Swapping Out Your Old Plasma Slows Aging & Alzheimer’s – Dr. David Haase with Dave Asprey : 708

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You're listening to Bulletproof Radio with Dave Asprey. Today's guest is a Vanderbilt and Mayo Clinic trained double board certified family medicine and integrative holistic medicine expert. I like to call him a very curious physician. He's a teacher, an innovator who's paid a lot of attention to, to the root causes of illness. And he's going to talk with us today about some very new cutting age anti aging techniques that you've probably never heard of, stuff that I've actually done, some stuff that I briefly mentioned in Superhuman. But we're going to go deep on how you can do things to your immune system, to your body, to your brain that you probably didn't know you could and things that we'll all be doing at some point, including young blood. I like how I said that. I'm talking about none other than Dr. David Hassey. David, welcome to the show.

Great to be here. Yeah, it made me laugh you say young blood because. Yeah, it conjures up quite some amazing images, doesn't it?

It does. And just to start out the show now, you and I both have a college student chained under our beds and we're siphoning off their blood to get the young plasma because it's clean than our plasma. Right.

You know, mine's on strike.

I have yours on strike. I replace mine. I mean my son Alan, by the way, if you're watching on YouTube, he's sitting next to me. So I mean, Alan, can I have a little bit of extra blood?

Is that why he's sitting so close to you? Do you have a little parabiosis going on? Yeah, right through his leg, like right there. It's like a little one of those tubes that just.

Yeah. So he, he won't share his blood with me and that's probably for the best because we might not have to do that. But let's talk for a little bit because I mentioned this in the book.

Why in the heck would.

And by the way, you're not actually an advocate of stealing blood from college students or young people and all that. I'm kind of putting words in your mouth. But you are an expert on what's going on in the plasma of our blood. So talk to me about why blood plasma is interesting as a source of anti aging compounds and why it's part of the aging process. Process?

Oh yeah. Oh yeah. I think it's great. And, and you listen, saying the word youngblood gets people's attention. Right. You know Everybody. So like, oh, that's, you know, vampire stuff. And that's really. No, not at all what I'm working on.

But you're disappointing me. Okay, that's it.

I know. No, no, but you know, listen. You know what kind of got me into functional systems medicine was do least harm, right? You know, we should always make sure that any interventions we do are things that are really going to help people and never harm. And so doing things safely is always at the top of the list.

You said something really important there. You said do least harm because do no harm seems like complete hypocrisy because. I'm sorry, did you stick a needle in my arm? You poked a hole in my arm. You did harm. It's okay. It was worth it. But that mindset has destroyed medicine. The first do no harm.

Exactly. And we're always going to be doing harm. Not doing anything is doing harm oftentimes. And I think that's the other problem. You know, some physicians are just plain chickens. You know, when we have data that shows us that there may be something that can help, but it's not yet considered the standard of care, not yet something that is globally accepted, you know, that is actually inaction has harm unto itself. And when we're dealing, I'm dealing with folks with Alzheimer's disease all down to individuals with maximizing cognitive performance. And those are different classes of interventions that are appropriate for both of those groups of people. You know, one has really nothing to lose and the other has a whole lot to lose. So, you know, treating patients as patients really is first, you know, patient centered medicine and listening and adapting to what an individual's needs are. That's the joy of getting to do this work.

Full, full agreement there. So now I want to maximize performance and live forever. And how many college students blood do I need to do that?

I don't know yet. I don't think anybody knows that yet. So for the people, listeners who aren't available. So how much have you talked about parabiosis?

Probably not enough unless people have read the book. Why don't you define talk about the history of this, where it came from and why we're not actually. You don't actually do that. I just keep putting words in your mouth because it's tied to what you really do do. But let's talk about that because it's, it's a great way to get going, I think.

Well, there's some fundamental principles right. On what creates health, which has really always been my passion. And instead of let's just treat disease. So there's amazing studies done both at Berkeley, Stanford, mit, Harvard, where they took cloned mice, a young mouse and an old mouse. They're really the same genetics. They'd grown up in the same environment. And then they attached them to each other, an old mouse to young mouse, side by side. And in about a week, an amazing thing happened. And the old mouse started to turn young. New bone cells, osteoporosis started to reverse, the liver started to function better, skin started becoming thicker, and new hair started to grow. Smell returned in these mice and the new neurogenesis ensued. So the sprouting of new neurons and also increased synaptic density, just like what you were talking about in intro statement, interestingly enough. So the ability to change one's mind is actually a physical event. You actually have to increase the number of neurons and connections or decrease them. That would happen in this week. But the other thing that happened is this old mouse and young mouse were connected, is that the young mouse was harmed, the young mouse was stunted by getting exposed to old because old is toxic. And when you recognize this fact that there are factors inside the plasma of old mice that actually can stunt body wide the stem cells in that young mouse, it makes you reconsider a lot. So then after about a month, those mice stay connected, the young mouse recovers, you separate them, and the young mouse lives to its normal expected lifespan. And in some similar experiments with rats, and we don't have, the older rodent lives closer to the lifespan of the young rodent. So there may actually be age extension involved as well. So the fascinating thing here is, oh, and then that study was followed up by, hey, let's just pull young plasma out of this young mouse and inject it into an old mouse. And sure enough, voila, those changes happened as well. And then some other interesting science which we'll get to as we start talking about Alzheimer's, also showed that pulling out, just getting rid of the old plasma was tremendously beneficial in humans. So this whole idea that your plasma is really the interface of what creates health, because your plasma is the interface in between the outside world and the inside world, right? So everything you breathe, everything you eat, everything you put in your skin has to go through your plasma to get to your brain, your lungs, your liver. It is the great interface. And so what, the quality of your plasma reflects the quality of your living. And you can dramatically change your plasma here and today by the choices you make and the environment you place your body in.

So when we talk about Plasma for people who are less medical than you are. This is just the clear stuff that your red blood cells are floating in and your white blood cells are floating in. Good description.

Exactly.

Good description, exactly.

So your blood is a mixture of cells and particles and fluids, and the plasma is a protein dense fluid, the yellow stuff that floats around, but it contains a whole lot more. This is also where you contain your exosomes. This is where you contain nutrients, hormones, signaling markers, the degenerated chunks of DNA and RNA that have come off of cells that have died recently. It's both garbage truck and grocery delivery van. The plasma is incredibly important. And that's why when we draw blood, most of the time what we're looking at is not your blood. We're looking at your plasma. So we've been assessing plasma from the very early days of medicine.

So when we look at something like, oh, your blood is clotting too quickly or something, we're looking at fibrinogen and thrombin. These are proteins in your plasma, not actually the red blood cells themselves.

Right, right.

And so you're saying that young people appear to have some good stuff in their plasma, or maybe it's a lack of bad stuff and old people have more bad stuff in their plasma.

And I think that's really the question. It's like, so is there some magic formula? You mentioned a bunch of great things in your book super being so superhuman. And I have to tell you, great job on the book.

Oh, thank you.

No, really, because I don't usually like popular press books because they're full of fluff. Usually it's blah, blah, blah, blah. A tiny bit of information packed in a bunch of story. You made it enjoyable to read, but also it's dense.

There's a lot of stuff in there.

There's a lot of stuff in there. And that's great, right? Because this is not a simple process. If anybody wants to think that there is a single magic ingredient, I think they're going to be disappointed. Clothco is a great example of that. That holds incredible promise as a single ingredient that comes out of plasma represented in young people. But it may not be the only factor that's going on.

It is, in fact, it's funny. I write about the youth encouraging factors that are documented to be present in young people. Things like thymic proteins and GHK that we can introduce for cheap to our own plasma. And then there's a bunch of bad stuff that's in there. And then Clotho, the protein. A good friend of mine, Jim is working on synthesizing this stuff in a bioreactor. It's just too sticky right now. So once he gets that out of the lab, I'm going to get it in my veins. And a lot of anti aging people, as well as people with kidney failure.

Will right stays in Australia. Yep.

I'm encouraged though to know that young people also have clothos. So if you get a plasma from a young person, you could do that, but maybe there's a better way.

So I think that let's go back into plasma kind of what do we know so far? Okay, so think of this. So I am a certified apheresis specialist. So I am trained on how to hook up a person to a machine. Pull. Apheresis is the process by which you pull blood out. You mix it with an anticoagulant, it goes through a centrifuge, then the plasma gets pulled off to one side and discarded. The cells are then mixed with a replacement fluid of some sort. So in that fluid, I like Coca Cola for myself. Yeah, I think that would be great for. I think that's really the bulletproof plan right there.

But the replacement fluids is obviously just like. More to the point, it's a replacement artificial plasma.

Correct. And most often what's used is albumin. So albumin is the protein that's usually in this replacement fluid. Immunoglobulins, so ivig, those are other components that get done in this. And so that replacement fluid joins your cells and that then goes back into the body. And so what you're doing is you're removing the old plasma and putting in some fresh replacement of some sort. Now there's a remarkably large study that's been completed and it's called the Ambar trial. And this is looking at actually treating Alzheimer's disease with the process of this plasma exchange that's going on. They took approximately 500 Alzheimer's patients, mild to moderate Alzheimer's disease. They did this process of removing their blood, separating it out and replacing all of their old plasma with albumin. And some remarkable findings came out. In people with moderate dementia, they had a 60% decrease in the rate of progression over 14 months. 60%. And in individuals with mild Alzheimer's disease, there were actually improvements. Over those same 14 months. They had improvements in executive functioning in memory. And so what we saw here was a large randomized, double blind, placebo controlled, multinational, multi center academic trial has not been published yet. It's been presented at three major international meetings which I attended. And, and this has been extensively debated. Already. But it's amazing that the world doesn't know about this. And that process of just doing therapeutic plasma exchange and removing the old and replacing it with a very benign, very safe substance like albumin or immunoglobulins. That's astounding. And that's a standard of care for treating many severe autoimmune diseases. So we can treat multiple sclerosis, neuromyelitis, optica, and some other horrible diseases using this plasma exchange process. But we have data now to show that this could be useful for Alzheimer's. So that is just, I would say, removing the bad. Okay, that's one side. Removing the bad.

In fact, from a nutritional perspective, it's the same thing. Oh, look, eat this. Because it's high in some kind of vitamin. Stop it. If it has a cyanide pill on top of it, it doesn't matter if it's full of vitamins. You gotta stop the bad and then accelerate the good. And it feels like in the practice of medicine, we've just missed that point here. So your idea. Hey, let's get rid of the stuff that's causing the problem before we start adding additional things like antibiotics or whatever else. I just could not agree more.

Yeah, yeah. And then the whole aspect of that, what you've been asking is what happens? What do you add in? Right. That's where all the energy is. Because those are what I'm talking about. Removing the bad, that's a procedure. I mean, you're dependent upon a procedure to pull out the bad and the old right now. And I think we're working on some cool technology. I think there's so many things coming forward, but for right now, that's a procedure. But if you want to add something in, be it exosomes, peptides, you know, all these things that you've been using and working on for a long period of time, those things, there's a lot of magic there. And the whole Young Blood idea is what started this process moving forward.

It did start the process. And to be clear, if you're listening to this and you've read Superhuman, you know this, but otherwise, there were no studies of the company that was doing Young Blood where you could spend six or eight thousand dollars to get. I thought it was overpriced. And I was concerned also about maybe the level of testing of what was going on in the plasma. You'd get. All I know is what I did in college, and I don't know that I would have won in my blood from back then anyway. Just saying.

So plasma. But let me say this. That can be done better. I'm convinced, okay? I am absolutely convinced because there are, there are facilities that can age and sex segregate plasma, that can do additional testing, can quarantine plasma for a long period of time. You should get your plasma from single donors, not these mixed donors. It should be tracked. There's so many things that if you're going to use plasma as a therapeutic, especially in somebody like you, if you're young and vibrant, the unknown. Unknowns are the things you really have to watch out for. And in medicine, we have to have a great deal of humility. However, if there's an individual with Alzheimer's disease and they have no future, their family is only seeing more torture ahead with the increasing loss of capacity and memory and function. Now, one has to always come back to what is the risk benefit ratio of interventions of those types. And I do think that there should be these opportunities to dive in more extensively utilizing young plasma as a therapeutic under good controlled circumstances, in good doctor patient relationship environments. But it's not a one size fits all. Here's this miracle elixir that should be pumped in. I wouldn't go there.

Now. I'm really. I have not tried plasmapheresis, although I would like to do it once every six months just to get rid of the gunk that builds up. But what I have done is I've done dialysis with a special filter that washes out all, not all, but many of the proteins from my own plasma, which is sort of a step towards what you're doing. So I sit there for a couple hours. Anticoagulant. But instead of a centrifuge, we're basically running my blood through a big filter. And then you get a big container full of weird foam that was all the proteins. And for things like autoimmunity, generalized inflammatory molecules, cytokines, stuff like that, it seems like a really good idea. And for added measure, I add some ozone to it as well, which is going to kill whatever is left. So I do feel really good after I do a treatment like that. And I'm also hungrier than anyone's business, which is something that happens from dialysis.

And Dave, I think that is a great thing. I think removing the bad can be done very safely. And the idea of ozone and all of that on top, I'm copacetic. Those are things that I think are amazing and that we should be thinking forward in those domains.

That's good. Now we have a bit of a problem Here though, because we just got hundreds of thousands of people listening to this going, I want a blood wash. I know that the ozone dialysis I do, it takes a couple hours. You have to have specialized equipment and a special filter and there's different kinds of filters. And you can have drops in blood pressure, so you need good nurses or a doctor and all that kind of stuff. And it's probably even a bigger deal with the centrifuge when you're doing plasmapheresis.

Actually less of a big deal, actually. So we're able to. Centrifuges are very stable. The filters often. And filters are amazing technology. And I see them really being the future. It's just what type of filter, how are they utilized? But with a centrifuge, we can separate all kinds of cells or plasma or platelets, et cetera.

So if someone wanted to go do this, there are almost no clinics in the os. I was going to fly to Germany to go do it before I found out there's a few people doing it. And I settled on doing the dialysis with a special filter instead of traveling to Germany. But how expensive is getting plasmapheresis for the average person?

Yeah, it really all depends upon a. How big that person is. You know, how much replacement fluids are there.

Discriminating against tall people?

I swear, not tall, you know, total.

Total body against fat people. Oh, that's even. That's. That's not even legal. I'm totally using it.

You can actually move your right and left arm and that can give you a discount right there. There you go. It's really high. No, but the price can range anywhere from major medical centers when they're doing this same procedure can be upwards of 14,000 per procedure. And so taking this into the outpatient realm and assuring safety on this can drastically decrease the price down. But we're still looking around $5,000 for most of the time for the actual procedure. Now, there are many procedures and there are. Volume is going to be important because doing this well is going to be done better at scale and that's going to decrease cost. Right now it is challenging, especially for people with Alzheimer's disease. The study that was completed was that there was one exchange done once a week for six weeks and then once a month thereafter. This is not a one and done operation for that particular component, but it is. And so this is where we have a lot of questions of balancing resources. But listen, as this becomes more popular, and I'm looking forward to teaching physicians on how to do this because I think that that is going to become once we have a better idea of what is the best way. There's no question in my mind. Listen, this goes back to the core of functional medicine. How do you create health? Well, either you abide by the law of the tacks, right? If you're sitting on a tack, you understand it takes a lot of aspirin to feel better. So you want to get rid of the tack, so you get rid of the bad or you add in the good. And removing the plasma is just one additional way of detoxing things that couldn't come out any other way or the body isn't able to remove it in any other way. So I think this is a fundamental principle how it is going to continue to express itself. We're going to see a lot of changes over the course of time.

All right, so what I'm translating that to is that it will get cheaper over time.

Absolutely.

So this is a big concern. A lot of people say, oh, this anti aging stuff, it's for rich old people and frankly rich old white people because well, there's a lot more rich old white people for all sorts of reasons than there are people of other races, at least in the US and the deal is that change the environment around you and inside of you to make your body do what you want. That's everyone's game. It's called living and just being responsible as much as you can and just knowing what to do. So I look at something like this and I say, all right, our job would be to make people know how impactful it is and then compare it to the cost of a long term care facility for someone with Alzheimer's disease and say, oh, if you can avoid 2 years or 5 years or 10 years of long term care, which is hundreds of thousands of dollars a year, this is actually a bargain. And it is. And that's where we start, right?

That's exactly correct. Especially if you go to Alzheimer's disease. Any memory care center that you get is going to be to $95,000 upwards. 150. It all depends on how nice of a memory care center you want. And so you can have a year of apheresis, especially in individuals with mild Alzheimer's disease, seeing them maintain a level of function. They can be at home, they know their kids names, they're not incontinent yet they can express their wisdom. And let me tell you Dave, I stayed away from Alzheimer's. I mean I love biohacking world. I like people who are sick that get better Alzheimer's is an incredibly hard place to be and work, and I fled it for a long time. But the thing that changed for me, and you actually mentioned this in your first chapter as well, and it touched me because I have a deep passion for wisdom. I think wisdom is what our world needs more of. And the, the tragedy of seeing a brain degenerate is that all that life experience that has been filtered and curated that is needed in the world goes away. And so treating Alzheimer's is really the protection of our resource of wisdom. And so it's not just what is the cost? Economics, having a grandfather that can still speak into your life in a way that is meaningful and loving. These are amazing resources. But, sorry, that gets me a little choked up because I think that it's a moral issue, really.

It is a moral issue. And it's one thing if, okay, it was time to die, it was time to die. But it's the last 20 years where you're not able to do what you're supposed to do when you're old, which is share your wisdom and learning with the next generation, right? When you're supposed to have energy and time to do that. And the world needs our elders. We do need that wisdom. And that was one of the reasons I wrote Superhuman as well. It's also why I'm willing and able to, thankfully, to go out and spend $5,000 twice a year to get my blood washed. And frankly, my car's eight years old and I probably could buy a new car, but I'd rather take that extra resource and put it into my body because that's way more useful and interesting to me. And I look at what's going to happen five years from now, and if this show does what it's supposed to do and you do what you're supposed to do, you train a bunch of doctors will be able to go out there and say, oh, this is now a thousand dollar procedure. And, and a thousand bucks is still a lot of money. But compared to a lot of the other costs that come with aging, it's in the realm of starting to get accessible and you need it more as you're older. And I feel like maybe insurance companies will start to cover it and that it's something that's possible. But I want to offer, okay, I want to offer something. And my whole reason, not reason, my whole structure for writing Superhuman was very, very clear. It was, this is how the body works for aging. This is what crazy billionaires are doing. And I held up my hand and I Did every single thing I could find and afford that a crazy billionaire would do. Given that I'm not a billionaire, not that I'm complaining, I'm doing all right. But there are some things where you're going, wow, they want a quarter million dollars for that. I don't think I could do that right now. That's out of my pay grade. But so I went and I did all that. But then I look at, okay, this is the super expensive, and then this is the. It's not going to cost very much, but it's the same pathway. And then here's the free. That's a similar pathway. So everything is entry level, no cost. And in terms of plasma exchange, look, if you're not going to be able to do this, you could do what I think that the old Greeks were into, like, oh, let's do some bleeding. You can actually donate blood?

Oh, absolutely. Just donating blood has survival benefit. So you're actually getting rid of your plasma one unit at a time and you're helping somebody else. So I'm glad you brought that up, because I think that is one of the things that I think plasma exchange can really bring forth is this understanding that we can help a lot of people in the world by just detoxing ourselves, having a good bleeding.

Yeah. Now think about this. If you were to donate blood, you can do it, what, five times a year safely?

Oh, more than that, usually.

So we'll just say five times a year because it takes a little bit of time and all that. That means you pretty much got one full plasma exchange. You got rid of an entire body's worth of plasma. Right. I'm assuming you have about five.

About a half of a half about.

It, because don't you have about five quarts?

You have about five liters going on in there. Right. And only half of each one of your donations is plasma.

So you have to do 10 donations to do. Okay, so 10 donations is worth $5,000 of medical cost right now, because that's what you'd pay for one blood wash. So 10 donations can help a lot of people, but 10 donations, you can't do that in one year. You're going to be really tired and hungry all the time, and you're going to need a lot of steak if you do that, and egg yolks. But over the course of two years, you actually can do something like this. And some places will pay you for a blood donation. Certainly it won't cost you anything. So that's one thing. The other thing to Think about here. And by the way, I'm just validating.

My thought process, but donating plasma as well. So, I mean, you can donate much more plasma than you can give. Give whole blood? Absolutely.

Just be a plasma donor. Okay, so there's your cheap version. Just donate plasma all day long and then you're happy as a clam. It didn't cost anything.

Yep.

Okay, well, there we go. That's. That's a way to do it. And then your body just generates its own plasma. Whether they give you glucose, 5% dextrose.

Or something, it doesn't take much. I mean, they're not pulling out a lot at that time.

Okay, so that, that's cool. And then the other thing you could do, and this is something that I've been doing for a long time, is I take a lot of proteolytic. These are protein degrading enzymes on an empty stomach before bed. Serrapeptase. All of this is in Superhuman. So there will be show notes for this. There's a transcript on daveasprey.com, so you don't have to stress about pulling over and taking notes right now if you're listening to this in your car. But I take Serrapeptase and some other protein eating things. And what those do is those eat up the stuff that's in your blood, those extra proteins floating around so you can have less of those molecules. And we know that this works because it markedly lowers fibrinogen levels, for instance, and thrombin levels. But also, when I did my ozone dialysis, what we found in the filter was they looked at that and they said, wow, you have the least amount of foam of anyone who's ever come through for a first time dialysis using the filter. Foam is a measure of protein there. So you can keep the plasma cleaner with protein enzymes. And they're talking 50 bucks a month, maybe a hundred, because I take handfuls of the things because, well, I do a lot, or free blood or plasma donations. And so I want people listening to understand you're at the cutting edge. How do we do a medical intervention? How do we do all this stuff? But there's ways that everyone can access this mechanism of cleaning the blood. What am I missing though?

Well, you just don't pollute it in the first place.

Oh, come on.

You know, so you know one of the supplements I know that you sell, I can't remember the name of it, but it's a prebiotic mixture and I just interfere. I chuckled when I looked at the ingredients Because I have been encouraging people to eat sticks and twigs for about 15 years, you know, because, you know, these complex fibers that cause the growth of healthy bacteria in the gut. You know, we need to have Larcher ribenogalactan, you know, that sort of comes from a larch large tree. And so there's so many interesting things that we can do by changing the health of our microbiome and that's going to change the quality of our plasma. Let's, you know, remove the foods that we happen to be sensitive to. Guess what? We're going to have fewer antibodies that are causing inflammation. And, you know, it goes on and on. So the fundamentals are always the fundamentals. You know, I spend my time. And the other thing is I've been working on is a computer program, a software package to help doctors assess complex neurodegeneration cases so that they can assess people through standard labs. Start at the basics, start at the foundations. A good questionnaire, good labs, and then layer on additional investigations as are needed to understand that person or what they may need to do. And oftentimes we're missing the foundations. You know, you just remove dairy out of somebody's life and it can be a massive transformative dairy protein, dairy sugar or dairy fat, all of the above for this particular individual. But I would say it's dairy protein and sugars for most individuals.

Yeah, it seems like proteins number one, sugar is number two and fats number three. And fat for a lot of people is beneficial.

Absolutely, absolutely. So, but, but the way people eat dairy is usually are not making those important distinctions, you know, so the pizza problem. Yeah, but I. So plasma is really a metaphor for how are we living our lives, what are we exposing ourselves to, how are we cleaning up and then what environment are we placing ourselves into? Let's come back to the plasma thing because there was a nice little study done for, done on Alzheimer's disease that came out of Stanford. The safety, tolerability and feasibility of young plasma for the Alzheimer's symptom amelioration. That was the plasma study. And they took a group of about 13 patients and infused these Alzheimer's patients with young plasma. And it was a very small amount of intervention that was done and they had some symptomatic improvement. Now all of these phase 1 trials are initially just understand safety, but plasma as a therapeutic is something we've been doing for a very, very long time. We've been using fresh frozen plasma. This is nothing that is out there, you know, as anything new in the world. But understanding the quality of the plasma is something new that we've been understanding. So it is not just what we're taking out of the plasma, but what we're putting into the plasma that does matter. And it's astounding how much effort we have. No. So when we exercise, we exercise, then we're going to turn on our mitochondrial cascade and we're going to increase our blood flow, we're going to drain our brain, or the glymphatics in the brain tissue are going to dump more, and we're actually going to be able to remove more of the toxins and the nastiness that is present. So it's always out with the old, in with the good. As a fundamental understanding of how do we turn around this freight train of destruction that is dementia.

Well, I love it that you're focusing on dementia. And it's so painful for families to go through it. And it's one of the reasons that last year I was the largest supporter of the women's Alzheimer's movement that's run by Maria Shriver. And it also hits women more than men. And I wanted to ask you about that, given that you're working on Alzheimer's and you're looking at this plasma stuff. Does plasma in women different than plasma in men? Does plasma in women different than plasma in men?

Yes, it is.

What's going on that's different there. That might be part of the Alzheimer's equation.

Let's kind of come back to Alzheimer's in women greater than men to begin with. I call Alzheimer's the failure of our success. Right. I mean, we've actually done a good job of decreasing heart disease deaths and cancer deaths and the end of stage or end of life, chronic degenerative diseases in many other categories. But people are living longer so that we're actually having more opportunity to develop late stage Alzheimer's disease. And I do believe there are immune differences that are tremendous between women and men, especially as it regards T cell function. And just as women have a higher propensity towards autoimmune disease, I think this is connected to their likelihood of developing Alzheimer's disease. So, you know, as we age, one of the biggest problems is thymic involution. So the thymus gets smaller and the thymus makes a large part of our cell mediated immunity. Both the cells that are told to be natural killer cells and go kill cancer cells, but also cells that are the regulators that say, whoa, enough there, big boy. Don't go over inflamed. So they are both our gas pedal and our brake. And as we get older, the thymus continues to involute and you have more and more fat replacement inside that organ and you produce fewer naive T cells. So they cannot regulate the immune system effectively. I would actually posit that we should get rid of the term Alzheimer's disease and we should call it age associated immunodementia, because the primary defect that I see going on is an immunoregulatory imbalance. And there's. Listen, I'm a systems medicine doc, so I think everything matters. But what is that one thing that really kicks us in the pants and our thymus involuting is a big deal. And recently there was a cool study done that actually looked at what happens if individuals were given metformin, DHEA and injections of growth hormone. And they were actually able to show not just a change in the DNA methylation clock, one of Horvath's earlier clocks, but they were also able to show that the thymus regrew to a very substantial amount and there was new naive T cells capacity. So this, this is.

And that was from which intervention? Or was it two?

That. Well, you know, I talked with this study authors and so it was metformin, DHEA and growth hormone injections.

The one with growth hormone also. Okay, got it. That's a good studying.

And there really wasn't, there really wasn't a lot of effect from metformin and dhea looking at the DNA methylation clock before that. And so I think growth hormone releasing peptides, I think, you know, it can, that's. I like interventions that the longer you use them either, the less you need them. Right. That's the mark of a great intervention like neurofeedback. Neurofeedback kind of goes into that category.

Sure it does. There's 40 years of Zen.

Yes, that's right, baby. I've been doing neurofeedback clinically for over 12 years and love, love, love that I think it's transformative for people's lives. But if it can't actually heal right, the longer you use it, the less you need it. At least it should not impair future function. So I think the growth hormone releasing peptides have an advantage over growth hormone in that if you stop using them, you're probably not worse off than when you started. You take growth hormone it yourself and you're going to have a challenge in kicking back your own production in some cases. So anyway, I go off on a tangent there, but the point is Growth hormone is very much associated with youth. It creates a cascade of regenerative processes. And one of the fascinating things we've gotten to observe here is a massive effect on immunoregulation. So I think these individuals in this study or studies like it will show a lower incidence of Alzheimer's down the road because they have higher immunocompetence. So this. Yeah, so there's my not so short answer to why do women have Alzheimer's more than men?

All right, It's a super complex thing, and no one knows to be perfectly clear. But when you do systems medicine or frankly, back biohacking, it's like you turn a gear, another gear has to turn, even if you don't know everything about it. So you can make intelligent assessments that are more likely to be correct than not. And that's the sort of thinking that is almost discouraged in medical school today, where it's like, we know this, we know this, we know this, but we're like, well, there's all these gray areas we don't know. But from an insurance perspective, if you go into a gray area that might save someone's life, but then they don't live, like, oh, you just got sued or you lost your license. Whereas a healer in the old times would say, well, this person's clearly dying. Let's see what might work here, and maybe we can save them. And so it's that system's thinking that says, all right, and from my perspective, look, I'm relatively young and way healthier than I ever was, but had I not gone into the gray zone, I would be profoundly unhealthy right now. So the ROI was there. And it's always about the ROI for the individual, not for the insurance company.

The nice thing, Dave, I see is a massive transformation happening in my colleagues. Physicians are some wonderful people, and the community of physicians really do desire healing in their patients. And what I see is a great dissatisfaction with the name it, blame it, tame it kind of a methodology. And medical students now are so curious. There's so much, much information available and exceedingly informed patients. So different than when I went to medical school and I was the fount of knowledge. Right now my job is not being the person who knows more. Now my job is the person who knows what to pay attention to. It's what to ignore becomes a much more important job. And when I think the difference between biohacking in systems medicine is, you know, biohacking, you're. You're often dealing with somebody who's maybe not as critically ill, you know. And so I'm dealing with people with, you know, very challenging problems, and they commit to diving as deep as necessary to figure out underlying causation. And it is a joy. I mean, it is set down. My book is Curiosity Heals the Human. A shameless plug there, but I should.

Have mentioned that earlier.

No, that's okay. That's fine. No, but curiosity, I think, is really what should drive us. And when we have that, the universe opens up to the potential that can be there. And so better questions are the first step, and maybe better answers will follow. But the humility there is. I can't imagine how you couldn't be humble practicing medicine because there's. There's so much we don't know, but also so much we can do that we have available.

Most of the doctors I know got into medicine for one of three reasons. One is they really wanted to heal and help people. Two is their parents made them do it through some combination of shame and financial manipulation. And then the third one is they just wanted to get rich, but they were bad at doing, really, research, because modern doctors, they do all right, but it's not a road to the gravy train the way it was 35, 40 years ago. So it's an honorable profession. And so what it comes down to is the ones who were forced into it and they didn't want to do it, they usually leave the profession because they just get tired of it, because it's actually hard work. And then the people who want to be healers, they focus on healing, get frustrated when insurance companies stop them from doing what they want to do that's in the patient's best interest. So then there's stress there. But it's that healer thing that's just so terribly important. And so I think you hit that really well. Your curiosity, in a way that I feel is similar to mine, has led you to go down other roads. And one of the other things that you write about and you talk about is transcriptomics. Can you tell our listeners what that is and why we need to pay attention to it?

Absolutely. Well, the transcriptome is all the RNA that your cells may make. So we have the genome, that's your DNA, and we have the proteome, and that's the protein. But how do you get from DNA to protein? You have to go through a step called rna. So your DNA, your book of life gets ready, and basically a copy gets made of the original blueprint. That copy of the blueprint gets shuttled out of the nucleus into the cell, it interacts with this big protein machine called a ribosome. And the blueprint nudges up against and amino acid after amino acid, after amino acid come up, get linked into a long chain. That chain then spontaneously forms, folds into a three dimensional structure, and voila, you have a protein. And the proteins are the machines that run the cell. They're the ones that have all this capacity for building and destroying and regulating. And protein is super important. So if you want to know what DNA is turned on, what you want to measure is how much RNA is present for any particular gene. So the number of copies of RNA give you an idea of what is the body telling that genome to do at this time. What kind of messages are coming in from the cell to say, hey, we need more coagulation proteins made? Okay, well, the gene for coagulation opens up, gets read, a whole bunch of copy blueprints go out and now we see have a massive production of fibrinogen, as you mentioned earlier. So it's such an interesting shortcut to ask what is the body really doing? If we, instead of looking at the downstream products, which would be like your metabolomics, all the small molecules that are floating around in the system, this is really saying, okay, what is central intelligence telling the body we need to do? And so we utilize a transcriptomic panel in our practice for individuals with complex chronic illness to understand, are there mitochondria functioning well? You know, is the body turning on the proteins that are necessary to produce mitochondria? Is the body making proteins to make ribosomes so that the body can make other proteins? Is coagulation turned on? Is apoptosis turned on or necroptosis or any of the other ptosises? And then what is the flavor of the immune activation? So differential studies of various conditions are being published now. So there's a pattern for, for an acute Lyme exposure, there's a pattern for a treated Lyme exposure, There's patterns that individuals that have been exposed to water damaged buildings. And so those are some real opportunities. And they're not easy to interpret. They take a long time to learn. You're having to learn an entire different language, frankly, what is the language of gene expression? And I was driven this because how do you assess what the cells are doing? There's so much chatter that goes on. You know, if there's not good nutrition, well, is that inhibiting the cellular function? If there's not good signaling that can inhibit cellular function? So you need to look at all of those different Components when we're not getting the results that we should. Oh, and you know, you often speak of nad.

Well.

I should be publishing a paper here pretty soon talking about how transcriptomics can help us understand whom may benefit more in those circumstances and what are the changes that go on in transcriptomics. With that, I need more case studies. My conclusions are not solid enough that I want to. But the point is we should be looking at before and after results because the. The only thing that matters are results, Period, End of story. I don't care what philosophy people have. I don't really. My favorite days are the days I change my mind if I have to give up a prior belief that was inaccurate. That's a great day. And I like being challenged. But transcriptomics has really opened my eyes to just how much potential there is for the body to heal. It's a new science. And the problem is RNA is a mess to collect. So when you want to do a blood draw for transcriptomics, you have to draw the blood. It has to sit for a certain amount of time. It has to. And then for four hours upright. And then it needs to be frozen exactly in a certain way. And it needs to be shipped on dry ice. And so there's a whole bunch of barriers present to doing these kind of deep dive measurements, this investigative medicine. And again, as technology gets better and we're able to put more of these things on microfluidic chips, as we're able to stabilize RNA more effectively, you know, this is going to become, you know, utilized more, more widely, which will be good for all of us.

So timeline, how soon can I do broad transcriptomics?

I think two, three months.

Wow.

These are really. They're already here, but not in a way that's translatable easily. But your question was actually different than that. Your question was, when can I do broad scale transcriptomics? The panel I'm talking about is only about 200 RNA, 200 genes. I don't consider that broad scale. Broad scale is when we're looking at all 20,000 gene expression patterns. And that's just done in a research lab. It's a different technology for stabilizing, reproducing and measuring the rna. Okay, so again, the details of how do you make something that is cutting edge mainstream? There's a lot of hurdles. There's a reason these things are not yet mainstream, because they're a pain in the arse to collect, they're a pain in the arse to interpret. And you usually need to do them repeatedly so you can see art Is what I'm doing working.

That is the biggest problem with a lot of biohacking is the track it to hack it. Perspective from game changers. You can track all sorts of crap, but tracking requires multiple measurements. That's why I like my aura ring. That's why I like engineers, glucose monitors. Stuff you can easily do, right?

There you go.

We're both wearing one. Stuff like that is really important. Okay, that makes good sense. Now, your book talks about kind of in a similar way to Superhuman. It's some of the cool things that are happening out there just in the world of medicine. Things that you're curious about, things that people don't know about, like washing your blood and looking at your transcriptome and looking at mitochondrial assessment is the other thing. Because people listening to the show for any period of time have heard me talk about mitochondria as being way more important than anyone thinks. I at the New York Times science bestseller list with my mitochondria book. But at the end of that, the best assessment I could find after looking at every blood test out there. This is a couple years ago, was actually a technology that we got for Upgrade Labs, one of the companies. I started that. That's down in la. We can measure the oxygen that comes off your body and use that to tell how this is different than a VO2 max test. But in the same universe, we can tell how good your mitochondria are doing. But that's kind of a pain. Do you have a new mitochondrial assessment test or a recommendation for one? Just tell me what you're looking at.

Yeah. So you may know that I kind of do most of the mitochondrial teaching for the Institute for Functional Medicine. So that's my.

You're my meal on mitochondria.

That's my jam, baby. I love my mitos because they're so fascinating. We just keep learning more and more, more and having to forget so much of the things that we used to know about them. Like a recent great paper was that these cristae, the folds in the inside of the mitochondria, they migrate extensively. Like every three minutes they're shifting around. It's just a constantly mobile internal environment of the mitochondria. But that's not what you asked. But I'm just geeking out. Sorry about that.

We can always geek out on mitochondria on this show. If people don't like it, they go to the Next Step episode. It's okay.

Yeah, yeah. So in the mitochondria, I think you have to look at Assessment in levels. So think of mitochondria as the mountain. And every assessment tool is literally an observer around the base of that mountain. And they're going to have a different perspective on what happens. So, you know, so measuring your CoQ10 level is a super important measurement to take. You know, the likelihood of sudden cardiac death in individuals with a CoQ 10, you know, less than 0.71 if they have heart disease. Heart failure is incredibly high. And I measured one of my staff members who's a young healthy woman, and her CoQ10 level was 0.3. I was just dropped my jaw and like, what's going on here? So the basic. So let's not forget the fundamentals, first of all. So CoQ10 can give you a lot of information. Alt, AST, GGT, LDH, these are all common blood tests that are done. They're usually called liver tests. They're not liver tests. They're mitochondrial function tests. They're involved in how the mitochondria. So when those go up, say when somebody takes a statin or is exposed to a toxin and those levels go up, it's a sign of mitochondrial stress that's going on. And so that can let you know the need for treatment. I think in your earlier, your intro, talking about the ability for these mice to forget after they have been shocked. Well, magnesium enables that process to occur. Magnesium threonate specifically. And magnesium threonate is important because it complexes with ATP. ATP is actually a salt of magnesium. Don't have magnesium, hard to have stable ATP.

Guess what I take before bed a handful of magnesium threonate and I take the other forms in the morning.

And so your life shock therapy, you've been able to forget that. That's really a good thing for you. But then what are other. So the more advanced techniques and starting to look at organic acid analysis, which I think is really, really useful. But that takes some interpretation skill and you have to prepare people.

Well.

I also am liking mitoswab. It's a new test that's actually quantifying the levels of the complex 1 through 4 and citrate synthase in a buccal swab. And then we do mitomics. So mitochondrial whole genome analysis, because you first of all sequence the mitochondrial DNA, but then there's over 1000 genes from the nuclear genome that are informing and enabling that mitochondria to function. And for people with severe fatigue and queasiness, headaches, muscle pain, thought problems, brain fog, a lot of those end up having a genetic basis. And one of the utility of knowing what kind of genetic basis is going on is just how hard are you going to have to work at this and for how long? You know, the mitochondria, not something you can switch on and off. You need to nurture these little critters and you got to love on them for a long time in a lot of ways to help them come back to a state of robust health. And then I've already mentioned transcriptomics. I think transcriptomics is going to be an excellent way of helping us understand, especially the nuclear mitome, you know, which genes are turned on at any time. Is our body believe that it's okay to actually grow new cellular materials? You know, is it going to make the energy for repair and regeneration? So that's not a simple answer on that. Because at the core, every function of our body is dependent upon mitochondrial function. Everything is dependent upon energy, period, End of story. So, you know, you just can't. Everybody wants a simple answer on this, and I'm looking for that simple. Now, your test is actually measuring the whole body capacity, right? You're measuring kind of the final, final, total, common, final, total output.

It's. How's, how's the system of the mitochondria doing? Because, I mean, you can pull a couple mitochondria out and unfortunately red blood cells don't have mitochondria. So, you know, you've got to get other kinds of cells. But then, okay, your skin mitochondria doing something totally different than your brain mitochondria. And since mitochondria all talk to each other and share information with each other in a complex system, I feel like ultimately the gold standard is going to be how good are you at turning air and food into electrons and heat? Like if you can do that. Well, we know, but it doesn't tell us what's wrong. Oh, something's broken. And if you can say, oh, in your citric cycle, the step five of making electrons is where you're leaking. And that's why you have muffin top and that's why you have Alzheimer's. That's happening. That is going to happen. And it's just a real pain in the ass. I can say ask, because I don't have a medical license. You have to say arse. I totally see the difference.

No, it's actually, it's a Canadian, Canadian, South Dakota thing. But I think you bring up one other point, is that it's messy. It's messy. Systems medicine is messy. Biohacking is messy. When you're Actually dealing with reality, it's messy. If you're going to deal with a made up idea like an ICD10 code, oh, you have type 2 diabetes and oh, that happens to be a particular ICD10 code for billing purposes. And if you stop there and diabetes is diabetes is diabetes, you can't start ferreting out, well, how did you get to this place? And the closer you try to get to understanding the multi causation of a diagnosis, the more uncertainty you actually have to be honest about. And I think that's actually a challenge. It's a philosophical challenge, not just with medicine, but with humans. We love certainty. We don't like things to be kind of cloudy, kind of messy. We don't like probabilities. We want certainty. But the bottom line is reality is filled with uncertainty and probabilities. And when we accept that we have so much more power, we then can start dealing with multifactorial analysis and multidimensional plans, like they call it a lifestyle and get huge benefit out of that stuff. But it's not this one magic ingredient that we all want to believe is happening.

I very much appreciate that perspective. And like I said, it's messy. Hacking mitochondria is tough, but you said something really straightforward. Coenzyme Q10. It's not that expensive to go get some CoQ10. I've been taking relatively high doses of it for many, many years and the data is out there that says it's a good idea.

Data is out there. And also it's just crazy how many upstream things that are possible. We don't have to do everything to do things that are very meaningful. Start where you are with what you have.

Now that's probably the most important thing that you said in the interview. You don't have to do everything. And I worry when I write books, like, I want a complete universe. But man, if you try to do everything in Superhuman, you better be willing to write a seriously big check. I know I did. In order to even like do the research for the book. But also the checker that you write is, in time, you're gonna have to fly around and do a bunch of weird stuff and take a handful of supplements. I don't do everything I talk about. I think that he sha woo the herb, even though it might be good for you, it tastes like crap and it ruins my coffee if I put it in there. So I'm like, man, it's on my counter, but I might not put it in because it's gross. What am I going to do about that. So there are limits. And that perfection and all that'll actually make you old. It'll probably give you Alzheimer's too. So it's like, pick something. If you improve, great. And if you didn't, stop doing it, and that goes for bulletproof coffee, too. Hey, if you don't feel better when you drink it, then don't drink it. It's okay. It just happens to work for most people. Just like Coenzyme Q10 works for most people. It's one of those things.

Yeah.

Well, I do have to recommend your book because a lot of people listening to the show, they get it that I'm very future oriented. I'm seeing things before they happen, and I have a track record of doing that. I don't like to be called a futurist, but a lot of what I do is that, what's it going to look like in a while? And I somehow know and position things for that. And I think you have that same thing, that same mindset in your book. So for someone listening to the show, you're listening to this saying, all right, is it worth my time to read it? Look, if you get excited about knowing what's happening in the future and maybe being one of the first people to live way longer than all of your friends, the ones who didn't do what you told them to do, I think this is a good book for you to read. How's that for kind of a dark intro for a book that's good?

I like a dark intro. I want to be really clear. I wrote this book for only a few people. I wanted the people who are really curious, you know, I wanted people that wanted to solve their own questions and start that process of, if you're stuck, where do you go from here? And the number of answers that are within us are of infinite number. So.

Well, your book is called Curiosity Heals the Human, and you are definitely an acknowledged expert in the field. The Institute for Functional Medicine is a major training ground for the functional medicine doctors who I've been recommending since even before I started bulletproof. And so you're the guy who trains them on mitochondria, and you're very deep on some of these other very cutting edge things like washing your blood. And people today learned from you. Here's the free version, and here's the $5,000 version. And if you're in the hospital, the $14,000 version. And that $14,000, that's just for the band aid when they're done, the procedure is even more. But on that note, David, I really appreciate you taking the time to be on the show and just the work you're doing saying, look, I'm a doctor and I'm going to make people better regardless of the way the system is set up. And I'm going to do it with hard numbers and science and understanding of complexity and that your curiosity is serving you and millions of others. So thank you, Dave.

Thank you for having me on. You know, everything I do is about how do we create health, you know, how can we maximize wellness. And it may seem like I am involved in these disparate things, but at the end of the day, the end of the day, it's about individual humans being able to live into the lives that they deserve and can achieve. And it's an incredible opportunity to engage that mystery and to work within it. So thanks for having me on. I really appreciate it.

You got it. Your website is David Hasee. That's H A a S E M D dot com.

You got it. You got it. And we'll have an assessment on there just how you can, you know, what is your best way for superhumanizing it was. This has been a ball. Thank you for the work you're doing in the world, Dave.

You got it. Now, if you like today's episode, definitely read David's book. Read any book that you think is going to provide more back to you than the time you spend reading it. And if you make that hypothesis, you test your hypothesis by reading or listening to a book and you were correct. What you do is you go to Amazon and you say, I achieved victory. That's a five star review. And if you, if you're like, this book was a total waste of my time, why did they kill a tree to print it? Then what you do is you go and you say, you know what, here's what was wrong with it. So the author can know and you don't give them a five star review, but we have to have feedback that you track it to hack it. So as authors, we care greatly whether our book was worth your time or not. Because if we spent 2,000 or 10,000 hours and had blood taken out and did all sorts of weird tapping into our bone marrow to write a book for you. Just let me know if it was worth it. Let Dave know if it was worth it. So thank you for reviewing the books you read and thank you for reading because reading makes you a better human. Have an awesome day and I'll see you on the next episode.

A human upgrade. Formerly Bulletproof Radio was created and is hosted by Dave Asprey. The information contained in this podcast is provided for informational purposes only and is not intended for for the purposes of diagnosing, treating, curing or preventing any disease. Before using any products referenced on the podcast, consult with your healthcare provider carefully read all labels and heed all directions and cautions that accompany the products. Information found or received through the podcast should not be used in place of a consultation or advice from a healthcare provider. If you suspect you have a medical problem or should you have any healthcare questions, please promptly call or see your healthcare provider. This podcast, including Dave Asprey and the producers, disclaim response for any possible adverse effects from the use of information contained herein. Opinions of guests are their own and this podcast does not endorse or accept responsibility for statements made by guests. This podcast does not make any representations or warranties about guest qualifications or credibility. This podcast may contain paid endorsements and advertisements for products or services. Individuals on this podcast may have a direct or indirect financial interest in products or services referred to herein. This podcast is owned by Bulletproof Media.