Follistatin & Klotho Gene Therapy, Stem Cells In Mexico, NK Killer Cells, Advanced Age Reversal Tactics & More With Adeel Khan

My name is Ben Greenfield and on this episode of the Ben Greenfield Life.

Podcast, Tony Robbins and Brian Johnson both have a plethora of doctors on their team who look after them and they've.

Both done follows up.

They've both done it. And yes, yeah. And I think it's still probably going to be another maybe two years before I think other doctors catch on to how powerful this technology is and how safe it is. The reality is our clinical trial is published now. It's a phase one trial. Yes, we don't have phase three data yet because maybe some doctors are waiting for the phase three data. But I always look at it as in medicine there's something called needed to treat versus number needed to harm, NNT versus nnh, which is essentially what's the risk and what's the benefit?

Fitness, nutrition, biohacking, longevity, life optimization, spirituality, and a whole lot more. Welcome to the Ben Greenfield Life Show. Are you ready to hack your life? Let's do this.

Well, folks, I first interviewed the brilliant Dr. Kahn in an episode in which we talked about the difference between getting stem cells internationally versus the usa. We talked about peptides, testosterone, hormones, tissue engineering, DNA editing, truths and myths of regenerative medicine and a whole lot more. I will link to that original show if you go to BenGreenfieldLife.com eternapul BenGreenfieldLife.com Eternapodcast and that's the name of Dr. Kahn's medical clinic by the way, Eterna. And I'm actually here at his Cabo location, or at least near it. We're perched on a rooftop here overlooking the ocean in Cabo. And Dr. Kahn has just been blowing my mind this week since arriving here and even before that at his Unlock Longevity conference, which we flew here to from Austin about all things regenerative medicine. And while I'm here, I'm actually engaged in a lot of these protocols, Follistat and Clotho and NK cells and many of the cool cutting edge things that he does. But since we're both here and even since that original show, he's got a lot more going on, I figured it was high time to get Adeel back on the show and he'll have a chance to give you his background here a little bit. But he's a Canadian board certified physician. He's really carved a very unique path in the field and has cemented his reputation as a regenerative medicine expert. Very forward thinking guy, entrepreneur. What I like about him too, engages in science based bodybuilding, fitness and he walks the walk and talks the talk, which is great. You do know how to talk deal once or twice. I've heard you on shows before, you actually do a great job. So I'm happy to have you on the show. But just kind of a background for folks. What got you into this? And especially, I'm just curious, you do a lot of unique stuff, so I'm curious what took you down the unique path that a lot of others didn't go down.

Actually you touched on it, which was a fitness background. Because it's interesting, when you go into medical school, you're taught pathophysiology and then you're taught how to treat that pathophysiology using medications or surgery. But for me, because I came from the fitness background, I was like, why aren't we talking about exercise or nutrition? Because I've seen that firsthand treat people with diabetes, with high blood pressure, cardiovascular disease. So it was kind of weird to me. And that's when I first I would say got suspicious, I guess. Not that I thought of some sort of conspiracy. I was just kind of like, why aren't we learning about this other stuff that I know can work? And so instead of just studying allopathic medicine, I started studying functional medicine and integrative medicine and alternative medicine. And obviously there's a lot of not so great stuff in those fields too. So you have to be careful and you have to be able to dissect that stuff and figure out what's actually evidence based or gives you additional tools in your toolbox to help people. And that's for me, a lot of it was because I was a sports doctor by original training. When you do sports medicine, it's basically just cortisone physio surgery, right. And that's pretty much. Or anti inflammatories, right?

Yeah. I don't know if I shared this with you, but when I graduated from school and eventually started a string of personal training gyms and studios, my main facility was called Champion Sports Medicine. I was partnered up with a sports medicine document, Dr. PZ Pierce. He was the doctor for Ironman Sports Medicine or for Ironman and for Rock and Roll Marathon. And so I saw a lot of traditional sports medicine and a lot of it. I mean he's a great doctor, but a lot of it was analysis, cortisone injection, string you through this injury, try and buy a little life out of that joint and then maybe eventually down the road refer out to an orthopod for either replacement or debridement or some kind of pretty invasive protocol.

Yeah, no, that's exactly what standard of care was. And it unfortunately still is, for the most part, unless you're going to a physician who's a bit more educated. And for me, it was like there was all these patients, for example, with chronic back pain. I was the first doctor in Canada to do orthobiologics for back pain because we started using PRP and different types of regenerative tools to start treating back pain. Because there's all these patients who are getting better with just cortisone, and a lot of them don't want to do surgery. So it's like, what's their options? They've already tried physiologically, so it's like, is this end of the road for them? Do they just live on pain meds for the rest of their life? And that we know what oxycontin and all these pain meds do for chronic back pain. They lead to all these issues. So that was big. I think that was my biggest motivator to get into this whole field was to just help people who are suffering. And then that led to so much more because it just opened this whole Pandora's box, I guess, of regenerative medicine, which is much more than just interventional pain. It's also cell and gene therapy, tissue engineering. And then now combining those is kind of what we're trying to do.

Do you remember where you were when you first heard about stem cells? At least not like high school biology stem cells, but like, oh, this could work in regenerative medicine.

Yeah, no, I was definitely. I think, like many people, it was probably that podcast with Mel Gibson and Joe Rogan. Cause so many people sent it to me. And that was kind of.

That was like maybe, what, seven years ago?

Yeah, seven years ago, exactly. I remember that one. Yeah, it was 2017 or something. And so I was like, this is so fascinating. But I was very skeptical, obviously, and especially back then, I think we didn't have enough data on intravenous stem cells and, like, knowing how exactly they work. Now we have a lot more understanding of the mechanisms, which we'll probably go into. But that's when I first kind of got more curious about stem cells. And at the time, I was working with Dr. Anthony Galea, who's kind of like the OG of sports medicine, regenerative medicine. He was the first one in the world to do PRP for. He wrote a textbook, he wrote a book. He's written a few books. He treated Tiger Woods.

I think I Have a book by him and it's written like a medical textbook almost.

Yeah, he's really up there when it comes to sports medicine. And so because I was working with him, he was doing autologous stem cells, which we talked about in the first podcast, where he was taking bone marrow or fat from someone's own body. Autologous, exactly. Yeah. And not really expanding them, but still using that for soft tissue injuries and maybe more mild cases of arthritis. But. But that was kind of my first exposure to the word stem cells clinically. But then as I went into it more and more, I realized that's not the. Really, as we talked about in the first podcast, those aren't true stem cells. And then when I learned about what true stem cells are, where you isolate them, you culture, expand them, and then you have a dose, appropriate dosing, then you can really do some really crazy things, not just for pain, but for autoimmunity. And then now, obviously aging as well.

I don't understand what you mean when you say true stem cells and how getting them from the fat or the bone wouldn't be a true stem cell. What's that meaning?

Because that's what we refer to as a committed progenitor cell, or Arnold Kaplan.

It's committed, it's married, it's time to marry. It's going to be.

Exactly, exactly. Because stem cells by definition have the ability to differentiate into many cell lineages and have the ability to self renew. Those are like the two main core components of a stem cell. So if it can't differentiate into multiple. If it's not a pluripotent stem cell, meaning you can differentiate into multiple lineages, then it's not really a true stem cell. And then the other component is the expansion of it. Because if you don't expand them, then they're not really a factory for producing new tissue. They're just kind of signaling molecules. And those signals are still pretty good. Like they still reduce inflammation. They're helpful, but it's just a misnomer that I don't think we can stop now because, you know, all the physicians in the US are still saying I'm offering stem cells, but they're not. They're just offering committed progenitor cells or medicinal signaling cells. Those are the words.

What if you take one of these so called committed progenitor cells, like you're extracting stem cells from someone's adipose tissue or bone marrow and you are expanding them.

Yes. You have to isolate that.

Does that still have the issue with them already? Being committed or if you expand them, do you skirt that issue?

Well, you. Yes, you actually isolate the mesenchymal stromal or stem cell of that fat. So when you, if you just, if I just took your fat and I injected it, it's mixed in with all this other stuff and so you're not really isolating it. So but when you do it that way, when you culture, expand it, then yes, you are isolating the Mexico stem cell. And then that is technically a stem.

Cell injection, but a non expanded fat or bone marrow injection, it's not really going to do much. And expansion, as far as I understand it at this point in terms of legality is something you can't DO in.

The U.S. no, it's still FDA not approved, which means it's technically illegal. It doesn't stop physicians from doing it. But I can, I know there's doctors who listen to your podcast and other practitioners and they gotta be careful because I personally have physician friends who are medical legal experts and they've had physicians lose their licenses because something bad happened with the stem cell product, like an infection and then they have nothing to back, they have nothing to fall back on because they shouldn't be doing this in the first place. So of course they're going to. Then they lose their license.

I want to talk more about what kind of stem cells would be best to skirt some of these issues. But because I'm so often asked about this, I got to run it by you. What you just alluded to is probably one of the number one questions I get about stem cells is how do you know they're pure, dude? Like how do you know what's getting injected into your body?

How do you know? Yeah, no, there's so much detail and this is actually something we didn't go into probably the first time because I've learned so much more working around the world, to be honest, in Europe, Middle east and then Japan, I learned a lot in Japan. They've been using culturally expanded stem cells for over 10 years and that's where I really got in DEP manufacturing process. So what you have to do is when you isolate, let's take umbilical cord tissue because that's what we're gonna, that's what we're using for you when you're down here. And why are we using umbilical cord tissue? Because it tends to have the best cytokine profile, which means it has the most amount of growth factors and the most amount of anti inflammatory cytokines, which are proteins that Reduce inflammation. Okay. It's superior to, for example, umbilical cord blood. Now, does it have the same propensity to turn into cartilage as fat? Maybe not. Because I remember we talked about that last time about how fat may be better for certain soft tissue injuries, but at least for the first generation of stem cells. And we'll talk about what second generation means. When it comes to first generation stem cells, it's really the signaling profile that's the most important. Because even culture expanded stem cells don't stick around for months. They stick around maybe for one or two months and then they're cleared up by your immune system. But they send signals to your own body stem cells to start the healing process and to reduce inflammation.

So even once they're out of the system, these cult still having some benefit because they've upregulated your body's own stem cells.

Exactly, exactly.

And that's called a paracrine pathway.

Exactly. Paracrine. Yeah, exactly. And that's why a lot of people and physicians have a hard time wrapping their heads around it. They're like, how can it have long term effects? And we've seen it in many clinical trials. There's cases of inflammatory bowel disease, lupus, ra, where people go into remission. And this is published data that's out there for many autoimmune conditions. And that's just intravenous stem cells. So how is it doing that is because. So when we manufacture the stem cells, we have to grow them in a way that ensures cell viability. So the way there's two main things for people to understand. One is passages and then the other is the culture medium. So the passages is how many times do you move it from one cell culture flask to another cell culture flask, which is during those three or four weeks of expansion. When you're growing the stem cells, you have to eventually through something called confluence and you have to change the cell culture flask. And if you have too many passages, the cel and you can actually have what's called replicative stress.

So more passages is not good. More replication during the expansion process is not good.

And so we use something called early passage mesenchymal stem cells. That's what you're receiving. And so we limit our passages to three. And this is something I learned in Japan. And that's what they've been doing for over a decade because I would say they're the world experts on it because they're obviously the birthplace of Yamanaka stem cells and all that. Stuff. Most other clinics, if you go to Columbia, Panama, they're using six passages, eight, some are using 10. So your viability is going to decrease. And then also there is risk potentially with those, because those cells can become senescent and then they can cause more issues. So you got to be careful where you're getting your MSCs. And then the culture medium, we're using something called conditioned media, where it's conditioned beforehand that just helps to improve the cytokine profile.

So it sounds to me like maybe when it comes to the expansion process, it's almost like a parabolic curve of benefit to where you want to reach the sweet spot of replication. And then once you overly replicate, that's where you run into potential for buildup of senescence and some of the other issues.

Yes, exactly. And so that's a really important nuance because people, I think, a lot of times don't know. They just don't know. Right. So they don't know how to ask those questions because they're not people. There's not really a good amount of education on that.

Okay, so you referred to different, I believe you call them generations of cells. What's that mean?

Yeah, so first generation, we just adapt, you know, we talked about, which is essentially taking mesenchymal stem cells, which can be from fat, bone marrow, can be from umbilical cord tissue, blood, and then second generation are what's termed synthetic biology. So meaning they're all made in a lab from skin cells or from any somatic cell in your body. So this is what the Yamanaka factors are.

What else besides skin would be a source of somatic cells in the body?

I mean, you could use any, really, muscle tissue, you could use fat.

But skin seems easy.

Exactly. Skin's the easiest. And that's the reason why we use skin. What it is, it's the overexpression of those Yamanaka factors. When you over express those Yamanaka factors, there's four transcription factors. It tells the cell, it over expresses pluripotent genes and it silences somatic genes. So basically it takes the cell back into a baby stem cell state. I love.

Like, I remember when this research first came out because I was at an anti aging conference and this guy, this was maybe like five years ago, this guy was super excited from stage saying all of this. But it wasn't yet available.

No, exactly.

In terms of like an intravenous infusion.

Exactly. You know why it wasn't available was because when you reprogram them, they become embryonic in nature. And then if they're embryonic in nature, that's great for regenerating tissue because embryonic is what's called totipotent, meaning it can turn to anything, mesoderm, ectoderm, endoderm. But the issue with embryonic is that it also happens to be teratogenic or has tumorgenicity, meaning it can cause tumors or uncontrolled proliferation. So how do we use these cells clinically without the risk of cancer?

That's a pretty important question.

Right. And then how do you. Well, two things. Number one problem is that doesn't again doesn't stop people from using it. They are still people. You can go out there, you can get what are called Yamanaka stem cells or induced pluripotent stem cell. IPSCs, that's the medical term I've heard of those. And IPSCs, you can still get them and some clinics are offering them and even clinical trials that have been done. But there is probably at least a 1% chance of tumor growth. And so for me, I'm always. I love. The reason I love regenerative medicine is because the high safety and low downside and potential upside. So I don't want to use something that may cause a tumor. So that's why I wasn't using IPSCs until now. And I'll explain why we're using them now is because we have a technology that can gene edit the IPSCs and prevent uncontrolled proliferation. So it's called HSVTK, but it's a very specific gene edit of a loci which essentially prevents or acts as a kill switch if the cells start growing uncontrollably. And so it's called fail safe. And this is a built in technology into the ipscs that we have.

And that automatically kicks in before they were to become what you call teratogenic.

Exactly.

Or we could use the word carcinogenic I guess, even though it's usually used for toxins, what have you. But the idea is that that would kick in automatically. You wouldn't have to know that they've become teratogenic and then hit some kind of fat.

No, exactly.

Program that's automatically built. Exactly.

Yeah. And then so that's. So those are called gene edited IPSCs. And then we can differentiate those IPSCs into different cell lines. And this is where it gets kind of cool. So this is the second generation technology that we have now and we're in the process of manufacturing and so IPSCs can turn into whatever you want. As we talked about, they're totipotent, so we can differentiate them into MSCs, mesenchymal stem cells. And why do we want differentiated MSCs? Because MSCs are good for cartilage regeneration for tendon, for soft tissue. Right.

Most uses in regenerative medicine.

Exactly. But there's certain uses where we may want something more specific. For example, for Parkinson's disease, we can create IPSC derived dopamine producing neurons. Oh wow. And then you can transplant them surgically or viva injection even into the brain. And then you can get new neurons that actually put patients into remission. And this was shown in a phase one trial that was done by BlueRock Therapeutics this year.

That's incredible. What about something like a diabetic case for pancreatic cell regeneration?

Exactly. That's actually the trial we're doing. Hopefully probably Q4 of this year or maybe Q1 of next year. But we're going to have, we're creating IPSC derived beta islet cells with the gene edit that we talked about. So there's no risk of cancer. And they're also going to be gene edited. Actually this is important too. They're also going to be gene edit to be hypoimmune. And then we use our cellular reprogramming.

That we use hypoimmune, meaning less of a chance to the body's going to have a hyperactive immune response receiving those cells, flu like symptoms, swelling, inflammation, etc.

And also importantly, they're not cleared up by your immune system because then they have more engraftment. So we use IPSC derived beta islet cells and the cellular reprogram technology that we're using. You don't need immunosuppressants. And then the hypoimmunity adds another layer of longevity of those cells because you want those cells to stick around. This is the biggest problem, regenerative medicine. There's two issues. One is getting those cells to stick around and number two is getting those cells to actually send the signals that you want or differentiate into new type of tissue because we can't always control the dosing, so to speak. So if we want to make cells like drugs where we can control them and know exactly what they're going to do. And so that's basically standardization. And so that's. But IPSCs allow for that because they're genetically engineered cellular engineering essentially. And then by transplanting them or infusing them into the pancreas, we can create new beta islet cells as long as we can get them to survive.

That's incredible. Genetically engineered IPSCs are what you just finished telling me about. I know people are going to ask this, and I realize it's sometimes an awkward question to ask as a business owner, something like Eterna Health, but I'm going to ask this because it's similar to the purity question I'm often asked. People say, well, Panama, Costa Rica, Cabo, Dubai, it's all the same. I'm just going somewhere to get expanded stem cells that I can't get in the us Is anybody else doing these type of genetically programmed cells? Is this a technology that you own and use, or how's it work?

It's developed by a Canadian company, and they've been around for seven, eight years. They have the patent for this technology. I'm the one, and this is my, I guess, kind of eye for it. I'm good at identifying technologies, just like the mini circle technology. I was the first doctor, obviously, in the world, which we'll talk about later, was obviously, I'm the face of the brand because I was the first doctor in the world to identify it. And then, same thing with this technology. I was the first doctor in the world to identify. And so we're creating these exclusive licensing deals. I didn't make the tech. I'm not, you know, I'm not a scientist by definition, but I am a clinician scientist now, because obviously I'm doing clinical trials, but I don't have a PhD, so obviously, people who have PhDs whose life's work this is, I'm the one to be able to bring it to patients. And that's just a skill I think I'm good at. And I could care less if people choose not to use our technology, but I just don't think there's anything better. That's not. Again, it's just being objective. Is there an IPSC technology out there that has a failsafe technology? No, there's not. There's only one group in the world that has it, and we have that technology. Okay. Okay, got it.

And your clinic, your clinic is primarily in Cabo and Dubai.

And then we're looking into Europe, Switzerland. We were working in Lugano as well.

Okay, but Lugano, where's that?

It's the northern part. It's like 45 minutes away from Lake Como. Okay. Yeah, yeah, yeah, exactly. Yeah. It's beautiful.

For someone who just wants to kind of like me, do a little bit of age reversal, feel better, you know, stave off Some of the degradation that would occur with age. This idea of an intravenous stem cell infusion is just kind of like a shotgun for the whole body. Seems like an interesting idea. And this is what I did yesterday. And just to clear any confusion, intravenous means you're not getting them injected into a joint, they're going into the blood. What was it that you administered to me yesterday?

Yeah, so there's a few things. One, because intravenous stem cells have been around for a while in like Panama, for example. But the issue there is that there's no prep done for the body. And I think that's really important. We put you on a peptide protocol. And why did we do that? It was because we wanted.

You had peptides in the IV bag.

And then before, remember you're also doing peptides before you did the IV, right?

Yeah, I did a peptide protocol for three weeks before I came here with Foxo SS31 and TB400, TB500.

Yeah, exactly. And frag 1, 2, 5 for, I think specifically. And the reason we use that combination is to decrease senescence and decrease inflammation because the microenvironment in which we put the cells in is very important. And if that microenvironment has too many cytokines, too much inflammation because of senescent cells, or just because of chronic inflammation, which a lot of patients who are looking to do this stuff, I mean, if you're healthy and young, they're probably not like, for you, it's probably not that much of an issue. But for some patients who are chronic pain or have autoimmune conditions, they're going to have a pretty inflammatory, heavy burden. And so we want to prepare the body because the intravenous stem cells, what they do mechanistically, they get. Most of them actually get trapped in the lungs. And then so how. So the question is, how do. If they're getting trapped in the lungs, how are they having these systemic benefits? It's because they're interacting with something called balt, B A L T. It's bronchial alveolar lymphoid tissue. And so similar to malt, which is in your gut, it's basically a lymphoid. So it's. It's a lymphoid tissue, which means it's almost like an immune organ which communicates with your rest of your body. And what that does is it reprograms or re educates the cells. And so it's called macrophage phenotyping or macrophage Polarization. So shifting the macrophages, which are white blood cells, from a pro inflammatory state to an anti inflammatory state, it's called M1 to M2 shifting. And that shifting is how they work mechanistically. And then a really interesting thing which just came out in the last couple weeks because we're still figuring understanding how MSCs work. So in the last couple of weeks there was a paper that came out showing that intravenous stem cells, one of the ways they work is actually through mitophagy. And what they do is they help to trigger mitophagy of old mitochondria and there may even be mitochondrial transfer of the new cells. So you're actually getting new mitochondria. And that's probably why people have better energy and better recovery and some of those benefits that we see after doing intravenous stem cells.

It's important that you actually brought that up because I've always been, and even on this trip, very cognizant of my lifestyle leading into a stem cell infusion, a dieta of limited or no alcohol, wearing an EMF blocking suit on the airplane and taking hydrogen tablets and polyphenols, getting here a couple days earlier and doing earthing and grounding and sunshine and workouts that don't involve a hefty amount of metcon and inflammation from.

Exactly. You don't necessarily want that oxidation.

Yeah, I think a lot of people don't think about that. I mean, that's just good for general body care. And then the use of these antisensecent compounds to further that even more. Which you get, of course, from a diet with a wide variety of plants and herbs and spices, et cetera. But it's nowhere near where you get.

From peptides or chests, I can say just anecdotally and obviously I think we do want to do some trials to kind of. We are going to do trials with the ipsc, mscs, IV and with the Peptide Protocol to really show its efficacy. But. But just anecdotally, I can tell you too, I've had patients, for example, who had IV stem cells and got no benefit from it. And then we do it with the Peptide Protocol and they get a bet and they get a benefit. Wow. So I do, I do think it makes a clinical meaningful difference. And that's why I don't like, you know, some people are just like, oh, I'm just gonna come and do the iv. I'm like, I'd rather you prepare for it.

Is there anything else in this magic bag?

Yeah, in the IV bag itself, we put thymolin, BPC157 and TB4. And the reason for that is that enhancing that immunomodulation.

What about exosomes?

And yes, we're mixing in exosomes too. So exosomes are kind of the soup that the stem cells grow in. They're the broth, so to speak. If the stem cells are the chicken meat, the broth is exosomes. And the exosomes have all those cytokines which we were talking about earlier. Now, the issue with exosomes in general is that they're cleared up by your immune system even faster than stem cells. And so they don't stick around that long, which is why just doing IV exosomes doesn't have the same benefit as IV stem cells for longevity. And in terms of duration of results, generally they only last for like, you know, four to six months. So you have to do them more periodically, whereas stem cells generally last for 18 to 24 months. Okay, got it.

Now that wasn't all, but that I.

Came down here to do.

On our first podcast, you talked about follow statin gene therapy. And as a matter of fact, I was at the gym last night and I was listening to a podcast with a pretty well known physician who was asking his guest about polistatin gene therapy. And the guy was kind of like research and it's kind of like those before after con photos that you see on Instagram. And they didn't. I'm not sure they were very well informed on what it actually was. But let's say you were talking to a doctor and maybe some fitness guy they were interviewing and they said, oh, there's nothing to this, this is silly. This is quack medicine. Fill us in.

I mean, I can say this publicly because they both talked about it. For me, Tony Robbins and Ryan Johnson both have a plethora of doctors on their team who look after them and it's not easy to get to. For them to a do the procedure.

They'Ve both done follows up.

They've both done it. And Brian. Yes. Yeah. And Brian's talked about, well, Brian went down to Honduras and did it. Okay, so it wasn't with me specifically, but obviously it's our technology. Yeah, Tony, I did it personally myself. But basically if first of all they have such a big team of doctors, we have to go through this process over and over and I think it's still probably going to be another maybe two years before I think other doctors catch on to how powerful this technology is and how safe it is, but that doctors are always late adopters. I think that's very clear. You know, just from the fitness.

I don't think the litigious nature of medicine in the US helps that out much.

No, it doesn't exactly shred on eggshells. Exactly. And that's why are we in Cabo. Right. There's a reason. But the reality is our clinical trial is published now. It's the phase one trial. Yes. We don't have phase three data yet because maybe some doctors are waiting for the phase three data. But I always look at it as in medicine, there's something called number needed to treat versus number needed to harm NNT versus nnh, which is essentially what's the risk and what's the benefit? How many people are gonna be harmed by this therapeutic in order for you to help X amount of people. So you'd be surprised how many pharmaceuticals are approved that have a number needed to treat up less than 200 or like 300 even. So Trulicity is a drug that is a perfect example of that, which is diabetic and cardiovascular kind of drug. And its number need to treat, I believe as like 1 over 337. So that means you have to treat 330 people or so to have one significant impact on drug using mortality.

And do you factor in the number needed to harm?

Exactly. And how many people are being harmed? It's something like 10%. So the number needed to harm is 1 in 10.

So higher than it was treat.

Way higher. Yeah. So the ratio is terrible for that drug. Yet it's FDA approved, yet it's being prescribed by doctors all the time. Why is that? It's because they figured out the peer review process. They know how to get approvals, they know how to work the system. It's really. If people are curious to learn more, just watch Lex Friedman's podcast with Dr. Abraham Sin. Okay, so he wrote a book called Sickening and he talks all about this. And it's a 90 minute podcast.

I'll link to that in the show notes at Ben Greenfield Life 90 minutes short for Alex Friedman podcast.

Yeah, exactly. Yeah. But then literally he goes into the details of how pharmaceutical companies know how to game the system. And so it's, it's, it's kind of sad because the reason I'm mentioning this is because if you, if you're getting these drugs that are approved, you can't, you can't hold something like Flollistatin to the same necessarily approval process or even stem cells because they don't have the same harm that a lot of these drugs have. A lot of these drugs have oxide targets and often later we find out all the other risks with them. Whereas these therapies, Follistatin is a peptide hormone that's bioidentical to your body. It's like going on trt, basically. Like we know and we know even with trt, right. There's always this debate about oh, maybe it risk of prostate cancer and all this other stuff, but it turns out it actually decreases mortality. Because you got to go back to first principles.

Properly administered.

Yeah, because you have to go back to first principles. What are first principles? What are the fundamental biological principles that govern health? It's muscle, it's inflammation, it's oxidative stress. Those are probably the most important. Right.

Glycemic variability. But that's kind of a.

But that ties into chronic inflammation too. Yeah, exactly, yeah. Insulin resistance and all that stuff. Right. And so TRT for example, is going to improve energy, it's going to improve your quality of life, better libido and all that. And then it's also going to improve your metabolic stuff because you're going to have more energy, you're going to exercise and hope maybe you'll be even more compliant because now you're exercising and you'll be better with your nutrition.

Although arguably, if you wanted to have children, you would probably want to consider something like enclomiphene or something.

Exactly. Oh for sure, yeah.

Instead of turning straight to trt.

No, for sure. Either way, let's just say optimizing your testosterone.

Optimizing testosterone is a better way to put it, right?

Yeah, exactly. Because some people don't need testosterone, they just need the precursor stress.

Lift everywhere through legs. Get creatine, vitamin D, zinc, magnesium, like.

There'S a lot of low hanging fruit before you turn to ingestion and endocrine. Just supper. There's probably 90, exactly 9% of population that doesn't need TRT. But obviously again that's a whole other topic. But a lot of people just go straight to that. But in terms of Follistatin, the reason why I'm not concerned about any long term risk is because you go back to first principles. What is Follistatin doing? Mechanistically it's inhibiting myostatin, so that's gonna allow for more muscle mass, it's gonna make it easier to put on muscle, which it's also highly anti catabolic. And we know after age 30 you start losing something like half percent of muscle mass. So if you're not doing progressive resistance training and periodization and eating enough protein, you're going to be fighting uphill battle. So false diet is going to make that easier. And then the other thing is, as you get older, the amount of muscle mass you lose and just to keep on what you have becomes even harder after your 60s. So if we can decrease that and shift it to a more anabolic environment, that's going to have so many benefits. And then people are like, oh, what about cancer? Well, mechanistically, there is no.

I was going to ask you about the teratogenicity, if I got that right, of Holocene.

There is. There is no mechanistic reason to believe there would be cancer risk. And we measured IGF1 too, which doesn't increase. But even if it did, again, you can make an argument that who really cares if you're putting on more muscle and you're decreasing systemic inflammation? Because Falstatin, the other pathway, it activates the one, myostatin inhibition and number two, activation of FoxO3. FoxO3 is a pathway that reduces systemic inflammation, and it upregulates T regulatory cells, which are kind of the cells that help with immunotolerance, which means it can help potentially decrease autoimmunity, but more importantly, decreasing systemic inflammation. And we know inflammaging, as the word is termed, is one of the biggest drivers of aging and slowing down, and slowing that down is going to help to fight aging. And we saw this in our clinical trial because we saw some people. This was people age 60 or over, on average. Their biological age reduction, this is intrinsic biological age reduction was 11 years with one injection. Wow.

Was that using the Dune didn't pace clock methylation data?

Yes, exactly. Yeah. Okay.

Yeah, that's a. I mean, obviously none of these aging clots are.

No, none of them are great. But it's the best we have. I think Generation Lab, which is the one company we're probably going to be moving for a phase two trial, they use something called biological noise, which is just like entropy. And I think on a longevity event, there's a lot of discussion about entropy because it seems like entropy is really the reason why our body ages. Right. And so if we can measure that entropy, then that will give us a better indicator of actual biological age, I think.

Is there an impact of follistatin gene therapy on hair skin?

Yeah, yeah, for sure. Anecdotally, people see their skin looks younger, but even with the IV stem cells I've had People say their skin's tighter. They don't have that loose skin as much. And the common. So our anti aging protocol is combining Follistatin with intravenous stem cells and the exosomes and the peptides and all that stuff that we talked about.

Right. So like I'm here, I did the stem cell infusion on Monday and then I'll do the follow stem on Thursday. Kind of spaced out a few days.

Right. And you're getting the full package, which is also natural killer cells and placental tissue, which we can talk about, we'll.

Talk about in a second. Another question that I have about the Follistat, you know, if you look at some data, if you're on massive doses of testosterone, there's even studies that show that you can gain greater amounts of muscle than you would with lifting and lower amounts of testosterone with Follistatin. Let's say someone, though I wouldn't advise this, weren't subjecting the muscles to stress and lifting weights, would they still see some muscle gain or muscle maintenance?

So I think this, it comes down to probably genetics. We don't fully understand it yet, but we did have some people because we did DEXA scans on everyone in the trial and we did have some patients who, for example, gained muscle and they weren't exercising. It wasn't like, you know, five, ten pounds muscle. It was like one and a half to two pounds of muscle. But that's still pretty significant for someone who's just not, who's not really exercising and eating a lot of protein.

I'm very curious to see what happens to my own body composition, because I already lift.

Yeah, exactly.

Combining a strategy like this with lifting.

Oh, it definitely. And this is what it is, it's a body recomposition tool. It metabolically makes it easier to lose fat and it also makes it easier to put on muscle. So if you're in a calorie surplus or a deficit, it's probably going to shift one way or the other. Now they're. Now, having said that, we have had patients who've had both. For example, they lost fat and they gained muscle at the same time. So it's that newbie gain phase almost again when you first started working out. So it's pretty cool what it can do, but obviously it plateaus. But then it's not like you lose that muscle afterwards. As long as you maintain it, then you've gained new muscle. And the gaining that new muscle is going to be so beneficial for your longevity and health. That's Why I have zero concern about follow statin. And that's the reason why you also chose it as our first target. Because our gene therapy plasmid vector can be used for any peptide that's less than 10,000 base pairs. Oh wow. So we're going to do and like we talked about Clotho, but we're going to do Clotho. Yeah, we can Clotho ghk which is copper peptide lh. There's a lot of other things in the pipeline too. We made CAR antigen, now car. The reason we're doing CAR plasmid is because we can transfect CAR into T cells, into NK cells and that makes it better for homing in on cancer cells. So we're going to do a clinical trial for that. So CAR T and CAR NK and CAR T and CAR NK are out there already, but the companies using it are using what's called Adeno associated viral Vectors aav. And the problem with AAV vectors is you sometimes have to go into immunosuppressants and there's risk with viral vectors whereas with the plasmid vector it's non immunogenic, there's no oxide targets and it's, it's very simple and it's scalable and it's a lot cheaper. It's reversible as reversible and has a kill switch. The biobact don't have that. So this is really a really breakthrough technology and it's hard for people to understand unless you really have your pulse on the finger. In terms of cellular medicine.

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You mean if you ever wanted to undo all of the follistatin gene therapy, you would just get like an injection.

Or an oral antibiotic? Tetracycline. Really?

Oral tetracycline could just knock it out.

Yeah.

Now what if you get it and you get like an antibiotic?

Yeah, exactly. Let's say, let's say you got like.

A tick, probably something to tuck away and know.

Well, let's say if you, I mean, most antibiotics you're taking amoxicillin or this or mice for most common infections. So for most people it's probably not an issue. But like, let's say you have an allergy or something and you have to take that, then for sure you would have to repeat the therapy, actually.

Expensive allergy.

What about Clotho? What's that?

Yeah, Clotho is a really interesting. I think it has something like 3,000 studies now on it in PubMed. And it's a super fascinating peptide because it's this large peptide that has all these cellular benefits for not just reducing inflammation, but for enhancing cognition too. So it's kind of like the ultimate no tropic. But the issue with Clotho, as with many other peptides, is a short half life. False Idol also has a short half life. So it's not really practical to inject yourself multiple times a day to sustain the levels. So that's why this delivery mechanism is so cool, because one injection can sustain your levels for 18 to 24 months. Wow. That's the beauty of it. It's a convenience factor. It's not like Clotho is new and.

This is like intramuscular injection.

Yeah, intramuscular or subcutaneous. Yeah, exactly. It's just like. And it takes literally two minutes and it lasts for 18 to 24 months.

Incredible.

So the convenience factor is just for me and for you too, I'm sure, because you're so busy. It's just like, okay, what can I get done in a short amount of time? That's going to have a big benefit on my health and longevity. And that's my favorite thing about the technology and the delivery vector that we have.

How many fewer insulin syringes do I have to keep on?

Exactly. You have to travel with it now.

What about this other component of the trifecta you that, that you referred to these NK cells? Why would someone do those?

Yeah, so a lot of our patients are. It's not like we're offering it as our anti aging package, but we may probably will soon because so many people are requesting to do NK cells. And the reason is because. And you can do blood work too, Right? You can do something like a lymphocyte map and then you could figure out like what are your NK cells? And a lot of people will be surprised how low they are. And the reason for it is because they start getting signs of immune dysfunction. They may not have full blown autoimmune disease, but. But they may be showing early signs of it.

And could that just be like thymus.

Gland degeneration, age or chronic inflammation in the gut and stuff like that? Right. And so chronic inflammation is always going to accelerate the degenerative processes. And a lot of people are walking around with chronic inflammation and hence why their immunotolerance decreases and as their immunotlerance decreases. And that's probably the biggest risk factor as to why you develop all these chronic degenerative conditions as you age. Because aging is the biggest risk factor for dementia, for heart disease, for cancer. Right. It's osteoarthritis. Aging is the biggest risk factor. So if we can target aging, we're targeting all these different diseases. And that's why it's hard for people to understand, because in medicine we're always taught system based, but now it's coming. Now we're learning that maybe system based isn't the best for chronic illnesses. It's coming back to the root causes.

Right. When you're halting a degenerative process or restoring compounds in the body that disappear with age. That's kind of a true definition of regenerative medicine.

Exactly. Yeah. So the Clotho should hopefully increase, potentially increase iq. We're going to measure IQ in a clinical trial.

You test me before and after?

Yeah, we will. Exactly. The matrix progressive, that test.

Yeah, just stick away, stay away from calculus. It'd probably be the same before and after.

Yeah. So.

This whole treatment that I'm doing, let's say someone is listening right now, even though there's some other things I want to talk with you about. And they were to call your clinic, what would they asked for? Just like give me what Ben got. Or is there a name to this?

Yeah, it's called Eterna Anti Aging Package.

The Eterna Anti Aging package, which is.

Basically Intravenous stem cells, exosomes falls down, gene therapy, and then natural killer cells can be added on too. And the reason we do natural killer cells too, as we, I think you and we talked about a little bit, is that they can help to clear senescent cells as well. And we know senolytics in general, which are oral medications to help clear senescent cells, are becoming popular because we know.

Senescence is one of the issues with an R. Rapamycin.

Yes, yeah, exactly. Yeah. But rapamycin again is an old drug that has some off site targets which may not be the best. And so the reason I like these cellular therapies is they're generally very safe and they don't have any real downsides to them. They're just expensive, which is the biggest issue. But we're working on bringing the price down. Our price is even cheaper now than it was a year ago. So I think in another couple years it'll be even cheaper because manufacturers can.

Just fly into Cabo or Dubai or any of these other locations and stay there for a few days.

Exactly, yeah.

Probably plan on what, five days or so.

Exactly, yeah. Just because we like to monitor you and do the whole thing and. Yeah. And then the NK cells and stem cells we do on different days. The other component to it, which we're going to do for you too, is the placental implant, which is just a simple subcutaneous.

I've always wanted a placenta.

Yeah, exactly. Who doesn't? So it's a very simple subcutaneous injection. But what we do is in our manufacturing facility, we take the placental tissue and we lyophilize it and then we just. It's basically freeze dried. And what we can do is we can reconstitute it with saline and then we can inject it subcutaneously. And what that does is it raises intracellular NAD levels. And we all know about nad, I'm sure because of NMN and all the popularity with IV NAD drips. But the problem with those things, nmn, I mean, that's a whole separate can of worms. But there may be some potential risk with NMN with kidney and whatnot. But. And then it's also something you have to take every day. And IV NAD maybe works, maybe doesn't, because it doesn't really always raise intracellular nad. I think you do the patches, right? Yeah. But the injection is just one injection and it can raise levels for up to three months.

And that's a placenta one.

Yeah.

Incredible.

So it's this convenience factor.

I didn't know that.

Yeah, it's a convenience factor. And that's why you feel boost of energy as well, right after the procedure. And then by then, usually the stem cells and the false status and has kicked in.

Yeah. Before we started recording, we were briefly talking about the vagus nerve and this idea of a vagus nerve block, which I've talked about a couple times on the show, but you started to film me and I said, wait, tell me on the podcast about how the way that it's done is important or your kind of, like, unique twist on it.

Yeah. So the vagus nerve block, or the stellate ganglion block has been around probably in medicine for over 20 years, maybe 25 years. We just put a regenerative medicine twist on it. So instead of just using. So the vagus nerve is around your. Your C6 level, which is around this area here in the neck. I'm pointing. For the people who don't see the video, I'm pointing to C6. Yeah, C6. I'm pointing near the carotid and the jugular, basically on your neck. And so the stellate ganglion is what's called. Innervates, your sympathetic nervous system. The sympathetic nervous system is what gets activated if you're running away from a lion or if you're stressed. And for a lot of people living in a modern environment, they're in what's called sympathetic overdrive. They have sympathetic arousal.

There's a lot of lions out there.

Well, our body thinks they're lions. Like public speaking, for example, triggers a lying response, even though we're not getting, you know. But why. We know, we understand that evolutionarily. Right. But because of the modern stressful environment, people are. So many people are living in this sympathetic overdrive, and they're easily aroused, which means they get easily irritable, their hormones get easily dysregulated, and that's because their sympathetic nervous system is becoming overactivated. This is very clearly seen in ptsd. The Body Keeps the Score is a great book that talks about how our nervous system remembers. And so this nervous system dysfunction is what underlies a lot of ptsd. Unresolved trauma, adverse childhood events. And it turns out a lot of mental health is actually rooted in unresolved emotional trauma, depression, anxiety, not just ptsd. And so by treating the sympathetic nervous system, we're blocking it using anesthetic, but we're also putting in peptides. And the reason we're putting peptides is because it helps to modulate or change the signaling. And then at the same time, we're using a different syringe and injecting into the vagus nerve. But the vagus nerve feeds into the parasympathetic nervous system, which is what relaxes your body. So we don't want to block it, we want to modulate or fine tune it so it sends the right signals. So we said we use exosomes and peptides because those are both signaling cascades that can basically reprogram the vagus nerve, which means it'll send the right signals. So it's called neuromodulation.

So you could smoke a joint every night or drink a half bottle of wine, or just get a vagus nerve ball.

Well, that's it. And that's what a lot of our patients. I've had. People literally quit smoking or quit drinking from it. I've treated alcoholics, I've treated addictions. It's pretty powerful stuff. I've obviously treated people with ptsd, suicidal ideation, and I've panic attacks, anxiety, and young girls. It really is a wide spectrum. And then some people just for honestly, health optimization. Like I did it for health optimization for on my side, My friend did it for me because I just wanted to have more resiliency. And I just, I live a very fast paced kind of go, go, go lifestyle. And like, it's good to have something.

Obviously be careful who you go to for this because it's like a needle.

In your neck near the carotid. Yeah. You got to go to someone who's.

Experienced ultrasound guided imaging.

Exactly. Yeah, you got it. Not. You can't use X ray. Some docs, old docs use X ray as not a safe way to do it because you can't see the. You can't see the back.

That was incredible. You found a meniscal tear in my knee yesterday that nobody had found with ultrasound.

Exactly. Ultrasound Dynamic high resolution ultrasound is so powerful, but it's all user dependent and very few people know how to do it. Like I said, there's probably in one hand, I can count on one hand how many people are good at it in the world.

And you think it's better than X ray or MRI for finding issues like that?

For finding small tears? Yes, because small tears get missed a lot. Because MRI is done in slices and they're like 3 millimeter slices and they can often miss small tears.

No, it only took you guys up close in 10 minutes.

Exactly. But it's because my technologist is. She's a brilliant technologist.

Right.

And she's. Yeah, but what we're doing, this is just a side note, but what we're doing is to try to scale this technology. We're creating a machine learning neural net. So we're going to train an AI system. Toktum, who's my radiologist, is training the AI to detect normal from abnormal. And then eventually it can guide the physician, make like a little circle and be like, inject here. That's very cool because that's the only way you can scale this because honestly, the reproducibility of doing that is really hard to treat it.

As far as a physician training.

Yeah, it's too hard. It would take years and years and it's just you can't scale it. So we're going to use machine learning for that.

Yeah. You started off explaining your background in fitness, and yesterday you were telling me that you would like to do some more things in the fitness world. What's that look like for you?

Yeah, so it's kind of this whole concept of. Peter Attia coined the term medicine 3.0. And I do like it because it gives you a good framework for understanding the evolution of medicine. And medicine 1.0 was kind of like the ancient bloodletting and leeches and whatever else they did. And then medicine 2.0 was kind of the modern era, which is pharmaceuticals and surgery, which worked great for acute infectious diseases. And then medicine 3.0 is this whole concept of trying to reverse or prevent disease in the first place with lifestyle interventions. But the problem is with lifestyle interventions is how do we make it more accessible to the average person? Because I think the bigger issue now isn't that most people don't know what to do is how do we actually get them to stick to it. And so what we tried to solve for is behavior change by developing this health dashboard. It's called Exalt. Xalt Fit is a fitness tech company that we develop because we're trying to basically deliver fitness at a large scale for the fraction of the cost. And the way we're doing that is by keeping the sessions with the personal trainer short because you only need like 15.

Virtual or physical?

It can be both, but virtual for the most part. But you can, as you know, with virtual, you can do everything very well with a trainer who's especially skilled. And you don't need 60 minutes, you know, four times a week. You only need 10, 15 minutes a couple times a week to get the longevity benefits. And there has been. There was a trial that showed that 11 minutes of exercise a day was enough to have longevity benefits. And.

Yeah. And so, and you have to take that with a grain of salt and compare it to the studies that also show that when exercising consistently is paired with a sedentary lifestyle, meaning sitting for 10 hours in between each, then it actually offers significantly fewer benefits than, than what you would think. And so I think that anytime we say things like minimalist exercise program, exercise for 15 minutes. No, you never want to send the message.

Exactly.

Well, engage in non exercise activity thermogenesis and walking and staying physically active the rest of the day. And for me personally, that's where the magic lies, is I can get a quick session in at the gym, but then I'm walking on my treadmill and I'm moving and I'm playing with the kids outside, I'm taking the stairs.

But that's because you've already built into your value system and this is so part of who you are, you're going to do that stuff automatically. But for most people, they haven't built into their value system. So that's why I believe every single person deserves access to a health coach. And that's the only way to keep people accountable. Because that accountability is really what keeps people with sustained behavior change. And so if you don't have a sustained behavior change, then you're never going to actually stick to these healthy behaviors. And that's why we created Exalt, and that's why we're just finally launching it and scaling it. Now we're starting with corporations because a lot of big corporations want to work with us, because they want their employees to be more active and live healthy lifestyles, because they're more productive. Right. And that's actually better for the employer, but for the average person, they can't afford thousands of dollars of personal training. And so this is much cheaper. And we're using technology to help make it more accessible.

Much cheaper. Like Ballpark, what would it cost me to work with a trainer?

You can get it for $1,000 a year. Oh yeah.

That's what a lot of people are paying a month for. Personal.

Exactly, exactly. For one session a week. But then if you want to scale that. But even just having one session a week and having someone just check in with you, see how you're doing, and then do a quick workout session, that can make a big difference on sustained behavior change. And we've seen that. And so I think just a lot of people just need someone to keep them accountable and tell them, tell and remind them how to stay on track. And give them those little tips on behavior change. Now medicine 4.0, which is kind of what, what we are talking about now is using cell and gene therapy to allow people to live longer and healthier lives. So it's not only about preventing disease, it's about using the latest cellular and gene repair to not potentially prevent it, but also to treat chronic illnesses and then to allow people for more healthspan. Because the whole reason I like follow statin, for example, is not because of all these mechanistic benefits. Fine, it's cool how it works.

But.

But at the end of the day it's going to allow you to stay healthier longer because it's going to allow you to pour more muscle and probably make you more compliant with the gym because you're going to get more benefits from the gym. People don't like to stick to the gym when they don't see the benefits from it.

Right, Right. Or don't know what to do. When I checked into the JW Marriott in Austin, I walked around and was looking at the facility. As I walked into the gym, it was completely empty except one dude standing by the squat rack. And that was you. I know that you practice what you practice. Preach. I think if folks were to combine our discussion we just had with the previous chat that we had in which we took some other dives into different forms of stem cells and regenerative medicine, they would have a really good source of regenerative medicine knowledge to rely upon. And then I'm going to link to that as well as everything else that we Talked about at BenGreenfieldLife.com EternalPodcast E T U R N A podcast. If you guys go to the Eternal Health website. What was the name of the protocol again? The anti aging protocol. Anti aging protocol, yeah. So that would be a good one to look into. I know you guys are very helpful via email and phone chatting with people about the questions that they have.

Yeah, we've hired furiously because we've grown exponentially. Yeah.

And you're working with like, you know, obviously we can't drop names, but celebrities and actors and pro athletes and then some really big names. I mean you're kind of the go to guy right now, so.

Yeah. No, the reason I like working with high profile people and the reason I'm grateful when they do promote us is honestly to reach more people. There are people who are falling through the cracks of the medical system who are suffering with chronic illnesses and those people are the ones I enjoy helping the most.

Awesome.

Cool well, thank you Dr. Khan.

And I'm looking forward to reporting back to my listeners how I feel and what I experience in these protocols they and that occur the rest of the week. So yeah, awesome.

Thanks.

All right folks. BenGreenfieldLife.com EternalPodcast Check it out. Thanks for listening. Leave your questions and comments and feedback there. Hello from sunny, windy Cabo. Thank you so much for tuning in. Have an amazing week.

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