Fix What’s Making You Feel Old—From Joints to Mitochondria | Dr. Greg Kelly : 1296

Lipopolysaccharides are bacterial toxins that are made in your gut. You have leaky gut. They get through. They inflame everything, including the joints.

Your joints can be insulin resistant, too, and can have issues managing blood sugar, just like your brain could. Joints tend to become more and more insulin resistant and becomes harder and harder as they get older.

Dr. Greg is an expert when it comes to the fields of longevity, of senolytic cells, of regenerative medicine. You're going to love this episode.

There's no medical doctor that can do imaging on your KN and 100% accurately predict what your experience of pain or comfort or other things in your knee would be.

If your blood sugar is high because you have insulin resistance, that's gonna glycate your collagen, which makes it dysfunctional and makes it create inflammatory molecules, and you're gonna have creaky joints that hurt. Can you actually reverse joint damage, or are you just slowing down the anemone? You're listening to the human upgrade with Dave Asprey. Greg, you've participated in 30 published papers in the field of aging based on everything you've seen. Is joint pain a symptom of aging or something else?

I would say, like most things, it's a symptom of something else. Even going back to your book, you know, your brilliant book Headstrong, right? Like, there's a lot going on with mitochondria that then translates into poor joint function, for sure. Zombie cells, which you and I have talked about in the past. Another clear L link to, you know, joint discomfort, joint issues.

So I started getting creaky knees when I was 14, and they would literally make a creaky feeling, like. And it wouldn't quite make a sound, but I could feel them gripping what's going on in there.

So joint structure is, I think, you know, like most things, once you start to get smarter about it, it's super interesting, complicated. But, you know, you have cartilage, you know, subcollagen, which you've been a proponent of way before the herd, so to speak, is an important building block. But then you have synovial fluid, so the lubricating fluid, that does a lot. You know, there's places that have pain receptors. There's others that don't within kind of the knee overall structure. But that creaking, I mean, I usually think in medicine you'd call that crepitus. And that can happen really young. I remember, you know, when I was a naturopathic student 32 years ago, I Had a fair amount of crepitus. And I think some of that is almost like cracking your knuckles. Right. There's not necessarily a physiological deterioration going on, but there can be, can be like a, you know, a early sign that something's not quite right there.

I did notice it correlated with hydration, which would be drying out of cartilage, probably, and much, much later in life. It's also based on uric acid crystal formation or oxalate crystal formation, or just straight up damage to the cartilage, which can come from high blood sugar levels. Probably all of those are signs of metabolic dysfunction, which are signs of aging. Right?

Yeah. And then you also have things like glycation of collagen, which you would know about. I'm sure some of your listeners would too, that, you know, that increases you. Glycated hemoglobin. Right. Is a marker for long term blood sugar regulation. But you can glycated, glycate cartilage, collagen, other things, which, you know, really impacts our joints tremendously as we get older.

Okay. So if your blood sugar is high because you have insulin resistance, most likely, or you just eat a lot of sugar, that's going to glycate your collagen, which makes it dysfunctional and makes it great inflammatory molecules, and you're going to have creaky joints that hurt.

Yeah. The other thing that's interesting with like, you would know glucosamine. Right. That's been again, three decades of being used for joint support. But almost no oral glucosamine can make it into like cartilage tissue, the chondrocytes, to make new cartilage. And really it's in part because it's not great bioavailability. It's a polar molecule, but it also competes with glucose for the same receptor to be taken into joint tissues. And, you know, just think of all the, the people in our society that struggle with glucose blood sugar regulation issues. So long story short for listeners, your joints can be insulin resistant too and can have issues managing blood sugar just like your brain could.

I noticed when I was about 16 and I was used to having really painful knees and I was diagnosed as having arthritis when I was 14. That was really exciting. If I took glucosamine HCl, my knee pain was way better. If I took glucosamine sulfate, nothing happened. Is there a difference between the two forms?

So I think historically the glucosybene sulfate has been the more widely used and more widely studied. Have you ever heard of the gut joint axis?

Absolutely. Tell Me more.

Yeah. So the, I mean, listeners know there's the gut brain axis, but there's gut muscle axis and gut skin axis, and there's a gut drainage axis. And old time nature past, which would have been my mentors, you know, very much focused on treating the gut, treating the liver as the foundation for almost whatever ailed their patients. The gut joint axis is just this same idea that things going on in our gut can have widespread impact, including on our joint tissues. And one of the mechanisms is the immune system. Another would be things like lipopolysaccharides, right. That are escaping the gut through leaky gut, getting to our joints and causing issues. And my guess is that maybe for you the HCL part was important back then, right? Just because HCl, stomach acid, that maybe that it wasn't the glucosamine as much as the little bit of hcl helping you break down things in your diet that probably weren't great for you at.

The time, you could be onto something there. I had been on antibiotics once a month for about a week, every month for years because of chronic sinusitis and strep throat, which was caused ultimately by toxic mold. So that meant I did have a leaky gut. And we know that lipopolysaccharides or LPSs, are major aging molecules, bacterial toxins that are made in your gut either at low levels or high levels. If you have leaky gut, they get through, they inflame everything, including the joints. So I know I had that going on. And I did notice when I had a bad gut, my joints hurt more. So I had basically inflammatory gut stuff causing some of my joint issues. And having more stomach acid would probably help. Um, so good theory here. What else? If, if someone's, let's say under 30 and they haven't injured their joints, but their joints are hurting all the time, if you were to just close your eyes and say, you know, in order of likelihood, here's the top five things causing joint pain, what would it be?

Number one would be diet that I believe most of us have, you know, for a lack of a better way to describe it, one or more kryptonite foods that we feel in our joints when we have those, you know, nightshades. Classically in, you know, naturopathic wisdom, we're wanting, you know, glute for many, many people can be one, even if they're not celiac. So it's why elimination diets or cleaning up our diet, doing some of the recommendations that you've championed over close to 20 years can make such a profound and almost immediate impact on joint tissue. So diet would be for sure, number one. Number two, there's Lisa Feldman Barrett, who I'm a big fan of in her book Seven and a half Lessons about the Brain. I think it was lesson five had to do with, you know, our social brain and said something like, you know, the best thing for our nervous system is other human beings. And the worst thing for our nervous system is other human beings. And exercise can be like that. Right. If we're exercising correctly, we absolutely need that for joints just to get blood circulation, clean out, metabolic waste, you name it. And if we're exercising incorrectly, we can be causing a lot of problems, especially tendonitis, things which people often experience as a joint issue.

So jogging or cycling excessively or with the seat at the wrong height or something could easily be a cause of that pain.

Yeah, yeah. Repetitive motion types of things where, you know, like maybe our shoes don't have the right arch support or maybe we're not allowing enough time to recover or we are doing exercising correctly. But just think of, you know, your classic tennis elbows can affect people even.

At a young age, sometimes overuse bad footwear, stuff like that. Okay. I know I probably had all of the above there. So I had been flat footed as a kid. And I remember when I first got orthotics in my early 20s, I'm like, you're supposed to be able to walk without it hurting. Oh my God. So maybe I'm the worst use case ever, but that could be a cause as well. Okay, let's fast Forward now. You're 60. What are the top five most likely causes of inflammation in your joints?

So it's just the passage of time, Right. Accumulated like one of the main theories of aging is this idea of damage accumulation over time. So by 60, I'm for listeners, I'm early 60s. Right? That would be, you know, we're working against that. But then within that framework, you have the hallmarks of aging. I think is a really useful paradigm where you have things like zombie cells accumulating which directly affects our joints as a matter of. It was among the first areas that scientists looking at zombie cells or senescent cells investigated. And it's an area I know that we've studied for qualia senolytic product. You know, autophagy becomes important, right. Because you know, things get gunked up and we need to recycle and repair those. Chronic inflammation is another hallmark of aging. Crazy important for joints dysbiosis. We've touched on right. Leaky gut and things like that. So you could almost really go through most of the hallmarks of aging and make the case they're impacting chondrocytes, synoviocytes or these other cell types that we need to build cartilage and to create the lubricating fluid in our joints and to repair tendons and stem cells. I didn't mention, but stem cells play a really important role in repairing our joints.

Going back to glucosamine for a minute, I mentioned glucosamine in, I think it was my longevity book talking about how it could be beneficial for preventing one of the seven pillars of aging because it dis, sugar or no, it displaces some other protein in a complex glycosylation thing. So there's actually a couple studies showing that glucosamine might not just be for joints, but to your point, you can't really absorb it. Is there like an intravenous or injectable or rectal or some weird way of getting glucosamine that might actually work or is it just not that good of a thing?

I honestly don't know. I know doing so Glucosamine is a pretty simple molecule used to build more complicated things and that category are called glycosaminoglucle glycans or proteoglycans. And they're your hyaluronic acids and chondroitin sulfates. And some of those things have been used, injected into joints, especially in veterinary medicine and horses and other things like that. You know, in human studies they exist too. So. But my guess would be some of the same limitations that cause glucosamine not to be so great for joints. Not it's not that it's bad, it's just not maybe as effective as people would believe is that it's the joints still need a lot of ATP to do their work and without correcting that, it becomes hard for them to work.

Well, I hadn't thought of that. Thanks Todd and Upgrade Collective for that question. So I asked my research assistant while we were doing this, Its name is ChatGPT by the way. And it's like, oh yeah, people do it, but only in Europe and Asia they do intravenous glucosamine and they say that it's 800 milligrams and, and it bypasses the poor gut absorption and it might have more anti inflammatory effects, but it's not that well studied and so it lowers inflammatory markers faster. So in other words, not worth it. You looked at more than 100 compounds to figure out what should you do for joints? And I kind of take that personally because I mentioned all the problems I've had as a young person with my joints. And I can do full deep squats, I can put an ankle behind my head. Like I fix my joints, thank God. And like I'm 52, if you believe the calendar, which I don't.

So it's, it's.

If I could do this, almost anyone can, given how bad things were for me. So, so when you came to me and said, look, you know, we put together something new for joints with Qualia, like, all right, like I gotta look at this stuff because I take really good care of my joints. And I gotta say, you put some stuff in there that I don't know about, which is also very unusual because I formulate, I work with you guys. I'm an advisor to Qualia. So I'm like, why did you do this? How did you find all of this stuff? So talk to me about how you think about building a joint supplement that isn't like everything else on the market with chondroitin and glucosamine and all the dumb stuff.

Yeah. So I kind of refer to those as the usual suspects. They're widely known, been used, like I said, for three decades. And you may not remember this because it's going back almost two years, but I actually scheduled time with you in the summer of 2023 to go over where we were at that point and what ultimately became Qualia Joint Health. And at the time, I shared a spreadsheet where we listed many, many dozens of ingredients, showed you how some of our research reviews where we'd synthesize all of the human animal studies into very in depth research reviews that we never share with anyone outside of the all your inner circle.

It's cool to be an advisor because you guys really do research that's just stuff I haven't seen. And like, this is, this is what I do. So kudos. Yeah, but you had hundreds of ingredients on that, on that thing. I might have added a couple. But I do remember going through and going, wow, this is exhaustive. So how do you narrow it down?

Yeah, so really we start with that big list. Sometimes we find out things, you know, just in our literature search that we didn't know about and then we read all the research, at the end of the day we grade it. So for like as an example, there's a cucumber extract in Kwai Joint Health called Cuberop. There's another branded one too. That also has a Yuma study. And we would have read the research summarized and at the end of the day, for joint health specifically, we'd give it a grade and say like okay, one is lol. I can't imagine any like person that ever read research would, would pay money for this. Five would be okay, this is a star. This can be a central thing and really help people. And so really when we go through those hundred ingredients, we're looking for things that are five stars. It's a big plus when you don't have to take massive number of capsules to get the five star result. Because especially as people get older, you know, it's harder sometimes for people to swallow capsules or swallow in general. And then even in younger biohackers are cor audience, they're already taking a lot of capsules. So you know, we wanted things that were effective and also ideally at a low amount. And then we like things that complement each other. So L carnitine is an example. There's animal studies, there's human studies on that for joints. You almost never hear about it. It's not a usual suspect for that, but it does some things that nothing else in the formula did. And one of those is helping turn fats into fuel for ATP. Right. And I mentioned earlier that our joints use a lot of ATP to make collagen, to build proteins, to make the lubricating fluid and the molecules like hyaluronic acid that give it its, you know, like it's cushiony effect. And the joints tend to become more and more insulin resistant and it becomes harder and harder as they get older for them to turn sugar.

You can have insulin resistance inside your, your cartilage.

Not cartilage. Cartilage has really poor white blood flow to it.

Okay.

But the joint capsule itself, like the capsule.

Okay. All the other surfaces.

All right, yeah. Synoviocytes would make meat molecules like hyaluronic acid and require ATP to do that. The chondrocytes that would make the things like collagen or other longer glycosaminoglycans were also using ATP. So. And sugar would be, you know, they're like the brain, their preferred fuel. They just get less good at using that as fuel to make ATP as we age or as we get unhealthy. Right. Like metabolic obesity would be the same thing. And so one of the things I thought was cool when I was reading the human studies on L carnitine for joints is that they emphasized overweight or obese women, typically middle age, more and you can kind of start putting the pieces together. That carnitine might have helped them disproportionately more than it would have an athlete because they're likely to have more issues with blood sugar.

That makes so much sense. And L Carnitine or acetyl. L carnitine has been a part of my cognitive enhancement and longevity stack since I was in my mid-20s when I had really bad brain fog because there's so many studies. But it's like the least sexy mitochondrial nutrient there is. Like, it's less sexy than Coq10, but it really works. And using it for joints is really innovative because I was unaware of that. So that's a super cool thing. And I have been using the new Qualia joint health thing. It's kind of cool to go from hundreds of things on a spreadsheet a few years ago down to a final product and to get to be an early adopter of it. And my joints feel really good. There's some other interesting ingredients in here, like the cucumber extract. That's one where I'm like, where did you come up with this? I've seen sea cucumbers for collagen, but cucumber extract, isn't that some kind of lectin food or something? What do cucumbers do? I thought they were for hydration. If anything, they're kind of a non food.

Yeah, cucumbers have been used traditionally, actually even within Ayurveda for a variety of purposes. And it turns out cucumbers have these really special. They're called amino sugars with an I at the beginning instead of amino. And those seem to have a really strong gut joint axis impact. So there's not been nearly the amount of research because they're a newer innovation, but they seem to do a really good job on. On what I would say is neutralizing LPS's impact on joints.

Got it. So blocking LPS via some weird mechanism we may not even understand yet. Okay.

You know. Yeah.

One of the things that Qualia is most known for now is Qualia's analytic. Now, this is one of my favorite supplements because you just take it two days a month and you're done. So it's the least pills of anything I have to take. And it works really, really well. What is the connection between senolytics and gut and gut health?

Well, senescent cells can accumulate anywhere. And senescent immune cells, the of the three original types of cells thought to be most prone to becoming senescent cells or zombie Cells, fibroblasts were one, so those are our connective tissue. And there'd be a lot of fibroblasts in our skin and our joints. As an example. Immune cells were number two, and endothelial cells were number three. And somewhere 65ish percent of our immune system resides in or adjacent to our gut. So it's just really, you know, subject to getting stressed out. I generally think, in a simple sense, of senescent cells, of cells that were so stressed that they had no choice but to become senescent. And without question, our diet and other things, our GI tract is, you know, the front lines for being stressed by at least part of the environment.

Okay, so gut stress, lps, mitochondrial stress, joint stress. Then you get zombie cells in your joints, and then you got to get rid of them. And so you can use the qualiosinolytic for that. What's different between that and what you put in the joint health formula that just came out?

Yeah. Think of the qualiocinolytic as something to help remove the cells that are interfering with joints doing their best. But then joints need a lot of support to do the building up and repairing and making new cells and, you know, support for the different structures that they make. So one of the ingredients in qualia joint health is called Ovomet, which is a undernatured collagen eggshell membrane from a company in Europe called Egg Novo that supplies both undenatured collagen. And by undernatured, what I mean is it the collagen would still be in its complicated biological shape, as opposed to collagen that's hydrolyzed or made into peptides. Both can work, but the undenatured works at a much lower amount for things like joint issues. But then that also has elastin, which is like a stretchy compound, and hyaluronic acid, which you can think of as your goo molecule, and precursors to things like a small amount of glucosamine and chondroitin and those other glycosaminoglycans. So it's just a really versatile nutritional building block. And one of the things that really originally grabbed my attention with Ovomet was meeting people from Egnovo and them mentioning that several European, well, specifically La Liga, the Spanish professional soccer team or league, had, you know, two teams were taking their product, and I was like, well, why would they be taking it? And they said, oh, like some of our studies have looked at, in one case, CrossFit athletes, mid-30s and over the course of eight weeks, their tendon strength and stiffness degraded, which then makes it harder to sprint, harder to have power and force through our Achilles. And we end up with micro tears that can subject us to a really somatic injury. And what that eight week study did in CrossFit athletes taking the overmatch, it maintained the right amount of stiffness in the tendons through that intense exercise period where the placebo group, it weakened progressively.

Eggshell membrane is another one of those weird ingredients like that. It doesn't trigger egg allergies for people, does it?

I've never heard of that. In part because it's such. We don't. We wouldn't normally eat that because it's. But it's about roughly 90% proteins. But the collageny kind of things and these, you know, like elastin, like the same things that make up our skin and joints.

What a lot of people don't understand in the world of collagen. And I had to go really deep on this before I went on the Dr. Oz Show. He has incredibly strong diligence before you can say anything, like, everything is triple checked. And people like to say, oh, if you eat some of the collagen, you just digest it and it's dumb, you should just eat jello. But it doesn't work like that because when the body detects different types of collagen in circulation, it means the collagen is not in the joint. And it says, oh, maybe I should turn on healing in the joint. So the fact that there's such strong clinical evidence for this, my guess is that some of the proteins on the surface of the ovument that you're using are probably signaling to the body that it's time to take a look at collagen health and then fix it.

Yeah, there's a thought that the undenatured collagens really work more through the gut joint axis and signaling that occurs that way than as the actual building block. And it's why with the eggshell membrane, it's only at 300 milligrams, you don't need nearly as much when you have these undenatured collagen molecules compared to, you know, the collagen I would put in my coffee or I'm doing a scoop of it, kind of working in different ways, but both can be useful. And both, you know, I think are important things to have in our diet.

You have something else interesting in there, Tamarind. And I have an unpublished article on tamarind that I just wrote a couple weeks ago. That I'm going to put out soon. What is tamarind and why would you include an extract of it in the quality drive formula?

Yeah, so we have this ingredient that's called Tamiflex that's a combination of turmeric and tamarind seeds and obviously both have been used in Ayurveda. I did a master's degree in Thai Thai language culture, but my focus was on medical and nutritional anthropology at the time. And tamarind's a really important flavor compound in Thai cuisine as well. And you know, so it was embedded in Thai traditional medicine, which largely they got from Ayurvedic traditional medicine. And it just has been really somewhat overlooked in the modern world. But it's high in proanthocyanidins, which are a super cool and important type of plant polyphenol. Us you think of grape seeds as a source of those. And that combination of the turmeric and the tamarind seed extract has been currently used in three human studies. The most recent had about 135 people. So decent sized study actually compared it to placebo and against turmeric and boswellia combo and just rocked across the board. It was fast acting, showed lots of benefits within the first 28 days. Impacted not only joint health questionnaires, but range of motion, knee strength, functional tests. Like what happens, you see these a lot in aging studies. Things like grip strength and timed up and go tests and stair climbing and six minute walk tests. So they didn't use grip strength, but they used several of those others and all of them improved progressively in the Tamiflex group. So I love things like that where not only are questionnaires improving, but objective things that track so much with longevity are also improving. And like I said, a lot happened within 28 days in that particular study.

One of the things besides nightshade that really trashes people's joints is higher oxalate levels in the body. This is plant toxin. It forms razor sharp calcium crystals in your joints and it's the other kind of gout and the major cause of kidney stones actually ahead of uric acid. So it's an issue. And one of the things that breaks it up is tamarind. So I don't know if tamarind extract directly pulls it out, but it's tamarind paste is one of the things you can use and it's probably through the amount of tartaric acid that's in it. But it's an interesting thing that could be part of it or it could be that it's a gut bacteria interaction. Do you think? You know how it works?

Works mechanistically. When they've done studies on this tamiflax, they would think of it as doing three main things. The cyclooxydinase lipoxinase family of enzymes. It helps to normalize the activity of those which is super important for getting the inflammatory balance of things back in balance. It does a lot to slow down the molecules like metallic metalloproteinases that break down collagen, that these are like in the extracellular matrix. So it tends to normalize those as well. And then they've not looked at this, but just from a naturopathic, you know, historical use perspective. The turmeric and boswellia would both be, you know, things that have gut activity. So I would be shocked if there's not some gut joint axis benefits going on as well.

Totally, totally believe you there. It's. Boswellia is one of my favorite ingredients and it's so powerful. And I've been using Boswellia for 20 years because I don't like having sore joints and it's exceptionally rare, like an injury situation or I did something weird in a sport. Otherwise I don't have joint pain and it's been so liberating for me to get there. I take regular anti inflammatories and I've switched to using qualia for the joint specifically now that this is available. And then I also have to limit the foods that I know give me arthritis. And the most painful one is I love hot peppers. I don't eat them. They're a nightshade. If I eat nightshade, my arthritis comes back. I don't eat nightshade. It doesn't. And that doesn't appear to be a genetic thing or a gut bacteria thing that appears to be or. Sorry, that does appear to be a genetic thing. It doesn't appear to be something that's epigenetic like it.

It.

It's either you have it or you don't, which sucks because I don't want it. Is there something that people who are sensitive to nightshades could do so they could still eat jalapenos until they cry sore joints.

That's a great question. I don't have a solution. I mean, things I would experiment with that I don't have confidence would work would be like a bromelain, you know, like.

Yeah, bromelain helps to a certain point. And there are lectin blockers that you can get you Just don't get enough coverage. So that's, that's a problem. Anyway. I don't think that one's going to be solvable without maybe like a mitochondrial transplant, but I'm up for that. One of the things that is missing in the conversation around longevity is functional movement or mobility. Right. You want to tell how long someone's going to live. Well, how good is your grip strength? That's a function of joints and muscles. But if your joints don't work, you can't have strong grip strength. And the other one is, can you get up off the ground without pushing down with your hands? And how long does it take you?

Right.

These are major things that are more predictive than some really expensive tests, to be honest. And that means mobility is important. Why is mobility just overlooked as something as important as VO2 max?

Yeah. Often these tests don't sound like they're particularly hard. Right? Oh, like grip strength or you've probably seen recently there was the 10 second stand balance test that had real long lasting predictive value. And the things like that, balance test, grip strength, it's not, it's tendons and neuromuscular. Right. So our brain's involved, our structures involved, like nervous system integrity is involved. Right. And so they seem simple, but it takes a lot of things coordinated to do those well. And you know, for listeners, you know, just when you have an opportunity or now if the situations, you know, stand on one leg and you know, balance for more than 10 seconds. Right. I would guess most of your listeners can do that, but many, many people cannot. And that degrades with the passing of years for most people.

One of the things that has me really excited at Upgrade Labs, we have a piece of tech that uses AI to do a functional mobility screen. So you stand on the AI cheat machine, you're on a force plate and it says, put your shoulder up, rotate down, rotate up, lift up your hip and do the things and it will score you. And I've been working on something in my left hip, which was my best hip until something happened. And so I'm doing functional recovery on it. But that AI picked it up even though I'd done a bunch of work. So it's kind of cool now since the beginning of my first book on biohacking, how do I teach people this? And I talk about functional movement and standing on a box and one arm is longer than the other and all this crap. Unless you're going to go hire Kelly Starrett or someone or the Human Garage or Aaron Alexander, people have been on the show talking about this, you're just kind of stuck and you get old. That doesn't work the way it did before, and pretty soon you're hosed. So one thing would be make sure that you have some sort of movement training, but you're not going to do that if your joints hurt. So then you take a senolytic once a month. We know quality senolytic, which is going to reduce risk everywhere. And then I think the Colia Joint Health is the best formula that I've seen in many, many years for making your joints stay young, flexible. Because it's a matter of fascia, muscle, and joint, and this is addressing the tendons and the joint and the inflammation. So you look at this as like a puzzle piece. How am I going to live for at least 180 years walking around under my own power doing what I want to do with a functioning brain? And like, okay, ultimately mitochondria are important. Inflammation is important. Mobility drives both of those. So you can't sacrifice that. So this is a part of my new regular practice. I'm on my second bottle of it. Thank you for sending it. Because before I was trying to put this together with a bunch of single ingredients. And if you're over here, Evan, you see my supplements room. Basically it's a wall of shelves full of of all my inventory. I want to take less pills. And the Qualia Joint Health lets me do that. And guys, you already know there's always a discount whenever someone comes down to talk about something. Cool. I did happen to be a part of the invention process of this one because I'm on Qualia's advisory board, so I have maybe some extra bias towards it, but I think it's really good. And of course, just go to qualialife.com dave15 and they're going to give you 15% off your subscription if this is a thing you want to get, and if it's not something you want to get, don't get it. You just learned a whole bunch about joint inflammation and longevity anyway, and that's totally cool. I want to ask you some more questions if you're up for it.

Oh, absolutely.

How do you quantify joint aging?

I don't know that there's a great. In the research I read the most widely used assessment for joints is just a questionnaire called the Womack questionnaire, which stands the Western Ontario blah, blah, blah. But it's just asks about activities of daily living, pain, flexibility, stiffness, things like that. And that will give a numerical grade. So I think that's always a great entry point that even has interpretation meaning certain score ranges would move from mild issue to moderate issue to really severe issue. So that would be a way, not the perfect way. But for listeners, qualia actually has meaning before our supplement company. And it has to do with your subjective conscious experience of some sensory thing. We usually think of our senses as vision. And the red of red would be maybe different for you, Dave, than for me. But we all have the qualia of our joints going on all the time. There's no medical doctor that can do imaging on your knee and 100% accurately predict what your experience of pain or comfort or other things in your knee would be. And I know when we decided to work on this, one of my hopes is that the qualia of people taking this would change from maybe less great words to words like feeling their knees are supportive and comfortable and fluid and things like that.

Now here's a question, and this is something that people have asked me this more than a few times. Can you actually reverse joint damage or are you just slowing down the inevitable?

So I would. My bias is always argue for the possible. Right?

Amen.

And so I would argue for sure we can reverse it. So as an example, Ovomed, I mentioned that study about the CrossFit 37 year old athletes. They did another study that was in sedentary, more elderly people and their tendon strength, this was the Achilles tendon that they measured specifically, actually strengthened over the course of the two months. Right. It repaired things and improved and made it more healthy. So yeah, for sure. I think we can do really, at any age, our body can repair. So it just needs the right inputs and we need to get rid of the things that are gunking it up and acting as obstacles.

I had been told three different times in knee surgeries before I was 23 that your body cannot build new cartilage in your knees and they could only repair damaged by surgery and take it out years later. There's a study, actually more than one study out now, that shows that a sham repair of your cartilage has the same amount of pain reduction as actually fixing the cartilage. So they took people and sometimes they did a cartilage repair, other times they just cut the knee open and then sewed it back up. And it had exactly the same effect on reducing pain. So there's something else going on in there. And then at the nonprofit longevity group that I used to run, we had a new member show up and she was obese, probably 400 pounds on a walker. And she probably was only mid-40s. And she came in and she said, I have no cartilage in my knees. It really hurts. And she showed us her X rays and she said, I'm determined, I'm going to work on this. And she had something called a prolozone injection. And I wrote about this in Superhuman as one of the stories of things that can happen. That's my longevity book. She had ozone gas injected into her knees. And that's not for the faint of heart, but it's not that expensive either compared to stem cells or something like 150, $200 cheap. And she came in six weeks later with her new X rays and you could see a layer of collagen that did not exist in her first X rays in six weeks. And at that point I said, you know those doctors who told me you can't grow cartilage? They just didn't know. Or maybe because I was younger, I was like, those liars, they weren't lying, they were just misinformed. So I know, because I've seen it and I've had it happen in my own body, that you can reverse damage and aging in joints. And I also know that it doesn't happen without the right nutrients. Like that's a thing. And it doesn't happen in the presence of constant inflammation and constant toxins either.

And two other things I think, going back to what you asked me, and we started off with, oh like, like diet would be one potential cause and the wrong kind of exercise. But you know, we never touched on sleep or body clock. And this oversimplifies it. But joints are, you know, during the day they get stressed with activity, exercise, that's all good, right? They're able, but that's, you know, tends to cause more catabolic things like breaking down. And then nighttime is when joints get to rebuild, repair. And nighttime does that for a lot of things, right? So because of that there's a built in body clock rhythm to joints and repair and rebuilding and sleep becomes crazy important. And I know in my university and Navy times, sleep and body clock just got hammered. So I had at a young, older age than you, but by my mid-20s, I was having quite a bit of joint issues. And remember Dr. At the time saying your knees look pretty old for someone your age. That seems that they're doing while eating and exercising. But I think it was those other things were just so imbalanced and out of my control.

I did not think about it. But of course joints have to have circadian rhythm because everything with mitochondria has a circadian rhythm. Do we have any studies about how important sleep is for joint pain?

That's a great question. Off the top of my head, I don't have any that I can think of. But without question it maps in patients and the like. Sleep does two things when we don't get enough. Like, one, it makes us more susceptible to feel the same amount of pain as more painful or just less resilient to it. But then anything that would normally need to have that time of the body clock for repair just doesn't get all the work done and that accumulates over time. So, you know, it's, you know, a night or two of sleep deprivation. We'll definitely usually feel the uncomfortable things in our body more in a more pronounced manner. But it's the slow wear and tear over, you know, weeks, months, years of not getting enough that just cause that beautiful dance of breakdown and repair to get so imbalanced that the repair functions just never can keep pace. And it catches up with us eventually.

It makes so much sense. And I just found a couple things that make, it makes a lot of sense when I look at the loop here. So if you get bad sleep, your IL6 inflammatory cytokines go up. And there's a study that says up to 40% higher pain reports the next day, which means you don't sleep because you're in pain, which means that your inflammatory markers go up. So it creates this nasty cycle. And there's actually a study documenting that and another one that says circadian misalignment amplifies joint stiffness and pain. So if you're on an airplane, you have jet lag, you do this sort of stuff. If you block it, then you're not going to enter the cycle. And if you take care of your circadian rhythm, it's going to work much better. And the quality of night is a good idea there. I take that especially for jet lag or to prevent jet lag. So there's, there's ways to solve all these problems. And I, I've just added the quality of joint health to my, to my regular, we'll say self maintenance practice. And I know for listeners I talk about a bunch of supplements. And one strategy would be here, here's the list of everything I take all at once. About 10,000 listeners would copy me tomorrow. I spend about $3,000 a month on supplements. And all of you would either get a headache, start sweating, or fill your pants or maybe all three because my protocol is highly customized for someone who's going to live to 180. I know my genetics, I know my microbiome. Like I know everything. And so my job is to tell you the things that I add or subtract. I'll tell you individual things I take. And why? Because you are not me. You have your own goals, you have your own priorities. And if you're 25 and your joints feel great and you got no issues, don't spend your money on qualia joint health. It's not the right investment for you unless you have tons of money and you're going to live to longer than me, in which case go for it, right? But if you've had issues and maybe you should take it, maybe you want to take it every other day, whatever, right? But maybe you want cognitive function so you invest there, right? And there's an unlimited number of things you can do every day to live forever and an unlimited number of things you can take. I'm just going to tell you the good stuff and why you have to decide your priority stack. And so now you know a lot about this one and why you might consider this. For me, the only thing more important than my knees not hurting all the time was that my brain would work work because the knees were a big issue. And I wish I would have had this when I was in college. It would have made a big difference.

I tend to think of this in that hallmarks of aging framework as like the quality solution for that inflammating category.

Yeah, exactly.

No matter where that's showing up, it could be our joints, but it could be our brain. It could be somewhere else.

It is all about inflammaging. And you've documented very well the connection between the joints and the gut and the brain, right? And fascia connects, all of it. So I feel like this is a necessary thing. And if you're listening this going, God, every time I hear this, there's another system to manage. Welcome to being human. Our bodies suck, right? They're also beautiful and elegant and amazing and all that, but man, it's like having a Model T Ford. There are people who still drive 100, whatever year old cars, they just maintain the living crap out of them. And the people who live the longest usually have incredibly good genetics. And most importantly, they had really healthy mothers and grandmothers. So they got the vitality passed down and they took a lot of hits in this life. And if you're alive now, you probably aren't one of those people which means you didn't have a mother who was as healthy. Which means you are going to have to do aggressive maintenance cycles of multiple systems if you want to feel really good and live long, longer than you're supposed to. It's the name of the game right now and we're working on changing that. There will be system wide single injection, gene therapy things, some of which I've already done, that are going to allow you to say, you know what, that system, I can do a one time upgrade that just bought me 10 or 20 years on that front so I can pay attention to something else. We're getting there. Or maybe you're going to shine a laser, you know, at your butthole. I have no idea. But whatever it is, there's someone working on it and I've never been more excited than ever. In the meantime, I'm going to keep my joints really healthy. So check out qualityoflife.com Dave15 they're going to give you 15% off subscriptions for this and do it if you feel called to and if you don't, don't. But I will tell you Greg here, man, 30 published papers. I looked at his spreadsheet a couple years ago. They narrowed it down. They did their clinical trials in Qualia has earned my respect over the years because they do more science than anyone else I've seen, except maybe my friends at Tideline. Those guys do a lot of science too, on their one molecule. They might be up there with you guys, but there are so many companies that don't do any. So great respect and gratitude for all of your work. Thank you.

You're welcome. Thank you for having me on the show today, Dave.

See you next time on the Human Upgrade Podcast.

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