Age Reversal: Medicine and Treatments

Foreign. I'd like to share my thoughts on where we're at with anti aging medicine. Can we really meaningfully extend life with interventions and drug therapy? What's available now? What's the FDA stance on it? So there's many approaches to anti aging medicine. I go to anti aging medicine conferences. Twenty years ago, actually 2004, I was a board certified in anti aging medicine by the American Academy of Anti Aging Medicine. I was a board examiner for them. Back then it was mostly about wellness, a little bit of hormone replacement therapy, some growth hormone stuff. And fast forward 20 years later, our knowledge of age has improved. Our way we measure age has changed dramatically and the tools we have available are widened and research is being done on drugs that may meaningfully extend life more than just wellness stuff alone. So I think this in a few tiers. So tier one is just general healthcare and wellness. So like if you go through traditional healthcare, you do extend your life. For example, if you did not, if you have high blood pressure and you don't treat it, you're going to die sooner. If you have diabetes and you don't manage it, you're going to die sooner. So there's conditions that, that healthcare right now extends life. A lot of people badmouth the American healthcare system. We have an unhealthy society in terms of obesity and some other things. We have a world class healthcare system that was very expensive, trillions of dollars. And we are living longer than we were say a hundred years ago. But that rate of length is slowing down. In fact it's reversed a little bit in the last few years for a variety of reasons. And back say a few hundred years ago, you know, there's a lot of reasons to die young. Infections and war and trauma. And then other people live very long. We look at the signers declaration of independence. Most of them live past 80. But in general, you know, lifespan back then was in the 40s and 50s. Now we're, you know, much longer in the seven late 70s. How do we get our age ends extend further? So wellness is number one. You need to do your regular healthcare. Then there's things like we, there's the finished study on saunas that shows the decreased cardiovascular mortality. There's, you know, eating properly, there's a lot of intervention you can do with alternative medicine doctors to get yourself healthy. Make sure you have good amount of minerals in your body and vitamins, proper vitamins in your body. So that's something that I'm not going to talk about. It's all very important. Exercise, lifestyle, that's very, very important. I do it myself, but I'm not going to talk about it in this discussion. Then the next thing is regenerative medicine. And I'm going to briefly go over regenerative medicine, how we, we're approaching it. So if tissues are degenerated, can we regenerate and regenerate them? One would be stem cell therapy for joints. So for example, if you have knee arthritis and abnormal weight and it has some impairment on your, say, exercise, you've shortened your life about 1.8 years. And if you're obese and you have arthritis in a single joint is about 3.5 years. So restoring that regenerative medicine, which would be stem cell therapy or prp, which works to some degree, platelet rich plasma, you can get that extension. Something I'm very excited about is treating apnea. I've written a book on apnea. You can get our books. I've written several books on regenerative medicine and even on sleep apnea. But go to our lower medical books, Google that, you'll find our books. But sleep apnea shortens our life. So there was a study done in Wisconsin in 1980, 1988, and the National Institutes of Health sponsored it. We didn't know if sleep apnea should be treated back then, so we did a study where we followed people for 20 years and they met first. They measured their sleep apnea score, they gave mild med, severe, mild, moderate, severe, and and they 20 years later, they went back to look at death rates. And people with severe sleep apnea were three times more likely to be dead than people with no apnea when they matched for other factors such as their age, smoking status, obesity, et cetera. In fact, people that had sleep apnea lived about 6.4 years less. And studies are showing that treating sleep apnea probably adds 6.4 years if you have severe sleep apnea. So that would be a regenerative therapy. We do what's called a night lays procedure or apnea lase procedure, where we regenerate the airway so your sleep apnea gets clinically insignificant. Hormone replacement therapy. I think of that as a regenerative medicine because your organs degenerated. If you went through menopause, your ovaries are no longer functioning and your lifespan shortens. And we know from numerous studies that hormone replacement does reduce all cause mortality or all causes of death. Reduces cardiovascular disease, breast cancer, particularly with testosterone in women, and probably adds about three years on your life if somebody goes on hormone replacement long term for men. Largest study Ever done was in the VA, about 83,000 men swallowed for six years. Average age in the 60s. They found men with low testosterone that did not treat the low testosterone were twice as likely to be dead in the next six years than those who treated their low testosterone. Testosterone replacement therapy extends life meaningfully in some of these clinical studies. Now, testosterone is not FDA approved for life extension. In fact, it's only FDA approved for men. They have low testosterone due to a brain damage, missing a testicle or having an extra female chromosome. But your doctor doctor can prescribe it for you for any reason. The FDA just governs what manufacturers can say. And testosterone was FDA approved for women for breast cancer. It's very good for breast cancer, for metastatic breast cancer back in the 50s, before it was FDA approved for men. There's no form of testosterone available right now for women other than compounded. So we get a compounded pellet for women is we use testosterone, estrogen in women along with progesterone and testosterone in men. That's regenerative therapy. Circulation problems. We're really passionate about advanced venous disease. Now. There's varicose veins that aren't going to kill you, but there's venous insufficiency that's advanced, where people get sores in their legs and swollen heavy legs, brawny legs, ulcers on their legs. And this meaningfully shortens your life. We have a treatment that reverses that. I was instrumentally been developing it back in 06, 2006. And we reroute the blood to get a normal healthy leg fat reduction. I can think of that as regenerative as well. So obesity is a metabolic derangement. And if we can reverse obesity, we can also extend your life. Right now with semaglutide and other drugs, we're seeing some meaningful improvement in obesity. So that's regenerative. So step one was what general wellness. Two is regenerative, three is don't die of anything stupid. And it sounds mean to say that, but it's not always true. But we can detect cancer pretty well. We detect cardiovascular disease pretty well before it happens. And neurocognitive decline way before it happens. So how do we handle heart disease? Right now we do cholesterol, which is pretty useless. May a stress test not going to tell you anything unless you're about to have a heart attack next week and that's it. But we can actually scan for people and identify who's gonna have a heart attack 10, 20, 30 years from now. So for young people we could do a calcium score, which is a CAT scan. It costs about 99 bucks and that shows it identifies people who are young that have some calcifications in their arteries, which means they have some ongoing disease. And this is really good a screening tool. You can't use it to map out Russian. We can identify people in their 30s that are likely to have heart attack in their 50s. And then we can do what's called a CIMT Rotted intima media thickness test, which is a study of the arteries, the neck arteries. It's a good window into all of our arteries and give you a cardiovascular age. So if you're 50 and your arteries look like they're 60, we know you're going to have a heart attack sooner than your peers. And if you're 50 and your heart arteries look like they're 30, probably not going to have a heart attack. So you're in good shape, keep doing what you're doing. And this is something we use to detect cardiovascular disease non invasively way before it happens. Very inexpensive, legitimate tests. They've been around for years. They're not covered by insurance, so doctors don't order them. And these are 100 to $300 tests. I mean, you know, we're doing all these blood work for expensive money. Stress tests, angiograms. We can just do a, you know, $300 ultrasound test to screen for disease. Now if it's there, you to do more stuff, but if it's not there, you're, you're good. Cancer. So we have our traditional cancer screening. Mammograms and pap smears and CAT scans and smokers of the chest, colonoscopies and others skin checks. But there's two additional ways that detect cancer that increases the probability of picking up cancer before it's a problem. Now cancer, once it becomes the size of a grapefruit, it's very likely to kill you. And if you pick it up the size of a peanut, how they can survive it, you can resect it, take it out, particularly if it's not spread. Well, if you do the regular screening test that's covered by insurance, it's mandated that insurance companies cover it under the Affordable Healthcare act. Prior to 2010, it wasn't required that insurance companies pay for cancer screening, but they do now. You only pick up about one out of four cancers before they're clinically meaningful, which means three out of four are going to be picked up when it's maybe too late. So what can we do? Well, full body mri, there was full body CAT scans. There's some problems with them. They picked up too many incidental things. Full body MRIs are much more accurate. And you can't just go to the hospital. You can't just go to a hospital and get a full body MRI. They're actually do organ specific MRIs. It would take hours, cost, you know, 30, 40,000. But there's clinics throughout the country that do full body MRIs with a different protocol where they're trying to look for things that are about 8 millimeter in size, which is small enough that they can run through the body pretty quick in an hour or so, small slices that they could pick up stuff that's clinically meaningful but not yet serious. And things like pancreatic cancer, sarcomas, ovarian cancers, even vascular lesions in the brain that could kill you could be picked up with a full body MRI costing that's two to $3,000 typically. And I've three in the last five years. Three in the last seven years of my life. I think I'll do it every couple years. Look for cancer. There's something called a liquid biopsy. So liquid biopsy originally was where we identify somebody had a certain type of cancer and we get the DNA of that cancer and then we treat the person. Let's say it was ovarian cancer or something. And then we do blood tests to see if there's any remnants that cancer still floating around so we know if they're in remission or not. Over time they got enough of these signatures, enough these thumbprints of cancers where now you can just get a liquid biopsy, redraw your blood. The company's called, the test is called, called Grail. It's Galleria is the company, they make a test called Grail. Anywhere from 650. I've heard Henry Ford Hospital locally here is about 650. We get the case for about 950. It's, you know, reasonably cost effective. It's not that good yet, but it's the best thing there is for liquid biopsy. It picks up several different tumor types that could be very early stage or late stage. So you combine your regular screening with MRI and leuko biopsy and it's negative. You probably don't have cancer with more than 99% certainty versus just doing your regular screening, then neurocognitive decline. So my mother died of Alzheimer's and Alzheimer's does kill people. You know, she couldn't figure out how to eat or drink. It's just a horrible Way to go. And she went down pretty fast. Two years. That was, that was painful to watch. And by the time we knew she had it, there was no intervention. However, if we picked it up earlier, we might have been able to do something. The brain is plastic. It can be repaired. We know that there's ways to intervene on early. Early Alzheimer's, late Alzheimer's, not so good. And you can do an mri, what they call neuro quantitative imaging. So what happens when the brain ages is it shrinks and the water in the brain gets bigger. Okay. So you have liquid in your brain called cerebral spinal fluid. And you have ventricles and spaces that hold this liquid. And then you have white and gray matter. That's your brain part. Well, as your brain gets older and degenerates, it gets smaller and water takes up the space. Well, you can look at your age and your peers and say, where are you at relative to your peers? And if you're at the 99th percentile, that's good. It means you're not anywhere close to getting Alzheimer's. You probably won't get it at all. If you're bottom 20 or 30 percentile, you're probably the one that's going to get Alzheimer's unless you do some intervention. Okay. Not going to get into all the interventions. I wrote a little bit about it in one of my books. For example, if you have apnea and Alzheimer's, you better treat the apnea. Apnea does accelera Alzheimer's significantly. There's other things that be done to create the brain, to regrow that have been done in various studies. So don't do anything stupid which would be neurocognitive decline, cancer or heart disease. And if you do always testing, you still might die, those things. But your chances go way down or you delay it for a significant period of time. Those are things you can do outside of your health insurance. Health insurance is really designed to treat disease, not prevent it. And until the Affordable Health Care act, there was no covering preventative care. It was not mandated. It might have happened. Wasn't mandated. Now we have a few things covered, but if you really want to do true preventive care, you're going to have to pay for it. That's just the way it is. So what do you love more, your life or your money? If you love your money, better keep it. If you love your life, better go ahead and spend some money on an MRI. About 2 or 3,000. A liquid biopsy, about a thousand or so. And the brain mri, I've had it done myself in comprehensive with other testing, I'm not sure how much cost. I would imagine 1500 or so. And the CIMT is about 300. We do that at our clinic. The CIMT, which is the cardiac age Aging. It actually gives you an age of where your heart, your cardiovascular system's at. And if it's problematic, the CIMT we can actually do more advanced tests of your heart itself. So those are the first three. General healthcare, wellness, regenerative medicine. Don't die anything stupid. And the fourth stage is truly working on reversing your age. Now we got to talk about how we're going to measure the age. And a lot of people have heard about telomeres. These are little strands on the end of your DNA that shorten as we age. Well, there's a lot of variabilities and things that affect that. So it's maybe not the best way to measure age, but something we were doing for years. So typically, if your telomeres were shortening fast, you were coming close to the end of your life. If they were longer than your peers, you're a little longer than your peers. But it's. It's fraught with problems. And now we're replacing it. What's called the epigenetic age. Epigenetic. So genes and epi. Epigenetic, and this is a marker, was developed initially by Dr. Horvath almost, I guess, about a decade ago. And we can really predict when you're going to die, accepting, of course, you know, car crash or some unexpected thing. But our body, our genes, put little methyl groups, little chemical bonds on our genes. We have this ATCG on our genes, and it puts it on the C. And it's basically a clock that tells you how old you are. Some people age, say, 1.1 year per year, and some people age 0.9 years per year. The person that ages at 0.9 years per year is likely to live to 100. And the person that ages at 1.1 years per year is likely to live to, you know, 55, 60. They're the ones that have that premature heart attack, and I'm one of them. My genes are aging faster than myself. Not that much faster, but faster. And I've reversed that. So that's one thing we can measure. We can also measure physical aspects of aging, such as our. How do we look? You know, are we strong and fit? Does our skin look horrible? Does it look great? Are we walking hunched over and slow? We can measure our strength. We can measure our VO2 max how we can extract oxygen out of the air, which is a sign of fitness, which would likely live longer if you're fit. We can measure our bone density, we can measure our organs. Is our brain older than our body? I talked about that earlier with the neuro quantitative imaging. We can measure our ejection fraction of our heart. We can measure fat around our liver. We can measure multiple things that have to do with aging. The cardiac age I talked about, the CIMT will say how old your cardiovascular system is. Well, the wellness stuff in the general healthcare can actually impact brain age and cardiovascular age. And I know this, I've done it myself. And we do it for patients. And this has been well established. So you can definitely reverse cardiac agents, no question about that. Drug therapy, lifestyle changes. Drug therapy is definitely part of it, big part of it, but lifestyle changes as well. But how do we impact our other aspects of aging? Well, there's a couple other things you need to know about, maybe you've heard about a little bit. One is called cellular senescence. Senescence, like senile being, senile senescence. So our cells grow and constantly replace themselves. So we have a. We're born with a germ line of cells. We become an embry into a little baby. And by the time we go from germ cell to baby, before that time, we're actually immortal. Those cells can grow forever. But once we get actual tissues now, those cells are mortal, they're going to die. At some point, the cells are turning over, over and over again. And over time they start accumulating damage. Damage in the DNA. The damage in DNA has to be mitigated somehow or it would turn into like a tumor, for example. And so our body has a protective mechanism which is called senescence, other protective mechanisms as well. But senescence, where if the, the cell has damage to it, it goes into a state of senescence where it stops growing, becomes kind of like a zombie cell, I've heard that term used, becomes a little fat, gets these big vacuoles in it or water pockets in it. And your body's supposed to go through and clean it up, particularly at night when you're fasting. We have a process called autophagy. Autophagy, you know, automatically eating yourself, where your body would normally go through and clean up your cells at night and kill off those senescent cells, and then the healthy cells will start growing again. Well, if you don't kill those healthy cells, I'm sure if you don't kill off those unhealthy senescent cells, they Put out a juice called sasp, Secretory associated senescent phenotype, senescent associated secretary phenotype. And tells other cells in the area, hey, we might have a problem here. I think I'm sick. You guys better stop growing and let's just lay here and wait for our body to clear out ourselves. Clear to cut out. Well, when you're 20 years old in an eight hour overnight fast that does happen. You have autophagies and peak effect. When you're 50, not so much autophagy occurring, particularly not with an 8 hour fast. Maybe a 72 hour fast, maybe a 48 hour fast, which we're generally not doing, that does stimulate autophagy. We're not typically doing that every day. So we start accumulating these senescent cells. When we accumulate them, we get organ degeneration such as, you know, bad eyes, bad liver, bad kidneys, bad heart, bad joints, arthritis, bad skin. So what can we do for senescent cells? Well, we could kill them, we could inhibit them or we can delay the onset of them. So all those things may occur. Well, this is being studied now. Doctors are treating patients with these drugs, but it's not mainstream yet. So the one is called a gero inhibitor. Like gerontology gero inhibitor block so blocking cells from getting old. And the classic drug for that is rapamycin. Rapamycin is a drug that if you're listening to this because you're interested in anti aging you might have heard about it. Most people have not. It's been. Unless you're like say a transpl. Surgeons we use it for heart. I'm sorry for liver transplants to avoid organ rejection. Just briefly. It's been around for decades. It was discovered on Easter Island Island Rapa, that's where it got its name from. And it's basically antifungal. Bacteria makes this antifungal compound. And they studied it and found it also did other things which was preventing kidney, I'm sorry, organ transplant rejection. I don't know if it was kidney or liver, but I think it was made a kidney transplant rejection. So it's been used for that for years. It's got different names, there's different things called rapalogs and they, it does work by delaying senescence. It is what we call fasting mimetic. It copies fasting. It might enhance autophagy, may enhance off autophagy. And for anti aging purposes people are usually taking in episodic fashion. We're thinking once a week or once every two weeks. It does probably impair muscle building. So if you're you know, strengthening yourself up, don't take the rapamycin that week. If you might take, when you're just doing non strength training exercises, the drug lasts a couple days in your system and it's something that's taken on an episodic basis by people that are doing anti aging medicine. And again it's not FDA approved for that. The doctor can prescribe it for you. That's perfectly legal. But that is, that's what's like the common one. Metformin is also being used to some degree for that fashion. There's a large study right now called the TAME trial. TAME trial looking at does metformin extend life? Possibly does, probably does in certain populations, may not across the board. Certainly in people that are obese or pre diabetic it would extend their life. And certainly on diabetics it's clear that met metformin in diabetics extends their life more than non diabetics. So, so this is very profound in a certain groups of patients or individuals. So rapamycin, JARO inhibitor, then there's senolytics. Senolytics drugs that kill off lytic kill senile cells. And the classic one is dasatinib. It's a chemotherapy drug that has a very short half life. And it's chemotherapy because you know cancers are senescent cells and it's. So that's one target for cancer is using a senolytic drug and in anti aging purposes it's used on a very episodic basis about once every three months, three days in a row. Perhaps we take a kind of a high dose of this drug just three times in three days, once a day. Along with quercetin and vicitin. Those are pronounced differently by different people. But these are two other senolytics and pretty high dose. And then you turn it off. So it's sort of a precision kill shot to kill off senescent cells in the body. And then is somatotroptin agonists, Somatotropin, which is also known as growth hormone. Kind of controversial. And it came out years ago for short statute children. And then in the 90s there was a study by this Dr. Rudman in Wisconsin where he found that giving it to middle aged men led to them looking and seeming younger. They appeared younger. Every measurement of youth that we had at the time, I got better, they got a little stronger, a little leaner, a little faster, a little sharper, it'll move around a little bit better. And Then there was a not an abundant supply of somatotropin or growth hormone and we needed it for short statute children while wealthy people were taking it for anti aging purposes with a period of work. So the FDA did ban it for that use. They specifically banned it for the use. Now in general, if a drug's FDA approved, your doctor can use whatever they want to want to use it for, but there's exceptions. So you can use Vicodin for pain, but you can't take Vicodin, a narcotic for a feel good drug. So your doctor's got prescribed it for a legitimate reason that's there's a law for that specific one, but not for say a beta blocker. You can use every one to. Well, growth hormone was outlawed for anti aging purposes, but there are drugs that are legal for any purpose. Growth hormone releasing hormone and growth hormone agonists. One we use is called Samorelin, that's growth hormone releasing hormone. So that simulates taking growth hormone. Anyway, growth hormone was studied in the 80s or 90s with Dr. Rudman. This was 1990, I think. And then there was study in 2019 by Dr. Fahey in California called the Trimex Study Trx Study where he didn't really know about Dr. Rudman's work. I met Dr. Fahey, he wasn't aware of that, but he was studying it for a different reason. He was looking at how to cryopreserve growth hormone because it has to be refrigerated. He's a cryobiologist, so he knows how to make stuff not need to be refrigerated. And he used growth hormone to see if he could regenerate the thymus in adult men in their 50s. Thymus is an organ that sits behind your breastbone that's responsible for cellular immunity, which really your cancer immunity for example, versus humoral immunity, which is your IgG and IgM, the things we tested during COVID So he People growth hormone in addition to metformin and DHEA to manage some of the blood sugar issues that occur with growth hormones. They measured their epigenetic age. Their epigenetic age, what they found that after six months of therapy, they measured them at baseline and they gave them six months of intervention. There's a certain pattern to it. It wasn't just taking growth hormone all the time and then they, a year later they measured their age and they had gone backwards a year and a half. In other words, they went backwards two and a half total years. They aged one year and they were one half years younger than when they started. And in personal communication he's continued this to some degree. He hasn't published it yet, but he's seen this be all be done over and over again. And that's reversing basically cellular immunity failure through the thymus gland. Regenerating thymus gland. And it's not clear how it affects the epigenetic age. Then we can look at the genes that make us age. There was a handful of factors called Yamanasaka factors, but there's three of the genes that we know we can or we believe our targets for drug therapy to extend aging. So MTOR mechanism mechanistic or mammalian target of rapamycin. We talked about rapamycin. There's actually a gene named after rapamycin, the target and pathway and gene that rapamycin affects. If you turn that off, longevity appears to our longevity increases in all clinical studies which has not been fully done in humans. It's ongoing right now. But in every animal and plant studied when they're given rapamycin they live longer. What's more, it didn't matter when they started the rapamycin if they started it. Let's say you take a 2 year old, a muscle lives 2 years and you started the mouse at 6 months or 18 months. They both groups lived about 30% longer. So rapamycin affects mtor. Then there's AMPK, another modifiable gene. We want this one turned on for anti aging and drugs that affect that are metformin and alpha ketoglutarate. Alpha ketoglutarate. Alpha ketoglutarate is a over the counter supplement. And there was a study done with alpha ketoglutarate by itself and it did reverse the epigenetic age. Again one study doesn't really prove anything. It's just sort of a evidence, not necessarily solid proof. And metformin also acts on that gene. And then there's sirtuin, which stands for the silent inflammatory regulator. And that is something you went on to slow down aging. And that's affected by something called nad. Now NAD is a part of the Krebs cycle. So those of you who are scientists, you know, Krebs cycle I couldn't even explain in this meeting is to, you know, I get put a poster on my wall, it's the size of a wall. But NAD declines as we age. And if we take a supplement to improve NAD, we get NAD levels that of a 30 year old and somebody that's 60. Now the prototype that's been used is called NMN. It's a precursor to NAD, and the FDA just recently banned that because one of the scientists who's very famous, who really popularized it, has a company that they want to. So that they get, you know, all the money out of the NMN, which has been a vitamin for the last 10 or 20 years. So NMN can't be sold anymore. I stocked up on it when I knew this was going to happen. You can still get it. Not every source has been shut down. And there's other alternatives to nmn, but that is the best one. And Studies show that 300 to maybe 600 days, a proper dose. David Sinclair reported doses about a thousand milligrams. I think that's what you make the drug on. But that does improve or does activate sirtuin. So let's kind of recap. We have rapamycin, that is a GERO inhibitor and acts on the MTOR gene pathway. We have metformin alpha ketoglutarate. That metformin is probably good in certain subgroups of people. Alpha ketoglutarate, probably anybody can take. When you talk to your doctor about when to take it, your doctor might not be knowledgeable in it. I think it does inhibit senescent, I'm sorry, senolytic activity. So we have a pathway where we stop it when people are taking their senolytic drugs. We have senolytic drugs, dasatin, quercetin and fisetin. And we have somatotropin releasing hormones to. To affect the aging clock. I'll tell you my story briefly is I've been really focusing on longevity since about 2017. I always try to take care of myself. My dad died young. He had hard heart disease. He had a heart attack and a bypass surgery when I was 16 years old. He's in his 40s. He had stroke in his 40s. Then he succumbed to congestive heart failure. My mom died of Alzheimer's disease, but not young. She was in her 80s. And I hear my dad's gene. I have what's called the heart attack gene. So I've always watched it exercise, ate well, take a cholesterol drug if needed. And my genetic. My. My age, by all means, looked pretty good. My cardiac age, I was able to actually reverse it. 16 years where my cardiac age is, but much younger than I am, about 20 years younger than I am. My brain age, I've been able to reverse that as well. So my brain age is about 20, 30 years that I am. I did that through wellness. But my epigenetic clock was a Little older than I was. It was a little bit older than I was, about two years. Which means that even though I was of myself, I was still going to probably die sooner than my peers. Maybe I would get some benefit from being very, very healthy and very fit. But my clock was aging a little faster than I would probably for the past, you know, 60 years. So I started doing the anti aging regimen in 21 and in 23, 2023. I've been measuring my stuff right along. I had gone backwards this whole of five years from my epigenetic age. But additionally, my physical performance, my physique, my bone density is all remarkably improved. So my bone density is at 90 percentile for a young man. My strength is off the charts for a man my age. I'm 60 years old and I can bench press 340 pounds, squat 540 pounds, which is unheard of for a six year guy weighing 180 pounds, who's not like a athlete. I just do the gym, one hour a day, three days a week weightlifting and four days a week on the elliptical. And my body fat is right where it was in 2013. I use the same machine. I'm at 8% body fat, 185 pounds. But my strength went up significantly, notably after the senolytic drugs. And that's what I saw the biggest change on. There were certain things I was doing when I went to senlytic drugs. My strength got better and it got better by a notable amount. It was just stronger. And then I kept on doing this for a year or so. And then I said, I'm gonna see if I can get back to my 2013 body density because I was, I was heavier than in terms of muscle mass and I gained about 3 or 4 pounds of fat and lost about 8 pounds of muscle, you know, from getting older. I had a spinal surgery in 2015 that set me back a lot. So I went through a one year period of just working harder. And again, at 60 years old, typically you can't put a lot of mass on. I was able to put on about eight pounds of muscle mass and lose the fat. And I got back down to my same weight from 2013 and the same strength or maybe a little bit better. So I was able to in the three hundreds when I was my forties and I can do that in that not now, but I could not five years ago. And I'm not materially different in size and only eight pounds heavier of muscle mass. So the muscles are younger, they will function like a younger Man's muscles, my bones are dense and my genetic age has gone backwards. These things are working in the right direction. This is not really for ready for prime time yet. You know, we have a few patients that are doing this. It's, it is the unknown. We're looking at safety profile. These drugs are used for other conditions and we know the safety of them. They're really well established. But this is, this is an unknown. Are you really going to live longer? Well, we don't know what happens when somebody's genetic age goes younger? Do they live longer? Well, you'd assume they would, but there's not a long term study proving that. And it would probably be, you know, 30 or 40 years before we know that because it would take a long time to wait for people to, you know, age and die. But on animal studies, when their genetic age gets younger, they live longer. So that's what we have to go by right now. There's a large trial with dogs, companion dogs, using rapamycin. They appear to be younger and living longer. Human study, there's one going on right now. It's, I think about two or three years into it where they're giving people different doses of rapamycin and see how much longer they theoretically would live. This will take a long time to get the results from that. The senolytic studies have been done on people that have senescent conditions such as idiopathic pulmonary fibrosis and chronic renal failure due to diabetes. And they show definitely a, like a decreased senescent burden. And of course, doing more studies now see thinking that there's organs to regenerate rate and there's a lot of buzz about this, you know, growth hormone study that was done by Dr. Fahey and you'll see that being repeated over and over again. So to wrap up, you know, general healthcare, don't jump to step four until you've done step three. You know, make sure you get your blood pressure in control, cholesterol is good, do all your regular screening, you're eating healthy, your body fat is down, you're strong and exercising. These are all important things to do. Either human globin A1C down, you know, below 5.2 or something. So next step is regenerative medicine, hormone replacement therapy where appropriate, stem cell therapy, where appropriate, or PRP if you have sleep apnea, that's a must treat. That's so common in America and so overlooked. And people just don't wear the CPAP devices very often. There's a surgery for it. It's Very expensive. They got some risks. We use a night lays procedure very, you know, we guarantee the results of that. Your sleep apnea becomes meaningfully, clinically, meaning meaningless venous insufficiency. If you have leg swelling, you should be evaluating, get that treated. If you're obese, you know, these semi lutide and similar drugs are very, very effective. We use a pattern to really cut down the cost of that where we put in a step, stepwise fashion to get people's weight down. We talk about that in another podcast and then, you know, do the advanced screening cint which is crowded into a media thickness test that checks your cardiac age. So basically it gives you age, your cardiovascular system and if you're 50 and your heart disease, your heart age is 60, you know, you got a problem. If you're 50 and your heart age is 50, you probably want to address it because one out of three people are die of heart attack. So you have a good odds of dying of a heart attack. Although it' pending, it's not coming right away, might be 20 years out. But if you're 50 years old, your heart looks like a 60 years old. Well, probably in the next 10 years something's going to happen. We got to address that neurocognitive age. Measure your brain. Okay, this is an mri, full body MRI and the liquid biopsy. And liquid biopsy is not that good yet. It will be good in the future. This is step one. So the early adopters are going to do this. They're me, okay, spending $900 for test. It's not perfect, but it will get better, better. And then the last step is to reverse the age which is senolytics, GERO inhibitors, DUS regeneration, reversal of epigenetic clock. And there's other things inside that package as well. Some people are doing plasma phisis. That looks very promising. So just in brief my, a friend of mine, David Hossey at the Maxwell Clinic in Tennessee is who I refer to. He does plasma phoresis. And they found that they, there was a study where they took an old mouse and a young mouse. They were genetically cloned. It was the same mouse, there's two different beings. And they, you know, let the mouse get to about, you know, I guess probably 2 years old or so. And then they cloned, they birded the baby and they did parabiosis where they sewed them together, put a cardiovascular system together and the young mouse became old, old mouse became young. This led to people giving themselves young blood, a young plasma where they would take the Old plasma out of them, out of themselves, and throw it away and inject themselves with young plasma. That procedure has been made, but they found that taking. Just taking the old plasma out and throwing it away seems to give some brain reversal and age reversals. And what is it? Is it the young plasma that was so beneficial, or was it the toxins in the old plasma? Appears to be the toxins in the old plasma, particularly for neurocognitive decline. There's a large study called the Ambar trial, A and B, a R trial for Alzheimer's. And they took people that had early Alzheimer's or moderate Alzheimer's, early to moderate Alzheimer's, and they did plasma exchange. I don't remember the frequency. I think it was a couple times a week for a couple months, and then once a month, and then they stopped. And what they found was they basically take the plasma out and throw it away and give them albumin and saline back. And they were getting these tau amloid, these plaques out of their blood system, which would create a gradient between the blood and the brain, theoretically, and pull those same plaques out of the brain that cause Alzheimer's. So your body doesn't seem to be able to get rid of these. In fact, you can do blood tests now, which we weren't able to do a few years ago, to see if you have this stuff in your body. You have a significant load of this, these tau and amyloid proteins in your body that lead to Alzheimer's, but not necessarily lead to Alzheimer's. They're causative of Alzheimer's. They're in the brain, in the hippocampus. And if it's in your blood, that means you don't have a good gradient between your blood and your brain. You want to have nothing in your blood and some in your brain. It kind of extracts it. It's like a dialysis system. So they did this AMBAR trial and they found these patients were getting meaningful improvement, particularly when they were doing the twice a week portion of the trial trial. Well, that was not a big enough study to lead the FDA to prove it, but I think you'll see this happening more often. However people are doing this and they're seeing their epigenetic age go backwards a little bit, they might do it multiple times, and it does seem to reverse brain age. So that's promising. Hyperbaric oxygen has been tried. I'm not so sure about that yet. Have already very good studies on it, and there's numerous other therapies that are under investigation right now. For extending life. And there'll be drugs that are copying the already FDA approved, inexpensive drugs right now, such as rapamycin and dasatinib, because a drug company, company really can't make money in those drugs or out of patent. But if you make one that's a lookalike, then they would prove that extends age. That would be potentially a multi billion or multi trillion dollar drug. This is probably going to be the biggest industry in history once we figure out how to extend age. Where you see people having lower birth rates. Well, if we could be healthy and fully in the workforce at 80 years old and feel like a 50 year old when we don't have to worry about the population decline so much. So that's coming. And stay tuned. We'll be talking about different aspects of this as time goes on. Thank you very much.