Why 50% of Us Won’t Live Past 76—And How to Beat the Odds. Pradeep Albert : 1233

Many medical subspecialties will be completely changed and replaced. One of the first specialties that's going to be changed mostly by artificial intelligence is actually going to be orthopedics and musculoskeletal injuries. 50% of people will not make it to 76 or 78. Older parents make less viable offspring. If you add red light to stem cells they produce different things, certain cells, they actually cause the stem cells to release different things. Exosomes are the greatest anti inflammatory I've ever seen. As physicians we risk the danger of becoming irrelevant.

You're listening to the Human Upgrade with Dave Asprey. We're going to talk about something that is just part and parcel to my quest for longevity. And it's regenerating tissues actually growing, well health and growing, maybe even new body parts. Our guest today is Dr. Pradeep Alpert who is an expert in stem cells and PRP and very specifically medical imaging and using AI to do what he used to do as a radiologist. And he's done 40,000 or so procedures which means he's got a lot of experience to share with us. So we're going to go deep on the implications of AI for longevity. And I don't think you can do this living to at least 180 or not dying from the four most common causes of disease without some help from knowing what's going on in there. Sometimes it's lab work, sometimes it's observation and sometimes it's imaging. You need all of it. And we're not going to get there without AI because the best people in the world, we're doubling our knowledge of biology every 13 months for all biology and the amount for humans is likely faster than that. In fact I've seen numbers up to every 72 days. So you can't be awake long enough to read everything. So we need a system and we have the system now and we've got a guy who's using it. So welcome to the show.

Thank you very much Dave. It was, it's a pleasure to be here and fascinating material as always and, and I'm not only happy to be here as a guest, I'm a big fan.

So what do you see happening with AI? Because if I'm at home and I can take whatever data I have about myself and I can run it through an AI system, do I need a doctor as much anymore?

What's happened is, is that over the past, you know, I would even say the past year or two, you know, with the advent of all the different AI tools and, you know, language learning models that are out there. We noticed that there's been an incredible amount of information that's kind of democratized to the general public. Some of it, most of it's very accurate, frankly, some of it is incorrect. But the interesting part is that I think healthcare from a fundamental point of view is going to change, and it's going to change very, very quickly. And I think if, you know, physicians in the United States are going to wait for the FDA or things like that to prove it, that's not going to happen. I think these things are going to come online from places all over the world, and patients are just going to enter the information like you just said, and they're going to be able to get that data back. And then they're going to go back to their physicians or their healthcare providers and say, hey, you were wrong or you were what? Why did you do this? So it's going to be an interesting next couple of years.

I've seen a transition from, you know, my parents generation where you have the, the white lab coat up on an altar and whatever the doctor says, you have to do. Kind of a paternalistic view now where some doctors from a couple generations ago say, well, I know the patient's terminal, but I'm not going to tell them because it'll just stress them out. I'm like, whoa. To me that feels kind of shocking. But the shift now it seems like doctors, at least the functional medicine, the longevity doctors, the regenerative doctors, they're like your partners and your coaches, and they're helping you think about things in a way that maybe AI doesn't yet. So does your doctor now a coach and a partner, less than a dictator?

Well, yeah. Well, so the entire, you know, just in my career as a doctor, I mean, you know, when I first started, doctors were up on a pedestal and now, you know, we were in during the pandemic, you know, we were kind of controversially discarded or brought back, depending on whatever, you know, you believe. But what's, what's fascinating about what's happening in healthcare and is that for patients, patients need to be able to understand how things are. Like, like if you can get information, the same information from your doctor as well as from your AI, if the doctor doesn't communicate why something is and personalize it to you, then it doesn't matter. Right. So I think that person, the personalization of medicine, which AI can help gather the data for, but to explain it to you and kind of look at things for you is what the role of the physician will be. But frankly speaking, I think that many medical subspecialties will be completely changed or replaced. I know for a fact when you look at images, right, there's machines can do them faster, better, more accurately, far more important, far faster than I can ever do it personally.

Elon Musk is famous for saying, if you look at the deaths per mile driven from fully automated cars, that it's much less than the deaths per miles driven by humans because of the same reason you talked about is radiology or medical imaging at the point where technology is better at spotting problems than the average radiologist.

I think we're there for certain things, not for everything. Right? So just like your whole. So one of the problems with medical imaging is, is that the way that the images are acquired, they're taken in different ways, and there's no, you know, there is some standardization and there's different patterns that people do all over the world. So I would say, you know, they talk about, you know, there'll be a turning point or a flipping point, probably, I would say within the next two years. I think that's going to happen. Now, it's interesting that you're bringing up drivers as cars, right? So as a radiologist, what people talk about is that they think that people like me will get replaced first. What was fascinating is during COVID when we had a significant decrease in the amount of accidents, you know, what happened at that time was, is insurance companies, you know, when the initial part of the lockdown had to start giving back money, they weren't giving it back because they were good people by law. They had to use a certain amount of their. Of their premium for actual accidents. So now they didn't know what to do because nobody was driving around. Okay, so what happened was, is that there was a significant decrease in the amount of accidents. And I believe that one of the first specialties that's going to be changed mostly by artificial intelligence is not imaging, because that's one everybody else thinks about. As commonly, it's actually going to be orthopedics and musculoskeletal injuries because the amount of accidents have decreased. The second thing that's also happened is that the amount of organ transplantation during that time diminished so much because we get most of our organs from young accident victims.

Oh, wow.

So, you know, things that you never would think about. So the unintended consequences of artificial intelligence are really, you know, are fascinating to talk about. It's not. People are thinking it's going to be, you know, a replacement, one for one. That's not the way it works.

Some people are, are bothered by this. Like one of the things pt, after you have some injection in your shoulder or surgery, you need physical therapy and recovery and functional movement. And one of the pieces of tech at Upgrade Labs is an AI driven functional movement exercise piece of equipment called Oxfit. And it's all driven by AI and it watches how you move, it measures how you move and it changes it based on your physiology, much like a functional trainer would. So you could say some functional trainers are going, oh my gosh, you know, that's evil. I don't think people are that motivated by technology. We're much more motivated by people. So the role of medical experts doesn't look like it's going to go away. But looking at, you know, 500 radiological films per day with your amazingly trained pattern matching system, it seems like working in a coal mine cognitively, it might take some of the drudgery out of it.

Yeah, absolutely. So there's nothing worse than looking, doing the, I mean, no matter what profession you're in, right? If you do the same thing every single day and you know, ideally, hopefully people that go into the specialty like, you know, I'm in, you know, you have to be somewhat intelligent to do it. But you take someone intelligent and you, you, you're making them do rote work again and again and again. So interestingly enough, I think it frees up intellect to be able to do other things. So I hope we're not constrained just based on our profession, but it's up to us to kind of retrain ourselves and kind of look for other things in the same field. Frankly, you don't have to look for things outside of your field. But I think it's going to be very interesting. I think that there are people that are survivors, they'll do whatever it takes to keep going. And there are other people that just mentally check in no matter what profession you're in. So I'm kind of excited by all the stuff that's going on because at the end of the day, you know, the reason that we become physicians in the first place is to kind of, you know, we talked about that curve, you know, that longevity curve is to shift that curve to the right to keep people alive, to keep people healthy. Those are the kind of things that I think that excites me and excites people like me.

So you have a couple books and guys Pradeep has come on the show because we're interested to talk about this. And he's not a professional author in terms of, you know, trying to sell a bunch of books. So this isn't to push a new book at all. But there's interesting stuff in here. His first book is for doctors about exosomes and PRP and stem cells. But this one, which is hitting Amazon, I guess it'll be on Amazon by the time it comes out. Lifespan decoded. There's a chart in here. And it's just the death by age curve. And we always say, you know, for me, our best is 120. I'm going to do 50% better. But the average. What's the average?

76 to 78, depending on, you know, your race, your gender, where you live, et cetera. So it's, it's variable, but let's say mid-70s.

Okay, so that's kind of scary. Say mid-70s, but it's a curve that means half of people die before that.

That's absolutely right. So that's an excellent point. So 50% of us will not make it to, you know. You know, it's ironic, you know, you're, you're, you're, you're someone that pushes longevity and, you know, you're biohacking and you're gonna be two standard deviations away from the norm on the other side, you know, to get to 180. But the average person, 50% of people that are listening, unfortunately, will not make it to 76 or 78 if statistics hold to be true. Okay. And I know this, your audience is very different. And they'll be on the other side of the curve. But I'm talking about the general population. And one of the things, one of the reasons that Dr. Alan Katz, who's one of my colleagues and I wrote this book, is that how do we shift that curve to the right? And we came up with three rules for longevity. And they're simple, but I think they're straightforward. And they're kind of somewhat amusing. But I mean, not amusing, but, you know, rather simple. Okay, These are three rules. We came, you know, we call it the Longevity Fight Club. And, you know, there's just three rules. Okay? One is don't die of a heart attack. Okay?

It's a good move.

Number two, don't get cancer. And number three, avoid dementia.

Okay, nice. Okay?

Those three rules, if you follow. I know it sounds simple and silly, but if you follow those three rules, you can make it to the other side of the curve.

Interesting. I had four in my book. Added diabetes to List, but otherwise totally alive.

Okay, there you go. Yes, we can add number four. Okay. But, but getting to that other side of the curve, right, requires like, you know, when we're talking about us as people, right? There's two parts of us, right there. There's the genetics of us, right? The things that make us up, our parents, our ancestors, our heritage, whatever, whatever that may be. And then there's the things that we do, our epigenetics. So we break down this into two different, you know, concrete portions of longevity. The genetics which you, you know, we could talk about how we modify that and what we do with that that you can't control. So epigenetics is what you can control and to kind of hack your genetics, okay. Because you're kind of moving your, your genetics into your epigenetics. So the analogy is, is like, it's like running a marathon, right? Life isn't fair. So let's say we all start at different places, right? And that's our genetics. So let's say you start at, you know, a 26 mile marathon. Let's say your genetics are better than mine. You started the two mile marker, so you have a two mile advantage over me, right. Some of us may even have a negative advantage where we start. Negative one. Holloway.

I think I started out that way hitting 300 pounds. All the arthritis at 14. Yeah. So I, I had to come from behind for sure.

So you're the master of the epigenetics, right? So what's fascinating is, is that if you, if somebody's ahead of you by two miles and they start off that way, and if they don't train for that marathon, right? If they don't, if they're just eating donuts and, you know, eating chicken wings or watching football all day long, they're not going to. And you start at negative one, but you're training for the marathon, you're running every single day, you're eating right. You're still going to beat that guy. So if we look at this as a race, we start off at different places, we end up. The idea is to win. And the idea is to get to the other side. And then if you wait long enough and the book gets into this, there will be technologies and different things, including artificial intelligence and all these different things that'll come out that will actually help us even push that further. So your 180 years that you want, I think is, is, is, is, is actually I, I love the fact that you, you say that because it tells me if you don't have a goal, then what's the point? Right? You can't, you, it's, it's not, you know, other people may listen to this and say, oh, that's insane. They're wrong. You need to have a goal. You need to have a number. If you talk about longevity, it's having a number. You better have that number and you better go for it. That's the way I think.

Yeah. It also creates this freedom where I feel like I'm just getting going, right. I, you know, whatever. My last birthday was, was about 28% when I meditate. 28% duty cycle. And I think the body listens too. And you know, that's kind of a spiritual mind over matter thing. How important is mindset? I mean, you're hardcore imaging your medical Western doctor.

Right? So, you know, I'm not the guy that, I'm not the kind of guy that usually meditates or thinks or, you know, but you know, coming from, you know, being born in India and coming from an eastern philosophy of that mind does have a significant portion of it now. You know, it's funny, when we talk about longevity, right. We talk about. People say, okay, my biologic clock is this, My chronological clock is this. Right. You know, I'm 53. Okay. And my biological clock is X. And people say that for those people in that curve, the vast majority of them, because people like, remember, people don't make that, that, that that half of them die before they get to that midpoint. The most important thing for them is, is that their biologic clock is past their chronological clock. Yeah. So if you really think about it, right. Like the people that are listening to this podcast, you know, they're intelligent, they're hardworking, and they have biological clocks for the most part, are going to be below the chronological part like yours is, I'm sure. But for many of people that are just random people, it's the opposite. And that we have to flip that for everyone. And that is the goal of, you know, that's a goal of, you know, we're talking about longevity physicians versus regular physicians. Every physician should be longevity physician. Yeah. I mean, it makes no common sense, Right. What's the point of.

You're an ER doctor. Trauma physicians are kind of their own breed, Right?

Yeah.

But even then, you know, the way you treat a trauma, if you realize that person's gonna be around for 180 years, you might change how you stitch em up.

True. Yeah. I think it affects every single aspect of health. And you have to be then it makes you mindful because maybe you won't pollute because you think, hey, I may be around for 50 more years.

Amen.

But people say, what about the environment?

If more people live longer? I'm like, well, number one, we have a population crash happening, and it's very strong in the data. And number two, if you might live for 200 years, you're not going to put the bottle in the ocean because you know it's going to be in a fish later.

Yeah. You may have to eat it.

Yeah. Like you don't mess up the sandbox when you have to use it multiple times.

Absolutely. What's fascinating, you just brought up the point about the population crash. So genetics. And we're talking about two things, right? Genetics versus epigenetics. So when you're talking about the actual genetics portion of life, and that's the one that was born with, what's happened, especially in Western cultures, is that there is an incredible, you know, there's a negative population growth. You've seen it in Italy, you've seen it in Japan. You're seeing it all over Western Europe. And I think the US Possibly due to different forces, may be, you know, equal.

We're equal, but we just had a lot of immigration or we would have.

Been negative as well.

That's correct. Exactly right. So what's happened to us is that we have an aging, you know, if we think about ourselves as mammals or just animals, you know, if you take the spirituality and you say, you, we're mammals, we are reproducing at a later time than. Than ever. So it's very common for guys. And I'll use, you know, so I have four boys and I. I have, you know, twins. And I remember when my wife and I, and my wife was pregnant with our twins, she just turned 35. And for women, they have to do an amniocentesis to make sure the kid don't have, you know, down syndrome. So they test every woman after 35 for genetic abnormality. But if you're a guy and you're starting to have a kid, when you're in your 60s or 70s, they don't test anything.

And your chances are much higher of having damage to your sperm. This is my first book on fertility. So guys are half the problem, right?

Yeah, exactly. Perhaps even more. And. And it's very sexist, right, to just check the. I mean, just the way you're thinking. So old. I mean, this is going to sound, again, very controversial. Older fathers, older parents. And I'm, I'm I'm guilty. I'm not, like, judging other people. I'm, you know, I'm a physician, so I had to kind of push shift in my life because I had to do all the training. But older parents make less viable offspring.

Unless they do something about it first before pregnancy.

Right? Absolutely. No, of, of course, this doesn't apply to everyone, but I'm just saying, on average, it's totally on average. But this is, you know, we're talking about shifting that curve to the right.

Yeah.

So what we could be doing, you know, if you look at it historically, that curve, antibiotics and other types of surgical interventions that push that curve to the right. I mean, in Western society, you know, the average life expectancy used to be in the 30s and 40s, you know, and now it's in the 70s. In Eastern cultures, it was always in the 60s and 70s, ironically, you know, when you were in Tibet and you see people live, you know, very, very old ages, right?

Oh, yeah. They're all over the place.

Yeah. Now, what's fascinating is that by changing our epigenetics, by reproducing later, we could be inadvertently shifting the curve to the left without, you know, without us knowing it. So that's a fascinating principle about longevity, and that's not something everybody thinks about.

In fact, the single cheapest and most effective thing you can do to have longevity is have a really healthy grandmother.

Absolutely. I mean, really, it's a direct correlation. You have a grandmother who's just thriving.

And your mom was healthy. You're probably one of those people where you smoke around, go, you know, every now and then I get a little sick and I'm fine and stuff doesn't hurt, and everything just works. You're probably going to live longer. Like, I had to work my ass off just to be at a baseline of health, because I did not have that right.

Well, that's what keeps you. And you're the kind of person that pushes the envelope. You get, you push. You know. Now, I think I was saying to you earlier, the older I get, the less I know. But, but I, I've learned from you, you know, so you learn, you know, you learn from other people, and you, you, you push it forward. But it's fascinating about the genetics part of it. Right. So it isn't just, you know, our, our heritability that causes longevity. Like, it's not, you know, all of that is not 100%. For example, there are certain genes that give us protection. You know, biologically, we're made to kind of reproduce and Then die off. Okay, so there's certain things, there are certain genes that protect us to get to us to get to a certain level. For example, you know, it may get you enough to provide you, you know, provide you safety from infection, et cetera, till you're like 40. So it assumes that you've already reproduced by then, and then it, it doesn't need you anymore biologically, it just cuts you off. And there's an advantage to that. Whereas if you're, you know, maybe you're supposed to be infertile and be a caretaker and gives you longevity, but it reduces your sperm count. So it's fascinating how the biology works. It really is, isn't it?

It's really fascinating. And if you take a fertile man and a fertile woman and you give them a diet that's high in toxins, low in protein, wrong kinds of fats and all of that, their hormones will decline and they'll become less healthy. And then their kids become less healthy.

That's correct.

I feel like one of the things that really affected the US was Dr. Kellogg back in the day where he said, you know, sexual desire is the root of all evil, so let's make a food that drops sexual desire. And it was low fat, high carb Corn Flakes. And, and like, the guy was kind of a weirdo on multiple ways. But it got into our, our system where people have been doing that, especially in the 60s and 70s, you know, wheaties champions and all that nonsense. It seems like the epigenetic effects of that two, three generations later are pretty meaningful.

Yeah. Now they're long lived. You know, I'll tell you, I'm. I'm guilty of it myself. When I was a young person, you know, I used to watch tv and you had to have your glass of orange juice in the morning.

Yeah.

Just probably the single most toxic thing you can do.

Right, Right.

And you have the US fda, you have all these people just kind of pushing the healthy breakfast. Breakfast is the most healthiest meal of the day or the most important meal of the day, they would say just complete poppycock, by the way. But the idea is, is that when you, when you, when you're taking in high levels of sugar, especially when you're a young person. Right. Frosted Flakes or, you know, Fruit Loops or whatever. And I don't want to mention particular brands, but, you know, the idea of a sugary meal, frankly. Yeah. So any of those type of things that would actually kind of be detrimental to you is the worst thing you can do. And the Epigenetics of it, frankly, is, is that you're. You're 100% right. What you're doing is, is that you're programming yourself to have weaker and weaker generations by changing who you're with. I mean, we know. And as you said, as you've written and said multiple times, a microbiome changes depending on what you're, what you're eating and what you're not eating, right?

Yeah. Do you think fecal matter transplants are going to be meaningful for longevity?

Interesting question. Yes, absolutely. And I'll tell you why I think they are. It sounds disgusting, right? Yeah. I'm willing to try anything. After 15 years of antibiotics, like, there's.

Not much I wouldn't do.

Okay. So, you know, it's like going back to some of the basis of longevity is kind of like what your, you know, your parents used to say. It's a company you keep. Okay. If you're with, you know, growing up in New York, you know, people would say, if you're with losers, you'll always be a loser. If you're with the winners, you'll be with the winner. That's a. But the same happens with, to us biologically, right? We are a cohort of people if we're with healthy. Like, if you, if you're, if you're hanging out with people that go to the gym all the time, it's been proven that the microbiome of you physically around you, it transfers to you. The same thing happens to young women, women that go to college, they start menstruating together. The pheromones start, they sink. So we think of ourselves as higher beings because we have intellect and we're having podcasts and we write books and all these types of things. But at the very nature, in many ways, we're animals and biological, and that's not a derogatory term. And that's what we are. We're mammals. And that doesn't take any of the spirituality out of anything. But still, that's what we are biologically. And so the point of that is that you really need to be. You know, you talk about fecal transplants, adding that stuff and getting that kind of gut microbiome and things like that into you. If you're sick and you can't figure out other ways to do it, it makes a huge bit of difference.

It seems like it may be part of longevity. And I think the science is still pretty young on it, but AI is going to help us with the data. We've got companies Like Viome out there, who are they added 10,000 new species to the catalog of what lives in our guts that no one knew about, much less whether they make you live longer or not.

Right. Absolutely. I mean, the amount of data that just to go through, I parsed through for this textbook with Dr. Katz, we had to take the most salient points. Right. So one of the reasons that, you know, conventional medicine. Right. Like I said before, every doctor should be a longevity doctor. Right. It's not something. I mean, what's the point of being a doctor if you're not trying to keep people alive as long as they can and as well as they can? There's so much data out there, and some of it's noise, but a lot of it isn't. And we don't realize historically, we admire people generations later. Oh, the guy was a genius. We never knew. I'm hoping with the advent of AI, which is going to be another side effect, which we're not thinking people like yourself are going to be admired in your own lifetime. I think there'll always be at least.

50% of people who are offended, and that's okay too. Right. And if people choose to admire or not, as long as they got the information, that's the thing.

But you're presenting it in a wonderful way and making people think about things that they. For example, as a conventional MD that goes through being a professor and teaching and going through that process, learning those things from someone like you, frankly, hearing about things and kind of processing it and reevaluating something that you already thought you knew. I think it's the best way to learn. I think one of the most incredible things in life, and this may not be a longevity point, but just a general point, is, is that you learn something and then you change your mind because you're like, huh, maybe I'm wrong, you know, but the ability to be.

Wrong without pain and suffering lowers your stress, and that means curiosity makes you live longer.

Right.

It doesn't kill the cat.

There you go. And. And not only that, like I said to you before, the older I get, the less I know.

Yeah. You just realize some things that were dogmatic, strong beliefs, and the amount of change I've had in my life on. On the spiritual, emotional, psychological even. I used to believe if I don't have six meals a day, I'll go into starvation mode. I'm sitting there at, you know, 250, 300 pounds, thinking that if I stop eating, I'll starve. And the reality, in fact, in the studies that I couldn't see because I didn't want to think about it was that I could go three or four months without eating and not die.

Right.

That was reality. But it felt so different.

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It feels like for most people listening and this is, you know, a special audience, the challenge of longevity is number one. Well, there's a lot of stuff I could do. What should I do? And we can probably boil that down pretty easily. But then how do I make myself actually do it? It's the patient compliance problem. How do you solve that with patients?

Okay, it's interesting that you say that. So, you know, going back to medical school, you know, we're taught. Don't, you know, tell. Teach patients don't smoke. Okay. Just a, Just a, Just a. Just something that every doctor says, right? Yeah. Now, if you're, you know, one of the biggest challenges is right when you're talking to people, young people, older people, people aren't stupid. If you just repeat the same thing again and again and without a reason. And you can't just say, oh, you're going to get cancer. Like that's. That shouldn't be the reason. Right. Because that's an unintellectual way of explaining why you shouldn't smoke. Okay. And I'm not. This isn't about smoking, but I'm just making a point about getting information to a patient. So if someone is smoking, if you could say, by the way, your body temperature is 98.6 degrees, and you're at this, you're taking a piece of paper, you're heating it up to a high temperature, you're inhaling. Just imagine when you get a temperature of 101 degrees, how bad you feel. You're shivering, you're not feeling great. Now you're taking toxic gases that are almost 200 degrees and you're inhaling them to your lungs because hot air rises and it burns up the alveoli in the top of your lungs and you get some damage to your lungs. And if you kind of say, okay, and every time you do that, you're doing that. Okay. So you can kind of interlock. You just said you're going to get cancer, you're going to die. You know, it makes no sense. Now someone's thinking, huh? So being informative, teaching people and talking to them, not as, like you said, up on a pedestal, but as an equal. Right, right. Like, being a physician, I think, is an incredible privilege. I've spent decades doing it, talking to people. But the best part about being a physician is that it's a privilege to take care of people. I mean, it's not a right, it's a privilege. And if you don't take it that way, and if you don't explain things the proper way, and if you don't treat them as an equal, then you're kind of being condescending. They're not going to trust you or believe you.

I've seen Studies, just recent surveys showing that public trust in the medical system and in doctors, doctors has gone from something like 80% to 30%. It's dropped precipitously in the last five years. What do you think is driving that?

Well, you know, this whole pandemic, right? And it's been a very tough. It's been a very tough process, I guess, because just inherently. Right, you know, and I'm not, again, not being political or being, you know, incorrect. And by saying this, but you get multitude of information points, some correct and some incorrect. Okay. And depends on how you take it. Right. And your doctor tells you one thing and then you kind of figure out, hey, this. This guy or gal that's telling you this, you know, you're seeing physically the opposite of what's happening. And, and like I said, people aren't stupid. So they're going to be like, well, maybe the guy I'm listening to is the wrong guy or the wrong gal, you know, and that is dangerous. I think one of the biggest challenges that's happened is that especially during this pandemic, we were told what to do because initially I think people were scared out of their minds. They didn't know what to say. And then they said instead of having a conversation about it, it was just like, you got to do it this way.

Some bullying.

Right. Frankly. And that is not the way to. Even if you're right, one of the biggest things about consensus, right. I know people are like, oh, facts are facts. That is incorrect. You have to be able to talk to someone. Like I said, it's a privilege to take care of someone. So if you can't convince, if I have a bit of information that's going to save you, it's my duty to do it in a way to communicate it with you and not yell at you about it. And that is the biggest challenge. I don't know how to describe AI can't do that part. Like you said, you can find whatever you want in AI, but you need to have someone that you can actually trust. And that's a big deal.

I've studied, you know, what do you do when trust is violated? When you're looking at studying relationships, it's a thing that happens. And the normal, healthy, human, tribal thing is you apologize and make it right. Right. And because of insurance and politics and things that are not science, it's hard even for doctors who maybe made a mistake or maybe were forced to do things to just say, you know what? Like, we thought we knew what we were doing and we were wrong, and we're sorry about that. And if we could just have those healthy, normal, human conversations, I think there'd be more trust in medicine than there is today. Because it's a scary place to be if you're someone who's sick and saying, well, I was going to go to the doctor, but now I'm pissed off at my doctor because, you know, I just don't trust him anymore. You're helpless at that point. What do we do about that?

Well, it's interesting that you say that. One thing that I find fascinating is a power of saying, I don't know.

Oh, my gosh, isn't that amazing?

Yeah, because, you know, like I said, I'm a professor. I teach anatomy, I lecture, I, you know, write textbooks. But my biggest, my most powerful words, I think I can say, which is actually true, when somebody asked me a question, I have no idea what they're asking me. I'm like, dude, I just don't know. I wish I could tell you, you know, I wish I could tell you. I just don't know. And then say, you know, let's go back to smoking analogy, right? Am I going to get cancer if I keep smoking? You know what? Statistically, probably, yes, if you keep doing for the next 30 years. But, you know, the stuff that you're taking inside of you, like, you know, the nicotine isn't terrible for you. In fact, it's somewhat protective against certain amounts of Alzheimer's disease.

You're saying this too.

This is great. So what's fascinating is that you can't be arrogant about things you have to say, okay, you know what? That part that nicotine actually gets you addicted to it, and you're taking a piece of paper, lighting it, and you're doing it this way, so you're addicted. That's bad. Yeah, that's bad, Right? So you're addicted to this. Okay. And this particular, you know, it's an oral fixation. You know, you also get used to doing something and habitual. Habitual people. But you're taking in something that possibly could be beneficial to you. Perhaps you cut out the other part and let's talk about it intellectually, okay? And, you know, like. And there's no. There's no debate about smoking. It's bad for you. However, when you don't know something, it's better to just be honest with someone. Say, I have no idea. I'm sorry, I have no idea. But through my experience, this is what I think we should do, because I've done this Before. But not to say, hey, I'm right, you're wrong, you're an idiot. Next.

Yeah, like, let's take your license because I disagree with you. That is such weird, toxic McCarthyist behavior. And on the the case of nicotine, I first heard about this and I have a very detailed book on regenerating the brain because mine was trashed by toxic mold. So wrote this book called Headstrong. And the data on microdose pharmaceutical nicotine is pretty compelling. So I interviewed the guy from Vanderbilt University who did the first study in 1986 showing that low dose pharmaceutical nicotine, but not smoking, reversed or prevented Alzheimer's disease. And it wasn't just one paper. You send dozens of them, right?

Yeah.

And so, but every time I say that, 90% of people go, dave Asprey said you should smoke. I'm like, did you not hear the words? How do you handle patients when you tell them something, but they hear something else?

So, you know, the, what I don't do though, is, is that when I talk to people, it's more like, you know, like the way we're speaking now. See, one of the problems right now with medicine in general, and it's not, you know, it's not like doctors are bad or evil. You know, we have a limited amount of time, okay? And it's a very corporate world. You're seeing like 50 people in your waiting room. You're getting paid 25 bucks a buck to see them. Your overhead is this. You're just like, you're getting killed. It's not, it's not easy to be a doctor. So it's not the doctor's fault. So you're getting stressed out and you have to keep your numbers up and you don't have time right before you would sit and you could see, you know, back. I remember being younger, your doctor actually knew who you were. They knew your name. You weren't. You didn't see somebody different. Every time you went to see the doctor, for the most part, you weren't a client. You weren't, you know, you were, you know, you were Dave, you know, they knew you. How you doing? How's your mom? You know, like, like, like things that, that actually mattered to you and they knew that you did. You know, there's a great, great scene in this movie. It's. And again, I'm a big Michael J. Fox fan and I saw this movie, Doc Hollywood. I don't know if you remember that.

I remember Doc Hollywood.

Yeah. And you, do you remember? I mean, this is A, you know, a weird scene where he's driving through and he breaks down in this little town and he sees a young boy whose cyanotic was blue and he wants to operate in his heart, you know, and the other doctor gives the kid a bottle of Coke and the kid's fine because he had chewed some chalk or something like that. You know, Dr. Ho said you should give the boy a Coke. What?

He said he's probably got a belly.

Aching, that you should give him a Coke. That'll be 65 cents. So the idea of, and it sounds like a hokey story, but that art of medicine is lost in, in, in, in, in, in what people are doing, you know, and, and, and being a doctor, like I said, it's a privilege. Listening is so important and kind of figuring out where that person's coming from, what their needs are. We just, you know, unfortunately people just don't have, seem to have the time for this anymore. You know, I don't know if there's just, you know, it's funny we talked about a negative population decline, but it seems like we have less time. Even though there, you know, seems to be a lot of healthcare providers.

Well, you're a doctor and you have some high profile patients and you know, you're running an AI imaging company. Rad Sherpa. And you do a lot of stuff. How do you manage your time?

Very poorly. Yeah, it's my wife and my kids. I'm like up early, I'm running around. I have four boys and my oldest is in college, so I'm driving around most of the day. The, you know what I do is that my favorite, it's fascinating. My favorite parts of my day are taking my kids. They're always late to school. I hope my kids aren't listening to this, but we're driving them to school, three of them, getting them in the car, driving them, barely making it if on time and then going there to pick them up a little bit late and kind of doing that type of thing. I cherish those moments. And being a dad, being a husband is like one of my greatest joys. More than, you know, being a physician or doing anything else. I, I enjoy just being around my kids and my wife and, and it's a lot of fun and I just enjoy myself. And then work is not, I'm not stressed out. I mean it's, you know, I talk to people, but I talk to them. I, I have conversations with them and, and they have conversations back with me. And when they're, when it's important I make time for them, and they make time for me, and they respect my time. So I'd love, and I'm honored to have that kind of relationship where I can actually talk to people. I wanted to get back to the point about epigenetics for a second. Okay. This is a very, very important point. So what we did in this textbook, right? Or I don't want to call it a textbook. This book is not written for just doctors. Right. It's written like I gave it to one of my twins. He just turned 15 two days ago, to read. You know, right? Now when I teach students or residents or whatever, I can't keep anyone's attention for more than 15 minutes. Okay? So I know we're going to be on the air for, you know, perhaps over an hour, but hopefully we're captivating their attention because the average person can't get a complex concept for more than 15 minutes now.

Wow.

And when you're teaching medical students in residence, you know, anatomy or physiology are important things. I can't do a TikTok dance, right? I mean, I have to keep their attention, and I have to sort of everyone's protection, right? No, but the good thing now is that they can pause, you know, because every many things are, you know, recorded. They can pause me. They can do their own TikTok dance and watch, you know, watch my dance, I guess, at the end, and, you know, keep going. But I think we were able to successfully parse that information to the general pop public is what is my goal, because what I wanted to do was to say, hey, you know, we're talking about epigenetics, right? Why exercise? Why diet? How does. How do these things, you know, how does senescent cells work? All the different things that you need to know of why you're doing what. Okay, why, you know, why do. Why do we, you know, listen to Dave Aspen. Why do we do everything he says? Why? And those whys are questions. Is it. Does it just work for everyone? And we try to give a scientific reason, an intelligent reason. This is what we're trying to accomplish. And I think epigenetics is a big, big piece of that.

It's a huge piece of it. And in the field of epidemiology, we're saying, well, let's look at a million people and what they do and what we think they do. And let's say, well, everyone should do what they do because they got this result. Even though we don't have causation or any science there. I find that that's a little bit scary. And with epigenetics, it gets even more scary. So the, the biohacking approach is, well, let's look at epigenetics, let's hypothesize what's probably gonna work for you, and let's measure some results. And if it doesn't work, you just stop and you do something else. My mistake when I was younger was I just was so sure that I knew what was going to work if I could just do more of it. And you know, going to the gym 90 minutes a day, six days a week, and the low fat, low calorie eating all the time and all that stuff, it made me worse until I kind of couldn't go anymore. And if I had known, here's how to do lab work, here's how to track my recovery, I would have seen in a month, oh, I'm on the wrong track. And for most people listening, if you want to get a medical lab test, you have to go to the doctor. Hope the doctor knows the test you want to get and will say yes. And there's a lot of doctors will say you don't need it, you too young. It's like that wasn't my question. In fact, why am I even asking for this? I should be able to just order it at home and I want to come in when I have a problem and I know my numbers are off and I want help with them. And do you see a shift in like the, the permission slid culture around lab testing?

I do. And you know, one of the projects I had started, pure mammography was, was which. And I no longer own, was to able to democratize that. You, you know, it was in retail centers and I'm working on an interesting project as well now in the medical retail space where the idea is that just think about, just. We'll talk about imaging and laboratory for a second. Okay, you just nailed it on the head. Most people are working, they're doing their thing and they have to go to see their doctor during the hours of 8 to 3, Monday, Tuesday, Wednesday, and they're off on Thursday and Friday, whatever. Some random schedule. To me, if you want good health, it should be available when the person that needs that health is available. So to me, laboratory and imaging should be open and accessible when people are off of work. So if you want an mri, and it sounds like such a simple concept, but it should be open at 11:30 at night because maybe you have to work all day long and you have to pay for that MRI or whatever. I mean, God forbid. Right. Or why should you be economically punished for healthcare? Same thing with labs. You're absolutely right. Right. I mean, if you're. See, now, here's. This is a sticky situation because if you're getting labs covered through insurance, then I can understand the insurance company. You know, it's a different way of thinking. But if you're willing to pay for your labs, then the doctor should be able. You should be able to get information about your own body and analyze it how you want to be able to do it. So you shouldn't have to go to a gatekeeper who keeps saying no to you.

Yeah, it's one of the projects I've been working on, part of Upgrade Labs, which is the. The franchise around AI and longevity that we've gotten up 32 locations in the process of opening. There's Axo Health, which is our platform. You can order the basic lab panels and someone comes to your house even in the evening and draws blood. At least in most states, depending on. And that's like a small way to say, at least you've got the numbers. And then, you know, you need to schedule an appointment because your numbers are out of the range. Right. And, you know, we'll tell you, well, here's the supplements that might move it in range. You can do it yourself. And I feel like we're at this interesting place where, you know, 40 years ago, you got a link, a leak in your sink, you call a plumber, and they come over and it was affordable and they'd fix it. And now most people say, well, just go to YouTube and then I'll go to Home Depot and I'll just fix it because that's so much more affordable. And the whole DIY movement's happening. Well, DIY for your longevity, which may highlight a medical problem that you would then enter the medical system for. It feels like we're right at the cusp of that. And that's why I was asking earlier about the relationship with patients, because you want a trusted doctor to work with on that stuff. You just don't want to schedule an appointment if nothing's wrong.

Right, Right.

Do you think insurance companies are going to stay the same?

Well, you know, there's such a financial incentive for you to be able to, you know, the answer to that question. Let me go back to what I. What I said before. I don't know. I don't know. But I'll say this. What I think is going to happen is, is that I think it's going to be incredibly problematic when these lab tests and these things are going to, as a function of time, they're going to get less and less expensive and less expensive and less expensive. For example, right now like an MRI machine costs 1 1/2 million bucks if you go to a cash paying place. Most of the US, if you go to a non hospital place MRI facility, you pay about $350. That's it. Not thousands of dollars for MRIs anymore. Okay. So the price of these things have come down significantly. So if you went to a hospital and it's owned by the hospital, they charge like two or three grand. But for like, you know, just if you just want knee MRI, it's like 350 bucks.

Look at an E or something.

Yeah, like, you know, whatever. So, so there's been democratization of laboratory that's happening the same way. The cost of these things are starting to come down significantly and the lab equipment, the, the, the diagnostic equipment is coming down significantly both in price and availability. Now you still can't buy an MRI machine for your own house, but now the wearables, you know, you're getting some of that information, you know, in a different way, right?

Yeah, it, it feels like it's going to keep coming down. There's some cutting edge stuff that it feels like we don't understand. Like around joint misalignment. What are some of the imaging technologies that are really good at telling someone, here's what's going on.

So interestingly enough, in terms of actually analyzing joints, which is what I have done most of my career, you know, you can do an anatomic, there's, there's different ways to look at it. Right? At least from an imaging point of view, you have three major characteristics. You can look at the anatomy of it incredibly with high detail. With a three test mri, you can look at every ligament, every, everything, you know, looking at it real time. The good thing about that is it gives you incredible anatomic detail. But I tell people all the time like, you know, and this is going back to, you know, we were talking about with insurance companies and doctors. So when you look at a knee mri, it's like looking at a car in a parking lot. Okay. If somebody comes with knee pain and you have a code to its normal mri, right? Looks perfectly normal. Like anatomically, it, it doesn't, you know what we, I mean this is a classic thing, you know, physicians and I'm, and I'm guilty of this myself. So I'm not, you know, acting like I'm different From anyone else. Oh. You know, our gut feeling is, is, oh, that guy's nuts. He's just, he's complaining for no reason. Yeah. So there's a functional part of it, right? I mean, the functional part is, is that maybe the patella, when they bend the knee, I'm looking at a static image. So it's like looking at a car in the parking lot. Right. You can look at the car, you can see that has four wheels. You know, it's parked in the parking lot. It's probably going to run, but we don't know if there's new gas in the car. We don't know if something's wrong. There's a spark plug. We can't see the functional aspect of it. We're looking at an anatomic aspect of it, and we're making an incredible leap towards something functional. And currently, for the most part, I mean, you could do weight bearing X rays, you could do musculoskeletal ultrasound, which shows you. I wrote a whole book on that, on dynamic ways of looking at the, of the knee joint. But most people, because we just don't, you know, like the art of the physical exam, when the doctor, Remember doctors used to touch you. You know, they used to, they used to feel your knees or they would, you know, they would move, you know.

If it's creaky and move things.

That's correct. They would actually spend time with you. Right. Like that physical exam. You know, there are textbooks and books written on this stuff right now. It's completely gone now practically. Because, you know, when I, when I first started training, you know, even though I'm a radiologist, I don't really examine patients that much. It was such an art, the old doctors, that I would, I would be like, wow, they figured out so much just by talking to the patient, putting the ear up against the chest or, you know, just using the stethoscope that just.

And the old tapping to like, figure out the sound of tissues is a lost partner.

When's the last time you saw anyone do that? Yeah, it's very, very, you know, they're like, okay, get a CAT scan of your chest, get a, get an MRI for your knee and see you later.

Wow.

You know, and that's what's happened and that's why people are losing faith. Not the doctor's fault, because it's made, the system is made to do that. The corporate system is made to do that.

I've seen some, some stuff in your book about weight bearing CT scans versus laying down and what is that doing for pro athletes and others who have just chronic pain?

So again, functional imaging, right? So the idea of actually, you know, when you're getting imaging done with, with the actual weight standing up, you can see the, the imaging that's being done on, on patients in, in a way that, that, that their joint mobility works or doesn't work. Again, you have to listen to the patient. Right? Because if, like I said, if you just look at a stagnant picture one way and the patient still has pain, the fault doesn't lie with the patient, it lies with you. Because you have found the problem. Nobody, in my opinion, for the most part, people are working. You know, I usually like when somebody's in the waiting room and then they're coming to me to do an ultrasound and check out their knee. If they took time off from work, paid the copay, or waiting for me to talk to them and scan their knee, there's something wrong. And if I say it's normal, it may be normal anatomically means I'm missing.

Something because the patient still isn't. Just like it hurts.

That's right. We haven't figured out the problem.

You know, up until my late 20s, it actually felt like there was a candle burning between my shoulder blades. Like really strong pain all the time. And then, you know, the arthritis, the knee surgeries, I just thought it was supposed to hurt when you walked because it always hurt. My entire life I played soccer. I did all the things, just what you do. Cuz I had misalignment. I was duck footed as a kid. I was eating foods that caused joint inflammation. For me, I lived in toxic mold. Like I did everything wrong. So being able to heal joints is a big deal for me. And there's sort of three technologies that are available and you've worked with all of them. So I want you to give me the short version. We got prp, we got exosomes, and we've got stem cells. How do you know when to use which one?

Okay, an excellent question. So I actually one of my colleagues who's an excellent physician at the Hospital for Special Surgery In New York, Dr. Vijay Vog, he's an expert on, you know, doing these type of procedures. And you know, just as I am, we inject a lot of these patients. PRP is just like taking your blood, spinning it down. It's like, you know, actually there's four options. There's the option, which I'm not a fan of, which is just taking steroids, injecting in it, which kind of weakens your, you know, that's, that's what conventional medicine does. If you have insurance, you're not getting prp, exosomes or stem cells. You're just getting, you know, steroids. It's going to make you feel better immediately, but. But it's going to weaken your muscle. It's going to damage your joint and all those other things.

You're getting a bonus too, though. You get to spend 12 hours on the phone with the insurance company for them to tell you they're not going to pay for that either.

That's right. Exactly right. Absolutely right. And it's the worst thing for you. It makes you fatter. Yeah. It deconditions your muscle around you and it really doesn't do that much for you. Okay, now, platelet rich plasma. If you Google, if you, if you're on Wikipedia, you'll see my picture from, you know, from a couple of decades ago. I was doing this, you know, one of the first people, just not the first, but one of many, but one of the first people to do it clinically. And the whole book was about classification and how to do it, taught it. PRP is a quick, inexpensive way to treat, you know, they're like grades. Right. I mean, it's really an economic question. I think so. It is, yeah. I'm glad you said that because what happens is, is that PRP should be inexpensive.

It's about a thousand bucks at the average provider.

Yeah. Between 500 to 1,000 bucks. Right. Exosomes is about 2,000 bucks. Now the interesting thing about exosomes are, you know, depending on what part of the country, depending on the jurisdiction, Some of them it's not allowed. You know, like there's a whole gray zone about them.

It's really like someone out there thinks they can tell me what I get to put in my body. It's the weirdest thing.

Well, yeah, well, it's the fda and that's the way it works. What's fascinating is, is that in certain jurisdictions, like in Antigua and other places around the world where they have these, you know, laws where you can actually have a stem cell injection, where, you know, where you can have, you know, the laws allow you to have it. So, so two things. One is jurisdictionally speaking, in the United States, PRP is allowed. It's legal. It's quote, it's legal. Most of your doctors are doing it. It's a first line of therapy in the regenerative space. But in order to do it, your body has to be well. So these are the Contraindications for people, for prp, in my opinion. One is that if you're, if you're older, your platelets aren't going to be as good as when you were younger. Okay. The second is, is that if you're in chronic therapy, let's say you have cardiac disease and you're on certain types of medications that make your platelets weaker, probably not the best thing for you. And if you have severe arthritis, it really isn't going to do that much for you, in my opinion.

Okay.

So. But it still works. It's a go to, and it's, it's legal in the US the second step up is the exosomes. So there are people that debate about whether exosomes really, you know, the term exosome is an interesting term. I've been doing cell molecular biology for the last decade, you know, growing stem cells and the milieu. So stem cell. So exosomes are the, you know, I have a funny New York City term for this. They're the hot dog water of the stem cell word.

I always call it stem cell poop, but hot dog water is even better.

Yeah. Because what it is is that the food is a hot dog. You boil the hot dog. You know, at least used to be when you go to New York, you'd have a lot of hot dog crunch. If you look at that water, it's a little dirty, it's a little grimy. But that water is fascinating because, you know, and the exosomes, like saying, you know, exosomes generically is a tough, tough thing to say because what ends up happening is that exosomes, it's like saying, you know, like food. The word food, right. It's like, it's. Donut is a food and so is broccoli. Okay. So the exosomes are really dependent on what type of stem cells are being grown.

Okay.

So this is fascinating. And this is, you know, come back to, you know, I'll talk about red light therapy, talk about sound. If you're growing stem cells, the exosomes are the growth factors that they release.

Right.

So fascinatingly enough, if you add a certain sound, you know, like being from Eastern culture, certain sounds like, oh, you know, certain megahertz of sound or frequencies of sound, I should say frequencies, they actually cause the stem cells to increase, to release different things.

Yeah. Even ultrasound will do it. And for listeners, there's a reason you hum. There's a reason that music can be healing. And now we have cell biology and stem cells changing in response to music.

Well, no, it's fascinating. So I'm not a guy that would ever believe this. Like I'm the guy, you know, I'm not the guy that would be like, you know, oh, that's not me. Okay. And I'm not the guy into light therapy or sound or meditation. But when I physically saw this from a biologic point of view, if you add red light to stem cells, they produce different things. Vitamin C, they produce different things. You add different things to the milieu of that hot dog water, you're making a different soup. So it's very important. So if you're putting in a crappy hot dog in the first place, it's going to give off bad hot dog juice. Right. If it's processed, it's not good. So the stem cells matter and the stuff that's in it matters. So it's a big, big deal.

Wow. Okay, so we've got prp, cheap and reasonably effective. And I think PRP is best for tendons and ligaments, right?

That's correct. Exactly.

Okay.

The, the, the, the, the insertion of the bone into, into a muscle and you know, the attachment, which are the tendons that, that's, it's ideal for tendons and then steps, ligaments next and then also into the joint space to bring down inflammation.

Okay, and what are exosomes best for?

So I just bespoke, I said to bring down inflammation. So they cause the opposite thing. The PRP actually causes inflammation. Okay. Exosomes are the greatest anti inflammatory I've ever seen. Okay. So what, what they do is, is both and they're used for everything from aesthetics to joint. Like for example, if you have a patient with really bad synovitis or which is just a fancy word for inflammation of your knee joint because of rheumatoid arthritis or some type of, you know, disorder. If you put exosomes in that, in that, and if you do the proper type, your inflammation reduces back. I've never seen reduction of inflammation as quick as I have seen with exosomes and the exosomes. But the key is you have to use the right axis homes. The exosomes that are, that are, you know, from the right type of stem cell. The exosomes that don't have any. So what happens is just. We're getting back to the hot dog water thing, right? If you're using pure water, it's just water. But what people are doing is, is that they're using like bovine growth serum or like, you know, they're using xeno, you know, like they're using. If you get stem cells and you feel like shivery or shaky or if you get some of these things, one of the things where they have to add steroid to what you're doing sometimes that's because they're using animal products.

Oh, you don't want animal stem cells. No, no, no, those aren't animal stem cells. They're just animal products that were in the medium that grow.

That's correct. So I'm not saying that's true. For every single one, there's something called phenolphthalin, which is, you know, remember, you know, when you're in high school chemistry class, it's xlx. Yeah, exactly. Well, you drop it, it turns blue or pink, depending on whether it's an acid or base. And it's an inexpensive way for many of these labs to see if something's infected because if it goes from pink to blue, then it's infected. That's like the, that's the poor man's way of looking at it. But if you're more advanced, you're using, you know, a flow cytometer and using genetic analysis for infection, you don't need any of that stuff and you have more pure product. So if you use that type of stuff, which is kind of, you know, what, what we've been using clinically, primarily outside the United States, primarily in Antigua, if you're, if you're injecting that type of stuff, the inflammation and that stuff is so much better than anything I've ever seen. And, and you know this, the sad thing is, is most, most clinicians or physicians don't even know what this stuff is. They don't know what, what makes it.

Out, what exosomes are.

That's, they just don't know.

And, and they also, there's a lot of different companies, some do really well and some don't. And I feel like the US is maybe the worst place to get exosomes because there's a lot of gray zone stuff around it too. And when I've been able to go to other countries where physicians have more freedom, the quality of exosomes seems higher. And, and there are, to be clear, there are some friends who have very good stem cells in the U.S. sorry, very good exosomes in the U.S. but if you're just going to a random clinic and they're like, oh, it's, you know, 350 bucks a month and we'll give you some stem cells, like, those are not good stem cells. And if they're Exomes. Those are not good exosomes because it costs more than that to make good ones.

That's absolutely right. So if you're playing in the gray zone, Right. You don't know what you're getting. You know what's fascinating is, is that when you start analyzing what's actually in there. I took a deliberate. You know what's interesting about the United States with cell and molecular biology is, is that for. To analyze placentas and things like that in the US you can't discriminate, which, which sounds like an amazing thing, but it's actually counterintuitive. So American made products. You know, people say, I want American made stem cells in the US If I get a placenta from anyone, you know, whatever socioeconomic group, whatever part of the country, I have to use it, I can't discard it. It's. It's sort of like, you know, so, so look, it's. Yeah, it's, it's biologic material. So when you go outside the US if you think about it, you can choose to do, you can do more screening.

What, like, so you can't just pay for the thing and throw it away. You have to just use it.

No, no. So, so what happens is, is that like, you can't say, I want. Again, I'm not trying to be politically incorrect, but you can't say, I want this type of, you know, like, let's.

Say, like healthy and young.

Yeah. Yes. You can't, you can't, you can't arbitrarily choose.

Wow.

And you can't say, you know, it's just, I mean, if you think about it, sort of discriminatory because. But, but healthcare is discriminatory. So if you go outside the US you can get, in my opinion, again, this is my opinion, you can get much, much better stem cells than you could ever get in the United States because there's a huge amount of ab. You know, like, like there's like three or four companies that sell placentas and they just mix them up. You know, you don't know what you're getting.

I, I am really uncomfortable with placental cells in the US I have done them outside the US I won't do them in the US I've seen too many bad effects from it.

Yeah, yeah. And I agree with you. And I don't think it's loud, except it's not really loud. So the people that are doing it are kind of, you know, they're in that gray zone. And when you're in the gray zone. Sometimes you cut corners. Yeah.

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I have done my own stem cells in the U.S. but now I I leave the U.S. i've done a few podcasts like with Vince. Gym podcast.

Yes.

Yeah. About my experiences down there and I having done Every joint in my body with my own stem cells in the U.S. it was like a truck hitting me. It was one of the most miserable things ever in Utah. And it did work, but it was rough, and I have a high pain tolerance. And when I use properly created stem cells, I don't have nearly the same reaction.

Yeah, absolutely. I'll tell you something else, which is interesting. You know, parabiosis, which I think Dr. Jean Papa was talking about when he was on your podcast, which is a fascinating concept of you're using, you know, a. Using, you know, young, you know, plasma transfer. So what I've been doing, you know, the research and the work I've been doing is that we've been taking some progenitor cells, like from, you know, from your fat, and mixing it with exosomes to see if there's any changes. And, you know, the Yamanaka factors are four of them, and you can actually change the age of that stem cell. Now, the problem is, is that if I took your fat cells or your bone marrow cells, you can get just a small amount of cells. Right, right. It's in the tens of thousands and thousands. Right. Like, there are companies out there that are not promoting bone marrow cells, which I think, you know, especially if it's not from you and from someplace else, it's a. It's a huge mistake.

I have 2 billion of my own marrow cells banked so that I can do those procedures.

Now, see, that's great because they're your cells. If you take somebody else's marrow cells. Not a great idea.

That's insane.

Yeah.

And, yeah, there's. There's a lot you can do when you leave the U.S. yeah, absolutely. Down to Antigua when you need to do advanced procedures.

Yeah, yeah, yeah. So we do a lot of stuff in Antigua.

And just for listeners. And who knows, maybe you're a regulator. Listening guys, you're destroying the US Medical system and economy by not allowing these things to work. We go to Abu Dhabi, we go to Thailand, we go to Antigua, we go to Costa Rica, we go to Cabo San Lucas, and the US Gets no money from that. It's the dumbest thing I ever heard of. Like, get out of the way and, you know, let patients sign a waiver and let doctors do their thing. I'm getting kind of pissed about that.

It's fascinating because I help with some legislation for some other places with that, with being intentionally vague. What happens is, is that, you know, I think in one of your podcasts, I forgot which one you were talking about. You know, the freedom to try and healthcare, et cetera. And I think it is so important, you know, these, these smaller, you know, let's be honest, right? People aren't going to these countries for the incredible medical infrastructure. Some of the best doctors are here in the U.S. yeah. So we've taken and created a system where we're out. We're taking intelligent doctors from major institutions and forcing them to go overseas to do procedures not because they're greedy, not because they're, they're evil, but because they're not allowed to, quote, do some of these things. We should be able to do clinical trials in the US without, I mean, it's a huge amount of cost of doing some of these clinical trials. Right. They say, okay, there's not great data on, you know, in stem cells or exosomes or prp. People will say all those things now. When I first started doing PRP, there wasn't great data on it. And that was 20 something years ago and people were saying detracting. And now there are, there is great data on it.

It's weird how there's never great data on new things by definition.

Right, of course. And then, then we should be able as long, you know, primum, non necessary. First thing they teach you in medical.

Schools is first do no harm unless you're thalidomide.

But, but, but, but you know, the gestalt of what we're saying is, is that, you know, we need to put together a medical infrastructure that doesn't make physicians criminals.

There you go.

Right. And, and to. You should be able to control what you want to do, especially God forbid you're really, really sick. Right. Why should you have to go to Latin America for a medical procedure? It makes no sense.

Not at all.

You know, you should be able to say, listen, this person's dying, you know, and, and, and you know, let's, let's, let's do this. Okay? I don't want to. The hospital doesn't want to get sued. This doesn't happen. You know, like suing is not. If somebody's on their last legs, I mean, you know, are they willing to try anything? And as long as a person is not taking advantage of them by charging some ridiculous amount of money, let them try.

Yeah, I, if at some point in my journey to live to past 180, I want to try something and I'm near death and they just won't let me try it, I'm going to invite the regulator in to have a conversation with me while I'm wearing An explosive vest, because that way I'm going to do a solid for the world. Is that a good strategy? Okay, I'm not really going to do that.

I'm not going to test that one.

But seriously, it's not the doctors, it's not the care providers, it's the people who sit there and say, I'm gonna decide from my fucking ivory tower with my, you know, big mallet that you're not allowed to control your own biology. And I'm, I'm getting really tired of that because it's a, it's a sacred right that is part of being alive. And like, I didn't sell it to my government. It's not in the constitution. And these clowns just don't have a right to. And I trust physicians, I trust science, and I even will listen to recommendations from the government. I also know that they're wrong a lot. So like all of those are good information sources. But who, who's going to block it? Like, you have to be mean spirited. If you got someone who's, who's dying and desperate, you could take advantage of them.

Right?

But if you're so afraid of that that you just create suffering, then that's not okay either.

No, I agree. The thing is, is that if you actually allowed it to happen, then people, and people have choices where they can go. The cost would dramatically decrease and nobody would be taking advantage of. Right. And you know, I, I have to blame, you know, and this is including my cohort, you know, physicians for some of these problems. What we don't do is we don't pay attention when these laws, and these laws aren't just random laws, they're passed. And, you know, it's easy to ignore things. You know, you can, you can use the. And we are busy and we're distracted, but it's time to try to, you know, you know, go through this. Like it's not enough versus them. We can actually try to change some of these things. And if enough people got together and actually actively lobbied for it, you know, the problem is, is that, you know, many people in the medical field are frenemies, right? They don't want to see someone else succeed and not, not. And again, I'm not being mean spirited by saying that, it's just a fact. You know, so if, if your colleague wants to try something and he, he or she thinks that's amazing, you know, why not? You know, why not?

Yeah. You also have the physicians trade union involved, the American Medical association that may have some partnerships with the Pharmaceutical industry. You know, I've, I've heard as much. Right. And sometimes I would say people are not healers, but who are administrators in medicine will do things like what we see is prescription glasses. Where in most of the world, if you need a prescription, you're going to get glasses. And they're cheap. But here, because you might have an eye problem, to force you to get an eye exam in the US you have to have a prescription for your glasses. And it's just creating a lot of work for optometrists.

Right.

And it's great if you're an optometrist because you have guaranteed income so people can buy glasses. But it's terrible for glasses, stuff like that. Like, there's all systemic fixes. And my hope is at some point soon that we actually just ask AI and has enough data to say, what's a streamlined system? Like, let's just re. Envision what the future looks like where what matters is, have we reduced suffering and have we extended health and extended life in humans? And how do we do it so that everyone gets paid what they need to get paid so that they have a healthy living? I think we can do it. Do you think that's possible?

Absolutely. You know, it's interesting. I took my son to El Salvador this summer for a mission trip. You know, we went on a. And my son, he's only 17, and we were doing this eyeglass thing, you know, and it was fascinating because, you know, there's nothing. There are people just waiting for glasses. Right. And I forgot the name of this machine, but it was just a plastic pair of goggles. And you just kind of twist it and it gives you the. Gives you your right prescription. Took, you know, a short amount of time for cool. And you. And you popped in the lenses. There are people waiting in line to get glasses. And you would think, you know, we're hanging, you know, we're doing some incredible. We're giving away, like, this is free. And this was just him, you know, it was done out of love. There's no charge. It was just, you know, charity.

Yeah.

It was a gift. And you know, that part of medicine, the idea of just giving, right. Not for any secondary gain. You talk about joy, you talk about the portion of the epigenetics, the epigenetics of joy. That is an incredible feeling, right? People couldn't see, now they can. They're happy. And it was free.

Wow.

I mean, that brought joy, you know, and I wish we had more of that here. And there's an incredible amount of need here in the US and you know, and there are people that are obviously helping and doing, doing the things. But I wish we can do it more freely without being kind of legislated out of being able to do it.

And I'm actually really hopeful that we'll move in that direction, partly just because systems collapse under their own weight. And the insurance industry and the whole medical system in the US Everybody knows at this point, so people are opting out and they're saying, I'm just going to do the DIY thing.

Right? Yeah, no, that's, that's, that's what's happening. And, and, you know, and, and if we're not relevant. Right. So the problem is, is that, you know, belong to some great academic institutions. We risk, as physicians, we risk the, the danger of becoming irrelevant because what will happen and it is happening now. So, like, I'll just give you a little blurb about the company that I'm, you know, rad. Sharp up. Yeah, yeah. So you have, you have, you can go online and it's, you can, you can pop in an X ray and it'll start, you know, reading it. What's happening now is, is that it's not going to happen. You know, AI is not going to. The revolution is not. The user base isn't going to happen primarily in the US because there's a huge FDA regulation. It's going to happen outside the US because let's say you're in, you know, in Bangladesh or India or Thailand or Nigeria, wherever, and you don't have access to muscle cell radiologist like myself. And now you can just pop in the thing and you can get the result immediately. It has a real benefit. It's low cost or almost free, if not free right now. And it gives you an accurate information to a knowledge base that you would never have before. And I'll tell you something else which is fascinating about AI. You know, we used to have, you know, historically, we used to have these city states and especially, you know, after the fall of the Roman Empire. And we're going to see, you know, if you go to small little countries, right, they're very unified. They're, they do everything together, but they lack a knowledge base to be able to do things like, for example, if you want to build a big bridge in a Caribbean country, you may not have the best civil engineer in the world. Okay, so what now with what AI does is it gives you the ability to give you technical information and you can control it yourself with your own, you know, you're going to see smaller places punch way above their weight.

Oh, for sure.

In everything. In everything militarily, from civil engineering. In fact, AI is a issue of national security for the United States. And, you know, and I'm hoping, you know, as an American, that we, we, we. We take, we treat it more intelligently than the way we're. We're doing. We invest more in it here, and we kind of, you know, go with it.

I, I certainly hope that reshapes the field of medicine so doctors are less bored, they have more time with patients. Patients are better informed. They don't go to the doctor when they don't need to. And I'm, I'm feeling pretty excited about it. But the one area that seems to be the hardest right now is musculoskeletal injuries. I've talked to so many people who have, you know, shoulder injury. I've got a. A subscapular thing over here that's just been a pain in the ass. I've had it injected multiple times, but I think I, I move too quickly or something afterwards. It never quite heals. And I'm not alone in that. A lot of people have done CrossFit and all have similar injuries. And these are the things where, oh, it hurts, but it moves around and there's a knot here and all of that. And you go in and they try all sorts of different things. What kind of imaging works best for musculoskeletal stuff?

So I find that ultrasound, joint ultrasound, just taking a probe, putting it right where it hurts, looking to see where it hurts. And that still can't be done by a computer or an AI, but it kind of, you know, I'm hoping that we evolve into, you know, from the physical exam into the visual physical exam, where you're actually looking to see where the joints are, where the joint capsule inserts. There's calcification. You know, I was one of the first people to start teaching all this stuff, you know, back in the early 2000s, musculoskeletal ultrasound. And I find that, you know, I used to do all these workshops, and many of my students now have become, you know, leaders in the field in this. And that's, that's all, you know, as a teacher, that's all you can hope for. You hope that the people you teach end up being much better than you. And I'm hoping you made a difference with that. Yeah, I'm hoping that people that listen to this podcast and listen to the things we're talking about, you know, Take some inspiration from some of the things we're saying and just really run with it and far supersede anything that, you know, any individual can do. The same way when you look at joints and you look for joint pain and things like that, the ability to palpate, touch and then also see. Which is an incredible amount of, you know, a knowledge that we can glean. And, you know, with joints, it's not so simple as just see, there's two different parts of joints, right? We talk about. What we're used to is injuries. The US because we're surgical world. We talk about injuries, injuries, injuries. Okay. We talk about tears. We talk about that. But there are other diseases, such as rheumatologic diseases which are underdiagnosed, where you have, you know, like an autoimmune disorder which affect your joint space. And those people don't need surgery. And to be able to diagnose that, and those people possibly, you know, need good nutrition or they need hormonal replacement, you know, and those types of things. So it's an interesting. You know, it's a. It's a. It's a eclectic point of view.

It is. And as someone who did have arthritis, I just gotta say, if you're listening to this and your joints hurt all the time, and it's not just one joint. It's either autoimmune or you don't know how to eat, and you're eating a bunch of foods with oxalate. Those are almost certainly the two things. And maybe lectins, which is still autoimmune.

Well, it's interesting you say that. A good friend of mine who's a nutritionist, he's like the best nutritionist I know. His name is David Allen. He's out in California. Oxalate.

Big deal.

Big deal. You know, there's oxalate deposition. You know, there's like different types. There's pseudogout. There's calcium pyrophosphate deposition inside the joint spaces. It's a metabolic problem. Right? And, you know, there. There are people that like. Like David, who are just, you know, incredibly, you know, talented. You know, they're. You know, the good thing about this is that, you know, working on this, on this book, you know, I get to meet people like Chris Asandra, who's a incredible specialist in hormone replacement. All these different types of people. And these are. Are not the only. The good thing is that there are some wonderful people that are, you know, doing these things. And they're not the only ones.

Right.

But they're all kind of working together. And, you know, depending on which part of the country you're in, you can find somebody just as wonderful as the people I just mentioned.

It's entirely possible to find good help on that. But if it's one joint that hurts all the time and you look at imaging, you look at functional movement and ultrasound is a great way to do it. And I actually felt like, strangely validated because I had this thing on my shoulder a long time ago and I was like, ah, just, you know, work it off. And I'm like, I keep trying to, you know, lift, but it's not working. And then, you know, you go in with an ultrasound, you go, oh, look, there's a tear right here. And you can really see it. And that's, that's really cool. I think I have a video of doing that with Dr. Odale Khan. And like, it's like it, it's real, right?

So there's a pair. There it is. And there's a picture's worth a thousand words. And also one of the, the challenges is that when you hurt and you get the MRI or whatever and you, and it comes back normal, it's disheartening to you. And you know, the doctor's like, all right, next, you know, like, all right, he does nothing wrong.

MRI is not going to show the tear.

That's right. Of course not. Because it's a functional, you know, we're talking about. Like I said, look at that car parked in the parking lot. It may not run because it doesn't have gas. You have to be able to move it around. You know, you got to see a drive. You gotta take it for a test drive. And that's a, that's a functional anatomic is just looking at the car. Functional is driving the car.

So the takeaway for listeners is that if you got something going on, you can get an MRI for a lot cheaper now than you could before. And it might show you what's going on and it's useful. And I'm a huge fan of whole body MRIs with AI. But then you might want to get an ultrasound view of it from. What kind of doctor do you go to for that?

Well, I mean, it's your sports medicine doctor who does, you know, and the great thing about this is it's multi multiple specialties. You have the radiologist, you have the physiatrist, you have the anesthesiologist, you have the pain, you know, medicine and rehab, physiatrist, orthopedic surgeon, Family physician who all subspecialize in that particular thing. So you have a whole, you know, panoply of doctors who can do that for.

You gotta find out what it is. And then we talked about what you can do about it. You start with prp, you can go for exosomes and you can go for stem cells, but probably not the random solid blender of stem cells you might get in the U.S. someone else's.

Okay, absolutely.

All right. Dr. Pradeep, Albert, it is really an honor to have you on the show. You've trained so many of the experts in the field, including guys who've worked on me and you really with your new book Regenerative Medicine Focused, you, you're becoming a meaningful voice in the whole longevity movement. It's not just making your cells younger, it's not just making your brain younger, which is a thing I recently did a podcast on. It's going through and being able to regenerate everything and if you can't see it, you can't know what's going on and you can't work on it. This is like the non lab work important part of longevity and biohacking that we don't hear about a lot. But I, I think it's important. I never knew what kind of imaging to do for what I'm like, it hurts. And you just spend a bunch of money at a doctor and oftentimes they don't know. So I've, I think we dispelled some myths here and just appreciate your future looking view.

Thank you so much and it was an honor and a pleasure to be here. The book is called Lifespan Decoded and so for those of you, you know, want to look out for it in Amazon, I'd appreciate it.

Awesome. And guys, it's pretty common to when you're publishing a book to go out there and do a deal with a book publisher. And certainly I do that with my books because I'm looking for like the largest impact I can do and it's a lot of work to do that and it's actually not that profitable. I would make more money pulling shots of danger coffee at a coffee shop on a per minute basis than I would from writing books. Like, like it's a labor of love. Anyway, this is a book that's self published on Amazon by two big name doctors. I promise you they're not doing it to make money. They don't want you to buy the book to make them feel good or to make any money. They put all their time into writing the book, because it's actually stuff that needs. That you need to know, and it's stuff that isn't out there. So why would you waste your time on this?

Yeah, no, I. I'm hoping to God that people get a lot out of this and, you know, so we're just happy to be, you know, here to kind of help, you know, and talk about that and talk about all the other interesting things we talked about. So thank you so much.

You're welcome. All right, final question. As a book nerd. So lifespan decoded. You're putting it out there. Are you going to do an audible version of it?

Absolutely. Yes, we're going to have an audio version.

Are you going to read it yourself?

Yeah, well, you know, we could use AI, but I think Alan and I are going to go back and forth because I think the little nuances of speaking could. Would be useful. But I think that's what we're going to do.

People really appreciate it when an author reads a book, and so I highly recommend that if not, yeah, you can use AI but it does.

It does lose something. Yeah, I think it's going to be like this, where we're going to just have a conversation and. And read the book as a conversation.

Oh, very fun. That'll be cool. And because you own the book, you don't have to do it exactly the way everyone wants. You can do it your way.

That's right. Yeah.

Just like medicine.

That's right.

All right, thanks again.

Thank you so much. Thank you. It's a pleasure to be here.

See you next time on the Human Upgrade Podcast.

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