had the idea that really we should do the opposite business.
What if we could, instead of being reactive we could be very proactive. We could go into a Walgreens or CVS and buy every product off the shelf and pretest it. So you would already know if it was good or bad. And if something failed, you would know ahead of time.

At this point, I had — as kind of a back-story — my dad had come in and started working with me to come out of retirement. He was starting to work at Avomeen. And so what I decided was I really felt like LabDoor needed its own focus. And so we kind of split up, and he went and he’s taking care of Avomeen now, and I fully run LabDoor.

So this was, for me it was a new way to work in the business. I kind of just jumped into the industry expecting it to be like it always was, and then just one day being the new person. I was just like, hey this is weird, why don’t we just start by testing everything?

(00:07:15) [Damien Blenkinsopp]: Cool. So how long has Avomeen been around?

[Neil Thanedar]: So that company has been around for about seven years now. And LabDoor has been around for just over four. It’s been all LabDoor for me for the last four years.

[Damien Blenkinsopp]: Okay. Cool. It’s very interesting. So it’s always good to see a family business. Your father’s kind of proud of you for carrying it on, the whole research lab area.

[Neil Thanedar]: Yeah, it’s so interesting. We always talked about it, but it was never something he asked me to do. It was just always interesting to me. And I think the science is so fascinating, when you figure out exactly what’s inside something. You get to break things down and you get to reverse engineer, it’s just fun.

The problem in the industry is really just, how do you get paid. Consumers need to see the data but they’re not going to pay ahead of time. It’s really just paying for this testing that’s the hard part.

(00:08:03) [Damien Blenkinsopp]: Right, yeah. So I guess you’ve got a slight advantage because Avomeen is associated with you, but how does LabDoor get paid so that you can do this for everyone else? Because the information is available for free, right?

[Neil Thanedar]: Yes. And so, what we want to do is do all the testing ahead of time and help you have all the data to make the research decision. And then what we’re finding out is that people, the next thing you’re doing is buying. And so if we just affiliate links down, we’ve got 10 percent of the conversion. And that really is most of the business.

And I think it’s what we, we love that kind of alignment with the consumer. So you’ve got the sense of I don’t get paid unless you actually find something you like. If you return it, we lose the commission. It’s this whole process where we can really be performance based.

And it’s also something where it’s sustainable. Every single day, there’s going to be tens of thousands of people who shop this site. They’re going to buy stuff, and that’s going to support the next round of testing.

[Damien Blenkinsopp]: Right. And I’m guessing it doesn’t matter what they buy. Are you putting Amazon links on most of the stuff?

[Neil Thanedar]: Yeah. So it’s really easy to put it on every single product. And we get some debate about this. The D and F products have affiliate links on them too.

[Damien Blenkinsopp]: The DN…

[Neil Thanedar]: The D and F. So it’s A through F. Every single product has the link.

[Damien Blenkinsopp]: Right. Well, I think that’s the way to go because you’re unbiased.

You’re not there to promote one product versus another. It’s just that you provide your objective information, and if someone buys something from using the information on your site to make that decision, you get a commission. But like you say, you’ve put a few links on the worst products and the best products, so there’s no official bias there.

I bring that up because there are some sites out there on the web which have been out there for quite a long time, and I’m sure people are aware or these – which are basically just affiliate review sites. And they have their number one product where they are getting paid, and all the others they are not getting paid. And obviously, they are just trying to cash in there.

But yours is a professional company without the bias.

(00:10:04) [Damien Blenkinsopp] Okay, so let’s talk about supplement quality to actually understand what the issues are. What is the context for us first? Why should people be interested or worried about dietary supplement quality?

[Neil Thanedar]: I think there are two parts of it.

I think the first part is actually that there are some products that legitimately have problems. They’re either massively under-dosing — and that’s maybe a third of the products that we see. So the active ingredient isn’t there, there are some sort of heavy metals or purity issues. And that might be the D or F grade products on the site.

And then there’s really this other group of products that you should worry about quality-wise — I would say the B and C products — where they’re just not highly concentrated. Maybe there’s some famous brand that you’ve always heard of, but like the fish oil is 50 percent Omega 3 instead of 90 percent Omega 3. Or the protein powder is 40 percent protein instead of 80 percent protein. And those are kind of the B and C products.

So those are the two things that you have to worry about: are you not getting what you paid for or are you really being cheated? These are the two types of quality control issues that we really find on a regular basis.

(00:11:13) [Damien Blenkinsopp]: Right. These are the most common things. How would you describe supplement quality? Because I know you’ve got your own kind of internal rating system, where you look through a whole bunch of different criteria.

[Neil Thanedar]: Yeah, I think what we really want to do is start by, it’s really kind of rewarding active ingredient quality and quantity, and starting to penalize for the negative inactive ingredients. And so, as much as possible it’s very, the calculations we try to be as intuitive as possible with it.

The number one factor is going to be the concentration of active ingredient. So it’s going to be the Omega 3 concentration in fish oil or the protein concentration in protein powder. Next, we’ll look at the quality of the active ingredient. We’ll look at the EPA and DHA in fish oil, we’ll look at the amino acid profile in protein.

We’ll look at label accuracy. So we’ll look at how those numbers compare to the label. And we’ll look at purity. We’ll look at mercury and PCBs in fish oil. We’ll look at arsenic, lead, and heavy metals in protein powder. And that’s really it. I think we want to try to look at purity and potency and figure out, ‘Does it work?’ and ‘Is it safe?’.

(00:12:19) [Damien Blenkinsopp]: Great. Thank you for that. So, how do we go about testing these things? What kind of technologies are you using to look at the supplements?

[Neil Thanedar]: Yeah, so it’s really kind of classic analytical chemistry. So we’re looking at chromatography and spectroscopy, like an HPLC or a GC-MS, ICP-MS.

[Damien Blenkinsopp]: Okay. Could you quickly describe that? I know what you’re talking about, but I think these are terms that the majority of people don’t really understand.

I look at chromatography as basically splitting things apart so that you can look at them. And then spectroscopy as actually doing the analysis. I don’t know if you’ve got a better way to explain it.

[Neil Thanedar]: So yeah, we’re basically separating, identify ingredients, and we’re figuring out their quantities. So an HPLC could actually look at anything from caffeine content or a kind of vitamin content, or it could even look at something like sunscreen content and look at the different sunscreen ingredients.

What we’d like to do, and I think this is a big part of our process, is if we can get a couple of HPLCs in the building and really ramp up our testing in supplements, that will allow us to start experimenting with other types of products that we could test.

And so really we’re looking at, in any of those machines, is we have standards of the ingredients. What are the best quality ingredients supposed to look like? You can run that through an HPLC and you’ll get a curve. Then you can run the product through the HPCL and get a curve and you can see the difference.

[Damien Blenkinsopp]: Great. So, when you say HPLC, what does that stand for again?

[Neil Thanedar]: It’s a High-Performance Liquid Chromatography.

[Damien Blenkinsopp]: Okay. Right, for separating things out.

[Neil Thanedar]: So yeah. I think those are the things where we’re not inventing, really. That’s not our, I mean there are a lot of scientific start-ups out on the market that are truly on the frontier of science. I think a lot of the work we do, there are new methods every year and things are advancing, but for the most part, it’s an established industry.

The testing part is established. I think the part that we’re trying to work on is – how can we test thousands of products. How does it get to a point where we test thousands of products?

[Damien Blenkinsopp]: I guess that’s primarily about cost?

[Neil Thanedar]: Yeah, it’s a chicken and egg problem, right? Because we’ve got to do the testing before you show up. So we need to, there’s kind of a constant process of kind of testing a little bit, add one more category, bring money back into the business.

And that cycle is really important to us. And the cycles are going faster at this point. We want to be at a point where we can test, instead of 25 products a month, 50 or 100 or 150 products a month.

[Damien Blenkinsopp]: So, with the approach to testing that you use, do you have to say what you’re looking for? Or does it actually show up, everything that is in the substance? So do you have to pre-decide that I’m looking for mercury, for example, or will you pick up other things in that process?

[Neil Thanedar]: You’re looking for specific ingredients.

[Damien Blenkinsopp]: Okay.

[Neil Thanedar]: So that’s the HPLC where you would look at caffeine versus a caffeine standard.

[Damien Blenkinsopp]: Yeah.

[Neil Thanedar]: And I think that’s the part that we haven’t quite, these ideas, these magical devices where you scan your food and it tells you every ingredient simultaneously. That’s truly on the frontier; that’s not science that exists today.

So we’d love to have more information on it. Until then there is, at some level, brute force work being done here. And at some level, we’ve got established panels of ingredients we can look for.

So you can look at all of the heavy metals at once, or you can look for a whole set of carcinogens at once. There’s a whole set of banned substances that you can all do in one scan. There are certain things that we’ve set up, and with everything else, there is a bit of brute force work. Especially with the active ingredients.

[Damien Blenkinsopp]: So when you say brute force, what does that mean?

[Neil Thanedar]: So you would have to, for example, for a multivitamin you would have to separate every individual vitamin out of there and test them each individually. And it might even be as far as vitamin A is going to be in the product in three or four different forms. So you would have to test each of the four forms of vitamin A individually.

That’s when I start thinking about, that’s truly where we start getting into reverse engineering for active ingredients. Where you need to get down to that individual level because we want our calculations to take that into account. We want to have, if different vitamins A forms have different bio-availabilities, we want to use that as part of the calculation.

[Damien Blenkinsopp]: So I guess in your process of trying to understand each new area, you plan a new category. For example, fish oil you’ve done, but then you come across something else so you’re like okay, maybe this is a growing supplement or something that people are getting more interested in so we’ll attack this category now.

I guess, first of all, you’re looking at some research to kind of see what the issues are, what kind of things you want to look at. And then you have these standard things, like carcinogens and metals that I’m guessing you’re looking for in most things, just because… I guess if something is made in China, the odds that it could have some metals in it, that’s one of the big concerns.

[Neil Thanedar]: It’s even beyond that. I think, well also almost every supply chain is global at this point. So we just test everything for heavy metals off the top. So those are certain things where it’s just automatic. An ICP-MS is expensive, but it gets a lot of use.

Whereas something like each individual ingredient, I think we have to make a decision on [what to test]. For example, with protein powders, we started with a very simple analysis. We started with just a [unclear 0:17:35], nitrogen analysis. So we were just looking at the total nitrogen content. And then we started looking at total amino acid content, and then we started looking a pre-amino acid content, subtracting pre-amino acid content out.

So there’s a whole range of how we get to the final data. I think the work’s never done because the next thing we’d want to do in protein is get into are there specific amino acid ratio [that are] more bio-available. So could we build into the calculations a system that scores the amino acids? That’s something that we would be interested in doing.

So at some level, there’s this constant improvement that has to happen. Many of the products on our site we’ve tested only once, because we test on a yearly basis and it’s the first year. That’s another thing that’s going to improve the data. So year two or year three, we’re going to get more data, we’re going to see is there any batch to batch, year to year variation.

So all of that stuff is part of our expansion process. It’s part of our growing process where it’s why we purposefully limited it to 25 products per month. That was our case, and we can hold to that. And we can consistently deliver that kind of quality, but we’re not going to go in and say, hey look we have 100,000 products on our site. It’s just not possible to do.

(00:18:54) [Damien Blenkinsopp]: Right, it’s not feasible. It sounds like you’re going to be on a learning curve. Say you did protein like two years ago, you do it another year and you’re like, you know what, last time we learned this, so we can integrate that and we can look for that this time, and that’s going to be important for the new formula.

Is that the process you’re going for with some of the main supplements?

[Neil Thanedar]: Yes. And it’s also, you get a lot of consumer feedback after that, because we might build our quality rankings based on usually very quantitative, what we talked about. Very quantitative factors like concentration.

But then what we need to figure out, and what we’d love to add, is more types of rankings. So there are other reasons or other ways for people to make a decision. And so we used to just have one set of rankings, and we found out that some people weren’t buying the number one.

And we said, hey, why do people not buy the number one? Oh, there are some people who are vegan so that’s not their number one. So we added a vegan filter. Some people were buying products for kids, and so we added a children filter. People were buying by value, so we added a value ranking that’s completely separate value ranking.

And I think in a perfect world, there would be, you could take a test where we would just know who you were, and your perfect LabDoor rankings would show up. And they would be perfectly customized to you. We’re on that lifelong path of getting to the point where we can perfectly customize it to you.

And quality and value and kind of vegan and sugar-free; we’re hitting the major ones right now. And then it just keeps getting better and better.

(00:20:25) [Damien Blenkinsopp]: Excellent. And so how accurate is the volume aspect? So you can identify and say that fish oil has DHA in it, or it’s non-oxidized. But how do you understand the actual amounts of this, and how accurate is that?

[Neil Thanedar]: So we’re looking at percentages.

So if you look at a fish oil capsule, it’s anywhere from 10 percent of that capsule is Omega 3, to 90 percent is Omega 3. If you tested the same product again that was at 90, you might see it at 92 or 88.

There might be a little bit of a variation there between tests, but you’ve got a good sense. The product that tested at 90 versus the product that tested at 80, there is a clear separation there.

[Damien Blenkinsopp]: Sure. So what is the swing, and is that, I mean that could be just due to each capsule, right?

[Neil Thanedar]: We’re taking an average of at least 10 plus capsules. So we’re getting a little bit of a range there.

It’s that kind of a range, so maybe in the 2-5 percent range. Sometimes in certain categories with many ingredients sometimes you see a 10 percent variance. But these things are pretty consistent. Once you put that first test out, you have good data.

And I think that 10 percent variance off of the label; the labels are often very inaccurate as well. So the labels tend to be more than 10 percent inaccurate. So I think what we want to do is as soon as we put that first data point there, you’ve already got better data than you had before.

And now our job is to go in and solidify that. And so there’s a constant tradeoff between ‘do we go to a new product’ or ‘do we test the old product again?’

[Damien Blenkinsopp]: Right. So when you’re taking the average, are you taking, say from one bottle you’re taking like 10 capsules or are you trying several bottles? How do you approach that?

[Neil Thanedar]: No, so we’ll want to take it all of it from the same lot. So we’ll try to buy three or four bottles and have it be the same lot.

And so then we might need 50 to 100 total samples because you might be 10 per test or similar. So you will end up using about 100 of those capsules in a round, and save the other 300 just in case a company comes back and questions the data, we need to retest. All of these kinds of things, so it’s important for us to do.

So we’ve got a decent range there. And I think what we found out is these companies are generally doing between two to four major batches of product a year. If you grab any one of those products off the shelf, you get really close on that first test. And then everything after that, we just have to test every year.

(00:22:54) [Damien Blenkinsopp]: Right. So you’ve mentioned lots and batch. Are they the same thing?

[Neil Thanedar]: So I think a lot of people would think, I mean there might be multiple lots in a batch. So it’s a little bit of manufacturing lingo.

I think we are starting out, so that’s part of our learning curve as well. We’re trying to get more into how manufacturers work, and how that side of the industry works because I think we jumped in just totally as consumers. And we were just like how can we figure out how to make this data out.

And then what we found out was there’s different, I mean from the industry there are companies complaining about, hey you’re sharing our proprietary blend. Don’t do that. Or, that data is wrong, or our data shows something else. Our internal lab says something else. And there’s a lot of that.

And in the early days I think we almost didn’t have the time to handle all of the information at once, and if we had to focus on one thing it would be consumers. We’d want to focus on the people who are taking the products. But now I think, as we step back and get a little more organized, we’re starting to figure those things out.

How do you talk to companies, how do you manage the system, how do you figure out and return that data back to the manufacturer? If we find something, can we alert them? I think we want to do a better job with that, we want to do a better job of being a part of the entire industry, instead of being this kind of renegade on the side.

[Damien Blenkinsopp]: Right. Do you get a lot of manufacturers reaching out proactively to you then? Has that happened a lot?

[Neil Thanedar]: It’s a slow, steady pace. There might be a manufacturer a month or something who will come out.

And I think there’s a whole range of them. I think the majority of the complains are honestly like A- companies who…

[Damien Blenkinsopp]: Right. The one’s who really care.

[Neil Thanedar]: Yeah, they really care. “I’m number 8 and I want to be number 1, and here’s why.” And there’s literally 20 reasons why, and five studies attached. And we love that; that’s wonderful. If you do that, our scientists will read all of those studies and we’ll talk about it over a meeting and it’ll be interesting to us.

And if you can convince us, [great]. That’s one of the big things that the protein manufacturers are trying to argue, add an amino acid scoring system. And maybe the ranking will shift a little bit. I don’t think it’ll do very much, but there might be a few products that fall out.

(00:25:05) [Damien Blenkinsopp]: Yeah. So I guess there’s the other subject that some of these products have been around for a long time. So protein is pretty well standardized as a market, and fish oil as well. But of course, then you have some of the newer supplements.

Those must be a bit more challenging because the research can still be evolving, in what the active ingredients are. “We’re not 100 percent sure, but we think it’s this one” kind of stuff.

[Neil Thanedar]: That’s a tough one. I think that is a lot more in our calculations. So the testing is much more straightforward.

So the nice thing is, even if we’re testing a nootropic or something, there would be specific ingredients where even if the clinical research hadn’t completely proven that that ingredient works or not, we could 100 percent know whether it’s there or not. We could at least know that.

[Damien Blenkinsopp]: Right. Because the first thing you’re doing is you’re just comparing the label. The label says it has this, and actually, it has something a little bit different in it. So it’s an easy comparison to start with.

[Neil Thanedar]: That’s easier. The part that we need to figure out, and sometimes we’re staggering that. We might really focus first on the ingredients that have really clear claims.

And now we’re kind of, we are getting more and more into specialty products now. So we are now ramping into testing B complex in glutamine and all of the joint support.

So now we’re going into things that have more complexity or variety. We’re starting to unpack our old categories. So now protein is going to have protein bars, and protein shakes. There’s going to be new categories.

[Damien Blenkinsopp]: I mean, a protein bar tends to be pretty complex in its makeup, right? It has all sort of ingredients.

[Neil Thanedar]: We want to figure out the protein quality in the protein bars because that’s such an important thing. We’ll start testing vegan Omega 3s in the next couple of months.

So it is that kind of constant process of expanding the existing categories, getting into new categories, and then doing the research on the fly. And we’re finding that in some places there’s not good research.

When you test an ingredient, and you have all the data and then, it’s garcinia cambogia and there’s no great evidence that says that it works. And in many cases, we still try to plug that data into our rankings, and you get like in our garcinia rankings, there’s not a single A grade product on the ranking. Because there’s just not enough efficacy in the calculation to get the score up.

(00:27:15) [Damien Blenkinsopp]: Right. So you have five criteria. [First is] label accuracy, which is very straightforward for you guys, you basically just compare. Then you have product purity. What is that exactly?

[Neil Thanedar]: We’re just looking at the heavy metals and contaminants versus upper limits.

[Damien Blenkinsopp]: Okay, great. And then the nutritional value, would that fit more into what we were just discussing about garcinia cambogia? How would you say that?

[Neil Thanedar]: Garcinia cambogia. No, nutritional I would think like the RDAs or daily values of the macronutrients.

So that’s what we’re looking at. We’re working on all of these names, and we’ll have to figure out exactly what they are.

[Damien Blenkinsopp]: Yeah.

[Neil Thanedar]: But I think nutritional value, I pour it over the daily value type stuff.

[Damien Blenkinsopp]:Okay, so you compare there. And then you’ve got ingredient safety.

[Neil Thanedar]: So I’m looking at the quality of the inactive ingredients. So what’s the safety risk of the inactive ingredients?

[Damien Blenkinsopp]: Okay. So if people don’t like aspartame or something in their pills, there you go. And then projected efficacy, would that be going back to our other discussion right now, as in is this really an active molecule?

[Neil Thanedar]: Yeah. So that’s concentration of active ingredient and the quality of the active ingredient.

[Damien Blenkinsopp]: Okay, cool.

Just so people know when they go to your site what they’re looking at and how to navigate it properly. So it makes a lot more sense and they understand where things are at, and how these things are based over time. And obviously, the label accuracy is the thing that they can trust the most from the get-go.

[Neil Thanedar]: It’s really interesting, and I think we look at it that we want to have different people weigh it different ways. That’s another part of our learning curve.

Some people want to be entirely efficacy focused. So it’s just like, give me my active ingredient. And I think that’s really important to people. “I want a 95% pure Omega 3.” And some people are very focused on purity, and purity is the only thing that matters to them. And they’d almost rather take a placebo that’s pure.

And then there’s a group of people who are all about honesty and label accuracy. And I think what we want to do is we have our own weighing system, and I think we’d love that as part of the personalization process.

We’d love to have a process where you put in your own weights for what you think is most important, and the rankings change based on that.

(00:29:21) [Damien Blenkinsopp]: Great. A lot of people in the supplement industry have certificates of analysis from the manufacturers. Is this something you get from the companies?

I guess you’re not reaching out to all of these guys, you’re just kind of buying up the products.

[Neil Thanedar]: No, it’s really a retail process for us. It’s an independent purchase.

The A- people will send us their certificate of analysis. And that’s fine. Anytime we’re working with manufacturers and there’s science going back and forth, we’re in a good place.

[Damien Blenkinsopp]: Yeah, cool. So their certificate of analysis is basically the same kind of analysis or something similar, to say what’s in it, that they’ve had done either by their manufacturer or themselves or a third party lab normally. And then they can compare it to yours and say hey, I want to be A+.

[Neil Thanedar]: Yeah, and sometimes it’s the other way. Actually, more often it is a request for a certificate of analysis from us because they want to go to their supplier and complain.

[Damien Blenkinsopp]: Ah, interesting. So do you think they’ve got false certificates of analysis? Or they just didn’t…

[Neil Thanedar]: Well there’s just so many moving parts in any of these supply chains. So if you’re making a multivitamin you might be sourcing 30, 40, 50 ingredients. And so if you see the LabDoor report and two are off, you know which supplier that is and you can go find out.

And that’s something that’s really interesting data that could help the supply chain and manufacturers. And honestly, we just haven’t found a way to package that data back up. It’s just that we’ve always purely focused on how to get the data first to consumers.

And as we build up more and more data, as we start seeing trends and see more years of data, that will be another type of business that I think would be interesting for us. Because that’s important to us; I think we’d want to be more and more integrated over time.

I could see a place where maybe LabDoor does all of those types of certifications. Instead of an Organic certification and a Gluten certification and the Tested for Sports certification all being different companies. LabDoor is going to have to do all that testing anyway. So if we could somehow say look we’ve already done the testing, here’s the certification, that could be a really interesting thing for us.

We’ll look at every part of the industry in every way that we can help. That’s part of the expansion process, it’s part of how we learn, how we grow, how we provide more value.

[Damien Blenkinsopp]: And now just to consumers but, like you say, to the manufacturers and the suppliers to improve the supply chain in general. Because it’s not necessarily the brand owners.

He could design a great product and he could ask a manufacturer depending on his due diligence, and [unclear 0:31:59] just to pick up on these things. And the testing given to him might not be his fault, but it’s not exactly what he wanted in the first place.

[Neil Thanedar]: Yeah, I think it’s between that and there are so many things that they’re focusing on. And I think that we want to be the place where if you’re a manufacturer, just focus on making the best product. We’ll help show it to consumers; don’t spend money on marketing, spend money on quality ingredients.

And we’ll give you the data you need. It’s really transparent; we’re really transparent with the A- people about what it takes to get to an A. And we’ll do that with everyone else.

Every company knows, obviously, the reason I’m losing to the number one guy is they have twice as much Omega 3 per gram as I do. Now I know that it’s going to be three times more expensive for me to increase my Omega 3 concentration. But that’s a tradeoff, and they’re going to have to make that equation.

And we would love it if LabDoor was driving so much sales to the high concentration folks that the math eventually worked out, that you should just make higher quality products.

[Damien Blenkinsopp]: Right, because you’ve provided more information into the market, and more people are making informed decisions, and thus it becomes more in their interest to raise the quality because their sales volume increases based on it.

(00:33:10) [Damien Blenkinsopp]: So what types of supplements have you looked at so far, and as an overview how have you found the general quality of supplements to be? Was it what you expected? Especially based on the articles that all came out last year about testing Walmart, CVS Pharmacy and places like that. There were a lot of issues that were brought up then.

[Neil Thanedar]: I think, well there are a couple of things. So one, we’re about to release glutamine, which will be our 20th category. So if you go to LabDoor.com/rankings, you will see the 19 rankings we have done so far.

So it is more than just protein and fish oil, there’s multivitamins, prenatals. We’ve also looked at vitamin C and D, calcium, magnesium, and zinc. We’re trying to go through category by category of the most popular.

And so under that list of the top 20 are the next 50 that we’re looking at. And those, really, consumers go in and vote on what they want to see next.

[Damien Blenkinsopp]: Oh. So you’ll do that, if people are like, “Yeah, I want this reviewed.”

[Neil Thanedar]: Yeah. LabDoor.com/rankings.

[Damien Blenkinsopp]: Okay, and they can vote for something new that they want ranked.

[Neil Thanedar]: Yup. And so there’s a whole bunch of categories in there. We’re just trying to grab them as quickly as possible.

So some of the most popular ones on there like glutamine and B complex and glucosamine are already in the lab. We’re already working on them. And just keep voting. Basically, you’ll get an email when that category is available.

What I’m going to try to do is over the next year or so finish those 50 categories. Really go through and say hey, in the supplement industry you can really come up with any major product and LabDoor will have it. Have at least one set of data on it. Just enough to get you in.

And I think once we do that and really get the lab fully up and running and instead of 25 products a month we really should be doing 100 plus product per month. That’s when I would say maybe we’ll look at other categories.

Maybe we’ll look at food and beverage, maybe we’ll look at meal replacement. I mean, we’re already kind of there. Protein bars are already starting to touch meal replacement and functional foods. Even baby products, like baby food and baby formula, are really on the edge of being a supplement; they’re manufactured in very much the same way.

And so any of those types of things we’d love to be in places where you feel like there’s some uncertainty. If you feel like, I don’t know what I’m buying, that’s enough for LabDoor to jump in.

It doesn’t necessarily need to be the supplement industry where you get data every week saying something goes wrong. I think it’s even a case where you are buying baby formula and you have no idea what’s in it. At any point where there’s any of that kind of insecurity, you should look to places like LabDoor to get some science and data, and make that decision with more backing.

I actually don’t think that the, I want to try to make sure that the supplement industry doesn’t get all negative stories. Really that’s where it’s starting to go, it’s really kind of pushing it to a lot of negative stories. And that’s not really our market. You’ll see that LabDoor is not the person driving a lot of those stories.

[Damien Blenkinsopp]: Sure. I mean, what do you think of the market? You’ve got the data on nearly 20 categories now. Where would you say it’s at? If you had to explain in objective terms, where is supplement quality currently at?

[Neil Thanedar]: I think there are about three even groups of companies.

There are a third that are doing a really great job. And those are basically the A products in the market.
There is a third that are like the B and C products that are just not worth it for the money. And those are usually the guys using brand or marketing to sell products. And then you’ve got the D and F…

[Damien Blenkinsopp]: When you say brand or marketing, could you give an example of that, maybe naming a specific company? But what does that mean to you? Brand or marketing?

[Neil Thanedar]: These are companies that I’ve literally looked at some of these companies that have, first the head of R&D works for the head of marketing in a lot of these companies.

You’ll see these companies haven’t made significant investments in R and D but are spending 20, 30, 40 percent of their budget or more on marketing. And these are companies that are truly spending more on marketing as a percentage of revenue than they are on the products themselves.

And you see that in the data. And those become the B and C products that are actually usually, more expensive than the A products. We’re finding that there’s really no correlation between price and quality. There’s just none in this market.

There are people who are in the middle group who are just medium quality for high price.

[Damien Blenkinsopp]: Right. So you’ve got some products which are brand driven. They’re a premium brand and have put a lot of good marketing behind it, but actually, the product doesn’t back it up.

[Neil Thanedar]: Yeah, that’s the second third.

And I think the third is honestly the D and F grade products, where people are honestly cheating. There are, and it’s different by different categories.

Something as simple as a creatine product you usually don’t have to worry about as much. It’s just creatine in a bottle. There are fewer things that could go wrong. Those products, maybe 5 or 10 percent of products, have problems. But there are things like garcinia, 70 percent of products have problems.

[Damien Blenkinsopp]: Wow. So it really does vary a lot by [category].

So creatine has been around for a long time, and it’s extremely standardized. So I imagine there’s a bit of market development. There must be so many manufacturing facilities now that the technology is well standardized at creating creatine and everything, so it’s a little bit easier.

And it’s also something very straight forward. It’s not like it gets damaged easily, like fish oils and so on. So yeah, I guess each category can be quite different.

[Neil Thanedar]: Yeah, so each category is quite different. Overall, it’s about what we need to do is try to get people to the top third as much as possible. If we can do that, if we can really help you focus when you’re in the store.

Because that’s what’s happening in the store. There are 100 fish oils. And how are you picking with 100 fish oils? And I think that’s why the branded marketing thing works so well.

When there’re 100 fish oils, you see the brand you recognize and that just makes that purchase easier. And what we want to do is say, what if those 100 fish oils were instead ordered from one to 100 in some sort of other system based on science?

(00:39:15) [Damien Blenkinsopp]: Yeah, excellent. A couple of questions. I realize you probably don’t want to name companies, but I’m interested in the Trusted Science brands, the ones that look like they’re doing research and backing it up with content like Thorne Research, Life Extension. People tend to trust these kinds of brands.

I don’t know if you’ve looked at those types of brands. Not necessarily those guys, but similar ones which are putting out a fair amount of content on their sites, and they talk about their research. Do those tend to have reasonable quality?

[Neil Thanedar]: We haven’t tested as many of those yet, and I think the reason why is because our initial way of picking the most popular products by category was to use online best-seller lists. And the Thorne and the Life Extension are usually sold through doctors so we missed that in the first round.

[Damien Blenkinsopp]: Probably a bit more expensive for most people as well. That might be a smaller market.

[Neil Thanedar]: It’s more expensive and just in different channels.

We’d like to prove that. We’d love to test those products and see is there really a price and quality correlation there. Because otherwise, industry wide there is zero price correlation. And there are honestly categories on our site where literally the cheapest product in the category is the number one in quality.

[Damien Blenkinsopp]: Wow.

[Neil Thanedar]: It’s amazing. It doesn’t work [unclear 0:40:29] maybe in handbags or cosmetics. So these are the types of industry where that works, right?

[Damien Blenkinsopp]: Could you give us an example? Is that something like creatine? Where it’s very simple?

[Neil Thanedar]: It might have been creatine. It might have been something like creatine where the people who were really trying to jazz it up with the fancy box, and five artificial sweeteners and not enough creatine, those are the people who are expensive and at the bottom.

And vice versa; the people who just throw 100 percent creatine monohydrate in a bag do pretty well.

(00:40:58) [Damien Blenkinsopp]: Cool. Okay, so we talked about the price correlation, and that there isn’t much, which is interesting. You looked at online reviews from consumers on Amazon as well, I noticed just recently. What were your results there?

[Neil Thanedar]: Same thing. Zero correlation. And what we might need to figure out is they might be answering totally different questions. The user reviews might be totally answering the qualitative question, and we’re answering the quantitative question.

And first of all, there are certain categories of supplements, like a multivitamin for example, where other than pill size there isn’t that much qualitative that you need to worry about. You’re not taking a multivitamin like, oh I feel better today.

There’s not that much qualitative to do. These decisions should be more quantitative. They should be more scientific. And so the thing we try to talk about as much as possible is for most of these categories we should be letting user reviews go and really be focusing most of our energy on scientific reviews.

[Damien Blenkinsopp]: Yeah, well unfortunately, they’re not around everywhere. You’re working on it, but it can be hard to come by.

I used to use Consumer Lab Reports, which is the other company that was doing it. And then you guys came along, and it’s a free service versus a paid service, so it helps me out that way.

(00:42:08) [Damien Blenkinsopp]: What I want to bring up, I don’t know if you’ve seen this new company, which is kind of trying to position itself right at the top of the supplement industry which is Elysium?

[Neil Thanedar]: I’ve seen that, yes.

[Damien Blenkinsopp]: With their anti-aging. And they have a scientific board of directors.

So they’ve really tried to go more the scientific approach that we should be trusted, we’re using a pharmaceutical grade production process. We have a scientific board of advisers of some of the top scientists in this area in the world.

I found that was really interesting and really encouraging in terms of really taking a step up. And it’s got VC funding. So it’s a completely different business model, really.

And I guess it’s only been possible now because of the size of the market, where they can now have a VC driven model where they can go and get top scientific advisers on board, sometimes Nobel prize winning guys to be able to raise the standard a lot.

So, it would be interesting if you help with your work to promote that kind of activity as well.

[Neil Thanedar]: Absolutely. I feel like guys like that are the new generation of the Thorne and Pure Encapsulations. And there are more people like that. I think honest companies really try to do that not just in supplements but in cosmetics and household products.

So there are a lot of places where there’s renewed interest in that kind of high quality and direct to the consumer brand. And I think that fits really well with where LabDoor is. I think we want to, we need to get to a place where that product is in a category, versus the other people.

And that would be really interesting. There’s now food test on some of those same ingredients, for example. And there are a lot of generic manufacturers who have the same ingredients as Elysium does, but there’s an issue of do you trust the generic manufacturer.

[Damien Blenkinsopp]: It’s interesting, because I looked on Amazon, of course, for the ingredients — because they’re being transparent about the ingredients, which is another thing. Not all companies will tell you exactly what it is in the product.

Some companies you can ask them for their certificate of analysis. A lot of consumers don’t know that, but you can just contact them. And sometimes they’ll give it to you. It depends on their policy. And sometimes they’ll say sorry we don’t hand out that for propriety reasons. Or whatever.

So there are a fair number of certifications out there. I don’t know if you’ve looked at any of these. Sometimes we see these stamps on products and we don’t really know what’s behind them, a lot of the time. Have you looked at any of those?

[Neil Thanedar]: We’ve looked at it a little bit.

So, I think my general issue with certifications is there are many of them and consumers don’t really understand what they all mean. I worry that in a situation where if you give too much information, it’s an overload and actually doesn’t get paid attention to.

So that’s one of my issues with certifications. What we’d like to do at LabDoor is to try and figure out if there’s some way to get beyond a certification, beyond a pass/fail system and get to is the product really good.

Because there are two different parts to this. There’s the part where hey here are the third, or two thirds of the products that are bad. That’s fine, but I think our business is really dependent on can we help you make a good decision. Can we help you get into the good third?

And so what we need to do as much as possible is find that way of saying I’m just highlighting the good products. I think for us that’s really we have to keep focusing on it that way. And so I want to, as much as possible I would like that not to be certification based.

I think if we wanted to say, look it’s not about whether it’s organic or not, it’s about what’s the quality of the product. And in many cases, just because it’s organic doesn’t mean it’s pure, in many cases, organic products can catch a lot of heavy metals.

[Damien Blenkinsopp]: Yeah, that’s a good point.

[Neil Thanedar]: So all of those things we don’t want to get into, we don’t want to outsource the decision to that single certification. That you really should be having your decision on a holistic approach to the product.

[Damien Blenkinsopp]: Yeah. I guess whether it’s organic or not, that’s kind of a philosophy. But at the end of the day, it’s the pesticide resides and the heavy metals that people are really interested in, a lot of the time.

[Neil Thanedar]: It’s very much like the filters, to me. So, if you want to have a vegan filter, or a sugar-free filter, or an organic filter, a non-GMO filter in your life I think that’s fine.

I think that’s just a fundamentally different decision criteria that’s almost like the quality and value ranking. We’ll let those things be, let them cross, and that is useful as a filtering tool.

[Damien Blenkinsopp]: Also, I think we kind of covered this, but have you come across instances where the certificates of analysis have been different to what you found?

[Neil Thanedar]: Yeah. What we’ll do is there’s a kind of a standard process.

So if we have our testing and our certificate of analysis, a company comes with their own, then we will go to a third party lab and we will get testing done there.

And the idea is basically if the grade goes up, we’ll pay for it. If the grade goes down, they pay for it. And that’s it, right? It’s just I think that is, we want to figure out a system where it’s just [fair].

I mean, at any given point we’re defending 700 products, and soon we’ll be defending thousands of products. And so we want to be able to say at some level we want to be the referee and we understand that not everything is going to be 100 percent perfect. And we’ll just be open to it.

And if you think that something is wrong, challenge us on it. And challenge us with scientific data with a certificate of analysis and look we’ll test it. We can always test more. That’s possible. The thing we can’t do is kind of get into shouting matches with companies.

(00:47:23) [Damien Blenkinsopp]: Yeah, sure. So in terms of, to give people an idea, how often does that come up? Does it come up a lot or is it relatively rare?

[Neil Thanedar]: I would say it’s less than five percent of the companies who will ever kind of come and talk to us.

And I think a lot of people indirectly come and talk to us. We’ll get emails from their customers complaining, or things like that. There are all kinds of side things.

I think it’s something where there are some very passionate people on the manufacturing side of the industry, and I think we’ve tried to be really open with it. I think it’s important for us to actually be talking to more of the industry.

I actually should be going – and I’ll do more of this — is going and travel, spend time at supply side conferences, where people are actually talking to the manufacturers. I need to do that. And I think that’s something that as we get bigger I should be talking to half or more of the industry.

Because I think if LabDoor’s data gets back to the companies, it’s going to be good for the industry. It’ll have rapid feedback. You’ll have feedback from consumers and from the lab. Both of those things are incredibly valuable for manufacturers, and it’ll make the products better.

(00:48:30) [Damien Blenkinsopp]: So we’re talking about the technologies you’re using are relatively standardized now. They’ve been around quite a long time. I think they’re currently getting better in terms of cost, right? They’re expected to get cheaper over the next years. That was just a training I was at recently.

But I was just wondering if you think there’s some variability. So say if they did come with another certificate of analysis and then you went to a third party lab, how much variance does there tend to be between labs?

Because just in my own testing, I test a lot of different things, and there’s a fair amount of variability between the labs, unfortunately. We’re still in the middle of a kind of, I guess it’s mostly the processes and ironing out all of these things, and some of the technologies are getting more mature over time and more stable.

For these particular technologies, how stable would you say they are in the accuracy?

[Neil Thanedar]: You’re getting good data out of it.

I think even in a situation where there’s a 10 percent lab-to lab-variation, firstly there are different labs and I think [with] the labs we use we’re seeing some 10 percent variation. And in many cases, we were talking about 2-5 percent batch-to-batch variation.

So even different labs, different product in a different batch, we’re seeing pretty similar results. And that’s just some of these products, and it’s with the established companies. The thing that we’re finding is there are some companies where the product is vastly different, from category to category. There are certain things where I worry less about that.

I think what we need to do is build repeat testing into the model. Because any sort of calculation like this the confidence goes way up when you get the second, third and fourth test. So I think that’s where we’re at right now.

The first test is good data, and it’s important for consumers to get it. And then every other test, the second, third, or fourth, you get a lot of increase in confidence, and then you just have to be consistent. Then you have to get on your yearly or every-other-year basis, and we’ll be humming along normally.

And so I think for us, LabDoor Year 5 out of a 10-year process of really kind of stabilizing everything and having a fully operational machine. And then we’d want it to just automatically test products.

Like every month people request new products, we test it. We’re automatically getting into new categories, we’re automatically maybe thinking about new ways to rank products, we’re getting deeper and deeper into personalization. But it’s a very, it’ll be a very consistent improvement process.

[Damien Blenkinsopp]: Have you got plans to retest any categories yet? Or are you doing your first retest with any category yet this coming year, or is it going to be a little way off yet?

[Neil Thanedar]: No, I think, well yeah, we’ll be doing retesting. I think we’ll get multivitamins retested next year. There will be whole categories.

We want to be, in 2017 if we can get to the point where we are not just, we’re marking the dates on when we tested it last and predicting when we’re going to test it next. And really as much as possible, say the popular categories are every year, the less popular every two years.

And again, just like everything, we can start shrinking those things because right now we’re on basically two-year testing cycles. And we want to push everything to yearly testing cycles.

And it would be great to say that LabDoor 2016 protein data is this and 2017 protein is this, and let’s see the trend of which brands have been consistently at the top and consistently at the bottom. Those are all things that it is about, we need more lab capacity. We need more testing.

We’re going out and we’ve raised venture capital. And so that’s a big part of this process and a big part of the reason why we think we can do 100 products a month next year instead of 25 products per month. That’s a big part of that too.

That’s how we’re going to get there. We’re going to have to get there 100 products a month at a time. We’re not going to be able to download the database of 100,000 products because that doesn’t exist.

[Damien Blenkinsopp]: Yeah. It’s step by step. You’re building lab capacity basically over time and trying to make sure it’s monetized. So it’s a step by step process. Great.

(00:52:19) [Damien Blenkinsopp]: Now let’s talk about some specific case studies from some of the more interesting takeaways. What have been some of the worst lab results you’ve seen in categories?

[Neil Thanedar]: I mean, the garcinia cambogia was still the worst category we ever saw. There were fully 70 percent of the products that did not have the labeled active ingredient.

[Damien Blenkinsopp]: So they had zero, had nothing?

[Neil Thanedar]: No, they had less than their quantity, but they had…well we’re talking about 10 percent or less than the label claimed, that kind of thing. For most of those products. To the point where it’s essentially nothing.

And what that is is that was a lot of fly-by-night, they are usually selling on Amazon. This is something where you can just spin up a brand out of nowhere, white label it, throw it onto Amazon and there’s no check. There’s nothing between you.

And then theoretically, there are user reviews between you and that product, but then these companies buy user reviews too. And so that’s it, there’s literally nothing between you and this product hitting the market.

And so we’ve seen, the cool thing is you go and look at a lot of those affiliate links and they’re broken, which means that the products have come off of Amazon, so not being sold anymore. And so there’s some sort of cat and mouse game there.

I’m sure some of them have spun up and made new products, and we’re going to have to go chase those down. But at least in some of those cases, we’re seeing that they’re gone, they’re not there anymore. And I think in those cases we do our job, when we show people what’s right and wrong. I think we’ve done a good job.

I think there are categories like that where 70 percent of products fail, there are categories like creatine where 10 percent or fewer products fail. And then there’s kind of the in-between zones where with fish oil you’ve got about a quarter of the products have rancidity issues. And so we’re filtering that, and that’s part of purity; that’s a part of our purity score.

So we’re seeing in different categories there are issues, but I think in the other categories they’re more like, hey there’s this like, half of the products that you need to avoid. Or there’s 30 percent of products or 10 percent of products you need to avoid. It’s still worth checking. Right?

In any of these situations, it’s still worth checking, but that’s the range we’re at. Somewhere between 10 and 70 percent you’ve got to worry about.

(00:54:21) [Damien Blenkinsopp]: Excellent. So, as you were talking there, I kind of took some guidelines or rules away from the situations you brought up.

Do you have any guidelines in your mind from the research you’ve done so far, on like if there is no data, having been through your research process, have you seen any patterns where you’re like, okay instead I’d use this heuristic to decide which product to buy, if I don’t have access to the data right now.

[Neil Thanedar]: We’re not seeing very much brand correlation. There’s not a ton of brand correlation.

One thing we find is that companies that only make one or two things do really well. So like a company that specializes in probiotics does a really good job in probiotics, but actually has a B- multivitamin or something. Those types of things happen a lot.

And so you have a protein specialist or the creatine specialist that does really well there; fish oil is the same way. So think about that. I think that might be one thing to think about, people who are specialists.

And then really other than that, send us the link on LabDoor and we will add it to our site. I think we need to test those products. We’ve had the luxury I think a little bit of kind of growing quietly. I think a lot of people are just learning about us five years later.

And we did that on purpose. And we did that very, kind of fundamentally we said we’re going to just focus on one category. We won’t go to the press saying, hey LabDoor is this great company, we’ll say hey look at LabDoor’s fish oil data, or look at LabDoor’s Vitamin C data. Look at LabDoor’s multivitamin data.

That part of it I think we’ve been focused on just, come listen to us about what we know. We’ll be an expert in certain things. We’ll be a destination in one category at a time.

And now I think we’re at a point where we need to move faster. And I think that’s why we’ve gone and raised more money. We are kind of going in and buying HPLCs and bringing them into the building. We’re buying auto-samplers. All this kind of stuff to make things go faster.

And so at this point, if you can find things that are specialty products and you trust them, take them. Otherwise, I’m really at the point where I’m waiting. I’m actually saying, well I’m thinking about taking curcumin, but I’ll wait six months until LabDoor tests it.

I might be in that process, I think because I know curcumin is going to be one of many other categories that are going to be… You’ve got an extract that certain companies, certain products are going to really pull a lot of heavy metals out of that extract. There are different extraction processes.

[Damien Blenkinsopp]: Yeah. There are some like that which are going to be challenging, for sure. Because it comes from turmeric, and turmeric can come from all sorts of places. So you can tell that one is going to be a complex one.

[Neil Thanedar]: And that reminds me of something like Ginseng, where the ginsenoside content you can look at. Ginseng is different than the active ingredient, and so you’re not always getting the same extraction. And it’s not consistent. And so in cases like that, I would basically say wait. And that’s how I do it. I wait until LabDoor has some data.

[Damien Blenkinsopp]: And you’ve got the inside guide to that. Okay. Great.

(00:57:20) [Damien Blenkinsopp]: The other heuristic I was thinking of was you were talking — because I’ve seen this a lot in Amazon — is you have these one product wonder companies, where they basically just make one product. And I think they just pop up.

There’s a new fat loss supplement that they just kind of jump on board. And you see that this company otherwise doesn’t seem to be anywhere or doing anything, but it’s just made this one product. Even it’s website sometimes isn’t great.

But on Amazon they’ve got thousands of reviews, and sometimes they’re at the top of the category. And you’re like what’s going on here? And often they’re giving away products for reviews, and they’re using a whole bunch of marketing tactics to establish themselves there.

But if you look a bit more into the company they don’t have a strong background and they’re just going to come and go. So that’s one of the things I’ve also noticed a little bit that might be worth thinking about.

[Neil Thanedar]: Yeah, we see those a lot too. I think LabDoor is really meant to replace heuristics with kind of a scientific method as much as possible. And I think that’s just really what, bringing us all the way back to the beginning, it’s really what motivated the idea of LabDoor at the beginning.

It was just the idea of imagining standing in a Walgreens with 100 options, and how are you making that decision? You’re going to use the heuristic, you’re going to use… If you were buying wine you would buy the second cheapest. There’s all these goofy heuristics that you can use. Maybe you buy the cheapest, maybe you buy the house brand, maybe you buy the famous brand, you buy the most expensive.

Everyone’s got their system. And we are kind of just consistently finding that any one of these heuristics has no correlation to the scientific data. So you really just have to keep coming back to the data to make your decision.

[Damien Blenkinsopp]: It’ll be interesting at some point for you to publish which heuristics were the worst in correlation.

[Neil Thanedar]: Oh man, I’d love that. That’s a great one.

I think we mess with this all the time, and I think this is another thing that we’d love to do more at LabDoor is get outside of just the testing that we have to do to grow the site. If we’re able to test 100 or 150 products we might have some leeway to take 10 or 20 or 50 products and just say, hey you want us to test a Chipotle burrito or a McDonald’s BigMac, we’ll do that too. Just because it’s interesting to us.

Or we might want to get into talking about user reviews. We might want to talk about trying to figure out a system to verify user reviews, or figure out whether…

Maybe actually teach people about these correlations. Teach people that there’s really no correlation between price and quality. So you shouldn’t use price. There’s no correlation between user reviews and quality in these categories.

And you should really think about what kind of products are experienced based products, where 10 minutes after you finished your meal you know whether it was good or not. And which products are truly scientific products.

[Damien Blenkinsopp]: And which are just subjects of experience. Someone’s just like, oh yeah I kind of like the brand and I bought it and I really enjoy the brand.

[Neil Thanedar]: Yeah. And so we really want to make, we have to figure that out. And I think that is such a — I mean we did that in VC meetings.

We literally, I was walking to the elevator after one of these VC meetings of an investor who said no. And he said, “You know the entire history of the universe, marketing has won.”

[Damien Blenkinsopp]: Marketing will find a way.

[Neil Thanedar]: And I said look, maybe we will. And we’ve kind of thought about that, and we said look maybe we just need to market the science better. We need to figure out ways to make the data easier to understand. We need to go, and that’s part of our team.

And so I think we’ll do that. We’ll find easier ways to teach this. Maybe we’ll redo the Pepsi challenge. And you redo the Pepsi challenge and you talk about, hey, there were problems with the Pepsi challenge. First, Pepsi was running the Pepsi challenge, and there are some credibility issues there.

And all of these things, and you can teach people through very simple systems that they already understand. “Hey this is how you’re currently making decisions, and this is how you are currently being marketed to and here’s how you should be marketed to. You should be marketed to based on science, based on the data, based on transparency and objectivity.”

[Damien Blenkinsopp]: I think the fact that Elysium and other companies like that are now showing up is showing that there is something changing.

Of course, marketing is always going to be important but I think some of this authoritative input is starting to become a lot more important, and trust. You see it across the markets, and there’s a lot of people talking about it. And so Gary Vaynerchuk and I, some of these people — I don’t know if you’ve ever heard of him.

[Neil Thanedar]: Yeah. Yeah, yeah.

(01:01:44) [Damien Blenkinsopp]: Yeah. But I think they’ve definitely got a point about trust for authority, and so on. And it’s going to become bigger and bigger. What are you looking forward to in this space? Are there going to be changes in technology which are going to help you over the next five or even 10 years do a better job of this? What are you looking forward to in this space?

[Neil Thanedar]: I honestly think it’s, for us, it’s as simple as getting 10 times bigger. I think if we get 10 times bigger every part of the system makes sense for us. And I think that’s what we’re trying to figure out.

We just got to 15 employees. This is a pretty tight unit here. And we need to go, as we grow from 10 to 100 employees here, and these are going to be mostly science and technology folks, those are the structures right now where we’ll be able to unpack some of these jobs. People who are doing five or six or seven jobs will be just doing one.

And we’ll be able to add some redundancy, we’ll be able to add more testing, we’ll be able to go faster. And really we’ll be able to, the spool engine will be running where, well really the old categories are paying for the new categories. All of that stuff needs to happen.

And as we grow, as we do that, I think this is where I see LabDoor becoming a more and more mainstream brand over the next 5, 10 years. And I want to have, very much like more experienced products like restaurants, you don’t buy without checking Yelp.

I think you really want to say for scientific products, for medical products, for health products, you don’t buy without checking LabDoor.

[Damien Blenkinsopp]: Where you want a functional benefit, you’re looking for this functional benefit.

[Neil Thanedar]: Does it work if it’s fake? Then, the more you think about that, you make so many decisions like that.

I just did this with a household cleaner. I was thinking about buying this Method cleaner versus this Honest company cleaner versus this Clorox cleaner. Does the green cleaner work? Does that organic certification matter?

You’ve got all the same problems. Is there anything toxic in this? I’m going to breathe this in, I might eat it. You’ve got all the same problems as you do with a supplement, and you make that decision even more casually than you do with a supplement because there’s even less data.

And we have to get into more and more of these categories. And I need it to be in a place where maybe I have your whole profile, I know exactly what you’re allergic to, I know exactly what your preferences are and I’m helping you in the entire drug store to make quality decisions.

(01:03:59) [Damien Blenkinsopp]: For a little case study there, I’ve been testing a whole bunch of pesticides and heavy metals and so on.

One of the more unique and interesting things I came out with in my samples was really really high atrazine mercapturate. Which was interesting because it’s been banned in the EU where I’ve spent some time since 2004 I think.

And so mine was off the chart; it was like 96th percentile. So I was hunting around trying to figure out where this stuff was coming from.

[Neil Thanedar]: Wow.

[Damien Blenkinsopp]: And I recently, I’ve been keto since January and so I started using different oils. One of them was macadamia oil, and it just happens to come from Australia where atrazine isn’t banned.

And I’m guessing [it’s out] because I’ve stopped that now. I looked into the research and it’s very probable that that’s where it came from. So I’m guessing that will be gone from my system the next time I test.

But yeah, just to say that this isn’t a theory. It happens and if you test your own body samples you can come up with stuff, and you’re like, “Whoa, I’m eating something toxic and I had no idea, didn’t even think about it.”

And I’m one of the guys who tests a lot more and thinks more about this stuff than most people. So if I’m getting that kind of effect, I figure most people are getting more of an effect than me.

[Neil Thanedar]: Absolutely. It’s so important to check. And I think, there’s too much. I hear too many of these stories.

Whenever you see that new negative supplement story, I think what happens is people withdraw and they become less likely to buy. Or they become more attached to their existing purchases. They stick to their existing brands.

And I think both of those kinds of withdrawing motions are wrong; you actually should go out and get more data. But the problem is it becomes this thing where there’s a lot of negativity and you don’t want to go out and get more data.

And so I think what we want to do with LabDoor is say look, well focus you on the best products. We’ll focus you on the A grade products, and let’s make it a good story. Let’s focus sales in the market, let’s put 100,000 of people a month and let’s focus them on the best products in the market.

Let’s reward companies for doing a good job and making a great product. And let’s see if there’s something really positive that we can do. Can we really reorganize the market to where the best quality products are making the most sales?

(01:06:06) [Damien Blenkinsopp]: Alright, so this could be a more challenging question, I guess. Just because some people wonder about this, but it can be really interesting what comes out of it.

Is there anything you’ve changed your mind about in the last few years in the testing area, or in supplements in general? Is there an underlying assumption of how you go about things, or what you’ve been thinking, that you’ve kind of turned on its head?

[Neil Thanedar]: There’s been a couple. I think one of them was really, we’ve kind of gone in two different directions with the data. We started with very technical, these long reports.

And then we went all the way in the other direction with this A through F grade, which was very simple, and the rankings were very simple. And we definitely needed to do that because I think that’s really what helped people actually use LabDoor.

And what we’ll probably do is slowly taper it. Our idea is to do every version of it. We’ve actually thought about this idea, we used to think of that as a fight between more data or less data. And I think the answer is actually all of the above, but we need to organize it.

So first you see the A, and the A breaks down into five categories. And those five categories break down into this data. And so what we’re trying to do, as much as possible, is everything. This is the point where we used to get into these fights of more or less, and I think the right answer is everything. And that’s one of the big things we’ve learned.

I think the bigger one, in terms of my mind changing, was really — we talked about it a little bit earlier — the manufacturers. I think I used to just be 100 percent consumer focused, and just said this is all about being the consumer watchdog.

And it still is about being the consumer watchdog, but more importantly, we are a marketplace that’s organizing these decisions for consumers. And so I think when it really comes down to it, our job is connecting consumers to the best companies and the best products.

And if that connection then makes us really good, and it’s not… The thing where we show people that there’s a bad product on the market is part of our job, but it’s not the core job.

And I think that was the thing that we switched. We came out there kind of guns blazing wanting to try and find the bad stuff, and increasingly we’re realizing that our job is just to find the good stuff.

(01:08:21) [Damien Blenkinsopp]: Okay. I’d like to hear a little bit more about you.

Do you look at improving your body and use of tracking? You’ve kind of already given us a couple of takeaways, but is there anything you track in terms of metrics or biomarkers or anything like that? For yourself?

[Neil Thanedar]: So these days my biggest focus is very, really into mental performance.

So I have a tracker of my major daily tasks that I do. And then I have a time tracker, where I’m measuring how much time I’m spending in a day learning versus planning versus training versus communicating versus executing in the business.

And so I’m separating my time and I’ve been using that to figure out… And I’m using that for optimization right now. For example, I’m noticing that as our company scales, I’m just noticing more push from executing to communicating. I’m seeing that switch, and really communicating is starting to become the more dominant mode.

And so I think for me between that and between more… I really like Headspace and Lucid, which are two mental training apps. Lucid is more focused on almost professional athletes. It might be more of strength training for your mind. Whereas I think something like Headspace might be more about conditioning, and it’s more about the endurance of kind of long-term training.

And so really that’s been my focus. In terms of my physical health, it’s really simple. I have Vitamin D and Fish Oil that I take every day, and protein and creatine that I take after workouts, and that’s really my base stock. There’s not really much that I’m doing.

There are, after that I’m curious about a lot of different ingredients that I’m waiting for us to test. I used to be a wrestler for many years, so I have achy knees. And so I’ve always been looking for joint supportive curcumin products. So that’s been something that’s really curious to me.

I really have been curious about nootropics and different kind of mental [supplements]. I’d love to see more caffeine plus thiamin plus other ingredient research. Try to figure out ways where LabDoor can get better at thinking about synergies between ingredients.

Those are things where it’s almost like we need to figure it out. We need to figure out the science before we can do the ranking, but those are the types of things we’re figuring out. And I think if we did that I would love to experiment more into the nootropics side, if I could get it right.

And so that’s how I track, but I think the last two or three years have been very mental focused. I feel like maybe the 10 years before that, between sports and through college I was so focused on all my physical numbers. And every since LabDoor especially it’s been very focused on my mental output.

[Damien Blenkinsopp]: Great. So that time tracking thing that you’ve done, are you tracking every minute of your day with an app in your phone or something? How do you do it?

[Neil Thanedar]: Yeah, so it’s an app called Hours. So all you have to do is turn it on in the morning, and then you switch it between different tasks. I don’t switch it between things too often, so it might only be five or ten total transitions per day. It measures it over time.

That’s really the most zoomed out version of it, and I try to do these things in sprints. So it reminds me the same thing of calorie tracking. I got a really great recommendation from a dietician once that said, “Track every calorie for 10 days and then stop.”

And that’s basically the same thing I’m going to do with this tracking. I’ve been doing it for seven days; I’ll do it for 10 every quarter or every six months, something like that. And I would come back to it and make sure.

The Headspace or Lucid I’m actually doing that at least, Headspace at least 3 times a week, mental training at least 5 times a week. So those I’m actually getting into the gyms, so to say, and getting my work in. But the really detailed tracking I try as much as possible to limit into specific sections.

[Damien Blenkinsopp]: Yeah. Tracking can be time-consuming. That’s the way I found it, to be more beneficial as well, basically doing what I call projects.

I do a project for a couple of weeks or something, make an adjustment. Hopefully, an action or something comes out of it and then move on to the next.

Actually, a lot of my friends have also done the time tracking thing. I did it for about 3 months, many many years ago. I learned so much about where my time was going, and I made adjustments on an every day basis. I haven’t gone back to it; maybe I should go back to it at this point, because who knows what’s happened now.

Did you get any, what are your big takeaways so far in the seven days? Do you make any changes, like, “Wow, I’m spending a lot of time there”?

[Neil Thanedar]: One thing that was initially bothering me that I felt like I wasn’t spending enough of my time actually executing.

And I think it actually taught me that when I was actually tracking what I was doing with that time instead, I was realizing that it was a lot of casual, like grab someone for 10 minutes and talk to them about something specific that we’d want to improve. And that was really high-value time.

And I was scared to do it because I felt like sitting at my desk writing emails seems much more productive. So I think that was really what it is. And I think so much of the mental training and kind of this work was actually just kind of confidence that you’re doing the right thing.

This is kind of just bringing the calm down, and kind of just bringing yourself into your zone as much as possible, and just feeling like… Just getting your priorities right.

I think that was the other thing. I had my priorities right and I was worried about it. And I think that’s why the 10 days really works because it’s just a nice check in. And if you feel like you’re doing a good job, or in the time like now that’s a bit of a transition, you can make a move.

(01:14:07) [Damien Blenkinsopp]: Great. Great. If you were to recommend one experiment someone should try to improve any aspects of their body, like mental performance or whatever you would think to have the biggest payoff, or likely to have a payoff, what would it be?

[Neil Thanedar]: I’m going to make sales for this mental training.

I came up with a system where also I think part of habit forming is attaching it to something. Attaching it to something where your new habit is attached to something that you do a lot.

And I think, one thing I noticed was I always get into moments where I’ll work for an hour or two, and then I’ll get up and want to pace or something. And then I’ll come back and sit down.

And so what I did is I said the first time, I noticed that the trigger for the pacing was something like I would get agitated or I had been working for too long. That’s the trigger. It feels negative, something negative is that trigger.

And what I attached it to is that first time I felt that kind of, I need to get up off my desk and go somewhere else, the first time of the day I felt that I would take my mental training app and do a 10 minute session. In that moment where I’m frustrated and agitated, I would take that moment.

And there are a couple of magical things. First, every single day of my life I have an agitated moment, so I always train. And it reminds me that when I’m agitated, it calms me down and then I get back. So it’s like a positive rep.

And any time I can turn that, you try to take a negative rep and turn it into a positive rep it’s always a huge improvement. Because it does a [unclear 1:15:35]. And so I’m trying, as much as possible, to focus on the atomic unit of the habit, and just getting it right each time.

[Damien Blenkinsopp]: Cool. Thanks for that. This is really interesting. Basically attaching it to something that happens to you all the time. And that you want to get rid of. So you’ve got that trigger, and you just turn it around.

(01:15:55) [Damien Blenkinsopp]: Okay. Where should, I mean we probably already know, but where should someone look to learn more about this topic from you?

Are there any good books or presentations on testing? Is there any more information if they want to geek out on this?

[Neil Thanedar]: The thing you want to do, I mean obviously for anything testing related go to LabDoor.com/rankings, that’s where we’re going to do all the voting. So to vote for things, I think that really helps us. Send us emails or Twitter or Facebook messages and tell us what you want us to test and we’ll test it.

Everything after that I think what we’d really like to do, and I think I really want to focus on people knowing that there are good supplements in every category. These things are safe. This market is safe. And it really is a matter of just doing your research.

And I think as much as possible if we can push and we can get into a sense where we’re focused on the research, and we’re buying based on science, that’s really what’s going to drive this. The more and more people who buy through LabDoor, if I can go to a company and they know that 20 percent of their sales are from LabDoor, that starts becoming a thing where, hey this is one of my major sales channels.

And that’s going to happen. And I think right now we might be in the 5 or 10 percent range for some companies. And we’re growing. And in some companies, it’s in different ranges.

And we want to get that up, and we want people to pressure themselves to focus more on science. To really make these decisions the right way. And I think it will pull up. I think the whole industry will come up and we will all get better products, and we’ll all be healthier out of it.

[Damien Blenkinsopp]: So when they go to your website, are there more details on what you’re doing? If some of the guys are listening to this today and they want to understand better what you’re doing, are there any resources on your website or anything they could look at?

[Neil Thanedar]: So, that’s honestly something we’re not doing a great job of right now.

So there’s some stuff on our site. If you go to LabDoor.com, it’ll explain how we make money, a little more detail to explain what labs we use and things like that. It even, on our top bar, it will say how we grade. So if you want to click there and get deeper into what the five grades mean, that’s something that we can do as well.

But I think the thing that we want to do this year, over the next 12 or 18 months a big focus for us will be bringing people into the lab. Can we do experiments for you? If anyone had a question or just wanted to do an experiment, I’d want to be able to do that more. I want to be able to bring cameras into the lab more.

All of that stuff, I want people to ask those questions. We’re working through YouTube right now. We’re trying to, we have a new studio that I’m standing in now that we’re trying to [use] to answer questions as much as possible.

And so I think for us, as much as possible it’s just being as transparent as possible, and doing Podcasts like this. Just talking to people. I think the first four or five years we needed to be quiet and do our work as much as possible.

And this is we’re just doing that transition point where we might step out, look up, and say hey people come look at this. We’ve got something here.

(01:18:54) [Damien Blenkinsopp]: Excellent. How can people best connect with you? Either you or the company?

[Neil Thanedar]: Facebook and Reddit are the two fastest ways that people get to us.

So if you want to talk to the company it’s just Facebook.com/LabDoor, or our Reddit user is just LabDoor and we’ve answered hundreds of questions on there. And sometimes that sparks lively debate, and we love that. The idea of why should certain rankings matter? Why does label accuracy versus projected efficacy, the weightings. It gets really into the details. That’s a really interesting way to do that.

I’m on twitter if you want to find me at Neil Thanedar. On Twitter, you’ll find I’m using talking about LabDoor or different things, like my ideas about testing. I think as we grow I started to think more and more about how LabDoor touches other industries.

While at the core we’re this scientific lab, there’s a big part of us that is a technology start-up. There’s a big part of us that is an online media company. At some level we’re journalists. And so as it unpacks, as we get deeper and deeper into LabDoor, my interests of what LabDoor can have kind of expanded.

So if you have any ideas about what we should test next or what, hey you should grade it differently, or you should think about LabDoor in a different way, I love thinking about that. I love dissecting what are the moving parts in any sort of industry. Not just ours, in any industry or business, it is fascinating to me.

So unpacking those is always so interesting. So yeah, ask me questions about that, happy to chat forever about stuff like that.

(01:20:32) [Damien Blenkinsopp]: Excellent. Thanks, that’s great. Do you have anything to ask or request from my audience? Anything specific?

[Neil Thanedar]: It really is, never buy supplements without checking LabDoor. Use our affiliate links, help support LabDoor’s business. And if there’s anyone that you know that, just help spread the word at this point.

I think we are right in that phase where I mean Yelp is really only 15 or 20 years old at this point. It took them a good 5 or 10 years to establish that brand. And that’s really that zone that we’re in right now, where we’re going from this ugg start to this trusted rating agency.

And part of that, most of that, is really going to be people telling their friends about LabDoor, and saying once you try it, you trust it and you keep using it. That’s really our business, and we’re going to grow as fast as people help us grow.

And so as much as possible, if there’s any way that your folks can share the word, we’d love that.

[Damien Blenkinsopp]: Okay. Thank you.

Neil, thanks for your time. It’s been a really great interview. I really learned a lot about the whole testing situation, and where it’s at. So it’s going to be really useful for everyone.

[Neil Thanedar]: Yeah, absolutely. Thanks for having me.

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Ketone bodies, whether gained from fasting, keto diets, MCTs or exogenous ketones have many potential applications with benefits ranging from performance, to health, to longevity and mitigating symptoms and risks of certain diseases.

There is growing evidence that ketone bodies, whether they come from fasting, keto diets, MCTs or exogenous ketones have potential applications across many areas from longevity to performance, to health and mitigating some of the risks and symptoms of certain diseases like cancer and neurologically inclined deceases. As such the whole ketone body area is what I call a high leverage area due to the many potential upsides.

So I’ve personally been investing more time into experimenting in this area as the payoff for that effort, looks pretty promising. You’ll have noticed that I’ve done a fair amount of fasting and since late 2015, that also includes the exogenous ketones and playing around with the ketogenic diet. More to come on my results with all of those in future episodes.

This interview is a very in depth look at many of the applications of ketone bodies and the nuances of their use in the body.

Ketones have a unique effect of being… anaplerotic… [This] helps to generate the bioenergetic intermediates [including] the Krebs cycle intermediates… to energize the brain when fuel flow is kind of low.
– Dominic D’Agostino

Today’s guest is Dominic D’Agostino. Dominic has something that I found relatively rare but makes for extremely valuable interviews. He has a combined prospective coming from both research and self-experimentation. He has a considerable amount of lab work and research specifically done into ketogenic diets, ketones, ketone driving supplements and a growing number of applications. And he has done a lot of his own self-experimentation for many years in this area.

Dominic is currently an associate professor in the Department of Molecular Pharmacology and Physiology at the University of South Florida, and he’s also a senior research scientist at the Institute for Human & Machine Cognition (IHMC). His research is focused on developing and testing ketogenic diets, ketone supplements, and amino acid formulations for a broad range of therapeutic and performance applications.

His laboratory uses in-vivo and in-vitro techniques to understand the physiological, cellular, and molecular mechanism of nutritional ketosis and supplement formulas. His current efforts are focused on evaluating different methods for inducing and sustaining nutritional ketosis and how this can be optimized to the specific individual and applications. So, we’ll see in today’s interview that there are a lot of nuances and it’s a bit more complex than just boosting your ketones.

Dominic’s research is supported by the Office of Naval Research, The Department of Defense, Support Supplement Companies, and Private Foundations.

Special Note: In the interest of full disclosure, since late 2015 I own a company (Ketosource.co.uk) that develops ketogenic and ketone driving supplements, foods and drinks for the UK.

The episode highlights, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know if you want more on this topic in the comments!

itunes quantified body

What You’ll Learn

  • Using exogenous ketones to mitigate some of the impairments of sleep deprivation (all nighters, or jetlag) (5:50).
  • How the stress response from scenarios like jetlag will kick you out of ketosis (and can be compensated for via exogenous ketones) (13:00).
  • Dominic’s background research and how his career has evolved to working on ketone bodies and ketogenic diets and their applications (14:50).
  • Recent research with mice that may indicate that ketosis reduces anxiety (17:00).
  • Screening a range of different naturally derived exogenous ketone agents for their therapeutic and performance benefits (18:40).
  • A once to twice per year fast or nutritional ketosis protocol for potentially activating a range of beneficial genes (37:50).
  • The press-pulse ketone body strategy for the management of cancer (40:40).
  • The benefits of the ketogenic diet for the management of epilepsy over the pharmaceutical alternatives (49:20).
  • Using the ketogenic diet to restore normal appetite regulation (50:15).
  • The various health, performance and longevity applications for ketone bodies (52:00).
  • Potentially reducing tremors in Parkinsons and Alzheimers with the use of ketone bodies (57:10).
  • Evaluating the legitimacy of recently raised safety and effectiveness concerns related to ketone salts and MCTs based on scientific facts and their track record over the last two decades (1:01:10).
  • How racemic exogenous ketones suppress glucose more effectively than non-racemic exogenous ketones (1:13:40).
  • Using MCT oil powder as a staple product for coffee, baking and protein shakes to boost the ketogenic profile of your diet (1:16:00).
  • Avoiding liquid meals in order to be able to elevate protein intake higher while remaining in ketosis (1:18:00).
  • What a typical ketogenic day looks like for Dominic in terms of blood ketone measurements from morning to evening and how he optimizes it (1:20:00).
  • How Dominic has identified his optimum ketone and Glucose-Ketone Index ranges for mental performance (1:21:00).
  • To standardize and control for your blood ketones and glucose you need to be fairly sedentary (1:34:10)
  • Dominic D’Agostino’s recommended self-experiment with the largest potential upside with the tactic to test and biomarkers to track (1:42:00).

Thank Dominic D’Agostino on Twitter for this interview.
Click Here to show him some appreciation for doing this interview!

Dominic D’Agostino

Recommended Self-Experiment

  1. Tool/ Tactic: Start Intermittent Fasting with fasting windows of 18 hours and eating windows of 6 hours each day. Dom recommends listening to Matt Mattson’s talk on IF before you start.
  2. Tracking: Get some baseline lab tests before you start the IF and again 3-4, and/or 6-8 weeks afterwards to see the positive impacts. Your lab tests should include fasting glucose, triglycerides and hs-CRP.

Tools & Tactics

Diet & Nutrition

  • Well Formulated Ketogenic Diet: The high fat, low carb, moderate protein diet that puts you into ketosis with typical blood ketones of between 0.5 and 3 mmol/L depending on execution and the person. Not suggested for children, teens or people in their 20s with good insulin sensitivity in general.
    Foods Dominic Makes Particular Use of:

    • Coconut Cream: Combines the fats with some of the fiber from the coconut flesh. Coconut cream is also known as Coconut Butter.
    • Ghee (Clarified Butter): Butter that has had the dairy proteins removed to leave solely the fats. As such it is considered dairy-free.
    • Wild Sardines
    • Sour Cream with Live Cultures: Didn’t find a link to this – if you know a good source please let me know in the comments.
  • Fasting Protocols

  • Intermittent Fasting: Sometimes referred to as short-term fasting due to the typical 16 hour to 20 hour fasting window. Dom noted that he has spoken to a fair number of high-performing CEOs doing this routinely recently.
  • Fat Fast: A modified intermittent fasting protocol whereby you restrict caloric intake in the fasting window (e.g. 18 hours of day) to some fats, exogenous ketones and/ or MCTs instead of a pure fast (no food or calories). Dom finds this method effective and that he tends to be less hungry going into the eating window (i.e. 6 hour window).
  • Periodic Fasting: Typically refers to fasts spread out by once per week or once per month. We’ve done past self-experiments on the once per month periodic fasting protocols via a 5 day fast, 10 day fast and fast-mimicking diet.

Supplementation & Drugs

Exogenous Ketones

Dominic’s lab has looked at a variety of exogenous ketone formulations in different scenarios and applications. Amongst their papers are included improved blood lipid profiles1 and non-toxic metabolic management of cancer2.

MCTs and C8 (Caprylic Acid)

  • Brain Octane: Pure Caprylic Acid (C8) from Bulletproof Nutrition.
  • Keto8: Pure Caprylic Acid (C8) oil from KetoSports.
  • Quest MCT Powder: MCT powder that Dom is using as one of his staples mixed into coffee for example.

Dominic’s Sleep Deprivation Effects Mitigation Cocktail

  • Exogenous ketone: Take your pick from one of the exo ketones listed above. Is beneficial to combine with MCTs such as C8 or MCT powder.
  • Caffeine: Needs no introduction – use coffee or your other favorite
  • Huperzine A: A nootropic herb used for cognitive enhancement via modification of acetylcholine levels.

Drugs

  • Metformin: A drug which is used to improve blood sugar regulation in diabetes. Researchers are looking at its wider applications with cancer treatment as it has been found to inhibit insulin secretion.
  • Ringer’s Lactate: The long term use of this racemic solution was noted as evidence as to the safety of racemic ketone salts.

Tech & Devices

  • Hyperbaric Oxygen Therapy: Increasing the amount of oxygen in the body with the use of a hyperbaric oxygen tank which uses air that is more highly saturated with oxygen and which is compressed. Dominic has worked on research with Doctor Thomas Seyfried looking at its application for cancer therapy in combination with ketogenic diets3.

Tracking

Biomarkers

    Glucose/ Ketone Metabolism

  • Glucose: Dom suggests aiming to keep values between 60 and 80mg/dl and that if you can maintain this all other biomarkers should be fine.
  • Glucose Tolerance (OGTT): The Oral Glucose Tolerance Test is a glucose challenge test whereby you take a certain number of grams (e.g. the typical standard is 75 or 100 grams) of glucose and test your body’s ability to regulate glucose and bring your blood glucose back into normal range over a certain time period (e.g. 2 or 4 hours). Dom used the OGTT to assess his insulin sensitivity – the more insulin sensitive you are the quicker your blood glucose returns to normal fasting levels e.g. between 60 and 80mg/dl optimally.
  • HOMA (Homeostatic Model Assessment): An alternative method to the OGTT used to assess insulin sensitivity/ insulin resistance.
  • Glucose-Ketone Index (GKI): This index was conceived by Thomas Seyfried and discussed in detail with him in episode 16. It assesses the weighting of the metabolism towards ketone vs. glucose. Lower values are ketone driven metabolisms and higher value (especially over 20) can be associated with heavy glucose metabolisms associated with chronic disease. Dom brought a new angle to this marker with an optimum everyday target he shoots for of between 2 to 4. Previously we discussed Thomas Seyfried’s recommendation of undertaking a 5 to 7 day therapeutic water fast once or more times per year targeting a GKI value under 1.
  • Lipids

  • Triglycerides: Dom believes this is the most important biomarker to watch. Optimum levels estimated as below 40mg/dl.
  • HDL: Higher HDL levels are said to be protective and beneficial. Dom’s value are around 90 mg/dl.
  • LDL: Dom believes keeping values in the normal to normal high reference range are perhaps optimal. This puts levels at approx. 80mg/dl to 110mg/dl. We previously discussed LDL in more depth in episode 7.
  • Other

  • hs-CRP (high sensitivity CRP): CRP (C-Reactive Protein) is a very common marker of inflammation that is used to assess cardiovascular risk amongst other things. It tends to drop on a ketogenic diet. Dom’s values have been between 0.1 and 0.2 since he quit dairy (Note: Damien’s levels are also at this level).
  • IGF-1: IGF-1 was discussed in more detail in our FMD episode. Dom’s IGF-1 values dropped significantly after quitting dairy.
  • Heart Rate: Typically heart rate is measured as the biomarker Resting Heart Rate (RHR) for standardization, which is an average of the beats per minute. See episode 1 to understand the use of RHR.
  • Blood Pressure: Optimum ranges are for systolic between 90 and 120 and dystolic 60 to 80 expressed as for example 110/70 mm Hg.

Lab Tests, Devices and Apps

Devices for Measuring Glucose & Ketones

The different approaches to measuring ketones provide different perspectives on your ketone metabolism. These can be looked at in terms of the ‘window of snapshot’ that they represent. Some methods have a snapshot of a longer duration, so provide more of an average reading, while others provide a direct status of that exact moment.

Moving from the more average-based value end of the scale to the more direct status end you have:

  1. Measuring ketones via the urine (via the ketone body acetoacetate) has the longest snapshot with it representing your ketone values over the last 5 to 6 hours.
  2. Measuring via the breath (the ketone body acetone) has a smaller snapshot window of the 2 hours leading up to the measurement.
  3. Measuring via the blood (via the ketone body beta hydroxybutyrate) provides you a snapshot of your ketone level at that exact moment.

The various devices available for glucose/ ketones testing and mentioend include:

  • Urine Ketone Strips: . Both hydration status and becoming keto-adapted interfere with the measurement values provided by this. Dominic recommends starting with urine test strips as they are the cheapest and effective until you get keto adapted.
  • Ketonix Breath Meter: Currently the only breath acetone meter. If you are moderate to high on this meter you are effectively in ketosis (i.e. typically over 0.5 mmol/L). Dom recommends this in particular for epilepsy since breath acetone has been correlated with seizure control.
  • Blood Glucose & Ketone Monitoring Systems
  • Precision Xtra: The most popular meter for testing blood glucose and ketones in the U.S. Has a broader reference range than the NOVA providing values for lower blood glucose levels instead of the LOW error.
  • Freestyle Optium Neo: Freestyle Optium Neo is the upcoming replacement for the PrecisionXtra, it comes from the same company and has similar functionality – the only difference in the meters seems to be a rebranding exercise.
  • Novamax Plus: Novamax Plus is a slightly cheaper meter with some greater accuracy and sensitivity concerns than the Precision Xtra or Freestyle Optium Neo.
  • Dexcom G5 CGM: A Continuous Glucose Monitor that Dom is about to start experimenting with for blood glucose optimization. Peter Attia has also been using this tracking device recently to optimize blood glucose regulation. We discussed continuous glucose monitoring and the devices available in episode 43

Other People, Books & Resources

Books

People

Researchers

Other Mentions

  • Tim Ferriss: Has been experimenting with the breathe hold extending effects of ketone bodies via ketogenic diet and exogenous ketones.
  • Ben Greenfield: Has been experimenting with using exogenous ketones for free-diving.

Organizations & Companies

Other

Full Interview Transcript

Click Here to Read Transcript
(05:32) [Damien Blenkinsopp]: Dom welcome to the show.

[Dominic D’Agostino]: Thanks for having me, Damien.

[Damien Blenkinsopp]: Yes, it’s great to connect. So you’re just back from a trip to Budapest and you just told me that you’re doing something to bypass the jet lag?

(05:42) [Dominic D’Agostino]: Yeah. Sometimes depending on circumstances I try to prioritize sleep and try to get between six to seven hours sometimes eight on the weekends if I can. But in the absence of sleep, I like to test certain things.

Usually happens once every month or two or I’m going to have to skip one night completely and have to get thrown right back into the fire of work again. I’m doing that now, and testing some different exogenous ketones in combination with caffeine and some Huperzine, and a few other little things in a stack formula that I’m working on.

It seems to be working because I’m functioning and I’ve been able to manage my tasks in a way that allows me to get stuff done.

[Damien Blenkinsopp]: So, this could be a new jet lag formula? Or if you want to keep going on sleep deprivation and work for a night or something…

[Dominic D’Agostino]: Yeah. So, inevitably people will come to the situation where they have to meet a deadline and stay up all night to get something. I don’t recommend doing it all the time because you can get burned out. There is no pill that you can take that will substitute for sleep.

But there are ways to extend your productivity and performance with two or three days of no sleep. I don’t like when those situations arise, but I worked on ways to mitigate some of the impairments that accompany that.

(07:13) [Damien Blenkinsopp]: That’s excellent, that sounds like another application for exogenous ketones I had not thought of. I know there are a whole bunch I want to discuss with you because it seems like there’s quite a few of them. So now if you want to work all night, they can help with that.

I’m tempted actually, what is the mechanism behind that specifically for sleep, is it just a pure energy thing or?

[Dominic D’Agostino]: As far as sleep? Mitigating sleep?

[Damien Blenkinsopp]: Why would exogenous ketones help with?

[Dominic D’Agostino]: Yeah, I think there are several ways that they can help. You can formulate things to provide energy to the brain. There’s various, what we call tricarboxylic acid cycle intermediates, including alpha-Ketoglutarate, creatine – is actually something that could be beneficial to the brain when energy reserves are low, and ketones have a unique effect of being anaplerotic. So if something is anaplerotic it helps to generate the bioenergetic intermediates which include the Krebs cycle or also called the TCA cycle intermediates.

Essentially just helping to energize the brain when fuel flow is low. Many of the TCA cycle intermediates are also precursors to neurotransmitters. For example, alpha-Ketoglutarate is a precursor to glutamate, and then from glutamate through glutamic acid decarboxylase we make GABA.

So, ensuring that we have efficient energy flow to the brain and sort of stimulating anaplerotic reactions and bioenergetic reactions we can replenish the neurotransmitters. Being in a state of ketosis too, can also be glycogen sparing.
I always had the opinion that when we sleep, part of the function of sleep not only restore neurotransmitters but to also restore brain glycogen levels.

Glycogen is actually stored in the astrocytes of the brain. Astrocytes are not just for support cells they have a really important function that pertains to glutamate recycling and sort of dynamic interactions with the synapses and recycling of neurotransmitters and restoring brain glycogen levels is a function when we sleep.

I think we need to look into this more but I have a theory that being in a state of strong ketosis could prevent some of the glycogen depletion that accompanies a normal day in a person that is normally sort of carbohydrate fed.

Where the brain is sucking massive amounts of glucose but if you’re ensuring that it gets a steady fuel flow of ketones it’s going to be glycogen sparing in that way. Sort of like what Jeff Volek is doing with the athletes and it showed in a recent metabolism paper, that being keto-fat adapted and keto-adapted can actually be very glycogen sparing. If you look at the muscles of lead athletes on a carbohydrate restriction, amazingly their glycogen stores are topped off in the muscles.

I think the same thing is happening, I see no reason why it wouldn’t happen in the brain. Our energy reserves in our brain tank, adenosine goes up, neurotransmitters are depleted – we want to sleep. Being in a state of ketosis can slow that process, and exogenous ketones can be a tool in a toolbox to help with that.

[Damien Blenkinsopp]: That’s really fascinating. It’s like the biochemistry of sleep, we’re getting tired and I think we understand on a very basic level but you’ve just broken down quite a few mechanisms which lead to us needing to sleep and how to counter them.

[Dominic D’Agostino]: Yeah, sleep is a really complicated subject. I did my Ph.D. in a pulmonary critical care department that was also a sleep lab. So I sat in on a lot of rounds and meetings with residents and fellows about the mechanics of sleep.

It’s just a fascinating subject, and something I’ll probably get more into research wise. But I do teach the medical students about obstructive sleep apnea and central sleep apnea, that’s some of the research that I did in my Ph.D.

(11:22) [Damien Blenkinsopp]: Excellent, and you’re on a keto-diet as well right still?

[Dominic D’Agostino]: Yeah. I maintain that but I also like to cycle a little bit because I think a lot of the therapeutic and performance enhancing benefits can be achieved with nutritional ketosis but I also think it’s good to have relative changes.

Not to stay on something all the time, but to adjust your macronutrients a little bit, and also maybe your calories a little bit, and occasionally fasting. These relative changes can produce some pretty good performance and therapeutic effects.

[Damien Blenkinsopp]: It’s kind of like exercise like promoting metabolic flexibility, is that where you’re coming from?

[Dominic D’Agostino]: Yeah, that was what I was going to say and relate it back to a hormetic effect where relative changes are good. For a while, I just stayed on the exact same ketogenic diet for a long time and I started adjusting and playing around with different supplements and I realized it’s good to sort of adjust the diet and even adjust your calorie levels sometimes. My life is variable, it kind of fits on with my lifestyle too.

[Damien Blenkinsopp]: I feel the same way. I’m probably doing the something a bit more varied these days. So, it’s just interesting, you said you are basically stacking exogenous ketones for sleep on top of your keto diet. Does that push your levels quite high?

[Dominic D’Agostino]: At least doubles or maybe triples where I would be. I have noticed in the past that if I just stick to my normal diet and I cross time zones. I’ve been in at least a dozen time zones for the last month and a half, two months.

When I do that and I miss a complete night of sleep, coming from Southeast Asia completely flips circadian. I realized that I get a stress response from that I think my cortisol goes up, my sympathetic nervous system can be activated. And I notice that can kick me out of ketosis a little bit or I’ll have levels that are — I would predict there would be much higher based on the macronutrient profile that I’m eating and even fasting.

So, I find that exogenous ketones can sort of help in those situations where I put my body into an unaccustomed stress.

(13:36) [Damien Blenkinsopp]: That’s very interesting. I’ve started to use some of the supplements, exogenous ketones for different scenarios a bit like that situation but we can talk about that later. So, I wanted to give people a background, would you say your focus area is ketones, ketogenic diet? Is that what you’d call your focus area of research?

[Dominic D’Agostino]: Yeah. I’m classically sort of trained as a neuroscientist. I did my PhD in something very specific, it’s patch clamp electrophysiology where you measure from individual neurons and you record the membrane potential, firing frequency input resistance of individual neurons, either in cell culture or in a brain slice, and studying pharmacology and the metabolic activity. I became very interested in observing fundamental neuronal activity.

I became very interested in the metabolism that was supporting that. I realized that the life that I was seeing on the amplifier of the oscilloscope, these neurons firing was completely a result of the electrochemical and the electrical gradients between the neurons, they’re like little batteries.

That was generated completely by the metabolic activity so cells they need to maintain negative 56 kilojoules per mole of energy and they will do anything to do that. Some substrates and some means of generating ATP are more efficient than others. In my early work, I was actually looking at lactate.

I was interested in Ringer’s lactate, so racemic Ringer’s lactate is actually used on the battlefield and also in surgery when people have a lot of massive blood loss. Lactate is extremely efficient fuel, and I studied hypoxia in the brain and ischemia, and I was interested in lactate for that. That got me interested in this whole idea of developing and testing metabolic substrates to preserve and enhance brain energy metabolism in the face of extreme environments.

Our work for the last decade has been funded by the military. So I’m interested in particular situations that would accompany military operations, like a navy seal using a closed circuit rebreather with high levels of oxygen. He’s susceptible to a limitation of his mission, would be oxygen toxicity seizures so the fundamental neuroscience that I learned in my Ph.D.

I applied that to developing and testing metabolic base therapies to preserve that cognitive function and metabolic resilience in the environmental extreme of high-pressure oxygen. That’s sort of a fun thing to do because there’s many ways to do it. I’m always looking for the next, or the optimal formula, of ketones and that’s why we don’t focus on any one particular exogenous ketones. We screen a variety of ketogenic agents or formulas of them to identify the one that’s most neuroprotective or anticonvulsant.

Now, we do cancer studies and we do wound healing, performance applications – and it might be a different ketone for different applications and we’re testing that now. In Budapest, we actually presented some really interesting work on anxiety. So if we induce a state of nutritional ketosis, the anxiety levels go down pretty significantly. In a rodent model, they’ll spend more time in like an open-arm of an elevated plus maze.

Perhaps that reduced anxiety can play a role in reducing seizures too, so it’s another variable that we need to look at. I probably went off on a tangent. My background was neuroscience and now I do what I would call a nutritional neuroscience or metabolic based sort of strategies to target neuronal processes and neuroprotection.

(17:43) [Damien Blenkinsopp]: How many years have you been doing this now?

[Dominic D’Agostino]: I started neuroscience research as an undergraduate in 1997. So, it’s going on about — 1996 or 1997 — so about 20 years now I’ve been into neuroscience research. The office of navy research, post-doctoral fellowship, was the first large grant money that I’ve got, and that was 10 years ago.

It took me about four years to recognize that the most potent strategy for oxygen toxicity for mitigating that, which I was being funded to do would be a ketogenic approach. Then the ketogenic diet at that time was recognized as something very obscure even just six years ago. So the funding agency really wanted a ketogenic diet in a pill per se.

In addition, to our ketogenic diet research which I feel is also very important we have developed these synthetic and actually naturally derived ketogenic agents to mimic the effects of fasting, the ketogenic diet, and also to further augment the therapeutic efficacy of the ketogenic diet. If the ketogenic diet can only get you to one to two millimolar, and we boost it in another one or two millimolar with exogenous ketones. We’ve realized that, that can be very beneficial.

Not everyone can follow a ketogenic diet including performance applications or for therapeutic purposes.

[Damien Blenkinsopp]: People find it quite hard. I don’t think it’s relatively complex to get into it. I speak to a lot of people who think they’re in ketosis but they’re not.

[Dominic D’Agostino]: Yeah, I do too.

(19:25) [Damien Blenkinsopp]: It’s a little bit tricky I think. So, alas comes the supplementation and so on which could make it easier. I think what’s really awesome about you, you self-experiment as well in addition to your research.

You’re always looking for this stuff and I know you’ve been on a keto diet for a long time, when did you start that?

[Dominic D’Agostino]: Yeah, that’s the fun part of this research that I’m really excited about. Well looking back, I did low-carb diets for a while because I was always into powerlifting, fitness, and nutrition. So, I would experiment, and I was under the impression that being on ketosis was bad.

When I did a low-carb diet or what I call the ketogenic diet, I remember smelling like ammonia. Because it was basically a very high protein, zero carb diet, with a normal amount of fat. Then I got educated I guess, being connected with the folks at John’s Hopkins who are using this on a clinical setting. I read the book by John Freeman and Eric Kossoff at John’s Hopkins, which is a great book, ‘The Ketogenic Diet’ for epilepsy and other disorders that’s out there.

There are one or more popular books on Amazon. I realized wow I didn’t know what a ketogenic diet was. I didn’t realize it has this fascinating history. You know written with Travis Christofferson, we wrote a three part of series on Robb Wolf’s blog about the ketogenic diet the history. When I actually got into the 4:1 ratio ketogenic diet, the John’s Hopkins which is like 90% fat.

And I transitioned into a state of nutritional ketosis, it was kind of difficult in the beginning. After about two or three weeks I adapted quite well and started realizing the neurological benefits. The appetite suppression was pretty extreme it was difficult for me to maintain my weight even.

(21:16) [Damien Blenkinsopp]: In terms of losing weight?

[Dominic D’Agostino]: Yeah, because my protein level was really high. I think I was getting probably 300 grams of protein a day which is really high. So, I had to drop that down to about 100 grams of protein a day to hit those macronutrient ratios.

Probably about 120 grams a day of protein, which was a relative change that was really low. When I reduced my protein to 1/3 but elevated my fat, and I still kept going to the gym. But at the time my academic career was sort of going full steam and I was in the gym less, but still making it once or twice a week.

My weights that I was handling on major exercises were maintained so I realized that being in a state of nutritional ketosis had a pretty profound anti-catabolic effect. So, I figured I’d be wasting away if I wasn’t getting my body all these protein. But I was amazed that I could eat.

I even started experimenting and went down to like 60 or 80 grams of protein a day. Even after a couple weeks and months I was able to still move the same weights.

So it really blew my mind that shifting the metabolic physiology to being more fat and keto-adapted had this sort of protein sparing anti-catabolic effect. Which makes sense if you look at it through like an evolutionary lens.

So if we stop eating and we didn’t make ketones to fuel this big, highly energetic organ in our head. If the ketones weren’t providing fuel for our brain we would liberate a lot of gluconeogenic amino acids from the skeletal muscle, and we would quickly waste away probably in a week or two, for a lean individual. That’s important to recognize in the context of using a ketogenic diet for a weight loss strategy and also for body composition.

For example, athletes that need to make weight which many sports do — wrestling, boxing, mixed martial arts – keeping that power to weight ratio is important. We think from the studies that we’ve done, we actually just got a study approved finally for publication yesterday showing elite level athletes or advanced lifters that the ketogenic diet is quite effective for body composition alterations and preserving strength and muscle strength and performance.

So that should be out pretty soon in general strength and conditioning. We realize that the ketogenic diet has far more applications than just pediatric epilepsy, which was it’s original application. We’ve probably studied about 10 different applications now in our lab.

(23:59) [Damien Blenkinsopp]: Excellent. So I wanted to run through some of those applications. First of all taking a step back because you mentioned lactate earlier. I think the majority of us assumes that glucose is the main metabolism. Then we learned about ketones and we think maybe there’re two substrates that we’re using for metabolism.

As I understand it, it’s a lot more complicated right? That we’re using a number of different fuels at any time?

[Dominic D’Agostino]: Yeah. I think the big ones for brain metabolism, which our laboratory originally focused on and now we’ve branched off, would be glucose would be the primary fuel for most people. Then ketones are sort of a backup fuel.

If you’re on a ketogenic diet, you’re running this hybrid engine and you’re using both fuels at the same time. With ketones probably the most efficient of the two. Then lactate too.

When we exercise, we mobilize a lot of lactate and put a lot of lactate back into the bloodstream through what’s called the Cori cycle. We convert that back to glucose and then replenish liver glycogen or muscle glycogen. But that lactate can also go past the blood brain barrier across which is called the monocarboxylic acid transporters and provide a source of energy for our brains.

Lactate metabolism in the brain can also occur under conditions of oxygen deprivation, so it may be beneficial. That was also an interest in my earlier work, using lactate to preserve bioenergetic processes in the absence of oxygen. What we call hypoxia or anoxia, which is a complete lack of oxygen.

Interestingly ketones can generate more ATP per oxygen molecule consumed. In a hypoxic situation, ketone metabolism may also be able to preserve the bioenergetic state of the brain. That’s something that we’re also looking into hypoxia and ischemia protection of the brain with various fuels, ketones, lactate preventing or an alternative substrate to glucose.

In certain situations, neuropathologies and even a hypoxia, stroke, a brain injury for traumatic brain injury can cause a quick impairment of glucose utilization of the brain. By internalization of the GLUT3 transporter and also inactivation or reduced activity of Pyruvate dehydrogenase complex, the PDH complex, can be impaired under certain conditions of brain injury. Even certain viruses that cause neuroinflammation can impair this rate-limiting step for glucose metabolism.

So, alternative energy substrates are a way to bypass that glucose block.

(26:37)[Damien Blenkinsopp]: It’s like a diversification strategy?

[Dominic D’Agostino]: It is, in diving we always talk about being redundance. You need a level of redundancy to ensure safety. I think the brain does that pretty nicely. So we achieve that with fasting.

We have an alternative energy substrates being utilized in the absence of glucose. It’s interesting to be able to delve into that and understand what happens during fasting in different states. From my perspective, it’s a fascinating field of research to develop naturally derived or synthetic agents that can mimic those processes.

(27:17)[Damien Blenkinsopp]: Right. Because we are on a ketogenic diet do we also use fatty acids directly for energy substrates or do they have to be turned into ketones first?

[Dominic D’Agostino]: Yeah. Hepatic gluconeogenesis will be in a state of fasting, completely dependent upon the liberation of fatty acids from adipose tissue. Fat mobilization is directly almost correlated to a ketone production in that fasted state.

Our heart can use fatty acids more efficiently than glucose – our heart is an awesome fat burner. The skeletal muscle is an awesome fat burner especially in the keto-fat adapted athlete, the liver, various organs can use fatty acids quite efficiently. The long-chain fatty acids do not readily cross the blood-brain barrier.

Short chain fatty acids do, and medium chain fatty acids can actually cross the blood-brain barrier. So, that was actually an interest of mine and we did some brain metabolomic studies where we took out the hippocampus of some rodent models that we looked at. We saw a high level of the C8 and the CA10 MCT that we administered to the animals.

I think if you look at the ratio between the blood levels and the brain levels. I think there was a kind of like a 1:5 ratio, so that wasn’t readily getting through but a lot of it was getting into the brain. Of course, the brain was metabolizing it.

Our numbers might have not correlated precisely in a 1:1 ratio in that way. But it’s clear that our body can use fatty acids as fuels, and it’s an incredible fuel for our mitochondria. Because it metabolized exclusively in the mitochondria through oxidative phosphorylation.

(29:03) I would say ketone molecules are I’d like to call water soluble fat molecules, sort of an excessive beta-oxidation or accelerated beta-oxidation in the liver, contributes to the accumulation of acetyl-CoA which drives ketone production, and hepatic ketogenesis. So the acetyl-CoA essentially condenses to form acetoacetate. Then beta-hydroxybutyrate and these spill into the bloodstream.

So it’s interesting that the liver is a massive ketone producer but it lacks certain enzymes that prevent the liver from using the ketones as an energy source so it lacks succinyl-CoA transferase for example.

So, the liver will produce massive amounts of ketones. Then dump it into the bloodstream primarily for our central nervous system to maintain energy flow to the brain, then the central nervous system, and probably the heart too. The liver is a greedy organ, if you fast and you eat, the amino acids and glucose will basically stay in the liver and the liver will take what it needs and put whatever is left into the bloodstream.

But with ketones since the liver does not metabolize ketones it puts them immediately in the bloodstream when it’s burning fat for energy. Looking at it through an evolutionary lens, that function is to ensure that our brain gets adequate fuel flow. In the absence of food, if our brain tanked because we’re hypoglycemic, we wouldn’t be able to hunt.

So, being very lucid and having our brains energized during a period of food deprivation ensure that our species survived. The humans that weren’t able to do that did not get on and live. I think we’re sort of hardwired in a way to function optimally when we’re in a fasted state and that’s important to recognize.

Also, in the context of a society that’s programmed to give three high carbohydrate feedings per day. The metabolic program that is activated during fasting is largely silenced because of the societal norms, associated with our macronutrient profile, but also our eating pattern which is frequent feedings throughout the day.

(31:22)[Damien Blenkinsopp]: Yeah. One of the reasons I ask this is because I’ve had some fear and scared feedback about fasting for instance, which is a bit more of an extreme situation like ketogenic diet normally. One of the things I did was publish some of my own information on YouTube and I got some crazy comments from people saying I was going to die because my glucose was low.

I think it was 3.3 millimolar or something about 54-55 mg/dL. My mother’s a nurse and she saw the numbers and she was quite shocked at the time as well. Everyone thinks that we’re driven solely by glucose metabolism that’s the only thing they look at. So I think it’s really interesting that we have several various fuels that we can be going on, turns out that the glucose isn’t that important.

Someone else just sent me the numbers recently and they were the lowest I’d ever seen, like I was doing a fast and she got 1.8 millimolar with her glucose. I don’t know if you’ve seen anything that low.

[Dominic D’Agostino]: I did. Well, when I fasted for a week I tried some strategies, I probably shouldn’t talk about it here.

[Damien Blenkinsopp]: Okay. In case someone else does it.

[Dominic D’Agostino]: Yeah. After fasting a week, I was staying around the mid-fifties to low fifty’s and occasionally I would dip into the high forty’s depending on my activity and things like that. I did some strategies — I’ll label it as “strategies” — to lower it down to a level that the meter didn’t read, so it just actually was flashing low.

The lowest my meter was able to read was 25 or 26 mg/dL. I assume 25 that’s the limit. I spent a good part of the day with it flashing low and unable to read. I was using the Nova Max meter, and I was using the Precision Xtra Meter and also using the Neo Meter, so I had three different meters and I was scrambling.

[Damien Blenkinsopp]: Is that the Freestyle Optium Neo?

[Dominic D’Agostino]: Yeah. The freestyle like a lower profile sort of meter than the Precision Xtra. So I had three different meters, and I was measuring and I was like, “Oh no I don’t even know what my glucose is. All I know it’s probably under 1 millimolar range.”

I was starting to feel a little bit — using different pharmacological strategies to lower it — but I realized that I was at a level that was universally fatal for everyone if I didn’t have my ketones elevated.

[Damien Blenkinsopp]: Right. But if you had been admitted to the hospital, they’ll put you on the emergency ward most probably if you walked in like that.

[Dominic D’Agostino]: Yeah. During this particular day, I was preparing for a lecture, I was writing a grant it was really a productive day. As I was working I was doing these things and I would do measurements and work for a little bit more and it just goes to show it was a very dramatic demonstration an alternative energy source.

For me, that has tremendous implications therapeutically for someone that’s experiencing insulin shock or a neurological disease with impaired glucose metabolism. So we worked very closely with the glucose transporter type 1 deficiency association. It’s a rare disease where the brain does not have glucose available due to deficiency of the GLUT1 transporter.

There are many different diseases like that. I was also inspired by the work of George Cahill, there was a study that was published in 1967. The first author was Oliver Owen and they fasted subjects for 40 days.

In another report that wasn’t originally published with the original report. I found it in another book they administered insulin, 29 IU of insulin they gave IV. In these fasted subject they lowered the glucose down to 1-2 millimolar and kept it down there.

[Damien Blenkinsopp]: So it’s like 35 mg/dL somewhere around there?

[Dominic D’Agostino]: It’s not even that it was about that 25 range that my meter couldn’t read. So one millimolar would be 18 mg/dL. That inspired me, I was thinking if these subjects can fast for 40 days I could do a week.

It’s about five years ago or so that’s when I did the week long fast and did some experiments on myself. One of the most interesting things that happened to me was my breath hold time. So at the time I was outside a lot.

I was in and out of the pool, taking short walks and trying to stay active, keep my mind off of food. Because the main challenge was just the pleasure of eating was not there. I was swimming I was under the pool and I realized, “Wow,I had been down for quite a while”, and I wasn’t gasping for air.

I got back up to the surface and my girlfriend was there at the time, now my wife, and I started testing my breath hold time. I was like, “Keep an eye on me.” Normally I could do over a minute about 90 seconds, but I was able to stay down for three to four minutes which is remarkable.

I don’t have any kind of specialized training. I’ve been wanting to take a freediver course. I know Ben Greenfield did and we exchanged emails when he was going through that because he was trying exogenous ketones. But I found that after one week of fasting, I had a profound prolongation of my breath hold time. I think that’s fascinating to me.

Fasting does definitely start to shut down your metabolism. I think my body temperature probably went down a degree or two so the metabolic demands just weren’t there. But I think our drive to breath has a lot to do with our CO2 sensitivity.

So there’s receptors in the ventral respiratory group and the ventral surface of the medulla that sense CO2 levels and drive the urge to breathe. We also have the carotid bodies, at the bifurcation of the common carotid artery that sends oxygen and CO2 and they also mitigate or they also play a role in the drive to breath.

I think there’re interesting mechanisms going on there. A desensitization in some way or in combination to just altering our metabolic physiology. I think that has some practical benefits for different sports, maybe military operations.

I want to study that a little bit further with adaptations that happen during fasting.

[Damien Blenkinsopp]: Yes, very interesting. I’m wanting to go and test that out with freediving.

[Dominic D’Agostino]: A number of other people have, I think I might have mentioned it once or twice very briefly, not as descriptive in other podcasts but other people went out there and did it.

I think Tim Ferriss did it. I’m not sure if he’d blogged about it yet but he sent me quite a few texts and emails just saying that dramatically enhanced his breath hold time. So, I’m pretty sure it’s a real phenomenon.

(38:15) [Damien Blenkinsopp]: Very cool, to kind of round that conversation off. I get these emails, like I said, some people are scared because they get injured in fasting particularly a very low glucose levels of 30-35mg/dL.

Do you think that’s something to be concerned about or is it absolutely no problem? Typically, they have ketones like six millimolar, somewhere around there at that stage?

[Dominic D’Agostino]: I wouldn’t recommend that for a long term sustainment of life. Because there are a lot of biological processes that require glucose: red blood cells, your kidney, certain immune cells, and even biosynthetic processes like the generation of certain neurotransmitters are in some part glucose dependent. I think it’s good to get into that level and I’m going out on a limb by saying this to be a mainstream sort of medical college.

I actually think it’s very good to be in a state of nutritional ketosis with sustained hypoglycemia for a period of time, and to do that at least once a year, preferably a couple of times a year. I think what really kicks on a genetic program that activates so many biological processes that I think could be protective from enhanced insulin sensitivity to autophagy, to activating a number of different genes. There’s certain ones obviously, ampakine is activated, mTOR is suppressed.

You put tremendous metabolic stress on glycolytic cancer cells or pre-cancer cells that we may have in our body, sort of an immune activation. I know Dr. Adrienne Scheck is doing some work with the ketogenic diet and she’s doing some elegant work on the immune activation, and from the gist of it and from other bodies of literature it supports the idea that the immune system becomes hyper-vigilant, to recognizing and attacking existing cancer cells when we put our bodies into the state of fasting.

Either prolong fasting or even the ketogenic diet. I think it’s good to do that sometimes. But say if you’re on the ketogenic diet all the time in the state of moderate ketosis and then you fast.

You probably won’t get the same benefits as a person who’s on a high carb diet and did a fast. It would be a lot harder for that person who is on a high carb diet to do a fast. It would be greater stress because it’s that relative change or that pulse.

Thomas Seyfried and I we’re going to work on, it was originally his idea. We talked a lot about this press pulse phenomenon for the metabolic management of cancer. The press would just be a mild state of nutritional ketosis and the pulse could be periodic fasting or some of the things that we’re interested in. Such as hyperbaric oxygen therapy that could be pulsed exogenous ketones to further allow for a greater hypoglycemic response.

Also, you could pulse various cancer-specific metabolic drugs like 2-deoxyglucose, or dichloroacetate, or 3- Bromo Pyruvate] could be used. The press would just be nutritional ketosis and that would metabolically compromise a lot of the highly glycolytic, which corresponds to highly aggressive cancer cells.

(41:41)[Damien Blenkinsopp]: When you say press that would be like something chronic that you’re doing?

[Dominic D’Agostino]: Yeah. We know that being in a state of nutritional ketosis causes suppression of the hormone insulin. The cancer cells that light up on a fluorodeoxyglucose PET scan, a FDG-PET scan. The PET [or PET-CT] scan is really the gold standard technique.

I would say when it’s coupled with the CT scan allows you to precisely locate where that hypermetabolic activity is. So the PET-CT is an incredible, gold standard tool to assess the location and aggressiveness of existing cancer cells. The greater the standardized values that are coming out, like 2.5 would be sort of the normalized value.

If you have a PET scan showing SUVs of a 100 or 250, those cancer cells are very aggressive.

[Damien Blenkinsopp]: So they show up as the big red and yellow blotches?

[Dominic D’Agostino]: Yes.

(42:47)[Damien Blenkinsopp]: Yeah, we spoke to Gene Fine on a previous episode he was talking about the PET scan.

[Dominic D’Agostino]: Oh yeah. Actually Dr. Fine, you probably know he did a study for 28 days. He did a study with a ketogenic diet and he selected patients based on their PET scans. The topic that I was going to touch on is that insulin suppression correlates with ketosis.

I think even the title of his paper didn’t even mention the ketogenic diet, it was something like insulin inhibition therapy can be used to target cancer. It didn’t even talk about the ketogenic diet. But if you read the paper, he basically used the ketogenic diet to suppress the hormone insulin as a therapy for managing these hard to treat cancers or people who have failed the standard of care.

So, that would be the press that I’m talking about. The ketogenic diet limits glucose availability to the cancer cells. It suppresses the hormone insulin which drives IGF-1, mTOR and other factors that cause cancer cell growth and proliferation. I don’t know if Dr. Fine talked about it, but he has a number of publications.

I was inspired by his work and I actually got us to look at exogenous ketones and the effect on cancer cells. We find that if you limit glucose, suppress the hormone insulin and elevate ketones, the ketones themselves have anti-cancer effects. So, we did a study, we published in the International Journal of Cancer.

The first author was my graduate student at the time, Dr. Angela Poff, she’s now a research associate following up on this work. We gave ketones to highly aggressive cancer cells that have a glioblastoma-like origin. When we grew the cancer cells in the presence of ketones, even in the presence of 25 millimolar glucose, it inhibited, it dramatically slowed down cancer growth and proliferation.

(44:47) We did a viability testing where we looked at live cells and dead cells and the ratios of that. We found significantly more dead cells when we grew the cancer cells with ketones even in the presence of glucose. The take home was that ketones were probably turning down or shutting off a lot of some of the glycolytic mechanisms and there’s previous reports suggesting that ketone metabolism can turn down glycolytic metabolism.

So, that would be the press.

[Damien Blenkinsopp]: It sounds like a signal even for the cancer cells?

[Dominic D’Agostino]: Yes.

[Damien Blenkinsopp]: For them to switch them off even if they can’t use the ketones?

[Dominic D’Agostino]: Yeah, we think so. Now, we need to mechanistically dissect those kind of signals that are happening with the ketones because they do high-level sciences. Our lab approaches things a little different. We don’t sort of identify a target and then work up from that.

We screen a lot of things at the top and find out what works. Then, once we found out what actually causes animals to live longer or produce a neuroprotective effect then we go and try to find the mechanism.

(46:00) [Damien Blenkinsopp]: That sounds like a little bit like the pharmaceutical drug research process where they screen many many molecules for doing something. Correct me if I’m wrong. It seems like maybe it’s an efficient process to find things that work by just screening a lot of things and then focusing on the things that are working.

[Dominic D’Agostino]: Okay. So, it’s a little different, with pharmaceutical companies they actually target a mechanism or a biological kind of process and enzyme.

[Damien Blenkinsopp]: So they’re all looking for an end result right?

[Dominic D’Agostino]: Yeah. We’re testing a bunch of things, we don’t even know how they work. We’re testing various ketogenic exogenous ketone formulas and we don’t even have the pharmacokinetic nailed down yet. We don’t even know specifically how they’re metabolized.

We feel that it’s really important to get this research done so we can get these therapeutic agents out there as fast as possible. We screen a lot in various agents, first in human or first in animal, and then we identify what works. But the mechanisms, the metabolism is incredibly complex.

What we find is that it’s not working through one particular mechanism, it’s many different mechanisms working in synergy. The ketogenic diet, you have an increase in the GABA to glutamate ratio or ATP production you have a greater bioenergetic potential of the mitochondria. You have more TCA cycle intermediates.

The list goes on and on. There’s a science paper showing that ketones beta-hydroxybutyrate is a HDAC inhibitor. We published a nature medicine paper showing that inhibits the NLRP3 inflammasome and that’s independent of metabolism.

(47:41)[Damien Blenkinsopp]: So it’s like a huge dynamic system? There’s no way you can see all of the mechanisms going on there? As you’re saying you looked for the end effects and then you started looking for the mechanisms.

All of these mechanisms that you just brought up and started piecing them together to see how it worked after you’ve got the end result that you wanted.

[Dominic D’Agostino]: Yeah. The important thing is that it works and then the secondary important thing is to find out the mechanism. Because once you do know the mechanism, if the majority of the therapeutic effects or performance enhancing effects are due to a particular mechanism, out of many mechanisms. Then we can tweak the molecule of the formula, the pharmacokinetics, to further enhance that particular mechanism.

Then we can go back and tweak the formula, or the molecule to make it hydrolyze faster or to increase the sustainment of it, or deliver it in a certain nanoparticle formula to a particular tissue or something like that.

(48:37)[Damien Blenkinsopp]: So we’ve already spoken about quite a variety of basic applications, benefits of ketone based metabolism, and ketones. Could you just go through the top ones in your mind, maybe the ones that we haven’t already covered? So I know a lot of people are focused on weight loss for instance.

[Dominic D’Agostino]: That probably goes back to what they call the ‘Banting diet’. That even predates some of the work that I first got attracted to in epilepsy. So, epilepsy that would be the big thing.

The ketogenic diet, the only thing that is used for standard of care in mainstream medicine is the management of epilepsy. I always harp on this too, the ketogenic diet is grossly underutilized as a tool for managing epilepsy because it works when drugs fail.

It works in about two-thirds of the population. Imagine the efficacy of it if it was the first line of therapy. If you have a child that’s two or three years old and you load them up with anti-convulsant drugs, we know that these anticonvulsant drugs cause developmental delays. It’s even more important in pediatric epilepsy, I think to start with the ketogenic diet.

I just like to throw that out there. We’ve already talked about epilepsy. So, epilepsy would be the big one and obviously weight loss. You have the original Banting diet. Then Atkins came out with what he said was his famous diet but it was really a playoff with the Banting diet. It allows for effortless weight loss because when you’re in a state of nutritional ketosis the ketones function to control appetite.

It prevents your appetite from controlling you. We don’t really know the mechanisms that regulate appetite control, are incredibly complex. But we think that the ketones are essentially telling the brain it’s in a fed state, that’s the simplistic way to put it.

(50:32)[Damien Blenkinsopp]: Okay. Ketones get converted back into fat? Because people know that you basically pee ketones out when you first get onto a keto diet. Is that one of the mechanisms also?

[Dominic D’Agostino]: Well, yeah. If you collect all the urine of someone that’s on a ketogenic diet and then you look at how many calories are there, it’s pretty marginal. I think Atkins even advertised, “Look you’re peeing out fat, you’re peeing out calories.”

But it only came down to like 50 to a 100 calories or something like that. I think the big effect, the metabolic advantage really, is not that you’re burning more calories. I think there’re different organizations out there that we’re trying to prove if there’s a metabolic advantage to being in ketosis.

I think the big advantage that we need to focus on is appetite regulation. Our current diet of processed carbohydrates contributes to appetite dysregulation. The ketogenic diet is very effective at restoring sort of normal appetite behavior because there’s no fluctuations in blood glucose.

If we’re on a carbohydrate based diet and we go hypoglycemic that’s going to trigger an intense craving for carbohydrate re-feed to re-establish that glycemia. That’s completely abolished on the ketogenic diet.

So when you’re on a well formulated ketogenic diet, the craving that you’d have with hypoglycemia is going to be significantly attenuated if not abolished. We talked about weight loss and type 2 diabetes pretty much every disorder out there. Let’s think cancer, even kidney failure, neurological diseases like Alzheimer’s disease and many other pathologies are sort of linked pathophysiologically to the metabolic dysregulation and also obesity type 2 diabetes.

If a diet does promote a healthy weight loss and sustainment of that weight loss, it’s going to be therapeutic for many other disorders. Some of the things that we study include Alzheimer’s disease, ALS, we have a really active cancer research program in the lab. I have two Ph.D. students right now studying.

One is looking at Metformin and other cancer-specific metabolic drugs but combining it with a ketogenic diet. His main thing is to locate drugs. But we think some drugs will synergize with the ketogenic diet.

In another project is looking at the ketogenic diet or exogenous ketones and branch chain amino acids to mitigate cancer cachexia, which is muscle loss or wasting, so we’re looking at that. Exercise performance we’re looking at that. The most recent data that I’m really excited about because of the pretty robust effect as far as some of the behavioral models that we use.

One particular model is the elevated plus maze which looks at anxiety. We found that being in a state of nutritional ketosis that was induced completely with exogenous ketones stimulates in the elevated plus maze which is like a rodent going out on a catwalk. You can go into a cave or come out into an open area where you’re on a plank and you’re elevated in the air.

It’s a very anxiety producing situation. In our rodent models validate as a very useful model. We’ll spend much more time on the open arm and less more time hiding in the cave. We think that has significant implications for military personnel with PTSD and anxiety in general, and a lot of depression too is also sort of a comorbidity there with anxiety, a lot of depression, and anxiety fueled.

[Damien Blenkinsopp]: You’re saying that they’re willing to go out walk on the plank, take that risk and feel comfortable with it?

[Dominic D’Agostino]: Yeah.

(54:28)[Damien Blenkinsopp]: Do you measure it by time spent on the plank?

[Dominic D’Agostino]: Yeah. Less anti-social behavior I guess. We set up this elevated plus maze and then we have a whole video imaging system above it. We keep the animals as low stress as possible.

We have the same person working with the animals so they’re not experiencing different smells, and things like that. The room is very very quiet. We pay attention to circadian, light on light off things.

There’s a lot of variables that need to be controlled and then we image them in the absence of ketones. We see how much time they’re like in the middle, in the open arm, closed arm and our video camera system sort of can track all that. We have various programs and algorithms that do all the calculations for various things.

We do a bunch of animals just on a standard high carb diet. Then what we’ve been doing is testing various ketogenic agents, or various exogenous ketone and ketone formulas that would be administered 30 minutes prior to being put in this elevated plus maze, and being there for a couple of hours. Then we’ll track all that information, it’s all done blinded.

We have one person who’s, usually two people part of the project that’s administering the agent. The person that does the analysis does not know what the animal is receiving. We’ve got a pretty robust effect with a few of the ketogenic agents on reducing this anxiety behavior.

That’s some new data that we just presented literally less than a week ago in Budapest. That’s what I’m just returning back now. So we want to follow up on that. We used one dose, we need to determine what would be the optimal dose.

There’s a lot of work that we still need to do to optimize that and maybe think about putting together a formula that could be beneficial for people.

(56:30)[Damien Blenkinsopp]: Very cool. One of the ones you didn’t mentioned is Parkinson’s, is that something?

[Dominic D’Agostino]: Yeah. There’s an earlier study I think that was done by Dr. Theodore B. VanItallie. Dr. VanItallie is like 96 years old. We still communicate on the phone and through Email.

He was one of the original ketogenic diet researchers. He did a small sort of pilot study showing that people with Parkinson’s disease can follow a ketogenic diet and that being in a state of nutritional ketosis reduced the tremors associated with Parkinson’s disease and prevented some of the symptoms. Not a cure, but it could help manage some of the symptoms associated with Parkinson’s disease.

There really hasn’t been a good follow-up study to that. I know there was a ketone ester that was developed at NIH and a study at Oxford. There was that group that had a clinical trial open. But I think they might have had some problems recruiting people into that clinical trial, that opened a few years ago.

I know there was a clinical trial looking at the effects of exogenous ketones on Parkinson’s disease. And if we weren’t tied up with so many other projects I would be jumping on that. Because I was able to observe on Alzheimer’s patients when they took a medium chain triglyceride supplement, or even exogenous ketones. They would have pretty dramatic tremors.

And some Parkinson’s disease-like symptoms can be manifested in people with Alzheimer’s, especially advanced Alzheimer’s. I was able to observe and also got feedback from caretakers that when they induced a state of nutritional ketosis it really rapidly stops the tremors associated with that. So, that needs to be followed up on.

The pharmaceutical industry dictates a lot of what studies are done. Because you need a strong financial backing on top of a university, or chain of universities that supports this kind of research. On top of a review board, an IRB, that will prove this kind of research using these nutritional metabolic substances. There are many hurdles that need to happen.

Then you have to recruit patients on top of that and convince them that it’s not a drug but it’s a nasty tasting food that could potentially benefit you. They were like — well, it’s easier for a child, a son or a daughter [who] is bringing in their mom who is typically in a situation — 80 or 90 years old.

They’re not going to want to try to formulate some nasty tasting shake to do that. It’s much easier to just give them a pill. These are some of the things you see, the feedback that you get from people who are trying to implement these kinds of nutritional protocols in patients.

There’s a lot of hurdles. A lot of people ask me, “Well, if it’s so effective, how come science is not using the ketogenic diet or exogenous ketones to treat all these disorders?” I could write a book on the reasons why, but nutritional research is so hard to do.

Because nutrition is really tied into the lifestyle thing, and getting institutional support, getting the expertise needed, ensuring that patients are following through and complying with the protocol. All of these things are hard to do. A supplement, in theory, is a lot easier but we’re at the very initial stages. Because these are just new entities that just developed.

(1:00:16)[Damien Blenkinsopp]: Right, it’s only two and a half years you’ve had the ketone salts for instance, and the esters a bit longer?

[Dominic D’Agostino]: A little bit more than that. I would say the ketone ester was actually developed probably about 20 years ago, if you look into the animal literature. Then they were dropped because it was thought that they’re very expensive to produce and they taste like jet fuel.

Some of the people that originally developed these things, like Henri Brunengraber. He’s like a hardcore metabolic physiologist-scientist who develops a lot of remarkable things. But he kind of drops it and moves on to the next thing.

There’s also sharing the chair of his department and running a billion other things at the same time. So, I dug up some of this research and realized, “Wow, why didn’t anyone follow up on this?” Then I saw some of the work that was funded by DARPA, showing that they were the secret project.

They were using these ketone esters for warfighter performance enhancement. I found some patents and some files on that. I was like, “Well, this is what I need to explore, for use of CNS oxygen toxicity.”

Not only can the ketones potentially mitigate the oxygen seizures but the ketogenic diet was super effective. Even independent of the ideology of the seizures that it tends to work which is really remarkable. But instead of giving an anti-convulsant drug to a warfighter, which can dull your senses and impair your physical and cognitive performance.

You could be giving an anti-convulsant neuroprotective substance that enhances the physical and cognitive performance. It seemed like a win-win situation. I’d rapidly grasped this idea and just went into this manic state of writing grants and writing proposals, and digging up all the research.

Then, I was calling my program officer and I was like, “You need to hear this information and what I’m going to tell you.” We actually had a little meeting at our university and he was like, “We have to do this.” He was very generous to fund some of the initial basic science proof of concept research that demonstrated the efficacy of this ketone ester in mitigating oxygen toxicity.

It worked better than anything we had ever tested or anybody had ever tested, even drug wise. That’s going back in 2009 or 2010. From there, I’m really in safety because I’m really scared about bringing something to market that could potentially harm someone. I know there has been some discussion out there about the quote and quote dangers of a racemic beta-hydroxybutyrate salt.

People need to recognize the difference between someone’s opinion and scientific fact. The scientific fact is that racemic beta-hydroxybutyrate salts have been used for decades for treating a disorder called MAD, Multiple acyl-CoA dehydrogenase deficiency. I get Emails from the patients or from the parents that are treating their kids with this, and it’s like a miracle for them.

I also get Emails from parents that are treating their kids with glucose transporter type 1 deficiency syndrome with a racemic beta-hydroxybutyrate (sodium beta-hydroxybutyrate), which is actually a prescription you can get in Europe.

But they’re also using these commercially available ketone salt products which would be the ones that you might be familiar with. There’s KetoCana from KetoSports, Pruvit makes Keto OS, Forever Green makes Ketopia. The Kegenix product which is the one I’m testing now. It’s a really excellent exogenous ketone product.

This idea which was talked about in various podcasts, I think in Bulletproof podcasts and Ben Greenfield’s that racemic sodium beta-hydroxybutyrate was dangerous and ineffective. It is an opinion and there’s no science to back it up.

If you go back and listen to the podcast you’ll hear the speaker actually reference no actual studies. So, it has an intellectual property supporting the non-racemic, so that needs to be acknowledged and appreciated.

What is appreciated from my end, the science backing up the efficacy and the safety are really profound – like I’ve said on expert panels to approve some of these molecules. And no toxicologist or physiologist could find any evidence that racemic, which is the DL version of beta-hydroxybutyrate, was dangerous in any way.

For example, if you’re a medical doctor or a combat doctor on the field and you’re treating soldiers that have a loss of blood or you’re in the emergency room just talking to the ER doctors, use the Ringer’s Lactate and that’s Racemic lactate.

So, L-lactate would be the natural lactate that you would find in your body. The DL would be in an enantiomer or a mirror image of that lactate. Both of the lactate molecules get metabolized to energy. So, the same things happen with ketones. So the D and the L version get metabolized to ATP, to energy.

A lot of the metabolism has been worked out with very elegant tracer based fate association studies by Dr. Brunengraber at Case Western. Lactate Ringer’s has been used in millions of combat troops and emergency rooms. If there was a danger to using a racemic metabolate, there would be a lot of dead bodies around – and that has not been the case.

Actually, it’s FDA approved, it’s widely used and accepted, and it was even studied the difference between L-lactate and Racemic lactate before it became a standard of care. Actually, it was looked into, and it had exact same effect.

So, if you use the Racemic versus the L-lactate have the same effect at preserving the metabolic activity of the tissues and being protective in that way. So, that needs to be acknowledged that when statements are made, that they could be an opinion and not validated by scientific facts.

The ketone supplements that are on the market now that I’m aware of are very safe and from feedback, they’re very effective. I don’t support any particular ketone supplement that’s out there. I’ve tested all of them and they tend to elevate my beta-hydroxybutyrate and the .5 – 1 millimolar range for one dose.

So, for me to really boost my ketone levels up, I have to take a packet and a half, or a dose and a half, which I can tolerate pretty well. But I think there’s a lot of room for improvement and the products that are out there.

I hope to work with these companies, hoping that they will fund research to support the further development and evolution of these products for different applications.

(1:07:30)[Damien Blenkinsopp]: Excellent. Thanks for going through that because that’s something I have my eye on as well and wanting to get some more facts. Something else that was thrown out, a couple of things was that the racemics were less efficient or were ineffective?

We also have all of the MCTs which people are using to kick up their ketones as well. We have the C8 and C10 of the MCTs, there’re various products around. Another statement that was said they were undesirable and you should avoid those as well unless you really had to take them.

For instance, if you have Parkinson’s it was okay to take them but otherwise you shouldn’t be really taking them. But a lot of people are taking these. Right now, there’s a bulletproof brain octane. I’m sure a lot of people are taking that.

KetoSports has got their own product that I’ve been taking for a long time personally. I don’t know if you have got any comments on that?

[Dominic D’Agostino]: Yeah. I study a lot of very expensive exogenous ketone products. But the more I look into medium change triglycerides, especially the C8 oil which is digested and assimilated much differently than long-chain fatty acids. When you consume it, it basically perfuses the liver.

I mean it goes right to the liver via hepatic portal circulation. It goes right through to liver and is burned as energy. So, they’re poorly astrophied, which means they’re not re-astrophied back and packaged into chylomicrons, like long-chain fatty acids.

Once they reach the liver, it’s basically an obligate oxidation. The medium chains are almost completely oxidized to ketone bodies. Some of them will spill into the bloodstream because we find them in the brain tissue and other tissues.

But it’s independent of the various transporters too. For the medium chain triglycerides to get into the mitochondria there’s various CPT-1, for example, is not needed to get the MCT into the mitochondria. So, they bypass a lot of these rate limiting steps.

And you consume them, it goes right to the liver, you generate a lot of beta-hydroxybutyrate and some of that gets into the bloodstream. So you have the combination of ketones and the medium chain triglycerides going right to the mitochondria. And that can be very therapeutic and beneficial for many different disorders.

You have to realize that the person making that statement that MCTs are dangerous or ineffective, has some underlying personal interests in advancing the commercialization of his particular exogenous ketone, and that needs to be appreciated and understood.

From our perspective, we’re interested in testing that particular ketone formulation and 20 other, and finding out the truth, finding out which is most effective, which is safe. When it comes to the racemic, and the statement that racemic beta-hydroxybutyrate is not as effective. We have not found that out to be the case.

Actually, the first ketone ester that we studied for oxygen toxicity was a monoester of the R-beta-hydroxybutyrate we have formulated. And that did not prevent CNS oxygen toxicity, which actually was very strange to me. But the more research I did I found out that you needed to elevate both the acetoacetate and beta-hydroxybutyrate in the blood to mimic some of what happens naturally, physiologically.

The acetoacetate through spontaneous decarboxylation to acetone, or maybe it has it’s own metabolic effect independently. The elevation of acetoacetate was absolutely critical. It also in the presence of beta-hydroxybutyrate but it was absolutely critical to elevating both ketone bodies to get the anti-convulsing effect.

We published that in the American Journal of Physiology and showed the pharmacokinetics and seizure work with that. So, we screened a lot of agents and found out the particular ketone ester that we found to be most effective was 1,3-Buntanediol acetoacetate diester]. So it was 1,3-Buntanediol that was racemic, so it would make racemic beta-hydroxybutyrate.

But even the non-physiological enantiomer gets broken down and converted to Acetyl-CoA and some of that goes back to the physiological enantiomer so it all gets broken down and metabolized similarly to Ringer’s Lactate which is used in millions of patients.

But the important thing about that particular molecule is that when it’s consumed orally it gets hydrolyzed and it rapidly liberates the acetoacetate. Then the 1,3-Buntanediol gets metabolized in the liver and elevates beta-hydroxybutyrate. So you have both ketone bodies elevated in the blood. We find that it’s absolutely critical to get a certain level of acetoacetate to get the anticonvulsant effect.

(1:12:30) One thing I didn’t talk about was Angelman Syndrome, which is characterized by impairment of motor function and also drug resistant seizures. It’s extremely effective in an animal model of Angelman Syndrome.

If you look at Angelman Syndrome and the ketogenic diet, you come across case reports showing that it basically puts Angelman syndrome patients into remission, at least for seizures. So, it’s highly efficient for that.

So, the first ketone ester we studied was this R in the enantiomer, the hydroxybutyrate, and it was not effective. So it was actually the racemic version of a ketone ester that was most efficacious.

But we’re interested in exploring all different pathologies and finding out which one. So, we have not found out that the R and enantiomer is any more efficacious for any other disorder than the racemic. I think that’s important to acknowledge.

We also found that medium chain triglycerides tend to formulate really well with this exogenous ketones. Not only are they carriers but we think they enhance the transport across membranes and they improve the pharmacokinetic profile, two of many of the ketones salts. So when it’s formulated with MCTs which have the nice advantage of also being ketogenic.

One of the benefits of racemic, the other enantiomer, so there’s D and L. The L-enantiomer tends to impact the liver in a way that reduces hepatic gluconeogenesis. So, you have this hypoglycemic effect that is very well characterized by our laboratory and other peoples laboratory.

[Damien Blenkinsopp]: So you’re saying that ketones go up and the glucose goes down?

[Dominic D’Agostino]: Yeah. It’s more pronounced with the racemic and we don’t know why that is.

(1:14:22)[Damien Blenkinsopp]: Is that beneficial to some of the applications more than others? Weight loss for example?

[Dominic D’Agostino]: Yeah for weight loss, maybe for seizures too. We know that reducing glycolytic metabolism can be beneficial for seizures but also for cancer. As I mentioned, we have pre-active cancer research program.

The lower we can get glucose or glucose response to a meal, the lower we can reduce that, the better therapeutic efficacy we think the agent will have. If we formulate the agent with food, so every time our animal models will eat the food they’re getting a dose of it.

Instead of injecting into the animal or ‘gavaging’ it in the mouth for our cancer studies, we actually take these ketogenic agents and formulate it to about 10 to 20 percent of the weight of the food. Then we count the macronutrient ratio, and then they eat it.

Every time they’re eating the food they’re getting a dose of ketones with the glucose. Because we do a lot of our studies formulating with a high carb diet. Because we want to find out the therapeutic effects of the particular agent and distinguish that between the ketogenic diet.

But we also published a study, about a year ago, where we formulated the ketogenic diet with the ketogenic agent. We did this with a ketone ester and found that it further enhanced the anti-cancer effect of ketogenic diet.

(1:15:48)[Damien Blenkinsopp]: Okay. I’ve got a few questions about this. There’s some MCT powders on the market which combine glucose. Me coming from a ketogenic perspective, that’s not something I want to take with the MCT powder. There’re other powders which don’t have the glucose.

Is there anything to think about or is it not really an issue? Because there’s this effect of the ketones pushing down the glucose anyway? Would it have zero effect? I haven’t tested it myself yet.

[Dominic D’Agostino]: Yeah, the MCT powders on the market like Quest Nutrition?

[Damien Blenkinsopp]: Not Quest, they don’t. It’s basically the generic ones. There’s this cheaper one, generic one, where they’ll put glucose syrup in it and some other glycemic ingredients.

[Dominic D’Agostino]: Yeah, with my interest in the ketogenic diet and staying in ketosis, I would rather get my carbohydrates from things like vegetables, salads, blueberries and dark chocolate. Basically encompasses my carb intake there. So I would avoid that.

A staple product that I use, I have it right by me right now is the Quest MCT oil powder. I did a little bit of beta testing for them as they brought that to market. We went back and forth, and I tested that a lot.

I consumed a lot of that and I did tons of the blood work and got to the point where I was really impressed with the product. There’s not too many products that I consider staple products, maybe about a half a dozen in total that I keep with me all the time.

That MCT oil powder is great, it’s very versatile. You could use it in baking, you could put in my coffee, you can add it to protein shakes to further boost the ketogenic profile of your shakes.

[Damien Blenkinsopp]: Do you take that with you? I take this stuff as well, I’ve got it right next to me as well in my coffee [unclear (1:17:32)]. What I was going to say is that you take that on top of your ketogenic diet?

But I think an interesting thing, I talk to people and they’re taking the exogenous ketones or the MCT powder as a normal diet, or the body builder’s diet where it’s high protein, and they’re not doing a keto diet.

Then there are other people who are interested in getting keto but finding it difficult. They’re using it to ease into the keto diet. So there’re a couple of different applications people use them for different things. I’m just wondering what you’re ideas are in those scenarios.

Dominic D’Agostino]: Yeah. If I put the Quest MCT oil into my coffee or shakes or things like that. I generally try to avoid liquid meals, because liquid meals digest totally different. The only liquid meal that I have would be my coffee, and I would put in some coconut oil and MCT on top of that.

Occasionally, I put in butter or coconut cream. I’ve been using coconut cream instead of full cream. The benefit is that I can elevate my protein a little bit more. I generally eat two meals a day now that I’m home and not traveling.

My meal in the evening is about twice the calorie count. So, I get about a third of my food calories in the morning and about two-thirds in the evening, but I get a lot of fat calories during the day I guess. Because I’ll make my coffee and whip it up and then bring it in a thermos, and drink that mostly in the morning. Then I’ll have a little kicker in the afternoon maybe.

That fat balm, I guess if you want to call it that and occasionally take some exogenous ketones too during the day, if I’m testing different products. It just adds to my total fat macronutrient ratio.

I probably get — with the coconut cream, the butter, and the MCT oil powder — probably get about an extra 100 grams of fat from that. So that allows me to eat a little less fat with my meal in the evening, and that makes it maybe a little bit more palatable because I could add some more protein.

On a typical schedule, I will do my physical activity in the evening. Then I’d like to couple that with a little bit higher protein intake.

(1:19:51)[Damien Blenkinsopp]: Right. So using the exogenous ketones or the MCTs to offset gluconeogenesis? Is that the idea?

[Dominic D’Agostino]: Yeah. This morning I had three or four eggs cooked in coconut oil. I usually have sardines, oysters, chicken, or steak from the night before. Then I’ll have a little bit of green vegetables cooked in fat, and that will be my breakfast.

It will be roughly under a thousand calories, somewhere around 800 – 1000. Then, I’ll get 1,500 – 2000 calories in the evening. During the day, I might even get an extra 500 – 1,000 just of fat or ketones.

I stay semi- fasted, so if I eat 6am or 7am I feel the best when my ketones get highest between like 3pm and 6 or 7pm.

(1:20:53)[Damien Blenkinsopp]: Okay what levels of ketones would you have then?

[Dominic D’Agostino]: I say high but it’s not really that high. In the morning when I wake up it’s maybe 1.0, sometimes .5 if I ate more blueberries or chocolate the night before. Right now, approaching noon, it would start to creep up about 1.5.

Then towards the end of my work day, I’m usually approaching about a 2.0 – 2.5 or somewhere around there. If I’m lucky I budget my time where I can go to the gym so I will be typically be working out. Then if I go home I’ll do some stuff, take my dog for a walk, do some sprints, and that’s when I feel most energetic – when I’m fasted, and in ketosis.

(1:21:40)[Damien Blenkinsopp]: Right, and you’re saying your blood ketones would be 2.5 or something like that and you’d feel that’s when you’re most energetic? Or you feel your best at that time?

[Dominic D’Agostino]: Yeah. I try to subjectively do this too. Basically, I would carry my meter, and I would be like, “When do I feel most energetic, and lucid?”. Then, I would measure my glucose and ketones at that point.

And I find that basically if my glucose is about 3.5 millimolar and my ketones are about 1.5 to 2.0 is when I personally feel the best, as far as energetic. So that would be a glucose-ketone index if we use the Thomas Seyfried’s calculation, of about 2.0. When you’re approaching 1.0, you’re starting to get into that therapeutic range.

But I think for all intensive purposes, for the normal person, if you keep between 2.0-4.0. It would be very abnormal for someone in a normal society to even approach that. If you’re hitting that then you’re doing really well.

You’re in an altered metabolic state. If you can sustain that, I think you’re going to get a lot of therapeutic and performance benefits from that.

[Damien Blenkinsopp]: So 2.0 – 4.0 in the GKI — glucose-ketone index — from Thomas Seyfried?

[Dominic D’Agostino]: Yeah.

(1:22:58)[Damien Blenkinsopp]: Which we covered in his episode in the past. Yeah, the only time I’ve got below 1.0 is when I’d be fasting. I’ve tracked full days as well, every half an hour I’ve tracked, it looks pretty similar to yours.

I’ve heard you say before that over 5.0 millimolar, in terms of ketones has some metabolic downsides. So, I was wondering about the ranges. Are there ranges that people shoot for between this 2.0 – 4.0 basically? You don’t really want to be lower?

Right? Say on the GKI, you don’t want to be going down to 1.0 unless you’re fasting or doing some pulse?

[Dominic D’Agostino]: Yeah, unless you’re really in a total fasted calorie restricted, deprived state, I think between 5.0 and 6.0. I think there was a report in a 60 day fast up to 8.0 millimolar. So that it may be beneficial there for just maintaining that energetic flow to the brain.

But if you’re on an isocaloric diet not calorie restricted. I think staying between 1.0 – 2.0 is probably good. If you’re mildly calorie restricted or maybe towards the end of an intermittent fasting, the fasting portion of an intermittent fasting day, approaching 3.0 may be optimal.

I based this upon thousands of blood measurements that I’ve taken and literally hundreds of blood measurements from other people. Between 1.0 – 3.0 millimolar I think is good. We’ve even seen it in animals, once you dose them up to about over 5.0 they start hyperventilating.

You create a mild metabolic acidosis that needs to be compensated for, so that you get the hyperventilation, they start getting even drunk and sedated, when you really start getting up there and has signs of ketoacidosis. In cases where they’re sedentary, that could be the reason. If you’re approaching 5.0 or 6.0 millimolar and you’re in an all-out sprint, you’re using that.

So maybe in the case of an athlete approaching the higher numbers could be beneficial if you train for that. But say you’re not trained for that and you dose up really high. Your body perceives it as a foreign acidic-metabolic substrate that has to neutralize, your bicarbonate compensates, and you have respiratory-renal compensation that needs to compensate for that.

I just had this discussion in metabolism and physiology with some people that I really respect. They were making the argument that anything above 4.0 or 5.0 is really going to be toxic to the body. I didn’t argue against that but we agreed upon — and there’s some pretty sharp minds in the room — anywhere between 1.0 – 3.0 was probably optimal.

As you know staying in 2.0 – 3.0 range is really hard to do with diet. But staying in a 1.0 range is pretty easy to do with a diet. I do a modified Atkins or modified ketogenic diet, and that’s pretty easy.

Then if I add a little bit of exogenous ketones or some C8 on top of that. I can easily boost that up to 2.0 – 2.5. I think that would give me a metabolic, performance, and cognitive advantage. I’m pretty sure about that.

So, that’s what’s exciting to me. So, not using exogenous ketones in the place of a low carb diet — but you might be able to do that too — I’m actually thinking about doing some experiment of getting off of my ketogenic diet for a period of time.

Not going super high carb but just being out of a state of nutritional ketosis and then adding supplements back in and then doing some blood work and see what happens there. I just haven’t got around to doing it because I enjoy eating ketogenic so much.

[Damien Blenkinsopp]: Right. Once you get into it for a while it’s like you don’t have to eat very often.

[Dominic D’Agostino]: It’s almost like I dread doing it.

(1:26:51)[Damien Blenkinsopp]: I was testing some of the supplements, the different supplements. I don’t think I didn’t do it very well. But what I was doing I was eating in the evening basically a high-carb meal lots of rice to put myself out of ketosis.

I did this for about a week and then tested different supplements in the morning. For the first reason, I don’t think it was a great control because I am basically keto-adapted now. I tend to pop straight back into ketosis relatively quickly.

I’d like your feedback on that whether it’s a decent control. Maybe I’m no good as a control because I’ve been just keto-adapted for a while and also may be I’d have to go for a few days ‘carbing’ it to make it a bit more realistic. What are your thoughts on that?

If you’re trying to do some normal, the first thing is, going back to your point about exogenous ketones. You’re saying like if someone just takes it straight off as some people are doing right now. They’ve been on a carb diet the whole time.

Then they can’t necessarily utilize those because they’re not keto or fat adapted. How long does that take? Should we be taking a lot of these when they haven’t really had that much exposure?

Do they have to take them over a period of a week or longer in order to start getting more benefits from taking them?

[Dominic D’Agostino]: Yeah, that’s a good question. Interestingly, we can use exogenous ketones even if we’re not keto-adapted at all, and that was our first study that we did for CNS oxygen toxicity. It was actually rats eating a standard rodent chow which is 60-70 percent carbohydrates.

We gave a single dose not even feeding it chronically, 30 minutes prior to doing a deep oxygen dive. It worked remarkably well and that really surprised me. So, taking a little bit of a step back, we use the R-enantiomer of the beta-hydroxybutyrate, and it didn’t work.

But then when we found out the ester that did work, that particular compound worked remarkably well. That kind of changed my thinking because I approached it with the understanding or the bias that you really need to be keto-adapted. But if you are adapted to burning fat and ketones for fuel, what has been shown is that you do up-regulate the transporters and the enzymes associated with ketone metabolism.

So, you will theoretically be deriving more benefit from exogenous ketones if you have been previously adapted to a ketogenic diet. I think from a practical standpoint, say you’re on a ketogenic diet and you choose to transition to eating carbs for some reason and then you throw ketones back in. Since you’re adapted to a ketogenic diet already, I think you’ll use those ketones more efficiently even by following a carbohydrate based diet.

We have some evidence to indicate that glucose disposal is enhanced in the presence of ketones. So, it may actually be enhancing insulin sensitivity. The glucose goes does, if you have animals eating a high carb diet and you bolus exogenous ketones, the glucose goes down remarkably low. Much more than you even get with something like Metformin.

What we don’t know why that’s happening, we want to look at the liver metabolimic profile. I think it could be influencing the liver in some way, and may be decreasing hepatic glucose output. Really it’s your liver that dictates your blood glucose, it’s all happening in the liver.

So, if you turn down gluconeogenesis in the liver, you would see a decrease in blood glucose. But also if you’re enhancing insulin sensitivity you would be facilitating glucose disposal and peripheral tissues with ketones. I know Dr. Richard Veech at the NIH has written about that and suggested that ketones actually do enhance glucose uptake and insulin sensitivity.

I get the question, what if you throw ketones on top of carbohydrates? What are the cells going to use? I think the cells will use what’s available to them and we know that the brain might not be able to use the certain types of fatty acids but they can use MCTs.

If you have glucose and ketones in the blood, your cells, your muscle cells, brain cells will be using both fuels. There’s some evidence that suggests that it will be using the glucose more efficiently in the presence of ketones. Because we know ketones can lower reactive oxygen species.

Excess ROS production can decrease insulin sensitivity and cause protein nucleic and lipid peroxidation that can inhibit glucose transporter processes. Even translocation of glucose transporters to the membrane or even PDH complex could be sensitive to the Redox state of the cell.

Ketones tend to normalize or prevent an oxidative environment that could potentially impair glucose transport and insulin sensitivity.

(1:31:56)[Damien Blenkinsopp]: There’s such a wealth of information in this area. It’s not like ketones are a panacea, but there’s just so many applications we’ve spoken about today, so I could go on talking to you for absolute forever. I’m conscious of your time also.

I wanted to round off of a bit of what you do more in terms of optimizing yourself and what you think is effective. For instance, in terms of blood ketones, you said you’re tracking your blood ketones. Have you used the other methods, the urine or the breath method?

The strips for the blood can be a little bit inaccessible in the UK, in the US sometimes, and also they are really expensive. The price varies. I’m sure you have your own ways of getting them but for everyone else it can be a little bit difficult, particularly in the UK I’ve found.

What do you think of the breath? There’s the Ketonix looking at the acetone instead. Do you think that correlates with the blood ketones, and it’s an okay way to try and optimize or not?

[Dominic D’Agostino]: Yeah, it’s a good question. I get this frequently. What I would say the breath, if you’re measuring moderate to high on a breath acetone meter you’re definitely in ketosis. I like it, and I wish it was more quantitative because I’m a numbers guy.

I think we’re all sort of what’s your number? There was like a ketone competition in the lab and my friends like, “You know what’s your ketones today?”. So we like numbers and I wish the unit could be designed.

I believe [unclear (1:33:20)] who’s working on a quantified meter. I like it, and I think it’s great for kids that are trying to manage their epilepsy because breath acetone has correlated with seizure control. So if you give this to a kid and he blows in it and he sees colors and he gets excited, I think that’s great.

It’s giving you a relative level but it’s not a precise level. But it’s also a snapshot of your level of ketosis over the last couple of hours. So your blood, beta-hydroxybutyrate can change.

I’m standing here in front of my desk and talking to you and relatively sedentary. But if I was to go and take a brisk walk on the other side of campus which I do occasionally to get things signed. I’ll come back and measure my ketones, and it’ll be cut in half.

It’ll go from two to one, or below one, just from brisk walk where it should be increased right? Because I should be mobilizing fat, I’m burning fat. But I’ve burnt those ketones for fuel during my movement.

(1:34:25)[Damien Blenkinsopp]: So then it goes into glycogen? I’ve seen this before and I didn’t understand it, that’s why I’m pretty curious.

[Dominic D’Agostino]: Well, it’s burned as fuel. Ketones are substrates, so they’re going to be burned up as fuel. And yes, you may mobilize glycogen from the liver so your glucose can actually go up. You might have some lactic acid from your muscles and through the Cori cycle goes back to the liver and you get some glucose in the blood.

The stress, the sympathetic nervous system from moving and running across traffic and navigating or whatever you do when you walk, that can contribute. What I really found that’s most important is you need to be completely calm and sedentary when you make these measurements to get accurate measurements to prevent the variability.

We have this issue with our rodent studies, we need to pull the food from them for about four to eight hours, to normalize the blood glucose. Because you have some that are nibbling on food, some that have gorged, others haven’t eaten. So the glucose is going to be all over.

To standardize and normalize glucose, you need to remove their food for a little bit and the numbers are tighter. The same thing applies for measuring ketones, especially blood ketones, you need to be fairly sedentary to do it. I really like the urine ketone strips, got a bad wrap, but I like the urine ketone strips.

They’re still used by John’s Hopkins. So, before you go spending a lot of money on getting ketone strips for the meter. You want to first confirm that you’re actually in ketosis on a urine strip.

If you’re registering 15 or 40 mg/dL on a ketone strip then it’s like, “Okay, at least if I take a blood measurement now. I’m going to register something on my blood meter and it’s going to be ‘I’m in ketosis’.” I remember the other meter, I think it’s the Novamax meter, would just give you this annoying, ‘low’, it won’t even read your number on it.

One person went out and bought a couple hundred hours worth of strips and have like 17 lows on there, and have come to find out you’re just eating too much protein or they think it’s okay to drink fruit juice. I forgot what the situation was.

Well first change your diet, then go out and get some urine ketone strips. Once you’re actually in ketosis on the urine strip then go back to the blood meter. And come to find that they tweaked their diet a little bit.

They did it until they were measuring ketones on the urine strip and they went to the blood meter, and bang they get 1.2 and they get all excited. So they could’ve saved a lot of money.

(1:37:04)[Damien Blenkinsopp]: Right. Because the urine gets a bad wrap, because it stops working once you get more keto-adapted. But when you’re first on a ketogenic diet and you’re trying to check that, that’s not going to happen. Right?

[Dominic D’Agostino]: Hydration state too, also plays a role, and less ketones will spill into the urine over time because you’ll conserve them as fuel. The transporters change a little bit. But if your hydration — if you’re drinking lots of water those people who carry water around with them and drinking.

Your urine ketones may register pretty low. Sometimes I wake up dehydrated and I would check my urine ketones will be quite high, whereas my blood ketones would be quite low. So, that’s just an indication of my hydration status.

It’s also a snapshot of what your ketones were over the last four, five, six hours because that urine is collecting in your bladder over time. So it’s sort of a snapshot of what’s happening through the course of the day, whereas your blood ketone is a snapshot of your ketone level at that point in time.

(1:38:04)[Damien Blenkinsopp]: Right, just a bit of information more about you and what you do these days? In terms of tracking things, it seems like you’ve tracked a lot yourself. Are there things that have stood out for you?

Overall, the time that you’ve tracked yourself and you found really useful insights from? Any quants or anything you’ve changed something you do in your life because of that?

[Dominic D’Agostino]: Yeah, I think initially when I started doing the ketogenic diet it was very dairy based. I was taking lots of creams, a stick or two. Two sticks of butter a day. So, I had a really high intake of dairy fat, probably about 200 plus grams of fat per day of dairy.

My LDL went up pretty high and my triglycerides went down a little bit but not really low. Then, I started replacing some of the dairy fat or the whole cream with coconut cream, and just using a little more coconut oil, getting more avocado in from my fats.

I still get dairy fat, by a sour cream that has live cultures in it. I’ll probably get about 50 to 70 grams of fat per day from dairy instead of like 250 grams of fat which I was getting initially. My lab test has improved. I guess you would say, I think my insulin sensitivity is better.

My glucose I can get lower glucose numbers now after eliminating some dairy. My triglycerides are really low now, they stay at 40s to 50s, I think it was 36 at one time. My HDL has improved and better and it’s really high, like 90 something.

My LDL went from really high to normal, but normal high. Now, which I think is completely normal and actually maybe even optimal. My IGF-1 levels are really low now compared to when I was on dairy.

I think dairy may have been contributing a little bit to some insulin resistance or maybe I was just getting a surplus amount of calories. My CRP levels also are the lowest now than they’ve ever been. I mean it’s like 0.1 or 0.2.

[Damien Blenkinsopp]: Right. Basically nothing, that’s the bottom of the range.

[Dominic D’Agostino]: Yeah, it’s like totally bombed out. I just feel better. If I eat a lot of dairy, I do wake up a little bit slightly congested, stuffy in my nose but it’s not bad.

I wouldn’t call it an allergies, and it could be due to allergies. But eliminating that has sort of helped, not eliminating, but reducing the amount of dairy. I don’t get in a whole lot of dairy protein. Maybe a slice of cheese here and there but I limit that. I limit casein. I don’t take away protein anymore.

The dairy that I get is primarily dairy fat. I was actually thinking about, I get very little butter, but I was going to switch to Ghee, and do some clarified butter. The triglycerides I would say for people to look at, for physiological biomarkers, your heart rate, blood pressure, sleep is an important one.

I wear the FitBit Charged. It’s really fun to look at my heart rate during the course of the day and in my sleep, and those sorts of things. I have a Dexcom that I’m going to put in. And I want to…

[Damien Blenkinsopp]: Is that the latest one? Is it the 4 or 5?

[Dominic D’Agostino]: Yeah.

[Damien Blenkinsopp]: I know Peter Attia is playing with that.

[Dominic D’Agostino]: Yeah, the 5 I think it is. So, I’ve just been traveling I just wanted to wait until I was put it in one spot and I can test it. I’m interested in trying that, and maybe working with some companies too, to do a glucose and ketone Dexcom.

I’m hoping to try that. That would definitely fit into your show. Yeah Quantified Self, and get some data for that, that would be good. As far as looking at physical biomarkers, you want to look at blood pressure, heart rates, sleep, and all these things improved when I got on a ketogenic diet.

I think there were various reasons for that. The lab test, the simple ones are probably the most beneficial ones. Triglycerides are the things that I look at the most. My HDL I think is important, and CRP, and of course your blood glucose. If you’re keeping glucose levels between 60 – 80, and doing that pretty much all the time.

Everything else is going to be good, that’s what I find.

(1:42:35)[Damien Blenkinsopp]: You said you did an insulin sensitivity, was that the homo or was it something else?

[Dominic D’Agostino]: No, I didn’t do that. I did the glucose tolerance.

[Damien Blenkinsopp]: Okay, the challenge.

[Dominic D’Agostino]: Yeah. I did like 50 grams, 75 and 100 grams I think. I think that was like over four hours, the 100-gram ones. Yeah, you drink the nasty Slurpee glucose and look at that. I’m extremely insulin sensitive. I dispose of glucose very fast.

I can also get a little bit of a hypoglycemic effect. If I’m on a ketogenic diet, and I go off of it. For example, I get some rice, sushi, or something like that, I will dip down into the low 50s and bounce back up again – very, very insulin sensitive.

(1:43:18)[Damien Blenkinsopp]: Thanks for that. If you were to recommend one experiment. I can guess what you’re going to say. So, we should try to improve the body whether it’s health performance longevity with the biggest payoff.

What would that be? How should they track it to make sure it’s getting that payoff?

[Dominic D’Agostino]: It depends on the person really. I don’t think low carb ketogenic diets are ideal for people in their teens or early 20s because they may be extremely insulin sensitive. I know I have tons of friends and I’ve even measured their glucose levels, and they’re great.

They stay pretty low, the glucose levels and they have adapted really well to a high carb diet. They wouldn’t want to do a ketogenic diet. So, maybe you’re expecting that kind of answer.

But, I think periodic fasting would be an important thing to do. I’ve been talking to some high-level CEO people and they tell me, “Well, I’ve been doing this anyway because I’m so busy. I wake up and I just work all day, and just go home and eat at night.”

But if your pattern of eating — like my patter of eating — I was obsessed with eating every two hours especially when I was really into lifting. I felt I had this preoccupation with food, preparing my meals, carrying it with me. I think it’s very liberating to not have to do that and to realize that your performance, energy levels, are not going to tank if you eat one meal a day.

If you were to do a short term fast, initially, and to do that every once in a while. I think, not only is very good for your metabolic health. I think it’s also good for your state of mind because it tells your body. It tells your mind that you don’t have to be sort of psychologically dependent upon food.

I would go five or six hours, and I’ll be like, “I’m starving I have to eat something.” I have been around people that are like that. My wife is kind of like that, she’s an incredible carb burner.

But if we’re traveling and she’s gone four to five hours without having a meal. I could see it in her mood and in everything. But that’s fine we’ll stop and get something to eat, and usually we’ll have coffee or something like that. But it’s interesting to see, and she sees it in me, “How could you go this long? Aren’t you hungry? What’s wrong with you?”.

She understands it now. She’s watched me do so many tricks and everything. If you’re not a big fan of being hungry. If you’re not a fan of having to eat every two or three hours because you’re hungry. I think doing some intermittent fasting would be a really good experiment for you to do.

I actually interviewed Mark Mattson at IHMC. So, I’m also a research scientist at Institute for Human and Machine Cognition. We interviewed Mattson, I think you did too for a podcast. He really went into the benefits of intermittent fasting and he’s at the National Institute of Health.

If you get a chance, he gave a brilliant lecture, presentation. If you go to IHMC lectures and look up Mark Mattson, he gave a great talk on this. He talks about all the health benefits.

If you do embark — if your listeners embark on [an] intermittent fasting experiment it would be interesting for them to track their blood glucose levels, their ketone levels, their triglycerides and their c-reactive protein. I think in each one of those biomarkers, if you want to call them that, will improve with intermittent fasting. I’ve seen it.

(1:46:51)[Damien Blenkinsopp]: You’re saying the 16-hour window or one day? Because you said short-fast, do you mean like a one day, 16, or 20 hours?

[Dominic D’Agostino]: Yeah. You could do every other day eating. But I think the easiest thing to do for most people would be, what I’d do if I do intermittent fasting maybe once or twice a week now. I eat two meals a day but like once or twice a week I’ll eat one meal a day, and it varies depending on what I’m doing and testing.

But it will be 18 hours of fasting and 6 hours of eating. Actually I get home late, so it ends being about 20 hours of fasting and four hours of eating. So, it will be 7pm – 11pm. I’ve done it [with] water and abstained from putting fat into my coffee.

I’ve also done what I would call ‘fat fast’, so I would put in some MCTs in my coffee and maybe get a ketone supplement during the day. I would still call that a fast because it’s basically non-glycemic.

[Damien Blenkinsopp]: Yeah, probably has very similar ketone and glucose effects.

[Dominic D’Agostino]: Yeah, I actually find that it’s optimal. So, I would call that a modified intermittent fasting protocol, where you would get in some fats and exogenous ketones during that fasting period. I’m a little less hungry once I go into that eating window.

I think that’s good too, so I tend to not over eat that much. My body is still strongly in a state of ketosis that has probably enhanced a bit with the supplementation. It tends to dampen my appetite a little bit so I’m not as ravenous.

But I don’t generally don’t get that ravenous anyway when I eat. But, I would experiment with that the intermittent fasting. I think it’s so easy to do. I mean intermittent fasting is easier to do than the ketogenic diet that’s what I find with people.

So, do some experiment, get some initial blood work, read up about it, listen to Mark Mattson’s talk on [the] IHMC website and you’ll find it there. I’m sure there’s a lot of blogs on the subject and do blood work before and three to four weeks after.

You’ll see pretty big effects, especially six and eight weeks after. You’ll see even bigger effects on your lipid profile and metabolic biomarkers.

(1:49:04)[Damien Blenkinsopp]: Excellent thank you so much for that, that’s a great one. Where would someone look to learn more about your topic? Are there any good books or presentations on the subject you’d recommend if they want to learn more about the whole subject of ketones and ketosis?

[Dominic D’Agostino]: One of the go to book that I would recommend is Jeff Volek’s ‘Art and Science of Low Carbohydrate Performance’. It’s a mandatory reading for students entering the lab just to get a hand on what the ketogenic diet is. The Ketogenic Diet Resource is a website maintained by a friend of mine, Ellen Davis, and I think has a lot of good information on it.

But I maintain a website to throw up links, compile links in there called ketonutrition.org. If you click on resources from the homepage, it will take you to dietary consultants, books, publications, list of podcasts, and lectures on there on a variety of subjects that hit on pretty much all the topics we’ve discussed. I probably need to get on there, but it’s relatively updated. I’ll probably update that in the next month or two.

Metabolic Optimization too, that’s a website that I started with Travis Christofferson who wrote the book ‘Tripping Over the Truth’ which is an excellent book that covers the metabolic theory of cancer. Travis and I maintain the website Metabolic Optimization, and we have Thomas Seyfried on.

We’ve had Adrienne Scheck, we’ve had Bruce Ames actually was our first guy. We’re going to line up a bunch of other speakers on metabolism so that’s another area where they can look up information on these topics.

[Damien Blenkinsopp]: Great, thanks for that. Are you active on Twitter? Where could people also connect with you and keep updated of what you’re at?

[Dominic D’Agostino]: I tried to post at Twitter maybe once or twice a week, not like super active. But on Facebook I post a little bit more. My page is maxed out, I got 500 or 5,000 people following me.

So I’ll probably create a more public page. But you could still follow me because I post things open to the public. I will post usually one or two studies per day, or podcasts or lectures per day on my Facebook page which should be very easy to find.

It’s always sort of topics relevant to the interests or the topics that we covered today. Sometimes I dual post on Twitter and Facebook, important things that pop up as far as studies and lectures and things like that.

(1:51:39)[Damien Blenkinsopp]: Excellent. Of course, we’ll put links to everything you’ve mentioned here in the short notes. Is there anyone besides yourself? You’ve already mentioned a few people, but was there any you would pull out and you would recommend if people wanted to learn more about the subject? Are there are some other people that you would recommend also?

[Dominic D’Agostino]: Yeah. My colleagues, there’s so many of them. I try to stay very active in collaboration. It’s really good for scientists to collaborate to help get their work out there. Also, to get other people to validate the findings that you did in the lab.

So, I know you’ve had Thomas Seyfried. He’s a great friend and colleague of mine. Adrienne Scheck is a fantastic scientist and a pioneer in ketogenic diets and moving the ketogenic diet into clinical trials at Barrow Neurological Institute.

There’s some of the mentors that even got me into this field — would be Dr. Eric Kossoff. He’s a neurologist at Johns Hopkins. He’s been a pioneer in using a ketogenic diet for kids with epilepsy, so look him up.

John Roe who’s a neuroscientist and pediatrician. He was originally at Barrow Neurological Institute and he was the first scientist I ever connected with to discuss this. The use of the ketogenic nutrition for oxygen toxicity.

Dr. Richard Veech he had a profound influence on me when I first got into this area of ketogenic diet and discovered exogenous ketones. It was his reviews on the subject. So if you look up on some of his reviews on ketones and the therapeutic effects of ketones, they’re really good.

Susan Masino has been really supportive of our work and she’s doing some really innovative work looking at the effects of the ketogenic diet on adenosine. Adenosine is a neuroprotective substance that’s elevated, has anti seizure, anti-convulsant, neuroprotective effects.

So, we actually have a lot of these speakers [who] will be coming to our Metabolic Therapeutics’s Conference which will be held either the last week in January or the first week in February. We had a number of speakers, we had Eugene Fine, Colin Champ, David Ludwig, David Diamond, he was a colleague of mine here at USF and [we] talked about cholesterol and statins.

We had Eric Kossoff, Adam Hartman, and a bunch of scientists. So, I would tell your listeners to go to the Metabolic Therapeutic’s website. We’re in the process now of sending out the invitation for speakers.

And pretty soon, I think we might have a preliminary site set up for that, but we’ll be updating that soon with all the different speakers and the topics that are going to be talked about. We really try to emphasize basic science, so you’re going to find lectures on neurophysiology, cancer biology, proteomics, tracer based metabolomics.

Performance — Jeff Volek will be there talking about performance. It will be a mix of things related to not just the ketogenic diet but metabolism in general.

[Damien Blenkinsopp]: Sounds fantastic so anyone can attend that?

[Dominic D’Agostino]: Anyone can attend that, yeah. We should have the registration going up soon. The problem that we had is that last year the venue was small. We wanted originally to keep it small, to cap it at about 250, but we had to turn so many people away.

So, this year we’re going to blow it up a little bit and probably have about maybe 600 – 700 people, hopefully in the same venue. But we’re going to get the whole hotel. You’re going to find a lot of great companies there that are producing these exogenous ketones.

So, Pruvit is going to be there, probably Forever Green, the company Kegenix – they make a great product that I’ve been testing recently during my travels. KetoSports hopefully will be there, and Quest Nutrition has a big footprint in our conference and they have been incredibly supportive of our work.

Scivation, who’s really the leader in branch chain amino acid supplements, will be there. Let me see, we have a lot of good sponsorship supporting this area of research. It’s really exciting to me that it’s becoming so popular it’s easy to find companies that are now emerging that are interested in developing products that can enhance nutritional ketosis.

So it’s fun to see a market for this evolving. They’re are creating products that I think will be very beneficial to patients even that are following nutritional ketosis for managing a disease process.

I do get Emails every single day from patients that are using these products that made a world of a difference. They couldn’t get into ketosis and once they did or their trial did, they started getting all these benefits from the ketones.

[Damien Blenkinsopp]: It’s a super exciting area, you’re very lucky to be right in the center of it.

[Dominic D’Agostino]: Yeah. I do feel lucky.

(1:56:48)[Damien Blenkinsopp]: Just as a quick anecdote, I gave some MCT powders and C8 to my mother because she has tremors. They have been getting worse over time, and they are so much better it seems. She was really surprised by that.

But it is an exciting area, they have so many crazy benefits, so broad compared to the other things we looked at. Which is one of the reasons I’ve covered it several times in different episodes, fasting, ketosis, all of these.

Whereas most topics I don’t cover in many episodes but this one has just so many applications, it’s just interesting. I think it’s worthwhile for people to learn more and more about it.

[Dominic D’Agostino]: Absolutely.

[Damien Blenkinsopp]: Dom, thank you so much for your time. I really appreciate it, we’ve covered such a wealth of topics. I know there’s so much more you could talk about. So, thanks very much for your time.

It’s been great talking to you.

[Dominic D’Agostino]: Thanks for having me Damien. I appreciate it.

References:

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Putting the body into ketosis and controlling blood glucose levels may prove to be effective therapy against certain cancers. This real case reveals one aggressive self-experimenter who used a combination of the ketogenic diet, fasting and other tools to control his epilepsy and send his brain cancer into remission.

This episode examines the ketogenic diet as a tool to fight against cancer. It is a follow up of the episodes on ketosis and fasting that we have done with Dr. Thomas Seyfried in episode 16, and Gene Fine in episode 36. You definitely should check those out for context before or after you dive into this one to fill in any gaps.

We are talking to someone who has actually used ketosis by a combination of ketogenic dieting and fasting as a therapy to fight his brain tumor. Our guest has gone through a variety of extreme approaches to ensure he remains in a high state of ketosis. In his case, his life depended on it. This episode is not just for those with cancer or epilepsy, but also for those interested in the benefits of the ketogenic diet. You can take some of the tools he used to improve your own state of ketosis if you are having trouble maintaining it.

[W]hen I have my blood tests . . . and [test] a number of markers for potential tumor progression, internally, I am actually much healthier than before I had cancer . . .
– Andrew Scarborough

I met Andrew Scarborough at a conference where he spoke about his experience with ketosis and its effect on his brain tumor. After being diagnosed with a type of malignant tumor called an Anaplastic Astrocytoma, Andrew underwent several months of unsuccessful chemo treatment. He decided to take his cancer treatment and management of his epilepsy into his own hands and to go the ketosis route. This decision was based in a small part on researching Thomas Seyfried’s work, which we will also discuss in the episode.

Fortunately, this decision has yielded very positive results for him, and his tumor has shrunk. In fact, it has disappeared from scans (seen below) and his doctors are now giving him the all clear. Andrew is now working with London-based hospitals to develop clinical trials for treating brain cancer patients using an optimized ketogenic diet.


Andrew's brain tumor before and after being on the ketogenic diet.

Andrew’s brain tumor before and after being on the ketogenic diet.


There are a lot of details in this podcast on how Andrew went about using the ketogenic diet, including the types of foods he ate, how he optimized the diet for his situation, the extreme measures he has taken, and how he has been able to keep up physical activity. We will talk about everything on his journey, including things like eating bugs and sheep’s brain, and quitting eating plant-based foods altogether.

The episode highlights, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know what you think in the comments!

itunes quantified body

What You’ll Learn

  • The beginning of Andrew’s brain cancer story (4:46).
  • Andrew is diagnosed with a grade 3 Anaplastic Astrocytoma (12:14).
  • After unsuccessful chemo treatment, Andrew devises a treatment using the ketogenic diet (19:19).
  • Using MRIs to visualize changes in the metabolic activity of the tumor due to the ketogenic diet (20:52).
  • Scans show complete remission since using the ketogenic diet (23:40).
  • Optimizing and maintaining the ketogenic diet for brain cancer management (26:40).
  • The biomarkers Andrew tracks to monitor the effects of the ketogenic diet (28:08).
  • The glucose-ketone index (29:13).
  • Andrew’s typical diet (32:58).
  • Maintaining a healthy 1:1 ratio of Omega-6 to Omega-3 (33:35).
  • The ketogenic foods Andrew eats (36:10).
  • Variations on the traditional ketogenic diet (41:30).
  • Supplementing the diet with insects (46:30).
  • Keeping up ketone levels and controlling seizure activity during exercise (50:16).
  • Andrew’s research on an optimized ketogenic diet for brain cancer patients (54:50).
  • More on Omega-6/Omega-3 ratios (59:15).
  • Limiting protein and fasting (1:00:32).
  • Using magnesium to prevent seizures during a fast (1:02:08).
  • Mimicking chemo naturally with diet (1:06:44).
  • The resources Andrew recommends for those facing cancer or epilepsy or interested in the ketogenic diet (1:11:47).
  • Andrew’s advice on what biomarkers to look at and where to start with the ketogenic diet (1:18:34).

Thank Andrew Scarborough on Twitter for this interview.
Click Here to let him know you enjoyed the show!

Andrew Scarborough

Tools & Tactics

Interventions

  • Hyperbaric Oxygen Therapy (HBOT): A therapy Dr. Seyfried believes may be beneficial to fight cancer but is relatively non-toxic in comparison to current treatment modalities (chemo and immuno-therapies). It exposes the body to higher levels of oxygen via having the person sit in a pressurized tank with higher oxygen concentrations. Andrew is adding this therapy to his current tools. Typically you visit centers that provide sessions inside hyperbaric oxygen tanks, however some new smaller and lower pressure HBOTs are now beginning to appear in the market that you can buy to use at home.

Supplementation

  • Ketosports KetoForce: KetoForce contains the endogenous ketone body beta-hydroxybutyrate (BHB) in sodium and potassium salt form. The compound BHB can be used as an energy source by the brain when blood glucose is low. Ingesting KetoForce raises the levels of blood ketones for 2.5-3.0 hours after ingestion. (Note: A similar product from the same company is Ketosports KetoCaNa). Andrew uses KetoForce to increase his ketone levels during gentle exercise.
  • Ancient Minerals Magnesium Spray: Most people with epilepsy have a magnesium deficiency. Magnesium supplementation has been used to reduce seizure activity in people with epilepsy. Andrew prepares his own magnesium chloride solution that he takes transdermally multiple times every day (about 230 mg per day) and during exercise, which can be a seizure trigger for him.
  • Curcumin BCM95: Curcumin is a derivative of turmeric which is an anti-inflammatory antioxidant and potentially has anti-cancer properties. Andrew takes Curcumin in tablet form with DHA because it increases the uptake of DHA to the brain.

Diet & Nutrition

  • Ketogenic Diets: The ketogenic diet is a low carb diet which raises the level of ketone bodies in the blood. Tumor cells are inefficient at processing ketone bodies for energy. The diet is commonly used to help control epilepsy in children.
  • Paleo Diet: A diet that mimics the nutrition of early hunter-gatherers, and consists of all lean meats and fish, fresh fruits, and non starchy vegetables.
  • Water Fasts: A water-only fast of at least 3 days and preferably 5 days is recommended by Dr. Seyfried as a tool to reduce cancer risk and to lower your glucose – ketone index to 1.0. They are the standard fast protocol used in most of the research studies looking at cancer inhibition or therapy for cancer patients. Learn more from Damien’s experience with a 5-day-water-fast.

Tracking

Biomarkers

  • Blood Glucose: A measure of the level of glucose in the blood at one point in time. Blood glucose is a biomarker for increased cancer risk. Therapies target reduction of blood glucose levels to limit cancer cell growth. Blood glucose levels vary throughout the day. Ideally levels should be kept below 100 mg/dL and below ~85mg/dL for fasting glucose. Andrew maintains his around 60-70 mg/dL.
  • Glucose – Ketone Index (GKI): The ratio between the concentration of glucose in the blood to ketone bodies in the blood. The calculation is Glucose (mmol)/ Ketone (mmol). Dr. Seyfried created the index as a better way to assess metabolic status. Therapeutic efficacy is considered best with index values approaching 1.0 or below. Patients with chronic disease like cancer have index values of 50 or more. Check out the episode with Thomas Seyfried here.
  • Cholesterol-HDL and LDL: The cholesterol biomarkers include lipoproteins and triglycerides which are found in the blood. There are standard markers that all doctors and labs will run, and some newer specialist labs that are more specific and accurate. There are two main types of lipoproteins, HDL and LDL. We covered these markers extensively in episode 7.
  • Omega-6/Omega-3 Ratio: Many Western diets are deficient in Omega-3 fatty acids, such as DHA, and have excess Omega-6 fatty acids. A high Omega-6/Omega-3 ratio promotes inflammation and the pathogenesis of many diseases, including cancer, whereas increased levels of Omega-3 (a low Omega-6/Omega-3 ratio of about 1) exert suppressive effects.
  • hs-CRP (high sensitivity C-reactive Protein): a marker for systematic inflammation that can be measured over a period of time to determine effectiveness of treatments such as the ketogenic diet. Ideally CRP levels should be <1 mg/L. High levels are associated with chronic inflammation, which is common in cancer and other chronic diseases.

Lab Tests, Devices and Apps

  • Glucometer: is a device used to measure the level of glucose in the blood. Andrew and Damien use the Freestyle Optium Neo Glucose/ Ketone meter. Andrew’s ketones and blood glucose levels hover around 65 mg/dl, which puts him somewhere around 0.6-0.8 on the Seyfried index. Check out episode 16 to learn more about the Seyfried Index.
  • Omega Blood Count: Measures the levels of Omega-6 and Omega-3 fatty acids in your blood. (Note: This test is only purchasable via offline retail stores such as pharmacies and health shops in the UK – an alternative test that Andrew recommends that you can buy online in US or UK is OmegaQuant.com)
  • Complete Lipid Panel: measures total cholesterol, triglyceride levels, HDL and LDL cholesterol, which are all found in the blood. High blood lipoprotein levels are associated with cancer.
  • Complete Blood Count: is a blood panel that measures the levels of the different cells in the blood. Numbers of the different types of cells vary depending on disease status and even between people. The test is often used to monitor cancer progression and treatment.
  • Magnetic Resonance Imaging (MRI): MRI scans use pulses of magnetic energy to visualize internal organs and structures. It can be used on almost any area of the body and provides information on tumors, bleeding, injuries, blood vessels, or infection. MRIs were used to monitor Andrew’s brain tumor.
  • Positron Emission Tomography (PET) scan: A PET scan is a functional imaging technique used to image body processes. A PET scan can be used to identify cancer presence and severity. A radioactive tracer, fluorodeoxyglucose, is used to tag cancerous cells so they can be visualized. Check out episode 36: Quantifying Cancer and Reexamining Which Cancers May be Inhibited by Fasts with Gene Fine to learn more about PET scans and cancer.

Other People, Books & Resources

People

  • Dr. Thomas N. Seyfried, PhD: University of Illinois, Urbana-Champaign. Dr. Seyfried’s research focuses on the mechanisms by which metabolic therapies manage chronic diseases like cancer, epilepsy, and neurodegenerative lipid storage dysfunctions. Check out Dr. Seyfried’s episode on “Water Fasts as Potential Tactic to Beat Cancer.”
  • Dr. Dominic D’Agostino, PhD: Assistant Professor in the Department of Molecular Pharmacology and Physiology at the University of South Florida Morsani College of Medicine, and a Senior Research Scientist at the Institute of Human and Machine Cognition. His research focuses on developing and testing nutritional and metabolic therapies for neurological disorders and cancer. His own website is Keto Nutrition
  • Dr. Colin Champ, MD: A board-certified radiation oncologist and Assistant Professor at the University of Pittsburgh Cancer Institute and University of Pittsburgh Medical Center. He is also board-certified in integrative medicine by the American Board of Integrative and Holistic Medicine. His focus is the role and effect diet and nutrition may have in cancer treatment.
  • Dr. Adrienne Scheck, PhD: An Associate Professor of Neurobiology at Barrow Neurological Institute. Her expertise is in neuro-oncology and her lab has been involved in investigating the effects of the ketogenic diet on brain cancer.

Organizations

Books

Other

  • Ketogenic Diet Resource: Andrew says this website has answers to just about all the questions you could have.
  • Clinicaltrials.gov: This site can provide you with information on clinical trials that are currently being done relating to the ketogenic diet and different cancers.

Full Interview Transcript

Click Here to Read Transcript

[Damien Blenkinsopp]: Andrew, welcome. Thank you so much for coming on the show.

[Andrew Scarborough]: Thank you for having me.

(04:39) [Damien Blenkinsopp]: Yes. You have quite an amazing story that a lot of people are very interested in hearing about. It’s always good to get the context of how this happened to you, and where it all started? Could you go into the beginning, how you made the discovery that you had this condition? How did it start?

[Andrew Scarborough]: Yes. I was studying a Master’s in Nutritional Therapy at the University of Westminster. This is before my diagnosis, and I was suffering from migraine headaches for a few months. Until suddenly I had lost my speech in February 2013, this was nearly 3 years ago now.

What I didn’t know at the time, that was my first partial seizure, and just being a man I carried on.

[Damien Blenkinsopp]: So to describe that, did you have difficulty saying words, or what exactly happened?

[Andrew Scarborough]: I went very dizzy, and then lost my speech completely for about five to six minutes, I was with a friend and we laughed about it because it was a bit strange. Because it was quite a cold day, it was February, I was just thinking when you get cold and shivering. You just stutter and loose — you struggle to speak, but it was a lot more serious than that.

I didn’t do anything about it. A couple of months later, I was experiencing very similar symptoms with pins and needles in my tongue and throat. To cut a long story short, I went on the train after a heavy gym workout. And, I felt like I actually have a lot of energy after the workout, even though I really struggled through it.

I just felt completely wiped out, even though it wasn’t the most difficult workout. I suffered more seizure activity afterwards, when I was getting on the train, very busy train actually in London to go home. And I devastatingly had a crushing headache, like my head was in a nutcracker.

The pressure was constantly building up, then I suffered a quite a traumatic brain hemorrhage, and grand mal seizure on the train, which wasn’t too pleasant, and the whole train stopped. I was rushed to hospital. There was so much blood in my brain that they didn’t know what to say, what actually was the cause.

As I was in hospital not knowing — feeling very confused not able to speak or walk at this point. I was given a CT scan and all that was shown was this massive blood in my brain. It looked like an explosion had gone off. I was still experiencing horrific grand mal seizures at this time, so I had things explained to me, and at the time, they were going in one ear and out the other, because I was so out of it.

That was quite a tough time from my family, and my first diagnosis was an AVM, which is an arteriovenous malformation. Because it looks so poor on the scans — because CT scans are quite ambiguous. All we could really see was just a tangle of blood vessels and arteries.

[Damien Blenkinsopp]: So, they thought it was an artery that had grown the wrong way, or you’d been born . . .

[Andrew Scarborough]: They saw it as being an unusual tangle of mess.

[Damien Blenkinsopp]: Okay, the arteries growing in the wrong way.

[Andrew Scarborough]: Yeah. They said, “No it’s not probably like that, it’s probably a Cavernous Hemangioma instead, which is a tangle of abnormal blood vessels, not tangled in the arteries.” Which is better because it was a bit less life-threatening, but I was given a number of misdiagnoses before. Eventually, I had an operation, because I was continually having these grand mal seizures that were starting to cause me cognitive difficulties, and my speech was getting worse, so I wasn’t able to speak at all at this stage.

(09:11) [Damien Blenkinsopp]: So, going back to the hemorrhage is that a stroke, is it the same as a stroke, or is it slightly different?

[Andrew Scarborough]: It’s very similar to a stroke, it was caused by the pressure of the tumor. Pushing against the side of my skull, and also it was between the speech movement area invading into the motor cortex, that’s why I had lost my speech completely. I had an operation not long after, in May 2013, to try and remove as much as possible, if this very vascular and invasive tumor, which was slightly larger than a size of a golf ball — but invading into the motor cortex area of my brain.

They couldn’t remove all of it because otherwise I would be completely paralyzed or dead. Because I was misdiagnosed, I should’ve had the operation awake but I was unconscious during it. The neurosurgeons said after, “Yeah we probably.”

If he has to do it again, he would have it awake so he could potentially get more out of it, but he couldn’t remove all of it because of where it was in the brain.

[Damien Blenkinsopp]: That’s interesting, what is the difference between you being unconscious and awake, are they able to get some feedback from you?

[Andrew Scarborough]: Yeah. You’re kept awake so they can monitor your responses, while they’re poking around in there to see what can be removed and what can’t, and what healthy brain tissue and what isn’t. One of the main issues with the brain surgery is it’s very difficult to distinguish what’s healthy tissue, and what’s the tumor.

[Damien Blenkinsopp]: So, this is what date now that you’ve had your surgery, and you’ve been given a clear diagnosis?

[Andrew Scarborough]: This point now? It’s two and a half years coming up to three.

[Damien Blenkinsopp]: Okay, it was a few months after your hemorrhage.

[Andrew Scarborough]: That was two months after that I’ve had the operation because they didn’t know what to do with me. There was a lot of blood in my brain, and if you think about a malignant brain tumor, it’s not a great thing if you’ve got a constant blood supply there — and it’s not a fantastic thing if you’ve had this thing that looks like an explosion in the brain, scattering around the cells, and blood everywhere. So, it just makes it more migratory, I guess if that’s the word.

More likely to spread into other areas, which is not ideal. I then had my pathology, finally, and it showed that the tumor was indeed extremely vascular. And there was still some significant scar tissue, as well as some slight enhancement there, but we didn’t know exactly what that was.

[Andrew Scarborough]: So you’re saying, is that a scan?

[Andrew Scarborough]: Yes, sorry.

[Damien Blenkinsopp]: Okay.

[Andrew Scarborough]: — This was the MRI scan after my operation.

[Damien Blenkinsopp]: Is that a straight MRI?

[Andrew Scarborough]: Yes, this was just a standard MRI, but I also had my pathology report from the amount of tumor that was able to be removed, and that came back as an Anaplastic Astrocytoma, which is a Grade 3 Astrocytoma — affecting the glial cells, the astrocytes in the brain, and quite important components of the brain. It’s not a great thing to have, particularly a high grade glioma, which is what mine was.

Brain tumors come in different gradings, so it’s like we’re staging how — with the brain it’s Grades 3 and 4 are highly malignant, and Grades 1 and 2 are slow growing. Grade 1 is typically a solid mass, that you can — if you can operate it can be curable. Even Grade 2s are known to come back, and do grow, but grow at a slower rate. But Grade 3 and 4 are the fastest growing, they grow quite fast. Mine was showing to be heterogeneous, it had quite a few Grade 3 cells in there.

[Damien Blenkinsopp]: Does that mean that it has different types of cancer cells there when you say heterogeneous?

[Andrew Scarborough]: Well, yeah. It showed numerous mutations. It’s very difficult to explain, but it showed that it wouldn’t be chemosensitive, it was negative for IDH1 which is a predictor of longest survival and chemosensitivity. It was also unmethylated for MGMT, which is a repair gene.

And that’s also — it’s not a good thing that it was unmethylated, so it was one of these gene mutations that they say is good to have for longer term survival. I also had tumor suppressor genes missing which again, with these Grade 3 tumors the timescale for survival is variable until it comes back. But in my case, I had just about the worse. It’s scenario terms with the pathology.

(14:33) [Damien Blenkinsopp]: So, did they give you a rough timeline, I guess at that point?

[Andrew Scarborough]: They said it was difficult to tell because of my age and the location of the tumor. Typically in that scenario, it’s around two years when it comes back, and that’s one of the best cases in that particular scenario. It’s a strange type of tumor because in a different scenario with different kind of pathology it can be up to five years or sometimes seven that it comes back.

It’s quite variable, but in my case it didn’t look so good, and I still had some scar tissue where there was lots of — healthy blood supply that could’ve had any enhancement that was present at the time, not great.

[Damien Blenkinsopp]: Must have been a shock, must have been a pretty big shock for you when that one came about.

[Andrew Scarborough]: Yeah, most definitely. I was told that even though my tumor was not chemosensitive that I should probably go ahead and have chemotherapy and radiotherapy, which I did for a short period because I was quite ignorant about it. I thought that it would potentially give me a bit more time.

But then once I’d looked into it I realized that it was only going to cause further mutations for me personally, and I didn’t want to see that. I started to learn my carbohydrate intake and go on a restrictive ketogenic diet after I’ve learned about it prior to my diagnosis, when I was studying a Master’s in Nutritional Therapy.

(16:17) [Damien Blenkinsopp]: Right, what was your lifestyle like before this all happened to you, and how old were you when this happened?

[Andrew Scarborough]: 27, 28. It’s difficult now thinking back, because my birthday’s at September 1, so I was 27 going on 28. It was two and half years ago and I’m 30 now.

[Damien Blenkinsopp]: So roughly 28 or 27.

[Andrew Scarborough]: Yeah. I was on a diet that I thought was healthy, so I was on a low fat, high carb with a complex carb diet, all whole foods, so I thought I was doing a good job, no processed food. I actually had quite a low body fat percentage and quite a high lean body mass. I thought I was very healthy, and I was very athletic.

I’d worked as a personal trainer for a few years. I was studying my Master’s in Nutritional Therapy and it was a shock to me that what I was learning in my undergraduate degree in Nutrition was completely useless, because I was learning all these new information that contradicted all the older information, but I was just learning about it. I thought it was interesting but it seemed to go against most of what I’ve studied for the past few years before that.

I thought I was healthy.

(17:44) [Damien Blenkinsopp]: When they gave you the diagnosis for the cancer —people at home are probably thinking, “Well is this one of those — metastasized, so it would spread to other parts of the body, or does it tend to stay concentrated?”

[Andrew Scarborough]: Yeah, well primary brain tumors typically just spread into the brain, which isn’t great because your brain is very useful. Apart from medulloblastoma, which can spread down the spinal fluid and into the central nervous system. It’s the central nervous system that can spread down the spine, and other also spread into the brain.

Mine is an astrocytoma, it would’ve just spread into the brain, and there can also be secondary tumors that come about as a response in the brain. It’s not a great type of tumor to have.

[Damien Blenkinsopp]: No, tumors are good ones to have, but it’s one of the nastier ones.

[Andrew Scarborough]: It’s the step down from glioblastoma, which is the most common type of brain cancer.

[Damien Blenkinsopp]: That always the worst, is the Type 4. . .

[Andrew Scarborough]: Yeah. I thought with my approach, with my own treatment strategy — I thought I have a little bit more time to play around with things and adjust to strict ketogenic diet. If I had a glioblastoma I would’ve pushed things a lot quicker. I did push things quite a lot, and I go to extremes with this diet and this approach.

(19:19) [Damien Blenkinsopp]: Yeah. Did you consider any other options? You said you took a little bit of chemo and radiotherapy —radiation, and pretty quickly you stopped, was that a couple of months?

[Andrew Scarborough]: I stopped after four months because I was proposed to have it for up to two years which is a long time, and I said no after a few months experiencing how horrible that was, and still having these horrible seizures. I thought, “Well, I want my quality of life to be good at least.” I stopped it, because my scans were still showing this enhancement.

I thought, “Well, we don’t know if that’s necrotic tissue or scar tissue, or if it’s the tumor activity.” But I thought that, because my tumor looked so glowing on the scan that it was potentially very responsive to carbohydrate restriction. So you do get some cancers that seem to use more glucose for energy, and you get some that actually use glutamine more for energy than glucose.

More or less they use both for energy, but because mine was so glowing up — lighting up like a Christmas tree I’d like to say, it showed that it was potentially more efficacious to just really cut down on the glucose, and see what was going to happen from that.

[Damien Blenkinsopp]: So these were all MRIs they were giving you?

[Andrew Scarborough]: Yeah, and interestingly even though it’s different from other cancers where you get a PET scan, and you can still see the enhancement there, on an MRI, that was interesting to me.

[Damien Blenkinsopp]: Do you know why that was? We spoke recently to Gene Fine who is talking about the PET scan, in the use of cancers. Do you know why you were able to see it quite clearly on the MRI in your case? Is that specific to brain cancers?

[Andrew Scarborough]: Yeah, I think from what I’ve seen in the literature it is, I don’t know exactly why that is. I guess it’s just you’re able to see the metabolic activity even with — I think it’s an iodine solution, not the good kind, the more radioactive iodine that they give you, rather than the supplemental iodine which you can get which is actually really good for hormonal control and certain cancers.

[Damien Blenkinsopp]: So, they give you an IV of that when you go to your MRI, so they can see more?

[Andrew Scarborough]: Yeah, that’s the contrast injection that they give you. Sometimes with PET scans, they do give you the — that shows up quite nicely with the contrast dye. I view my scan straight after I have them, so it’s interesting to view that.

[Damien Blenkinsopp]: Yeah. So I think its gadolinium, is that the contrast dye you’re talking about?

[Andrew Scarborough]: That’s one of them, but I don’t have that one from my scan, I have something else. I can’t remember exactly what it’s called, but I’ve had a few different kinds of scans. I’ve also had MRI spectroscopy which is a fascinating type of scan.

It works with lights, allowing you to see the microenvironment in the brain. And we’re looking at how the ketogenic diet is changing that environment within those biomarkers within the brain as I’m progressing. That’s really interesting to see.

(23:02) [Damien Blenkinsopp]: Yeah, so great. What kind of scans have you been having over time, and how frequently? And how have you seen the ketogenic diet impact that over time?

[Andrew Scarborough]: Well initially I had a standard MRI scans which were quite boring. The cancer cells, [unclear 23:19] was that wasn’t the best for brain cancer, even though it’s world-renowned for other cancers. At that time, I had the enhancement and significant scar tissue, and I had Hemosiderin, which is a blood staining, that was quite a lot of that showing on my scan.

Since then I’ve had progression in a way that I’ve been given a statement saying that I have a response, that I’ve achieved complete remission, and the enhancement is no longer present. I’ve also had significant healing of the scar tissue, and I’ve had vast improvement of my symptoms. So, I am completely off medication for epilepsy which I was told by five different neurologists — that I’d be crazy to even reduce the medication, and I should increase it because my seizure activity was so bad.

I’ve just had a linear progression of improvement in that respect, so I’m completely off medication for the epilepsy, and for that, I do a number of things which controls my seizure activity. And if I forget to do those things I instantly have seizures — it’s like being on a tightrope you have to keep up with doing all these things, I haven’t had a seizure in a long time. When I start to stop doing these things, or I slip up even a little bit I get an aura, which is a warning for me that I’m going to have a seizure.

I have emergency measures to reverse that, which I’ve devised myself largely. It’s interesting.

(25:07) [Damien Blenkinsopp]: Yeah, sounds very interesting, we’ll jump into that. So the epilepsy is a symptom, it’s driven by the hemorrhage that you had and some damage?

[Andrew Scarborough]: Yeah, and also it can provide these for an indicator of where you are with cancer with the brain. Particular with the temporal lobe epilepsy which is a typical response from a temporal lobe brain tumor. My tumor was between the temporal and frontal lobe, so I have three different types of seizures, which is fun.

Monitoring my symptoms and my seizure triggers, and my theories on what would resolve the seizures, not just the ketogenic diet but things I could do with the ketogenic diet to optimize it specifically for brain cancer management. I was able to work out what worked out most effectively for me personally and relate that to the literature as well. I was then able to go to my neurologist and say, “Well what do you think of this?”. And then when they said, “I think it’s absolutely ridiculous, there’re no science behind it.”

I was able to show the science behind it and my results. And then they could say, “Well that’s very interesting.” I’ve had success that they didn’t expect.

(26:42) [Damien Blenkinsopp]: That’s great. So when were you given the sign off, when they say, “Okay your scans are clear.” Did they say it’s in remission or do they say it’s clear?

[Andrew Scarborough]: With that kind of cancer it’s never deemed as curable and I don’t think it can be curable, but personally I think you can achieve and maintain complete remission, and maintain that status indefinitely. From close observation of the animal studies, when they come off the diet after they’ve achieved complete remission, same kind of cancers, that it comes back almost instantaneously. The unpublished human studies I know the same thing, the same occurrence.

I am very keen to stay on this very strict ketogenic diet, and I actually feel quite good on this. Internally, when I have my blood tests which I have a myriad of different blood tests just to see how I’m doing in terms of my general health. A number of markers for potential tumor progression. Internally I am actually much healthier than before I had cancer, which I find that kind of funny.

(28:08)[Damien Blenkinsopp]: So what kind of improvements have you seen, what are the biomarkers that stand out for you, the test results that have come back, and been useful?

[Andrew Scarborough]: The first thing I looked at was my vitamin D. When I was first diagnosed it was in a severely deficient range, and now it’s in the suboptimal range. People would say it’s too high now, it’s 200, and previously was 20.

I also have my triglycerides tested, I have my cholesterol done, and all those fun markers. I have a full blood count, my white blood cell count was pretty good, I can’t remember the exact figures. It’s actually better than before I had cancer, which is not typical even years after you had cancer, immunity can be compromised, so your white blood cell count is typically quite low, and I found that quite interesting.

(29:13) [Damien Blenkinsopp]: It’s great to hear about that progression. Let’s talk about the actual things that you’ve done in terms of where you started in your ketogenic diet, because I know that people said they’re ketogenic. Have you been tracking your blood ketones and blood glucose since the start? And have you seen how that’s changed as you’ve changed your diet?

[Andrew Scarborough]: Yeah. The first thing I did I went out and got a glucometer to measure my blood ketones and blood glucose, and I was comparing that to book cancerous [unclear 29:45] disease, and the glucose-ketone index that Thomas Seyfried devised and came up with, with his colleagues. I had a number of conversations with him about it, just over email, and I was amazed that he got back to me.

I found it very interesting, I started with trying to do the fast, to start with, to get me in ketosis quite quickly. But I realized with epilepsy that’s not a great idea. I had quite a few bad breakthrough seizures attempting that.

I decided not to try it that way, I decided to do it gradually and over time I managed to get into the therapeutic range within just a few weeks.

[Damien Blenkinsopp]: When you say therapeutic range what is that?

[Andrew Scarborough]: I was using the glucose-ketone index, which you use a ratio where you divide your blood ketones by the blood glucose, and you come up with a number, and you try and make sure that number is — I think it’s above one. I don’t measure it anymore in that way because I’m consistently in very deep ketosis with very low blood glucose, so I don’t have to do it anymore.

[Damien Blenkinsopp]: Yeah, we actually covered the index with Thomas Seyfried before. I think it’s a glucose divided by ketones, and there’s a couple of other little things you have to do in there, it’s not super straight forward. I put a spreadsheet up for some people who are asking, when he was talking to us he said it was under one.

So I guess that’s what you are aiming for and you seem to be saying you’ve gone…

[Andrew Scarborough]: Yeah at that time, that’s what I was aiming for, but now I’m consistently above 3.5, so I don’t have to worry about that so much.

[Damien Blenkinsopp]: Oh, in the glucose-ketone index?

[Andrew Scarborough]: Well my ketones are typically above 3.5, and the blood glucose is typically hovering around 3.5 — at the very least one to one.

[Damien Blenkinsopp]: Okay, so for the people at home, because in the US the blood glucose measurement isn’t millimolar. So you’re talking around in between 54 and 72 mg/dl, like 3-4 millimolar. I’m guessing you’re hovering around with the Seyfried Index somewhere around 0.6, 0.8.

So it’s well below one that’s what you’re saying because your ketones are so high.

[Andrew Scarborough]: Yeah. In the evenings it goes sky high, well the ketones go sky high, the glucose goes really low.

[Damien Blenkinsopp]: Do you mean from 5 o’clock onwards — it’s interesting because I saw that in some of my fast and some of my earlier experiments also.

[Andrew Scarborough]: Yeah. I guess it’s a hormonal thing that happens, and also because there’s that period of time where I only have typically two meals a day, that’s the in-between period, I guess where it goes that high. So that’s where I’ve unintentionally fasted for that period of time even though the diet’s mimicking fasting itself.

(32:58) [Damien Blenkinsopp]: What is a typical day look? What are you doing now, what is your typical day look like? I’m assuming at the moment you’ve got the most extreme version of your own program for this, is that correct?

[Andrew Scarborough]: Yeah. Typically I have 85% of fat and 15% protein in my diet, but over the last few days, I’ve experimented with 90% fat and 10% protein, and negligible carbs. Typically on my 85% and 15% protocol that I follow which is very similar to the animal studies, and quite similar to very strict ketogenic diet for children with epilepsy.

I restrict my calorie intake to 1,600 calories — calorie restriction is extremely important for brain cancer management. You probably discussed that with other people I’m guessing. What’s also important I think is the other things that I’m doing.

Personally, I think it’s very important to make sure you have correct therapeutic ratio — I like to call it of omega 3 and 6 in the blood, and I have at home testing kit for that which I send off to the lab every few months.

[Damien Blenkinsopp]: Okay, that’s interesting, is that a dry spot test?

[Andrew Scarborough]: Yeah, it is. You just have to collect quite a significant amount of blood, and it gives you a report back just saying what you’re ratios of omega 3 and 6 are in your blood.

[Damien Blenkinsopp]: Which lab are you using for that?

[Andrew Scarborough]: Well, the testing kit is by — if you go on Omegasense.com it comes up. There’s a center called the NutriCentre in London, and I just get it from there. It’s a pretty good test, very accurate.

[Damien Blenkinsopp]: Have you seen that change? This is actually the current levels ratio, it’s not like it’s your diet of the day like we were talking about — the blood glucose and the ketones which are changing all the time. It’s a more stable marker which is evolving over time, so you’re choosing for a range you want to keep it within.

[Andrew Scarborough]: I’m just trying to get us close to 1:1 ratio as possible, and I’ve experimented with a 2:1 and a 3:1 ratio in favor of omega 3 which is quite hard to do, but it’s very interesting. We know that omega 3 fatty acids exhibit neuroprotective properties and can represent a potential treatment for a variety of neurodegenerative diseases. It’s really interesting, we know that they are shown to be cytotoxic to tumor cells themselves.

Ideally, an optimal ketogenic diet for brain cancer should have, in my view a better ratio than omega 3 and 6. I think the standard ketogenic diets that are applied to humans at the moment are way to high in omega 6 which is inflammatory. I struggled when I was doing a standard ketogenic diet because of that.

[Damien Blenkinsopp]: What are you taking in order to raise your omega 3 levels? What are you doing in diet specifically?

[Andrew Scarborough]: Well, initially I was eating lots of brains because they are the best source of omega 3 that you could get, and that’s high in DHA, and one of the main fatty acids in the brain is DHA. The brain is 70% fat, and the rest is mostly water, it just makes sense to me to have in my diet mostly fat and water, that was my main reason for doing that.

We also know that the fatty acid composition of gliomas differs from that founding non-malignant brain tissue quite significantly. The reduction of glioma DHA content is really interesting to view — we know that in gliomas which is what my tumor was, and what a glioblastoma is as well. We know that they have significantly less DHA in and around them.

If we can increase that — the literature shows that it can have a very potent effect, particularly when on a ketogenic diet, in shrinking these tumors.

[Damien Blenkinsopp]: That’s great so you’re still eating brains today, is this a large part of your diet? What types of brains?

[Andrew Scarborough]: I was eating lamb’s brains, but, unfortunately, I’ve stopped eating them because of the very, very low risk of Scrapie which is like a CJD, a Mad Cow disease but the lamb form. Even though it’s a very small risk, and you probably have that same risk if you were to eat any infected tissue of that same animal, I just thought it would be a good idea to avoid it, which is a shame because it’s my favorite type of food on the ketogenic diet.

It’s a perfect ketogenic food, but my second most therapeutic ketogenic food that I found is sweetbreads which is the pancreas and the thymus gland of — in my case I get them from lambs again. I’ve done an experiment which is on YouTube, on my YouTube channel, just look at Andrew Scarborough, and look at my sweetbreads experiment, I’m testing the myoglobin of sweetbreads and it comes up very high on the glucometer for ketones.

When I test my blood after my postprandial blood glucose and my blood ketones after eating, my ketones shoot up very high, and the blood glucose stays more or less the same as before I started eating.

[Damien Blenkinsopp]: That’s interesting. Out of interest, how much do sweetbreads cost? Are they relatively cheap or expensive?

[Andrew Scarborough]: Well I mostly get them for free, sometimes I have to pay a pound for them.

[Damien Blenkinsopp]: Okay, so they are very cheap.

[Andrew Scarborough]: Yeah, because no one wants them.

[Damien Blenkinsopp]: Right that’s what I was thinking.

[Andrew Scarborough]: They’re incredibly nutrient dense, rich in trace minerals such as zinc and selenium, and they’re rich in protein, and omega 3 fatty acids. Like the brain, and like all the fish — the great source of omega 3. They also raise ketones very high.

[Damien Blenkinsopp]: Yeah, that’s very surprising. I don’t know if you’ve heard new supplement ranges which I’ve been playing around with it, exogenous ketones.

[Andrew Scarborough]: Yeah, I take those as well. I take KetoForce, mostly when I’m trying to do exercise because exercise is a huge seizure trigger for me. So yeah I play around with that.

[Damien Blenkinsopp]: It sounds like the sweetbreads are more effective than the KetoForce, KetoCaNa and the other ones.

[Andrew Scarborough]: Yeah. I actually made a supplement, a sludgy juice that the sweetbreads come in because I have them completely fresh straight after the animals are being slaughtered, well not straight after, but not long after, because they have to do a number of things just to make sure they are safe to eat. I made a supplement out of that and tested it, and it was very interesting the results, but it tasted absolutely foul.

[Damien Blenkinsopp]: Is that a downside of sweetbreads, they’re really awesome except they taste bad.

[Andrew Scarborough]: Yeah.

[Damien Blenkinsopp]: Okay.

[Andrew Scarborough]: It’s not the best tasting, you have to boil them for a long period of time, but they’re very nutrient dense and very effective.

[Damien Blenkinsopp]: How do you eat them? Have you got a quick recipe for the people at home, and they’re like, “Oh like a great thing to try out.” But if it tastes horrible is there some way to mask it.

[Andrew Scarborough]: The best thing to do is boil them for about an hour, that’s actually a short period of time typically for sweetbreads. Normally, it’s a lot longer. And then if you add tarragon to it, it actually compliments the flavor, and it actually tastes a lot nicer.

That’s one of the things I do, it goes well with tarragon. I just consume every bit of the animal, and I don’t have any carbohydrate so that’s how I get around possible nutrient deficiencies from not having any fruits and vegetables. And it allows me to not count carbohydrates, so it’s a Paleo-Ketogenic diet.

[Damien Blenkinsopp]: It’s a pure meat diet, right? Basically a pure carnivore?

[Andrew Scarborough]: Meat and fish, and fat, and that’s it.

(41:37) [Damien Blenkinsopp]: I do know there’s a little bit of story behind the reason — first you were on a ketogenic diet and you were doing more of a straight forward one with the coconut oil, and all of these kinds of things, what happened?

[Andrew Scarborough]: I noticed that with certain people with certain types of brain injury, your brain can be more sensitive to salicylates which are found in coconut oil, various vegetables and fruits, especially ones that have seeds. I wasn’t able to have avocados or any of the staple ketogenic foods that you have. I also couldn’t have dairy because I had a reaction to that, and I wouldn’t advise dairy anyway on a ketogenic diet for anyone with cancer let alone — brain cancer, because of IGF-1.

It just doesn’t make sense to me that there’re so many ketogenic diets for cancer management that have been based around dairy.

[Damien Blenkinsopp]: Right. There’s a lot of cheese, cheese is pushed quite hard…

[Andrew Scarborough]: Yeah, loads of cheese and double cream, and it’s not efficacious for me, even though I’m astounded that they get any results with these trans fat. And they do get some results, that’s encouraging for me on my — what I would call a more beneficial and effective ketogenic diet for this circumstance.

(43:06)[Damien Blenkinsopp]: Could you explain quickly the IGF-1, because there are people at home that are not quite up to speed on the IGF-1 and the dairy aspect of it. What’s the problem there?

[Andrew Scarborough]: It activates insulin-like growth factor and that can cause cancer cells to proliferate faster. One of the ways I get around that — I used to eat lots of butter, but because it’s more insulinogenic and it has milk proteins and casein. What I do is I have Ghee, which is clarified butter so the milk solids and the casein have been removed, and it’s much less insulinogenic and I actually get a much better blood ketone readings as a result as well compared to butter.

I find that interesting in itself, and we also know that compared to coconut oil, Ghee has much more omega 3 fatty acids, and coconut oil only has omega 6. If you’re basing a ketogenic diet around — just loads and loads of coconut oil which is just omega 6. Even though coconut oil is fantastic for achieving ketosis, I would advise it in moderate amounts if you can tolerate it because it’s really good.

I would say that making sure that you have enough omega 3 by having more animal fats is more beneficial in terms of the overall nutrient profile than just consuming tons of coconut oil.

(44:44) [Damien Blenkinsopp]: Right. You mentioned you eat all the parts of the animal, I’m guessing you mean all of the organs…

[Andrew Scarborough]: Yep.

[Damien Blenkinsopp]: Do you consume what you would call a variety of these? Do you try to cycle them, and the widest spectrum possible? So what other organs are you eating, are you literally eating all of the different organs on a rotation each week?

[Andrew Scarborough]: Yeah. Literally everything but mostly heart, because it’s very very cheap, it would cost me 60 pence at a time, and you get quite a substantial portion— because lamb hearts are quite fatty, there’s a huge chunk of fat on them. I can just eat them as they are, and I don’t need to add extra fat.

It’s a fantastic source of iron, zinc, selenium, B vitamins, folate, and it’s the best food source of coenzyme Q10. It’s funny how people pay an absolute fortune to get pills that have a coenzyme Q10, and I just get the best source that you could possibly get for 60 pence at a time.

[Damien Blenkinsopp]: There’s a psychological barrier about the taste, and it’s just what we’ve become used to really. I’m definitely nowhere near as far as you — I’ve been eating more organ meats and I’m trying to push it up, I just made another order today from a new company actually. I’m slowly building my way up, and it’s a taste I’m struggling with, recipes I think help with that, learning how to cook and deal with the different tastes, and just getting used to them.

[Andrew Scarborough]: Yeah. I actually did quite well to start with brains, they’re actually the most tolerable in terms of tastes because they just taste like creamy eggs.

[Damien Blenkinsopp]: Oh, I would’ve never thought that.

[Andrew Scarborough]: They taste like creamy salty eggs.

[Damien Blenkinsopp]: You just don’t look at them while you’re eating them.

[Andrew Scarborough]: No. And a number of things I do are just for entertainment, to keep the diet interesting, to make sure I have enough trace minerals. That’s why I added insects to my diet quite early on because anytime you eat the whole animal you’re getting a variety of nutrients. When you eat insects you’re consuming the whole animal — it just makes sense that it would be a beneficial thing to have.

[Damien Blenkinsopp]: How do you consume those? Because I know there are cricket bars out there in the US, how are you consuming insects?

[Andrew Scarborough]: What I do is I get the fattiest insects that are ketogenic, I get waxworms and super worms. Mostly insects that reptiles eat, I get them from a pet shop that sells them for reptiles now, I used to get them online.

[Damien Blenkinsopp]: Oh, man. Okay did you used to buy from [check 47:31 – Bug Grow], was that the specific brand — was that the only place you bought from?

[Andrew Scarborough]: Yeah, I tried a few, I tried silk worm, pupa as well — a few different insects have different medicinal properties, they’re in Chinese medicine. They’re really interesting in terms of the properties that they have. But we largely ignore that, mainly what I do now is I get them from the pet shop.

I just stick them in the freezer to kill them, and then I’ll give them a gentle wash and eat them …

[Damien Blenkinsopp]: You just eat them straight?

[Andrew Scarborough]: The problem, if you get them online is that they’ve been dehydrated and cooked so much that the nutrient profile isn’t as good as if you have them fresh after they’ve been wiggling about. I also grind them up and make my own flour after I’ve frozen them. That makes quite nice breads, I make a zero carb ketogenic bread which is very useful. People actually think it’s proper bread…

[Damien Blenkinsopp]: You don’t tell them right?

[Andrew Scarborough]: I’ve actually offered it to people without telling them, and they quite like it, and then I tell them what it is, and they want to punch me. But it’s actually surprisingly quite nice.

[Damien Blenkinsopp]: A quick story here, I was in Mexico 15 years ago and I went to Taxco. Anyway you go up into the mountains, into this old city and they were selling plastic bags full of live insects for eating. It’s something that we used to do — we don’t do in modern society. . .

[Andrew Scarborough]: If you look at anthropology, and how we evolved, it’s largely ignored especially with these Paleo diets — we evolved primarily eating a variety of insects, and in quite a large amount. It suggested that the man would go out and go hunting — would only about a 20% success rate catching these larger animals.

The woman would be mainly collecting insects for food. Seasonally they would collect nuts and berries, but it’s a fact in anthropological studies that we did consume a large amount of insects before we moved closer to the coast to eat fish, and that’s how our brains developed more. It’s an ignored fact.

(50:16)[Damien Blenkinsopp]: It’s really interesting, we’ll get there. There’ll be people writing books — maybe you, about the missing parts of the Paleo diet, Paleo upgraded. You did mention that, when you exercise you’re taking exogenous ketones, because of your epilepsy, why is that?

[Andrew Scarborough]: When I exercise my blood ketones go down, lower than my individual therapeutic reading for seizure control for me personally. I have to do that, and I also have to take another experimental treatment of mine which is proved effective, which I learned from the literature on epilepsy. It’s a magnesium chloride solution that I mix into water, and I have a specific amount that reverses auras.

An aura for me is when you have all symptoms that you’re about to have a more serious type of seizure. An aura is a partial seizure in itself.

[Damien Blenkinsopp]: Okay. Maybe you would loose your words a little bit?

[Andrew Scarborough]: I would get pins and needles in my mouth and throat, and I would feel very dizzy, and faint. I have this horrible feeling like I’m going to collapse and have a tonic-clonic seizure. When I take the magnesium solution that I take three times a day, it actually reverses that aura, it is a potent preventative measure that I found to control seizure activity extremely effectively.

People with any kind of epilepsy, their levels of magnesium drop very low, and there are certain types of the day that magnesium is at its lowest, and typically that’s when seizure threshold is also at its lowest. If we can control that, we can control seizures very effectively. Also, on a ketogenic diet, supplemental magnesium — particularly magnesium chloride are found most effective.

It acts as a natural statin, it has a beneficial effect not only on cholesterol, in a natural way not like a typical statin where it’s actually destroying that process, it’s working with your body to do it naturally. I find that it also controls blood glucose — it regulates blood glucose very effectively too. I see it as my replacement for my medication that I was on previously, and the medication interestingly actually causes magnesium deficiency as well as calcium deficiency, deficiency in vitamin B-12 and vitamin D.

[Damien Blenkinsopp]: Which medication where you on?

[Andrew Scarborough]: I was on the maximum dose of Levetiracetam, which the brand name is Keppra and Sodium Valproate the brand name for that is, Epilim. I was both on those and the highest possible amount that you could be on. You can imagine the side effects of that, and the nutrient deficiencies that caused were just quite substantial.

When you’re withdrawing from those drugs you could actually get breakthrough seizures if you don’t address those nutritional deficiencies, and those seizures can actually cause SUDEP — it’s shorthand for sudden unexpected death in epilepsy. I was told consistently that I was highly likely to have that if I was to — not only come off my medication which is what I eventually did but reduced the medication. I have to reduce that medication for a period of almost two years.

I had to do it very slowly, and adding these nutrients and trace elements so that I was not having these breakthrough seizures that were life-threatening. It was a difficult balance, but I achieved it.

(54:50) [Damien Blenkinsopp]: It makes it easier when you titrate down slowly, but still you’ve been courageous in pushing for all of these things when you’re getting this pushback which is saying it’s really dangerous. Just in terms of the exercise, how do you bump your ketones up – is it the KetoForce?

[Andrew Scarborough]: Yeah. I consume that throughout my workout but I tend to mostly just do quite a light bodyweight exercise because I don’t want to stress my body too much. Thomas Seyfried himself recommends that cancer patients don’t push themselves too much with exercise, because it just puts too much stress on the body and on the brain. Mostly I just go for long walks, in an area with lots of oxygen, and I’m actually going to start having hyperbaric oxygen therapy fairly soon.

I’m in discussions with a number of facilities about that, and I’m going to start doing case studies on patients. I’m actually working part-time at the moment with Imperial College London in Charing Cross Hospital, to start-up clinical trials hopefully next year with brain cancer patients using — what I would call an optimal ketogenic diet.

We’re looking at magnesium for these brain cancer patients, we’re looking at the omega 3 and 6 ratios in the blood, we’re looking at C-reactive protein as a marker for a systemic inflammation, and we’re able to measure that for over a period of time to see how that changes while on a ketogenic diet.

[Damien Blenkinsopp]: With cancer is that typically high the hs-CRP because of the inflammation, or is that just a. . .

[Andrew Scarborough]: Yeah. It’s typically higher than normal, but one of the main ideas of measuring that is to have a marker that you can measure over time. I’m a huge fan of testing and I know that even if these things have no effect on cancer, they have an effect on epilepsy and blood glucose management.

We know that these are prognostic factors and they’re also effective at managing epilepsy which many brain cancer patients have as a result. I’m very keen to start doing this in patients more, and I’m working very hard to do that.

[Damien Blenkinsopp]: It’s very exciting that you’re able to work in hospitals. This is starting next year you said, potentially?

[Andrew Scarborough]: Yes. It would also be featured in, New Scientist magazine early next year. My story and my approach will be featured, and that’s very exciting as well because it’s getting the message out there and we can then have the actual data on humans which is missing. It would be — as I’ve said before it will be efficacious.

We’ll be able to not just translate the diets that have been used for children with epilepsy which I don’t believe …

[Damien Blenkinsopp]: As good, as they could be?

[Andrew Scarborough]: I don’t think that they’re translatable for brain cancer patients because I think it’s just very different. For example, when I was on the standard type of ketogenic diet, they did include those ingredients. I developed symptoms that were similar to Temporal Arteritis, where my temporal arteries became so inflamed that I nearly went blind and I was prescribed steroids for it.

But instead of taking the steroids what I did is I looked at how much omega 6 I was taking in my diet, and even though my blood glucose and ketones looked fantastic, and the ketogenic diet is anti-inflammatory in itself. I was having these inflammatory responses which were only controlled and reversed when I re-addressed the balance of omega 3 and 6 ratios. That in itself is quite powerful.

(59:15)[Damien Blenkinsopp]: Interesting. Where did your omega 6 ratio start? We read studies where the standard American diet, for example, is you can get ratios of 20:1, 10:1 — quite far off.

[Andrew Scarborough]: I’ve read up to 40:1.

[Damien Blenkinsopp]: Were you not so bad because you said you had a reasonable — you were trying to have a reasonably healthy diet before. I wouldn’t expect you’d have the sad numbers.

[Andrew Scarborough]: Yes, prior to initiation of the diet, I would say I was most likely about a 10:1 ratio. But, on the ketogenic diet, it was probably quite similar actually because it was including lots of nuts, coconut oil, coconut milk, coconut cream, lots of vegetables that were high in omega 6. I just thought it could be done better — then I transferred on to what I like to call a, fishogenic diet.

I was consuming a lot more fish, and I felt instantly much better and then as I cut down on the vegetables – cut them out completely. I had an instant response where I can’t even remember the last time I had a headache, even a mild headache.

(60:32)[Damien Blenkinsopp]: Great to hear. I’m conscious of your time I know that you’re really busy currently. But there’re a couple of things — I do want to make sure we cover before you go. We didn’t speak about glutamine and I know that an important part you mentioned up front that’s something you had to restrict quite sharply. But how did you do that practically?

[Andrew Scarborough]: Well, the first thing I did was limit protein quite significantly, and I did a number of therapeutic fasts, and it wasn’t until then that I actually saw the greatest response in my MRI scans, in terms of the complete remission. One of the other things that’s quite effective is with the magnesium it has an effect on that as well. I need to find the study for that, but I can send it to you if you’re interested in reading it.

Another thing that I’m actually looking into for the long term is Metformin, because Metformin on a ketogenic diet has quite a potent effect. It has a number of mechanisms which I can’t remember all of them off the top of my head, but that’s one thing that I’m playing around at the moment. It gets an effect on MAMP and a few other things.

It’s quite hard to explain, it’s quite technical.

[Damien Blenkinsopp]: In terms of the fast, you said that’s when you really started seeing the effects, so that would mirror — we had Thomas Seyfried on here and he was talking about the importance of the fast. How many days — was that a pure water fast? Was it a seven or five day fast?

[Andrew Scarborough]: It’s interesting because I think that — when these researchers are talking about fasting for brain cancer patients particularly if they have epilepsy, what they fail to note is that there’s ionic changes that are happening in the brain when you’re doing these fasts. A patient with epilepsy can’t — especially if they have brain cancer in my opinion shouldn’t just do water-only fast.

I think that they need to do what I call, a ’magnesium fast’. When I fast I have my magnesium water solution that I make up myself, and that prevents me from having breakthrough seizures while I’m fasting because I have such low body fat percentage. My longest fast has only been nine days. I aimed for 10 but I couldn’t do more, I’ve done that a few times but I need to have my magnesium-chloride solution or I instantly have breakthrough seizures, not the good kind either.

I found out the hard way initially, but now it’s just the easiest thing that I do.

[Damien Blenkinsopp]: You’re taking specifically magnesium chloride, is that because it’s a spray kind or is it actually the magnesium chloride specifically — there’s something about the chloride which is helping?

[Andrew Scarborough]: It has something to do with hydrochloric acid and how you digest it. I’d say it’s more bioavailable and it seems to me to be just in my personal experiences that it seems to get the brain very quickly. The literature doesn’t actually say that, but personally, I found that — even though there is not much in the literature about that.

[Damien Blenkinsopp]: Are you buying a specific brand? We’ve talked about using magnesium spray transdermally, but I’m just wondering if you’re using one of those sprays? How much you’re taking of it?

[Andrew Scarborough]: It’s designed to be primarily used transdermally this particular type, and I just get it from a health food shop, it’s mainly people who do sports who take it, which is interesting and funny. I typically take about five sprays three times a day. I can’t remember exactly how much that is, for 10 sprays it’s 150 milligrams of magnesium.

It’s variable depending on how mixed up the solution is — typically around 230 milligrams in a day that I would take. If you consider our water is too high in calcium and not high enough in magnesium. It’s addressing that imbalance that we have, we know that we should have at least a 2:1 ratio of magnesium to calcium, that addresses that imbalance.

We know that in the mornings after we wake up, magnesium levels are lowest. Primarily take it in the morning, after waking up in the afternoon, and before I go to bed.

[Damien Blenkinsopp]: Have you checked your RBC magnesium levels?

[Andrew Scarborough]: I haven’t because I don’t think it’s an accurate measure. I just go by how I feel, and sometimes — I see the epilepsy as a blessing because everything to do with epilepsy with brain cancer is typically very similar to what would work for treating the cancer. If something is working for the epilepsy, you’ve got a pretty good idea that it’s beneficial for the cancer, and most of the things that I actually research about what helps in terms of my epilepsy, experimentally and otherwise.

I found incidentally that it has quite potent anti-cancer benefits as well. It’s really interesting the relationship. It’s quite empowering as well. What I would call spectacular results because I still can’t believe I’m not having these horrific seizures all the time without medication. It’s quite empowering to know that it’s potentially having the same benefit on the cancer.

(1:06:44)[Damien Blenkinsopp]: Yes, it’s pretty amazing your journey. I don’t know if you’ve come into contact with other people with similar stories to tell — I know that some other people who had cancer, you said, unfortunately, they’ve passed away — the ones you were relating to. But if you come across any other people who have been experimenting like yourself.

[Andrew Scarborough]: Yeah. I actually have a group of friends now who I came into contact with just through seeking out long-term survivors, and I have a group of long-term survivor friends who had glioblastoma many years ago, and now have no sign of disease. I have a group of friends with various other cancers who are still here now. They’ve mostly done a drug cocktail treatment on themselves, which is very interesting.

Personally, I wanted to try and copy that drug cocktail treatment but do it in a natural way just using diet.

[Damien Blenkinsopp]: When you say drug cocktail, is that chemo or is that more Metformin and things like that?

[Andrew Scarborough]: It’s more Metformin and statins, and phosphates, and various other DCA, and other very interesting drugs. Personally, the only one I’m considering is Metformin, and potentially a few others, but mainly Metformin and Curcumin which I take in tablet form with DHA because they work synergistically. Curcumin actually increases uptake of DHA to the brain.

Because we know that around these tumors, or where the tumor was – DHA is very low. We know that if you have Curcumin and DHA that’s a powerful combination. Curcumin is cytotoxic to the cells. We know that DHA is, and is essential for brain functioning.

[Damien Blenkinsopp]: You really have built a whole lot of armory against this — it sounds like you’re doing really well. On the Curcumin – there’s many forms available on the market today, you’re taking one of the bioavailable forms…

[Andrew Scarborough]: Yeah, it has piperine in it as well.

[Damien Blenkinsopp]: Okay.

[Andrew Scarborough]: It’s a component of black pepper. I have a number of strategies that I use, and I’m constantly optimizing my metabolic formula.

(1:09:14)[Damien Blenkinsopp]: Do you feel constant improvement? I don’t know if there are any symptoms because it seems like you’ve got most of it under control. Do you think you’re going to be able to repair your body, do you feel any signs of that in terms of potentially resolving the epilepsy?

Do you think this is more likely something that you’re just going to optimize and maintain so that it never bothers you, so you never get the actual symptoms?

[Andrew Scarborough]: As my brain has been visibly healing at a very fast rate on these scans while I’ve been utilizing this protocol, I’ve also found my symptoms have improved with that quite substantially as well. I had facial paresthesia constantly all throughout the day, everyday, and a number of other debilitating symptoms I couldn’t even go out and walk a few steps. The fatigue was horrendous as well.

Being able to do what I am now and this non-stop activity, and just doing so many different things, and having my seizure activity controlled in such a great way that’s much better than before — even before when I was doing all these things I was still getting more activity. I haven’t actually done that many more things if I compare to even just a few months ago. Definitely improving in quite a dramatic way, despite having to keep up with all these things.

It’s getting easier to control, to the point where I have days now that I have no symptoms at all, but if I get overconfident and I forget to have my magnesium drink or do something that’s just out of my routine, I’d definitely have more seizure activity coming. Even though it’s not to the degree that I used to have.

[Damien Blenkinsopp]: I guess really say why you’re saying epilepsy is a bit of a bonus for you because it’s early warning detection system for you…

[Andrew Scarborough]: Yeah.

[Damien Blenkinsopp]: — Whereas cancers can creep up on you and you won’t know unless you’re watching the scans and even the scans aren’t showing a small progression. So right now you can still have a small amount of cancer left, but you can’t see it. It does seem like a pretty nice little tool, even though it’s not nice to have it, in the longer term it sounds like it’s a beneficial thing for you.

[Andrew Scarborough]: Yeah, I can see it as beneficial now, I couldn’t before but it definitely is.

(1:11:47) [Damien Blenkinsopp]: Well Andrew this has been an amazing — it’s very inspiring episode today. I can really say that — I’m totally going to take some of the things that you have been trying and start testing them out myself. I would like to ask you — where to look first if they would like to learn about this topic if they’re facing cancer or epilepsy?

Are there good books or presentations on the subject, the first places to go to, to start learning themselves about this?

[Andrew Scarborough]: I would thoroughly recommend the book, Cancer as a Metabolic Disease by Thomas Seyfried. I think that’s a great starting point. For anyone starting a ketogenic diet I would recommend, Keto Clarity, that’s a good resource to use. I would also go to www.ketogenic-diet-resource.com — that has answers to just about all the questions that you could have.

For help to a dietician, if you live in the UK I would recommend the charity, Matthew’s Friends. In the US, I would recommend the Charlie Foundation which is the sister organization of Matthew’s Friends in the UK. It has recently started to see — it’s mainly brain cancer patients that they see because they get around with that by saying that they’re treating the epilepsy.

I would also go on Clinicaltrials.gov to see what clinical trials are happening globally to do with the ketogenic diet and different cancers.

[Damien Blenkinsopp]: Right, so if they’ll just search for a ketogenic diet on there…

[Andrew Scarborough]: Yeah, if they search for ketogenic diet and cancer on Clinicaltrials.gov they can see all of the clinical trials that are currently happening in terms of ketogenic diets for different cancers. It’s very exciting that more and more of these are popping up, and I hope to — I have a meeting on Thursday to discuss having proper official ketogenic diets, using the right approach in this country, and that’s really exciting new development.

[Damien Blenkinsopp]: Is that with the government, NHS or some other body that’s going to help promote it.

[Andrew Scarborough]: This is in conjunction with brain tumor research, they’re one of the very few cancer charities that actually are going all at it with this metabolic research, and they’re doing that with Imperial College London. It’s a small charity that’s doing this, it’s quite incredible what they are able to do being such a small organization.

[Damien Blenkinsopp]: It’s great they’re starting to be – some grounds building from the bottom and up.

[Andrew Scarborough]: Yeah, and I’m going to start-up my own individual research with a few of my lecturers at my university because I want to get these things happening much faster than if it’s going through clinical trial protocol. I want to do this myself with lower grade gliomas, so that we can see a long-term response to try and shrink these tumors hopefully, because they are not as aggressive, but, they still are incurable.

I want to see what effect that we can have on them rather than having to go through all the standard treatment to go through clinical trials. I think that’s very exciting going forward.

(1:15:25) [Damien Blenkinsopp]: That sounds really exciting, and I’m sure anyone who – maybe affected would be very interested to know more. What are the best ways for people to connect with you and learn about you, and keep up with you when you’re doing these things, they can stay up to date on them. Are you on Twitter, you mentioned you had a YouTube channel?

[Andrew Scarborough]: Yeah, my Twitter name is @ascarbs, and I’m on Facebook if people want to add me on there, Andrew Scarborough. I also am working on a website at the moment which is www.metabolictherapy.co.uk, and that has a holding page at the moment, but it should be live shortly. I have a YouTube channel, Andrew Scarborough, and I have a blog, My Brain Cancer Story that’s the title of it.

People search for Andrew Scarborough and My Brain Cancer Story, they should find it.

[Damien Blenkinsopp]: Excellent. We’ll put all those links on the show notes of course also, make sure all of that is there. Is there anyone besides yourself you’d recommend to learn more about the stuff that you mentioned, Thomas Seyfried, is there anyone else that people should look to?

[Andrew Scarborough]: I would look at the research by Dominic D’Agostino, also I would recommend Dr. Colin Champ, I’ve had various discussions with him online which are very interesting. He’s very interested in my approach and he is very unique, he’s a radiation oncologist who is very supportive of this metabolic treatment. Very similar to my oncologist who – it’s quite a rare thing to find – but it’s very encouraging.

There’s Dr. Adrienne Scheck, who I’m having a meeting with on Thursday she’s coming overseas from the Barrow Neurological Institute in the US, and she’s the one that does the rodent studies using the ketogenic diet. It’s great to be able to discuss with her.

(1:17:29) [Damien Blenkinsopp]: Great, great, thank you for those. Some quick items on your – just a personal approach on what you would advise people to get started with – are you still tracking any biomarkers, on a routine basis?

[Andrew Scarborough]: Only occasionally with MRI spectroscopy but we’ve stopped doing that now just because it looks a bit boring and nothing’s really changing. It all looks really good, that’s why we’re not monitoring it anymore.

[Damien Blenkinsopp]: So maybe once in every six months or once a year?

[Andrew Scarborough]: Yeah, just to keep an eye on it, but everything that you would expect to be elevated but would be a bad thing isn’t showing up – it sounds like a good thing. It’s very new research, we don’t know too much about it, but it’s very promising for the future.

Because if we can see these things before they show on the scan, in terms of enhancement or just showing in an obvious way then it’s – that can only be good for the patient really. Then we can intervene in a non-toxic way.

[Damien Blenkinsopp]: So if you were to recommend one experiment, basically you’ve done many experiments to get to this point – they’re not proven recommendations by doctors and so on. What would you recommend that someone with brain cancer or potential other cancer – what would be the first thing they should try, the biggest payoff from all of the things that you’ve mentioned, what should their first step be?

[Andrew Scarborough]: The first step should definitely be reducing carbohydrate intake. The second step would be reducing protein intake to maintenance levels, and therapeutic fasts are very important. But the main thing, I would say is the omega 3 to 6 ratio, I believe that they should be an omega 3 to 6 index, just like with the glucose-ketone index, and they should work together, as a synergistic therapy.

Because you could even argue the ratio of omega 3 to 6 is even more important than the ketones. I would also say, the magnesium is very important with that too, those three things. Therapeutic ketosis, the omega 3 to 6 ratio and the magnesium I would say are very important for brain cancer patients.

[Damien Blenkinsopp]: Great, thank you, that’s some great takeaways for people at home. Andrew, I’ve got to say this has been really amazing interview – it’s amazing all of the different avenues you’ve run-down and all of these different aspects that you found to improve your situation. I know it’s going to be an inspiring story for the audience.

Thank you very much for being on the show.

[Andrew Scarborough]: No problem, we did cover a lot but we got there in the end.

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