Challenging Bryan Johnson On His “Never Die” Biohacking Protocol

I want to be admired by the 25th century. I think we really are at this stage of potentially the most extraordinary existence in the galaxy. My objective is not life maximization, it's species maximization. It's trying to get life in this part of the galaxy to flourish.

When you know something is going to be shorter versus longer, is it fair to say we more are likely to enjoy that? Are you essentially making your life less valuable by living longer years? Brian Johnson is the most heavily tested human in history. After flipping Venmo for a cool $800 million, Brian became obsessed with Project Blueprint, his self funded scientific endeavor to, for lack of a better term, live forever. He has adopted an extreme lifestyle where he is aggressively exploring highly experimental treatments and and research all aimed at extending his lifespan into infinity. And while longevity is admirable, quality is just as important. So I invited Brian to New York City to not only learn the ins and outs of his extreme approach to life, but also break apart the philosophy of a man who's not only desperate to live to tomorrow, but to establish a legacy 500 years from now. Given the lack of quality of evidence behind most anti aging therapies, I wanted to focus less on the individual protocols, but instead discuss this uni philosophy of exhibiting complete control in a field where perfect is often the enemy of good. This is an episode unlike any other that I've done. So please help me in welcoming Brian Johnson to the checkup podcast. Where do you gain your inspiration for going on this journey and how do you stay motivated? Because I know it's not easy to make sure that you're following all the.

Rules to the T. Yeah, it's very hard to be human.

Yes. Understated.

Yeah. I mean, really what I'm trying to do is to back up in a thought experiment. So imagine if we were speaking, if we could whisper in the ear of those that lived in 1870, we might say something like, hey, there are these new ideas about microscopic objects that cause infection. They're called germs. Now, most people would hear that idea and say, that's crazy. You're telling me beyond the resolution of my eyes. And that's the thing that's doing this death thing? No, but it's always the case that the future is always present. It's here right now. And the question is, what is it? And so if we imagine the same thought experiment from the year 2500, the 25th century, and they whisper into our ear, what do they say? That's what I'm trying to do. I'M suggesting that they say don't die is the only thing that we as a species figure out. And that is because we're baby steps away from superintelligence. And when you have intelligence that's a million times or a billion times smarter than you are, you have to figure out what to do. And so people think that blueprint is about health and wellness or about vegetables, and it's really not. It's what to do on the eve of superintelligence.

And that task is to live the healthiest life possible. For what goal?

It is an observation that our intelligence relative to an insect, we're orders of magnitude more intelligent than insects, and we can do things that insects can't do. AI is going to be orders of magnitude more intelligent than we are. It will do things we can't do. And one of those things could be solving aging. We don't know, but it's reasonable to contemplate that that could be a situation. Now, if that's the case and we're this close to these tools being available, then we may shift as a species from caring about wealth accumulation and status and power to simply don't die. And so the observation is that don't die is the most played game by everyone all over the world. Every day, you and I breathe every few seconds, we look both ways before we cross the street. We all play don't die. So it's played more than capitalism, it's played more than any religion. It's the most played game in the world.

And if we take this thought experiment further, once we get to the point of don't die and we've extended life so indefinitely that we're not dying, is it then survive and push out the people who are coming on to the earth. Like, what changes then in this hypothetical, or at least future thought provoking experiment?

In doing that, I try to put myself in the. In the position of Homo erectus a million years ago. So imagine we travel back in time. We're there, they have the ax in hand, and we pose a few questions. We say, where is food? Where is danger? Where is shelter? We listen to those three answers, but then we say, what is the future of the species? We primarily listen for entertainment purposes. They're not going to be able to riff on quantum mechanics or string theory or computers or all the things we have today. We may be Homo erectus right now. So our ability to imagine what may exist and what problems may arise. And so it's the first time in Homo sapien history where we Cannot predict even three months out. We just no longer know and we're up against a wall of fog. And so when we're in this situation, I come back to the simple question is, what is the one thing I do know is I don't want to die. And by doing that, then I've taken the systematic approach to say, okay, if you're going to go about that process, how would you do it? You would go about measuring everything you could in the body, trying to assess scientific literature, measure again, and just go through this process, trying to figure your way out, what can we do today?

Yeah, like the idea of surviving is innately written in our code to some degree. Right. That's why we have anxieties when, as a form of problem, of progress, when things get safe, we become anxious for no reason at all because we're. Our brains were attuned to survive. And then at some point we get to the age where we no longer can sustain life and life ends. And there's people who claim there's beauty in that, the fact that life ends. Do you disagree with that notion?

You know, humans are very clever and we create clever stories to justify anything we feel uncomfortable with or anything we want to be excited about. And so if you look at the number of things humanity has done to, to try to reconcile with death, I mean, every religion is an attempt at reconciling with death. And we have cultural norms like live fast and die young. And so we have all these, all these tools for us to say that death is not only okay, but it's desirable. Now, would we have invented those stories if death never was? Or is it the reaction to this inevitability that everyone feels pained about? And so in a, even if you said two, two decades ago that death is a maybe or that don't die, you would be ridiculous. It's not. It was never possible until right now to even pose the question that, is that real or are you just like off in la la land?

The, the notion of humans creating stories after the fact and being like the Monday morning quarterback, if you will, is so commonplace and happens all the time in our logical reasoning as a form of fallacy. But isn't the thought of don't die just another version of that story from the other side of the perspective also kind of without data knowing to whether or not this is just a story we're telling ourselves?

Certainly could be, yeah. And that's why I try to go through the thought experiment of if I try to be as aware, self aware as possible and strip myself from all things. Literally. The only thing I can say about my existence is that I want to continue to exist in the next second and the next second. That's all I know. And so for me, that I'm trying to create clarity of thought. This is, again, is like when we look back at previous centuries, the 15th century, we compress the entire century into 20 things that were accomplished. Everything else is gone. You know, you may have an ancestor's biography, but that's your ancestor. But we as a species, compression, that same thing is going to be true for the 21st century. They're going to look back at us and so much of what we care about and we think is the end of the world if something doesn't happen, is going to be lost to history. No one's going to care. And so I've tried to, in my own thought experiments, say, what is the.01% stuff that does survive in this time compression?

And what is that in your mind.

That the 25th century? If we could listen into that conversation, they would say, it's amazing that Homo sapiens, with their primitive brains and primitive tendencies, were precocious enough to figure out the only priority they had was don't die. Now, don't die individually, don't kill each other, don't kill the planet, and align superintelligence with don't die. That it was a fabric of all intelligent beings on a single philosophical substrate of don't die.

It's very Darwin in its perspective. Right. Survival of the fittest, survival the longest. Right, yeah, we're just changing the adjective here or the adverb. We, we, we talk about in medicine frequently measuring not just length of life, but quality of life. If we get too focused on the length of life, isn't it true that the quality of life can then suffer as well? In your eyes or you disagree with that?

I think it's possibly. That is a valid observation in the 20th century. I think it's something that should be questioned in the early 21st century on the eve of superintelligence. And this is. I come back to this again and again. I don't think we can say anything about the future. It's like asking Homo erectus, you know, posing the same question and then saying, what do you think about blink? There's just no intelligence there to even comprehend the reality. And so when you talk about the change of intelligence, as dramatic as we're contemplating, it's hard for me to imagine that our priors would map to that.

Well, I'm sort of speaking more about the present in the situation of, let's say we have a person who. Their quality of life is suffering because they're on a ventilator. They have no longer any brain activity, but their heart, lungs are working because of the machine. This person is technically alive, and we can get a lot of years of life out of them. But is that without the quality that that person would have wanted for themselves? Where do you fall on the spectrum of that line of thought?

Yeah, I mean, I actually went through this as well in signing my will documents. I had to go through this thought experiment of how long would I stay on life support and under what conditions. I agree it's nuanced and challenging. It's very hard. I think you're probably aware of the literature where people who. People say, who work, for example, with ALS patients, they'll say, if I ever become an ALS patient and if I ever get to the stage of deterioration, please just pull the plug. And then they arrive at that state, and they don't want someone to pull the plug. And so I've just seen again and again that a person's imagination on what. What they may want is almost always wrong when they arrive at that place. And so for me, I'm always very careful imagining what I think I want, when right now, I could say, like, oh, of course, that's a valid point, that. Just pull the plug. We don't want that. But there's very few things as strong as wanting to continue to exist.

Aren't you thinking about that future perspective that you say we're so inaccurately judging every time you make your daily decision to eat the exact number of calories, sleep the same number of hours, do the protocols as you're doing them because you're thinking you'd want to live as long as possible. Is there a world where you do live much longer than you would have if you had not done those things and then wish you lived a shorter life?

I think that's possible in a previous era. Now, I don't think so. What is that? If you look at the differential between intelligence of what AI can do versus ourselves, and the speed at which it's moving, I'm open to this idea that everything I care about, everything I perceive to be valuable to me, may be completely replaced with some other framework that if you look throughout humanity, I mean, there's been thousands of human civilizations rise up, each have their own cultural and social norms. No one's exactly alike. So we've seen that human Intelligence can structure itself in a very long, very wide variety of ways. And you walk into now with that kind of new intelligence and you look at how AI agents play in games and what it is so unintuitive to us, what they do, that this is why I'm open to this idea that it's a reality that may be incomprehensible to us.

Yeah, I definitely think it's uncomprehensible. And I think part of it is what makes us human, for lack of a better term. And again, that could be something we say to pacify ourselves surrounding the unknown. When you know something is going to be shorter versus longer, is it fair to say we more are likely to enjoy that? If I tell you that there's less of a certain baseball card, the rarity of it is higher, which is essentially a shorter life, rarer years.

Right.

Don't we put higher value on that? So are you essentially making your life less valuable by living longer years?

That's not my lived experience. Like I'm, I'm 46 right now.

And you look great for your age.

Thank you. If I were to live to 50, you know, that's a very, it's a finite time frame that I have to live and let's say an alternate universe, I live to be 90. You know, I'm not sure how I would mentally reconcile with that and say like those four years were the best years of my life because I was all in on living versus, you know, for the remaining 40 years. I got to live, I got to see the following things or do the following things. I don't know. To me that seems like a very hard question to answer.

Yeah, that's a very reasonable answer. If you know, you follow all these tools that give you ages of certain organs or your performance on certain tasks. And, and I'm gonna be very open about my bias and skepticism about those things because I've seen non validated technologies come and go throughout my young career as a physician. And I've been hesitant to recommend them widely to people outside of maybe entertainment or gamifying certain things like exercise. And I've also seen it not be widely applicable to the general population. Like even something, if we really simplify it to step counters. Before we used to recommend in our family medicine clinic, everyone give them a counter that will, you know, gamify, make them excited to walk.

And it did. Yeah.

But once we tracked them for a longer period of time, we saw like everyone fell out of love with them. It was the novelty of the situation that caused them to use it and then they stopped. So when I hear things like there's the age that your body currently is or the age you're going to live until like there's the 10x health that the insurance predictor would tell you how long you technically will live if you continue living your current lifestyle. I find those to be wildly inaccurate because I don't find them very well validated. But what is interesting to me is if I could tell you with certainty that you're 46 now at 50 guaranteed death from my new technology, would that make the next four years more or less enjoyable.

Than if I live past.

If you didn't know because you're, you're seeking knowledge.

Right.

And I'm always like okay, knowledge. But with knowledge that you can actually change something. Right. Because otherwise knowledge with more knowledge is somewhat scary in some scenarios. So if you could know age 50 is the end or not know, like I have, I have a helmet here that I could put on and give you exact estimate. Do you want to know?

I would definitely want to know. Yeah. My relationship towards data is I want to know all of it. Yeah. I mean I think that your thought experiment. Yeah. If you put a clear line on death, then you definitely are self generating a mental state that is an aroused state that probably isn't sustainable over some duration of time. You're going to live differently. Yes. So I think it's a fair that that that definitely plays into human psychology that I would live probably. Probably. Well, I live pretty ferociously right now. But like, yes, I would definitely have probably higher intensity of living, I would imagine.

When you say higher intensity, does that mean you stop your protocol?

I don't think so.

So you get incredible enjoyment of doing and living this regimented lifestyle.

Yeah, I mean my, my meaning making game how I understand my value. I want to be admired by the 25th century. I want them to point and say in the early 21st century and now I built this model based upon my reading of a lot of biographies of previous centuries. I admire them for having done seemingly impossible things. So yes, I would do it because my objective is to point the species in a direction of don't die. I think we really are at this stage of potentially the most extraordinary existence in the galaxy. And that's what I want to be known for, that's what I want to try to accomplish. So my objective is not life maximization, it's species maximization. It's trying to get life in this part of the galaxy to flourish.

So you're hoping with the results and knowledge and data that you gather about yourself, someone else could look at that and say, oh, I've learned from that and I too can help myself, my family, etc.

I'm trying to turn the zygote. I mean, there's so many examples throughout history where individuals or small groups of individuals did something that changed the course of humanity. And that's the objective here.

When you make some of these things that could be tangible takeaways for others, isn't it somewhat problematic in that you're the most measured man in the world? Right. Is that correct or. I think it is stating, okay, you're tailoring your approach very individually, right. Based on data markers, things you're gathering about your hormonal profile, your growth, your physiologic state. Isn't it then difficult to generalize that from. For people of different genders, different activity levels, races, medical conditions, or do you feel like it's universally applicable?

Yeah, I think it's more universally applicable than it is personalized. If you look at the core tenets of blueprint, of prioritizing sleep, getting exercise, eating well, and not doing bad things, most people, that's on point four. And there are nuanced things that are particular to me. I take rapamycin, I do metformin, I do a carbo. So those things are on the outlier blueprint. But the primary is really the basics we all learned our entire lives, which are just the hard things to do.

So do you think then that takes away from the revolutionary aspect of blueprint in that this is what's been said to us for 100 years.

So it's not that the science is revolutionary, it's that the philosophy behind it, death has always been inevitable. And if we contemplate that it may not be inevitable or that there's like even the. Maybe it changes everything so the don't die. If we just. If we try to isolate and say what things threaten the continued existence of the human race, I would say there's three things. One is human annihilation, either through weapons of mass destruction. Two is the Earth becoming unsustainable, the biosphere. And three is something with artificial intelligence that we don't build it correctly and there's some undesirable outcome. I tried to become all I could try to become each one of those problems. So what I'm trying to do, I'm trying to solve climate change through health and wellness. That we treat planet Earth the same way we treat our bodies. It's an identical relationship. Now if, if you replace my body with planet Earth, you do the same protocol, you do get a whole bunch of data, look at evidence, you'd create a protocol. You'd go through the process of doing it again and again. The scientific method. So what I'm trying to say as a species is it's the philosophy and the way we approach our existence which is what's important. Not that going to bed on time is revolutionary. It's saying that we're in this special moment in time and the way we solve our existential threats is through individual decision making. It's not blaming someone, it's not pointing fingers, it's not asking someone else to come in and save us, is through individual powers.

Does the fact that as we multiply, if we don't die, the effect on the Earth is disastrous. So is that a tenant that kind of doesn't vibe with the original mantra of don't die?

Yeah, it certainly could be. It reminds me, however, of the problem in early 19th century New York where horses were the primary mode of transport. And there was so much manure all over New York, where it was disastrous. The Hudson had all this manure, People were getting sick, the drinking water was polluted, and everyone thought the world's coming to an end. And then Henry Ford made the Model T and that solved horse manure. Now, of course, the car caused all kinds of other problems, but still the horse manure problem went away. And so I know overpopulation is the imagination, but there's also a possibility that overpopulation is a horse manure problem. That is not really a problem. There's something else the problem. Now, it could be, but I just call attention to this, that a lot of people hear the argument and they jump to overpopulation and they foreclose this other thing so fast without giving the other side of the, of the contemplation any breath, any air to breathe. And so what I'm saying is we, if we're cautious and wise, we'll realize that no previous generation has correctly mapped the future as it's unfolded. Most of it has gotten wrong. So we're probably the same. The majority of our imaginations are likely wrong.

Yeah, I mean, that's very fair. If you ask anyone in November 2019 what they envision the next few years would be like, everyone's guess would be wrong.

That's right.

So that's true. When you say people foreclose on the notion of overpopulation, perhaps being a good thing or living forever could Be a good thing. Who are those people that you're referencing?

Oh, so if you even say the idea of living forever, it breaks the human brain. You can't say those words like no one can comprehend it. So it just provokes this knee jerk reaction which just squashes it. Squashes it. So I like to talk about living tomorrow because living tomorrow and living forever, they're identical. You know, I, in my current State As a 46 year old, I in my mind assume I'm going to live forever. Like death does not seem real to me because I'm not yet in that state. Now when it does creep up, that's a different reality. But I don't live life with the expectation that's going to end anytime soon. I think I have all the time in the world. It's like this trick our minds play on us. And so I really focus on don't die and don't die for tomorrow because that's what we understand, that's what we care about and that's how we build habits for this moment.

So you focus your mindfulness towards the don't die mentality and you're saying that you can plan for it once you get to that state, but in reality most people don't plan their deaths. I mean they're obviously unique exceptions, but most people, something happens and they're no longer living. So how can we guarantee tomorrow? And that's why I feel like it's hard for folks to comprehend because it doesn't seem feasible right now. The same way that the airplanes were not feasible back then.

Exactly.

The reason why it's puzzling to me as a physician is because I see how flawed science is currently and how a lot of data confuses us at times. Like prime example of false flags on tests that then require follow up or interventions that are problematic. Like I've read about you receiving colonoscopies earlier than the traditional recommended screening period of age 45.

I didn't, I. Oh, you didn't? I didn't know.

Okay.

I did a pill cam.

Oh, you did an endoscopy.

Colonoscopy. Okay. Yeah.

So, so you don't do colonoscopy. Okay. And there, is there a reason why you chose the pill endoscopy versus yeah.

Because the polyp detection was high enough that we thought it was a decent coverage. And the, the risk of death, I think it was like 1 in 10,000 on the colonoscopy. So we felt like the risk trade off of the detection was better for.

The pill cam and Then you, you discount the part of potential intervention and prevention aspect of colonoscopy. Like if there is a polyp, you can remove it versus on the colonoscopy. You can't do that.

Yeah, the pill was such a benign thing. I took, I fasted, I took some laxatives, I did the pill and then I drank laxatives for six hours. And then I got the 40 or 35,000 images or whatever it was just to get a baseline of what do we think we can find here. And it was a pretty, it was pretty good technology.

Yeah. And was there anything interesting that you took? Nothing. Perfectly clean.

Perfectly clean. Yeah. But an interesting video. But I mean, to your point, like I, I agree with you. For me, the science doesn't need to be true eternally for this to make sense. In my mind, like, we all know the science is gonna move. Some things I do today are not gonna be good ideas and it'll transform into something else. Totally agree with you. Like that's what has always happened, to be naive to think otherwise. What I'm really trying to say is, it's that we're vigorously engaged in this process because we have this practical question. So as you can tell, I think a lot about AI. So we build these super intelligent tools, then we have this question, what do we do with them? Do we use them for war? Do we use them to get more social media followers? Do we use them to kill each other? What do we do? And so we're bringing AI into all the games we humans play. That's potentially the most dangerous thing we can do as a species. And so the question is, if we don't bring it into our existing games, what would be the new game that replaces that game? And so what I'm betting on is as AI progresses, it's going to create existential crisis for us as a species, continually. And it will create questions like, what do we do for a living? Do we still work? Do we have identities? Does it create videos better than any movie maker? Does it replaces us in many ways? Does it do government? Like, who are, do we elect leaders anymore? Like, we have to basically revisit every facet of society because this new thing is here now. That's pretty traumatic for us as a species. That's a lot of change. Like we look at a little virus, like it shuts society down. And now we have a new form of intelligence coming on the scene that's going to shake every pillar of our existence. So what I'm trying to say is the process I'm going through is just simply a process of trying not to die. We're doing our very best with the science we have today. We're making mistakes, we're improving, we're open to all this stuff. But it's just the process and it really is meant to say, what do you do when you have really powerful technology? You apply it to improve the condition of all humans.

Yeah. Like the idea of the notion that you point out of folks like the things we do in science today will evolve and we'll look back 100 years from now and say, oh my God, I can't believe we used to do colonoscopies. We can just, with this thing, see internally, we, without even going inside the body. Right. There's going to be plenty of that. Those things will come up and will be tested on a wide population. When you're using yourself as the benchmark for tests, especially when you're very excited about the technology and the testing, do you see how bias can impact the outcomes of those results?

Sure.

So how do you safeguard against that?

Or you don't? Yeah. So we do our best. Yeah. But this is, I think of myself more like Magellan or Ernest Shackleton or Lewis and Clark or any other explorer before me. I'm trying to demonstrate something that has never been done before, which is a bravery to try to tackle death. Now this of course, is a story as old as mankind for the first time. I think this is the first time in history it could be taken with a serious face. And that's what I'm trying to do. And so yes, I'm going to make mistakes. Yes, it's an n of 1. It has all these kind of limitations. Totally aware of all this and I'm not going to try to make the argument otherwise. What I'm trying to say is it's a worthwhile endeavor.

Yeah, I could see pushing towards that endeavor to some degree brings tremendous value. The, the concern I have is there are people that look to you as a figure, who's very influential, who is looking great for your age and even for younger than your age and say I want to do that too. And they don't have the means to, of doing certain things outside of the pillars that you mentioned of sleep and exercise and they, they start spending their limited time budgets, etc to try and chase that dream. And my thought is anytime you're prioritizing something, it's at what cost? Right. So when someone asks me like, is diet soda bad? And it's like, for whom? For what condition Is it replacing what, like all these questions pop into mind. So it's. Is this a worthwhile endeavor for the general public? Because for you, who am I to say what's right for you? That's completely your world. Right. You have bodial autonomy. But the question is, what should the general public be taking away from your journey?

Yeah, I mean, let's. Let's imagine we pose a question. Someone sees someone else gets wealthy through this thing called capitalism, and they want to start doing it too, and they start doing it at the cost of all other things. Is capitalism a good thing?

Is capitalism a good thing for whom? In what condition? I mean, like I would ask all those same scenarios.

Yeah, I mean, it's like any pursuit for humans, they lock in on a given game they want to play, whether it's their own wellness or whether it's trying to make money or whether it's trying to get social media followers. I mean, there are these pathways any human can take for any system they want.

In those pathways, a lot of times what ends up entering into the space is survivorship bias of someone who has been lucky, taken the right path at the right time, et cetera, et cetera. And then people try and follow that Route 1 to 1, and oftentimes it doesn't happen because, you know, and of one, as you precisely put it. So I'm just trying to find what can I take away from your journey to bring to my viewers, to my patients that's going to actually make an impact that is valuable to them in the long run. Besides the philosophical thought experiment of what if we don't die? Because I think that is a valuable thought experiment. I think there's so much value into thinking beyond death. And I think you said that a lot of the cultures in the past, they lived very differently and they evolved very differently. And that's true to some degree, but there are some unique through lines, like the thoughts, what happens after death, the fact that almost every culture had some sort of substance that allowed them to escape reality, whether it was alcohol or opium. You know, there is these human flaws in us, and that's always been largely celebrated. But now we're taking the other approach and celebrating potentially getting rid of human flaws.

Right.

Is that the correct way to think about it?

Yeah, I mean, what I suggest for your patients is that I'm making the observation that we humans have largely seen ourselves as martyrs for certain causes. So people take better care of their pets than they do themselves, better take care of their kids than they do themselves. They take Better care of their professional advance, their wealth accumulation. So people prioritize a very long list of things higher than their personal wellness because they think they're achieving this immortality of legacy and contribution through these other vectors. And what I'm saying is the age of it, of martyrdom may be coming to an end where it may make sense to put your mask on first. That means going to bed on time, it means exercising, it means try not to engage in bad vices. And so it's really a fundamental shift of how we understand ourselves. That's why don't die. It is a philosophical argument, but it also informs what you eat for breakfast and what time you go to bed and whether or not you, you drink alcohol and whether or not you smoked a cigarette. So it's extremely practical on a day to day basis.

Well, practical is tough because, you know, the human psyche takes so many different forms. Like I've treated tens of thousands of patients and, and not all successfully, might I add, and some of it may be optimal. Treatment wasn't there, the presentation of the condition wasn't very clear. But also because patients don't oftentimes take care of themselves as well as they should. And the human psyche is so imperfect. So is it practical to say that how long of your day of waking hours do you spend not dying?

Yeah, a lot for me. Yeah.

Like, is that practical?

Well, so the people doing Blueprint are able to play the power laws. So what we've, what we did at Blueprint that was unique is we went through all the scientific literature, all health span, all lifespan studies, we graded the effect, we scored the effect size and then we graded the evidence and we said, can we define power laws in health span lifespan? And we put all those into me and we measured everything, we made it all public. So basically we're just trying to say, as a scientific person project, where are we with the fountain of youth? Like if you look at it from an organ, by organ perspective, and every measurement we have, whatever you think of those, those measurement modalities, whether it's gold standard, silver standard, like whatever the case may be, here's a rough assessment on where things are at and then we can distill it and say, all right, mom and dad, here are five things you want to do in life and you can allocate, you know, 30 minutes a day to these five things. So we've, I've tried to make it very easy, approachable, lowcost. It's why I've made the whole thing for free. Like my parents, my my father, 71. You know, like, they're pushing the ages where they're really starting to deal with their averages of aging. And they've been able to implement these power laws and dramatically change their.

What are the power laws?

So the five big ones are not smoking, a exercise six hours a week, a blueprint or a meta training like diet, a BMI of 18.5 to 22.5, and then moderate to no alcohol, and then sleep, you would add there as well as the.

Sure. And that's the part that you get for free with the blueprint protocol.

That's the influence. So, I mean, so I spend a lot of time doing all these measurements and testing all these therapies, but the takeaway for someone else is do those five things. And so if you don't smoke, not a big deal. If you don't drink, not a big deal. Here's the rough dietary protocol to follow. Maintain a proper weight, get some exercise, and you're there for a power law. Now, that also means try to eliminate vices, you know, which is probably the hardest thing.

Sure.

And so. Yeah, but it's like these really basic things that most people know, but they're not implementing. Now, if you want to go to a more graduate level, then I've got those things for you too. But I've tried to just meet people where they're at and say, here are some things you can do with baby steps to be in a better spot.

If you went on social media and you talked about those pillars exclusively.

Yeah.

Or sorry, parallel.

Yeah.

Power loss.

Yeah.

You would probably not build much of an audience. Not because anything against you, but just because there has to be something sexy and fun and unique, and that's why folks are paying attention. Right. So as much as you're saying, like, these are the five healthy habits that everyone should follow, they're more interested in what you're doing to the extremes. Am I right in thinking that, or you think I'm disconnected?

It's the entryway. Yeah. But when they have to, they can observe it. But when they pull it back to their life and say, now what do I do? It comes back to those things and.

Those things that you do. Like, some of it seems really out there for me. At one point, were you doing plasma transfusions from one of your younger children? Take me through the logic of that and why you decided to do that.

Yeah. So we were exploring various therapies we could do, and plasma came up as one. The effects in animal studies are pretty convincing and not convincing. The effect size is good, so we thought, we'll try it. So what happened? I was talking to my father. He called me one day and he said, he's in the law, Legal profession. He said, I just wrote a brief. I walked away. I came back, and it was a scrambled bunch of words. And I was like, I couldn't believe it because I didn't see it when I was writing it. So he realized that he was experiencing a lapse and he wasn't aware of it, which terrified him. And so he said, I will do anything for my cognition. And in our research in doing this, we had seen that a lot of trials were being done for Alzheimer's and Parkinson's, as we said. Interesting. I said, dad, I would be more than willing to give you a plasma, a liter of my plasma, as experimental therapy. And he said, I would do anything to try to combat this. My son overheard the conversation. He's like, hey, I'm into. So, like, great. There's like a multi fan. There's like a multi generational plasma thing. How fun. Like, okay, some people go to the beach, some people go to plasma.

Okay, very interesting.

So we went there, and it was. It was actually really fun because my. My father was mostly missing from my childhood because he was engaged in hard drug use. And I always wanted him to be around, and he never was. And it was very hard on me. We've always worked very hard at our relationship. He just has had a lot of challenges. And then my son. I was married, and I had three kids. I got a divorce, and my three children were split between dad, who had left the religion, and mom, who had been in the religion. And so for 10 years, I was the other. I couldn't be trusted because they were part of this religious group that said, this is how we understand reality. Dad is not part of that, therefore, we can't trust him. And so, weirdly, I was without father, and now I was this super engaged father trying to raise my children. And they were like, thanks, dad. But we got this, and it was this form of torture. And I had one of my three children come decide to live with me, and he and I have become best friends. And so it was this moment where, yes, it was about plasma because we thought it was safe, but it was also about my dad, myself, and my son and the three of us getting together. And so I know from the outside looking in, it seems crazy. It's eccentric. It's everything that triggers people in so many ways. It was also one of the most special moments of My entire life. Now when I measured my biomarkers, there were no change in my biomarkers. We didn't see any effect. When we looked at my dad's biomarkers, we looked at his DNA methylation. Using the Danudin pace algorithm, his speed of aging lowered by the equivalent of 25 years. Now, speed of aging, the DNA methylation is still a silver standard, right? It's not, it doesn't have all cause mortality. So it's not gold standard. We still don't know what it means and why. Still it's, you know, a legitimate scientist, it's a legitimate technology with a lot of scientific publication on it. And it stayed. His speed of aging stayed down. 25 age equivalent for 6 months had a meaningful impact on his biology. And he would say in his subjective experience as well. So from my father's perspective, it was one of the most substantial interventions he's had in his entire life. And so I know that from the media's perspective, looking in, it's absurd. From my personal experience, it was one of the best experiences of my life and meaningfully impacted my father.

Yeah, that's awesome that it brought you guys closer together as a family. And I think the, the reality of all of these things is everyone has their own risk tolerance. And some people can look at a rock climber and say, you're ridiculous for risking your life. You're ridiculous for jumping out of a plane. I became a professional boxer. And they're like, you're a doctor, you're getting head injuries. Yeah. And I agree that it's, you know, not healthy and I don't recommend it. The issue comes in when we say lines like the test has a lot of scientific research behind it. That statement to some ears will sound like it has validity to what we're doing. And we have to be really careful on how messages land to the general public where the validity of the weight of evidence is unclear.

Yeah.

And I don't want folks thinking that that is the answer to their longevity or that this is mandatory and they can skip out on certain health habits or they can't be healthy unless they have plasma of someone younger. So my goal of educating on science is really just getting people to think about the scientific process of what evidence means. Because you're a brilliant person in terms of your knowledge. Right. You can think much deeper than the average person. You, you way smarter than I am in your knowledge of understanding evidence levels even. And I think about the general public not having the depth of understanding of what a DNA methylation test is and hearing it and sounding like sci fi and them craving it, as if that's the answer. I'm like, man, I wish they would just listen to your five power laws, because that's what I want them to listen to.

Yeah.

And that's where probably the biggest criticism would occur from the medical community. But the fact that you and your family bonded over this and someone finds it weird. Humans do all sorts of weird stuff. I mean, like, that should be without judgment, what you and your family do. So I don't think that's valuable. Is there anything that you've done in this journey that has ended up harming your health?

I'd say the worst outcome was using human growth hormone. We were repeating a study that was done for thymus rejuvenation, so the gland responsible for the immune system. So we, we did 100 days of human growth hormone. 0.6, 1.8 IU was the dose. And we successfully changed my thymus fat fraction by seven years equivalent. So I, according to three MRIs, we regenerated my thymus by seven years. That was positive, but it came at a pretty extreme cost. I had intracranial pressure increase. I had my blood glucose were messed up. It was pretty disastrous for my body. And so I don't think we would do HGH again. I think we'd probably take a different approach, maybe look at some peptides or something. But we were trying to go after. No one had not no one. Only one group had tried to do thymus rejuvenation. It's a really hard one to get at, and we wanted to take a stab at doing something hard.

And why was the thymus the primary organ you were focusing on with human growth hormone?

Because, well, I guess we've been trying to rejuvenate all my organs. So we take each one, the heart and liver, lungs, and then we say, how do we do that? And then what therapies are available. And the thymus just has such a huge yield because it's the immune system. You know, very few things have such a power law in the body. So we wanted to put our targets on that. And we found there was a therapy that had been through a study. So we had some data on some number of participants.

And when you undergo one of these trials, you take a lot of measurements in order to see how one therapy impacts the others, because you're doing many therapies at once. Is there ever a fear that they're clouding the judgment of what's actually happening when you're Trying to perform a measurement.

Yeah, we've borrowed from pharma. So pharma has the same problem. When you introduce a drug into the body, they have a statistical process where you go through a questionnaire and you try to isolate and then use probabilities to determine whether a given therapy has a given effect. So we've tried to use stats to, but it doesn't, it doesn't create a crystal ball. You're still dealing with probabilities and you're still dealing with potential confounds.

Yeah. And I mean a lot of that statistical power comes from the number of people involved and the randomization of it. So that is also tricky.

I'm just thinking of the, that's, that's absolutely fair.

The, the, the, the guidance that again, we can issue from some of these things.

Yeah. And I mean, knowing all these things, we do our best knowing full well. We just. Because It's n of 1, we're limited, but we do genuinely try to be intellectually honest.

That's great. I, I have a, a theory about like fitness trackers and it's going to be widely different than your viewpoint. So I'd love for you to critique me on my viewpoint and what you think, but give me a genuine, like, reaction to what I'm saying. When folks come in and they say, should I monitor my sleep score? Should I monitor my fitness tracker? Should I do these things? My usual answer is no, and I'll explain to you why. And you tell me if you think you agree, disagree, and why. My thought is when you have a sleep tracker on, a fitness tracker on, it potentially makes it more difficult for you to understand and listen to your own body. And one of the most important things, when I see a patient, let's say they come in for the symptom of pain, knowing, is that symptom of pain urgent? Is it scary? Is it an ache from a hard workout that they can push through? That sort of knowledge comes from trial and error without outside measurement. It comes from, into intuition of your own body's functioning. So for example, when someone sleeps, well, but then we tell them as scientists, hey, you actually got a bad night's sleep, we lie to them. They perform worse on tasks because we've led them to believe that off of their device, even though we were tricking.

Yeah, yeah.

And then people will say, but Dr. Mike, when I have a drink of alcohol, my sleep score goes down. That incentivizes me to not. And I think that's wonderful. But the question I would ask them is if you had the glass of alcohol and you didn't sleep well and you wake up and you feel like shit. Did you need the watch to tell you that? So it's like I could see the instances where it helps. It would have helped anyway and you would have known. I could also see the instance where it tells you something that could potentially even be harmful because it leads you to believe something negative about your body. And because there's so many confounding variables happening in life at the same time, it creates a notion of control that I believe we don't have and we don't have yet. What do you think about my stance?

Yeah. This year I achieved eight months of a perfect sleep score using my wearable. I don't think anyone in the world has ever done that before. And it was my personal experiment to see could I achieve high quality sleep every single night. And to do that, I needed to create quite a few intuitions. I needed to understand what happens when I eat pasta at 5pm what happens when I watch a movie on a big screen an hour before, what happens in the hundreds of questions. I basically was trying to build intuitions. What happens when, you know, and when I go to bed, Can I deduce my heart rate? And my resting heart rate is my biggest predictor of my night's sleep. And so I would say I would never have been successful at doing the eight months of perfect sleep had I not had a wearable. I just would not have known how to connect these variables. And because I was doing this in a systematic way, I could isolate these effects more. I could isolate a given day, a certain dietary thing or whatever the case may be. And so, yeah, I, I think that for me, it was the only way for me to figure out sleep.

Do you think eight months of perfect sleep is necessary for a healthy lifestyle? Like, if you had every seventh day you had a shitty night's sleep, do you think that would derail your ability to live a healthy lifestyle?

I was so. I don't know about that. I, I was doing it because I, I come from the entrepreneurial community and that culture is very much grind culture, as you're a martyr. I mean, I'm sure as a doctor.

They abuse us all the time with our 24, 36 hour shifts.

Exactly. So you come from a culture where people will tell stories about your bravery and courage if you stay up for multiple nights working on a project, or if you're so tough you don't need sleep, or you only need two hours of sleep. And so there's all this lore and mythology and status that comes around, comes along with not prioritizing sleep. And so I was trying to change that zeitgeist to say, I'm from this tribe and I'm going to show you that I can be equally as productive in life and do so on high quality sleep and even improve my productivity. So I was trying to prove something to my community that it really is important to prioritize your sleep. That if you think about it from. So you take a leader of a company, let's say it's 100 employees or 500 employees, when that person is self deprived, is sleep deprived, they're inebriated, it's as though they're actually drunk. So you have a, a drunk person leading the company you work for. I don't want that. I don't want to tell stories of how bold and courageous they are by missing sleep. It's really stupid.

Yeah.

And so I was trying to make that point and I was trying to say, you too can do this and achieve the best performance of your life. And so I, I had a number of objectives. Whether you can miss one night, that's kind of like a cheat day to me where that's one of the most common questions I get. I don't want a cheat day. Like I've now got to a point where I can imagine doing a given thing, eating a donut or ice cream or whatever, or a pizza. It makes me sick because I know how I'm going to feel. I know it's going to ruin my sleep. I know I'm going to be groggy. I'm going to hate life the next day. The pain is so intense and it's so long for that teeny moment of maybe pleasure. But now I'm past it. And so the cheat day thing I think is a bad idea. It's a bad cultural moment. And I wouldn't want to because then we're so. We're such an uncontrolled form of intelligence. Right? Like we're just totally out of control. And if you give anybody a vector to be like, and today you get to anything you want, it just becomes disastrous because then like tomorrow's like, well, one more day I'll spend next week's day. Tomorrow.

Yeah.

Runs away.

I could see how. I mean, we're talking about extremes of situations. You know, giving someone unlimited Runway or giving them extremely limited Runway where they have none. Neither of those are going to be ideal. Just on the way that the human body works through Homeostasis of it's trying to keep a balance. And there's frequently a statement in healthcare that I've referenced where the enemy of good in medicine is perfect. And I've seen that time and time again, either from a procedural standpoint where we're suturing and we're trying to make something perfect, when we do and we try to make it perfect, it actually gets way worse, whereas we had it good. Or we try and normalize someone's hormones and when we try to make it perfect or higher and achieve hyper optimal performance, it backfires and creates a negative effect. So I worry that chasing to the extremes, chasing perfect, chasing don't die can create negative impacts on people. So do you think there is potential negative impact from chasing don't die?

Yeah, I think I could definitely respond to this comment and make and use words that would make sense in the year 2024 of like, yes, like, I agree and like, here's all But I'm really going to comment on this from the 25th century perspective because that's the one that I think that is not included in the conversation. And so I know when I built my software at my payments company, Braintree Venmo, we weren't like if the transaction is $97.28, we're like, it's okay if it's a penny off. Like you need absolute precision for that transaction and if the servers are down, you can't process the transaction. If it's down three hours, three minutes a day, that's okay. Like absolute precision. So we build technology with absolute precision because that's what we can do. Demands we tolerate this idea. In any part of our lives where we don't have control of certain circumstances, we say, well, well, here's a way to think about it and here are the side, here are the pros and cons that given thing. But I think it's, that's the framework we have because that's the possibility of the technology we humans are. We, we're not built to be perfect. We're kind of messy creatures now. That may not be true for the future. We may be able to build ourselves with precision that is unimaginable to us right now. And so right now that I would say, yep, reasonable opinion. Totally agree. Also, we're going into this new future and so I'm building myself. I want to be the example of what we can build. And so I go to these lengths to say, yes, you can achieve perfection and it's great. And so we'll have all this help from all these tools of biological engineering, molecular engineering, artificial intelligence, like they're going to converge on us. So we're becoming a new species and new possibilities are there. And I'm trying to bridge to this new reality.

So you're thinking about it from a philosophical standpoint of the future. It's so interesting that throughout this conversation we're talking about answering questions from the future of the 25th century. But at the same time, you're very wise in predicting that. We don't have the power to predict. We suck at predicting. So how can you be answering me from the 25th century if we're so bad at predicting?

I look at the systems that can be predicted. So, for example, if you say intelligence is currently increasing, that is like you say a general trend, like whether, you know, whether you think it's an exponential increase or linear increase or some other curve, it's generally increasing. So more intelligence, the world, we're getting better at harvesting energy from the sun from all sources, so that's improving. We're getting better at storing energy in batteries. We're getting. So you can take these macro trends and say, what's happening at a civilization scale and then map towards humans. We're getting better at augmenting humans. So in my car, my car is going to drive itself or it's going to give me little vibrations that I'm on the side of the lane or all these things. So you look at the apparatus, those are the things I model out with, with accuracy. And to say, if we're on this general trend line, I can follow those. But as to the specifics, you know, like, I don't know. So I. That's how I, how I try to map my personal life is system structures on the inevitabilities of what appears to be society absent some kind of catastrophic event.

Yeah, I, I struggle around that concept of prediction with trends because I just. The humans are so imperfect from just their ability to predict things that aren't available to us. Like the idea of a virus coming in and destroying us. Because before that, our idea of a terrible virus was original SARS virus, which was incredibly lethal. So when SARS CoV2, the virus that causes COVID19, came about, people said, oh, well, it's not as lethal. This is gonna be great. And actually, because it was less lethal and more people walked around asymptomatically and spread it, it killed exponentially more people.

Yeah.

So like the idea that something is even less worse could be worse.

Yeah.

And that's where I feel like the human flaw and why when you say like you're trying to put your spreadsheet together without any inaccuracies is because that is a measurable thing. You can define it, you can count it, it's there. And with humans, when I look at a blood test result, I have ranges.

Sure.

And those ranges suck.

Yeah.

Our temperature that we use to gauge non fever versus fever is horribly inaccurate. When I try and lower someone's blood pressure to what we call the ideal standard to reduce rates of heart attack and stroke. The idea that it's going to work for the person sitting in front of me that I'm actually treating this with, even though I have good research to say that it is, it's not going to work. 99% of people that I'm giving the medicine to, and yet it's still valuable. And that's coming after trials that have failed 99.99% of the time with biomechanical mechanisms that rationally made sense or were proven right in animal models or petri dishes or lab models. And I'm like, oh man, there was so much failure leading up to this point and yet I still have such a lack of control of my patients. Well being, I struggle to know how I can compare someone's health to their, to the spreadsheet, which is counting digital dollars or physical dollars. That. That's what is hard for me to wrap my head around.

Yeah, yeah. I mean, I'm sympathetic to what you said. I mean there are some things that the power laws of evidence, like, you know, is smoking going to shorten lifespan, increase the probability of cancer? Pretty reasonable. You know, is. Is exercise helpful to increase lifespan? Pretty reasonable based on the data. So I think if you score the data and you try to isolate those, you can step away from a total chaotic world into more predictability. But the things I'm talking about for predictability is not whether a virus is going to show up, not the lethality of it. Those things are out of control. I'm trying to say what is the total compute power on planet Earth? What is our ability to engineer biology to perform the functions that we design it for? What, like I'm trying to say system laws as a species, because within humans and human systems, we have the element of chaos. That is just very hard.

Yeah, there's. Yeah, there's a lot of chaos. And you know, I think what your message, I hope resonates with my audience is that you've spent a lot of time researching and measuring things and still the Pillars and the power levels that you find most valuable are the things that are the most simple and available to everybody. And I hope that's what folks take away from this message of, you know, putting on sunblock and, you know, protecting themselves from excess sun exposure, UV exposure, not drinking, not having bad habits or limiting those habits, making progress along the way. So I think that message is so invaluable. And the fact that you've developed a passion for it is truly, truly admirable. It's, like, really cool to see someone who's genuinely passionate about it and also recognizes the weaknesses of it. And at the same time, there's some critiques I have as a skeptic of looking at it whole picture and saying, I love that you're thinking about it from the 25th century, but are we going to get to the 25th century? Are humans a thing in the 25th century? Is the way the exponential growth can continue. I'm such a strong proponent of saying I don't know that it's hard for me to be able to give definitive answers in such an uncertain place. The world is.

Yeah, my. My protocol does not need to be right for my message to be correct.

That's. That's powerful. Yeah, because I think it's more of a philosophical message of, hey, don't let thought limitations limit how you think about what potentially.

Yeah, like we. We have built a society around dai. If you look at the DAI economy, so fast food, junk food, cigarettes, environmental toxins, grind culture, you know, lack of sleep, there's a huge amount of money spent in dai. If you look at the don't die economy, seat belts, medical care, smoke alarms, it's equally as big. And my prediction is the amount of money we're going to spend on don't die is an exponential. It's a right up to the right. And the amount that we spend on dye is gonna go down. That we as a species are going to mature past our primitive ways of the death culture we have right now and walk into a new era. And so it's the gist that matters. It's that I am going to take care of my. It's like the way you take care of a car. Like you want the car to last a long time. You're doing the same maintenance for yourself. Like you want your body and yourself to be able to go on this journey. That's what I'm trying to do is I'm trying to say, get us in the right spot in this moment, after 4.5 billion years, and we could have the most spectacular existence ever.

Well, thank you so much.

Thanks, friend.

Awesome having you on the podcast.

Thanks for having me.

Medicine from the future? How about medicine from the past? Click here to see a video of me reacting to medical devices from the medieval times. And as always, stay happy and healthy.