Biohacker Must-Do’s for Maximum Health Optimization and Longevity w/ Siim Land

I'm a big fan of just a regular comprehensive blood panel. Most of people I'm interacting with, you could call them like hobbyists, longevity enthusiasts, or, you know, people who are preventively just trying to take care of their health and are curious about it. So, you know, for most of these individuals, it just comes down to just optimization and trying to optimize all of their health and try to get as healthy as possible.

Hello. Welcome Back to the Dr. Joy Con podcast. I'm here to enhance your health, to live your best and longest life possible. So I've invited a wonderful expert and friend, Sim Land. Welcome, Sim. Thank you for being here. Thanks for inviting me.

Happy to be here.

Yes. So Sim is a super expert in longevity despite his young age, but he has been very helpful in educating the public and providing some incredible content on YouTube. And that's how I found Sim in the first place. And he also has written books, which is remarkable. Very, very highly prolific, so very admirable. And, Sim, I'm so glad to have you back to share your expertise.

Yeah, I'm a bit of brick.

Yeah. So, you know, having been in the longevity space for quite a while and having visited different clinics, you know, throughout different countries in the world, probably it's a little overwhelming, I think, for people who are in the biohacking space who want to optimize their health. There's so much going on. Of course, in each biohacking conference, there's more and more technology. So what do people do and. And how do they actually work on themselves? Because the whole point is that this is individualized, right? It's not a one size fits all and everybody do the same thing because we need to see where each person is at. So what are your thoughts on all these different longevity clinics and what everyone is doing? Do you feel that. That they're all doing amazing things? Do you feel that some people are on the right track? Um, some organizations do an incredible amount of tests and some are a little bit more tailored and limited in how much they test. What are your thoughts? Should people just go for the whole. The whole range of tests, which can be pretty overwhelming?

Well, I guess the problem with, you know, what I like to frame it is that we do want to be aware of as many biomarkers as reasonably possible about our health. And the more, you know, the more insightful you can. The more insightful it is and the more educated guess you can or decisions that you can make about your health. So in one sense, it's obviously very positive to test a lot of things and measure hundreds of biomarkers, et cetera. The same with supplements. Like, yes, you could take hundreds of supplements out there. Is it always necessary? You know, in most cases, not. In most cases, you get the majority of benefits from just a handful of supplements, and you can eliminate a lot of the supplements. If you have an unlimited budget, obviously, then it doesn't really matter that much how much money you spend on testing or supplements, et cetera. So it depends a lot on the particular person's budget and what their priorities are. I do think that with testing, the biggest problem is that if people test, but they don't do anything about improving those results. So if you don't really change anything and trying to make any marker better after testing it, then you just, you know, wasted your money or you don't really. You could have even skipped the testing altogether.

So.

So I think the most important thing about any testing is that, okay, if you're gonna test whatever that is, blood work, you know, MRI, CT scan, DEXA scan, VO2 max, whatever the test you're taking, that you have to be willing to also improve on that marker, whatever the result is. So let's say you get a VO2 max score that is very low. Yes. You know, that can be insightful, that even if you don't improve it, you know that you're in a slightly lower VO2 max and that puts you at a higher risk of mortality compared to people with a higher VO2 max or your age group, for example. But it's still more important to actually try to improve the marker, because even if you didn't test it, you just focused on improving the marker by doing cardiovascular exercise and following otherwise healthy diet and keeping a normal body weight, et cetera, then you would have been even better off than by testing it then not doing anything to improve it. So the foundation should be just trying to live as healthy of a lifestyle as possible and trying to take care of your body and follow a regular exercise routine, a regular healthy diet, and maintain a normal body weight. That's a baseline. And if you follow all these kind of fundamentals, then you can avoid a lot of unnecessary testing. And you can also be sure that most of these biomarkers can be in a more normal or optimal spot to begin with. But if you do test something, then be willing to also adjust your lifestyle, adjust your diet, adjust your sleep routine, whatever it is, based on the results that you're getting. Because humans are kind of stubborn. You know, we are creatures of habit. Habit that if we follow certain habits and if we do it for a very long time, we're unwilling to change them, or we're like less eager to change. It's going to be very hard for a smoker to give up smoking. Even if they get diagnosed with a very serious disease or alcohol or whatever vices people might have that harm their health, if they've been doing them for decades, then it's very hard for them to quit and change it. But even like small things, let's say someone likes their ice cream, or let's say they stay up late too much, whatever the small thing may be, even these small changes can be very difficult to change. But if you do test, and there is, let's say, okay, you need to change this to improve this marker, then I would highly encourage people to do, to do those changes because then otherwise the testing was a waste of money, if that makes sense.

Right, right. So what would be some of the essential tests that you think that people should not skip?

Yeah. So, you know, let's say I'll start with pretty much like a minimal budget and even tests people can measure for free without paying anything. So waist circumference is one of the, I guess, more general biomarkers that can be very extremely insightful to your general health and body composition. So we know obesity is bad for your health. And waist circumference can be a very good estimate of your level of adiposity, especially the amount of visceral fat around your organs. So the visceral fat gets stored in between muscles and around the organs and tends to more accumulate around the belly. So if you have a very big, this kind of a beer belly or pot belly, then that tends to be a sign of more visceral fat. So storing more weight around the hips, that isn't inherently as bad as storing the weight around the belly and just measuring your waist circumference, you can get a reasonably good estimate of your especially visceral fat mass around the organs. Because, yeah, if it's kind of a. If the waist circumference is bigger than your hip circumference, then that's like this imbalance between excessive visceral fat and, you know, you might have still subcutaneous fat as well under the skin that gets stored more on the hips in excess amounts. But the ratio is what matters more. So the waist to hip ratio. So the waist should always be narrower than the hips for both men and women. So you measure the waist circumference around the belly button and the hips around the hips. So that's you know, free, everyone can measure that and generally lower waist circumferences are better. Another free test people can do is even something like push ups or pull ups, some sort of a body weight strength test. How many push ups can you do, how many pull ups can you do, how many squats can you do, etc. So muscle strength and muscle mass are also associated with longevity. And people with higher muscle mass and higher muscle strength tend to be healthy as well. Because in order to achieve a higher muscle mass and muscle strength, you need to be doing some form of physical activity. And the hours you put into doing the physical activity make you healthier. So to say that if you have a higher amount of push ups that you can do, that means you are putting in the work at, you know, at other times, maybe not necessarily at gym, but maybe you have some sort of a physically active job or maybe you grew up in a farm or you have like a history of doing a lot of physical activity. Those things still carry through for many years in the future. But generally just having a higher muscle strength that, you know. Yes, there's the grip strength machine, the dynometer that measures grip strength. It works the same way that a higher grip strength is associated with higher total muscle strength across the entire body. And it means that you've put in the work of increasing your muscle strength. But you know, it doesn't necessarily have to be a grip strength machine. It can be push ups or pull ups. I like pull ups because in order to do a lot of pull ups, you also need to be slightly lower body weight. So that's kind of a good test because it includes body fat percentage, muscle mass and muscle strength. So if you were to be very strong but you're not able to do, you know, any pull ups, then it's kind of an imbalance between the strength and the body fat percentage because you probably have too much body fat. Yes, you don't need to do like 20 or 30 pull ups to be considered healthy. But you know, let's say a fit and healthy man should be able to do at least, you know, at least five at minimum, but you know, ideally over 10 pull ups and women, you know, at least women do significantly less pull ups than men. But you know, at least one or two for a woman is still reasonably strong as a baseline strength for muscle, as baseline test for muscle strength.

How many can you do?

Well, for my 31st birthday last month, I did 33 point pull ups. So I'm trying to small challenge that every year for the Birthday, I'll try to kind of one off the pull up. So next year I'll try to do 32 again at least.

Yeah, wonderful. That's a great goal.

Yeah. And the last test I would say is, you know, so let's say how do you measure your VO2 max, which is another important biomarker of overall cardiovascular function? And higher VO2 max is associated also with a lower mortality risk and lower heart disease risk, et cetera. So it's again, if you have a high VO2 max, you're healthier generally, your body works better, and you've probably put in more work with some physical activity. Maybe you don't necessarily do like cardio or vascular exercise, but you're doing some form of physical activity that increases your VO2 max. And the Cooper test is a free way to estimate your VO2 max. So you can find online calculators. So how far can you run in 12 minutes? The distance in kilometers or miles, and you can estimate your VO2 max based on that. So it's like a scientifically validated way to measure VO2 Max without actually doing the VO2 Max test. Now, the VO2 Max test is a bit more accurate.

Run in meters, is that?

No. How far can you run in 12 minutes?

In 12 minutes, you measure that in.

Meters, it can be miles as well. It doesn't matter. Yes, you just run as far as possible for 12 minutes. The Cooper test we did in high school, and how far you run is the score. And then there's like online calculators you can calculate your VO2 max from. So then you get the VO2 max number. The higher the VO2 max, then the fitter you are. So athletes have a VO2 max of, you know, 70s. Sedentary people might have it in their, in the 20s depending on their age. So it declines with age. The older you are, the lower it can be and the unhealthier and the less fit you are, the lower the VO2 max is. So you want to keep your VO2 max, you know, above 20 for as long as possible. But the challenge is that if you have a VO2 max of 20 in your 30s already, then you know it's going to drop to into the teens by the age of 50. So once it's below 17vr VO2 max, then that's considered like a frailty threshold, that you're not able to be physically independent with your everyday activities, you're not able to get off the toilet, you're not going to be able to carry your groceries or you know, do physical things. So for just the quality of life perspective, you want to keep your VO2 Max relatively high.

What's the best way to improve VO2 Max?

Any form of cardio will increase it. So if you don't know where to start, just starting to do some form of cardio, whether that be even just going for a jog, longer runs, whatever it is, any form of cardio will, especially in the beginning, will increase VO2 max. Going into more specifics, you know, there are certain interval workouts as well that will increase. So interval training is more effective for VO2 max than low intensity steady state cardio. But ideally you want to do both because there's, you know, pros and cons to both forms of exercise. For low intensity cardio, the pro is that you can do it for a long time and very frequently without wrecking your nervous system and you can recover from it very fast, especially if you do like this low intensity zone 2 cardio. If you're doing slightly more, faster intensity like zone three, four, then that can, yeah, be more taxing because you're not in a, in this zone two state, which is characterized by low lactate and higher fat oxidation. So the zone two, you could do, you know, hours and hours without really burning out. But doing a lot of zone 34 can eventually attacks your nervous system. And the same with zone five, you know, you're not able to do interval training every day for five hours straight. Whereas realistically or theoretically, you could do that with zone two. Like you could do five hours of zone two every day. It's just you don't have the time probably. So that's why interval training can be a good way to get more benefits of VO2 max in a shorter amount of time. And yeah, from the studies, you want to get your VO2 max at least above 50 milliliters per kilogram per minute. So we don't have much data about. Is 60 better? Maybe for some things it might be better. For cardiovascular disease mortality, it might be better, but we don't know yet. We don't have that much data about people with a VO2 max of 60 and above, but at least above 50, that's a good goal. So my goal with longevity is to keep my VO2 max above 50 for, you know, at least until I'm 80 years old. So there's actually one study of an 80 year old Norwegian man who had a VO2 max of 50, which is, you know, pretty insane for an 80 year old because a VO2 max of 50 is what a normal 35 year old person would have, who doesn't, who isn't like an athlete.

So this is a person that's exercising consistently and especially cardiovascular.

Yeah, he had a very consistent exercise routine. Yeah. Several workouts per week.

Right. Get out there and move and get your heart pumping.

Yeah, yeah. And I mean, obviously I also think that blood tests are very insightful. I'm a big fan of blood tests. So everyone has different opinions about health, like what is healthy. Some people will say, okay, I feel good, I'm not obese, I don't have diabetes or something, that I'm healthy. Yes, that is categorically true. Health is the absence of disease. Health is also many other things. Health is a state of physical and mental well being, includes the absence of disease, but it also is something you can quantify. How do you know you don't have a disease? You need to measure it in some ways. If you have high blood pressure, then you have hypertension. Right. We have certain diagnostic criteria that diagnose you with a particular chronic disease if you meet those criteria. So like metabolic syndrome, it's defined as having three or more of the following. High triglycerides, high waist circumference, high blood sugar, high blood pressure and low hdl. So if you have three or more of the following, then you're diagnosed as with metabolic syndrome, which is associated with increased risk of diabetes, heart disease and other chronic diseases. So that's what you don't want. So blood markers are just a way to see what goes on inside you. So yes, you can feel good, but a lot of things you can't feel, you can't feel really if you have high blood sugar, you know, eventually if you have like very serious diabetes, you might feel it with neuropathy and retinopathy and those kind of things that it actually starts to physically affect you. But mild elevation in blood sugar, you know, let's say you're not in. You wouldn't feel pre diabetes. Right? You wouldn't feel any difference with pre diabetes. Yes. You might have a little bit of extra weight, you might have a high waist circumference. So those are signs that you potentially could have prediabetes even without testing your blood, but you wouldn't otherwise feel prediabetes. And even like regular diabetes, probably you wouldn't necessarily feel. So testing those markers actually would show what is inside, what goes on inside you. And you wouldn't definitely feel other markers. You wouldn't feel homocysteine, which is a risk factor of a heart Disease, you wouldn't feel different lipids, you wouldn't even feel your blood pressure. So there's a lot of things that you intuitively you could feel normal, but you don't necessarily actually know if there is something wrong because you don't feel.

Most of these biomarkers and of course cancer markers. How extensive should people be checking as far as screening for cancer?

Yeah, so I would much rather not try to find something that isn't there or you know, not trying to find something that is wrong and you know, that is a risk of testing, that you start testing things, trying to find something, you know that something might be wrong. So I much rather would take a more conservative approach to testing in general because, yeah, there is obviously always the risk of false positives with blood tests. So a lot of blood tests and markers, they can fluctuate. You know, you can get some false positive tests with other, more, let's say advanced testing like MRIs and stuff. So you could, yeah, go down a rabbit hole and do unnecessarily extensive testing or spend unnecessary amounts of money. But for, you know, cancer, I would just much rather focus on the healthy fundamentals. And even regular blood work can, you know, certain blood markers do correlate with increased risk of cancer as well. So I would just rather if there's nothing wrong with those, just your lifestyle and you're not smoking, you don't have a genetic history of cancer, and you know, your blood work is also normal, you have low inflammation, you have low blood sugar, low homocysteine, and you know, just you otherwise live a healthy lifestyle, then I wouldn't start to really chase, chase something that isn't there.

I've seen that in my patients who get not only start to chase and track all the time, but also the psychological burden of thinking something's really wrong with them. I don't think that's actually that helpful. Put them into a whole different mental space.

Yeah, so I've had a few markers that were abnormally high in one test, but if I tested them a few weeks later, they were normal. So there's some markers that just fluctuate. You know, heavy metals can fluctuate, certain inflammatory markers fluctuate. It's always, you know, if someone does a blood test or whatever test, then, you know, I think, you know, any good doctor would probably just retest first before doing anything else.

And will hormone tests be the fundamentals that you would suggest?

Yeah, I mean, hormones are incredibly vital and I think hormones play a more important role in your well being. And quality of life. So how you feel and what your mood and just yeah, how you feel in day to day. But hormones also, you know, fluctuate and hormones need to be taken in a context. So because they can be very sensitive to various activities really like sleep, your calorie intake, you know, let's say testosterone, testosterone is incredibly volatile to your, you know, just overall calorie intake and your body fat percentage. If someone is, you know, let's say a mat for a man, if they are 12% or 13% body fat, which is, you know, lean, but it's not very like shredded or very low body fat, then their testosterone at 13% body fat would probably be higher than if they were to be at 8% body fat. Now is the person with 8, 13% body fat healthier because they have slightly higher Testosterone, maybe like 15, 20% higher testosterone than the 8% body fat person? We don't necessarily know because if you look at animal data then calorie restriction is the most potent way to extend lifespan, non genetic way to extend lifespan. And calorie restriction would require you to be leaner. You know, we don't have human data obviously about what would happen for humans if they do long term calorie restriction for, you know, many decades. Will they live longer if they are, you know, always single digit body fat percentage, we don't know. But it would be hard to say which one is healthier because the third person who has 13% body fat, yeah, they're not obese, but they have slightly more body fat. They have slightly higher testosterone, but they also would probably have slightly higher blood sugar and slightly higher lipids, slightly higher waist circumference because of the increased body fat. It's a matter of context. So yes, the 8% person male, for them, their testosterone might be slightly lower, but their other biomarkers might be better, if that makes sense. And likewise they might regain some of the weight. So let's say it's very common for at least the bodybuilders and fitness competitors to see a massive drop in their testosterone during their competitive season. At least. Natural bodybuilders, the pro bodybuilders, they obviously inject and take exogenous testosterone. But natural bodybuilders is very common for their testosterone to tank quite, quite low into like the 200s, 300s would be pretty common for a stage lean fitness competitor to experience. And yes, they feel awful during that time because they're very lean and low energy intake and low testosterone. But usually what happens is after the competition they just Regain some healthy weight, they go towards more 10% body fat, you know, so it's a short term adaptation, short term phenomenon, this low testosterone.

The reason behind low body fat relating, correlating with low testosterone?

Well it's mostly just the restriction on energy, so you're just eating less calories and that results in less hormone production and lower thyroid levels. Now there are ways to maintain slightly higher testosterone levels even on a lower body fat percentage. In my opinion, higher carb intake. And there are studies as well showing that higher carb intake helps with maintaining higher testosterone at a lower body fat percentage because the higher carb intake maintains better thyroid functioning as well at lower calorie intakes. So for thyroid and your hormones, the carbohydrates are incredibly valuable. So low carb, high protein diets consistently lower testosterone in men and you know, yeah, it doesn't have to be low fat diet, but a slightly higher carb, maybe moderate fat diet tends to result in the best testosterone at least in males and the same for females. You know, carbohydrates tend to support female hormones as well. So very restrictive diets usually lower female hormones as well and can result in some disruption in their menstrual cycle. But yeah, for let's say longevity then both sex hormones are quite important. For females there's like a different type of decline. They have relatively normal hormones until menopause and after menopause they drop close to zero. Whereas for men it's a kind of slow decline over the course of decades. But it's not linear that, that it's for declines in the same speed for everyone. You know, there's going to be some 80 year olds who have very high testosterone as well and some younger individuals who have lower testosterone. So it's, you know, genetic, environmental and lifestyle related. How much they sleep, how much food are they eating, what other type of things they're doing? Alcohol, circadian disruption, all of these things influence testosterone. So a single test I guess is not a very accurate picture for testosterone at least.

Yeah. And what about some people go for very extensive microbiome tests or toxic exposures including heavy metal or other infectious agents. So how important do you think is? I mean we know, we know we live in a toxic world and also with a lot of underlying infections pretty, pretty prevalent among the population. How important it is, is it for us to be diving into that?

Well, for gut test I think it's only worthwhile if you have some actual symptoms, some gut related symptoms, some gut related disorders. So this would be useful to just Help to diagnose what is the particular issue and what things you could do to improve your symptoms. For an otherwise healthy person who doesn't have any gut related symptoms or gut issues, I don't see a lot of value in testing your microbiome if you don't have any gut problems, because I don't think we actually understand a gut microbiome that will yet. It's a very complex ecosystem and it's not that, okay, you just have this bacteria and this diversity and you know, that means that you have perfect gut microbiome or something like that. It's very complex and context dependent as well. So for some people a specific composition in the microbiome might be like, beneficial and for others they get more symptoms, et cetera. So I would rather only test the microbiome if you actually are trying to improve something related to your gut health or food intolerance or something else like that. And you know, if you just follow a very diverse diet and you don't have symptoms, then chances are you're in a very good spot with your microbiome test as well. So you wouldn't necessarily need to test it. And the problem is also that there's a lot of commercial tests and most of these commercial tests aren't clinically validated. And the same with a lot of these epigenetic tests. Each company does its own thing in terms of what do they measure and how do they report it, et cetera.

So pace of aging and current biological age, that's what you're referring to, right?

Yeah. So these epigenetic age tests, they all measure different things. They all say it's your biological age result, but they all give different results. And the same with probably gut microbiome tests. If you were to do the top most popular gut microbiome tests out there, they would all give different results in terms of your microbiome. So which one is the most accurate? It's hard to tell because each of them or all of them haven't been clinically validated. Yeah. The other question you had was toxicity. Toxicity. So yeah, I mean, you can measure heavy metals in the blood. The issue with that is also that short term exposures can, you know, give you some different results. So for example, I measured heavy metals in January this year. My lead was pretty high, like, so I take the same test, I've taken the same test for, you know, several years and the same company and it's always been normal, but this year it was something like 10 times higher the reference range. So, okay. You know, but then I measured it again in a few weeks, maybe one month, and it was normal again. So, you know, that's just an example that I was maybe exposed to some heavy metals, like inhaled some fumes or something like that, like, you know, whatever it is. Like we do live in a world where there is more heavy metals in the environment and around us. So, you know, I could have eaten something, I could have breathed in something, drank some water or something like that, and it just could have registered as a high lead number in that test. So, yeah, and the same, you know, these would be probably worthwhile to measure these things as well, quite regularly at least heavy metals. But be aware that they do fluctuate as well and not necessarily if you have some of these heavy metals, like, you know, aluminum or mercury, something like this high, that it doesn't necessarily mean that you have toxicity. Me personally, I didn't do anything. I didn't start. Some people might go down a route that they start some detox protocol or some galation therapy if they see a high heavy metal result on their test. I would again first retest and then consider possible options. You know, I do a lot of saunas. I think that is a very useful tool in this world where we are exposed to more various heavy metals and, you know, microplastics even, and air pollution, etc. So sauna is a, you know, I do it for other reasons. I do it for the cardiovascular benefits and just feels good. But additional bonus and additional motivation is that it helps, it does help to excrete heavy metals and even possibly microplastics as well. There are studies for heavy metals that you do sweat out heavy metals. There's no direct evidence for microplastics yet, but I do think that it is possible.

Yeah. How significant is the problem of microplastics? Because now there are people who are changing the clothes they're wearing, being concerned about, I guess, absorbing microplastics directly through the skin. How much evidence is there that this is happening?

Well, I think, I guess there's no quantified ranking of what is the most, like, effective way for your body to absorb them. You're probably just, you know, eating microplastics is probably, or, you know, consuming them through your mouth or drinking water. That has microplastics. That's probably the most direct way your body absorbs them. You know, they go through your gut, then absorbs through the bloodstream and spreads throughout the body, you know, inhaling as well. I mean, the microplastics are everywhere. I actually was in a conference in Tokyo and someone had made some sort of. Not a camera, but it was like a, Like a lens and they showed. So supposedly it showed microplastics. And yeah, it was like this blue lens and, you know, covered everyone's, Went through everyone's clothes and you saw these small white kind of dots, and those are supple, like microplastics. So it just showed. Yeah, like on your, on your, on your shoes, on your beards, on your hair. So they're everywhere. You know, they just exhaust fume or not from exhaust fumes, but brakes if cars drive, and the tires, everything. Plastic bottles, food packaging, different personal care products. So they're everywhere, you know, and I think recently I even saw some headline that microplastics have seeped so deep into the earth that they're like at the level something like you know, kind of thousands of years ago was this kind of earth crust. So they've seeped so deep into the earth that they've kind of traveled back in time. Obviously there were no microplastics in the dinosaur times, but they've seeped so low that in the earth crust they're found there. So, yeah, they're just everywhere, and I don't see a way where we will be able to avoid them. Society would probably collapse if we stopped using plastics altogether because they're so useful and they're just everywhere by now in industrial and just manufacturing purposes. So, yeah, we just have to find ways to deal with it and minimize our unnecessary exposure. So, you know, don't. Don't microwave plastic Tupperware and eat from it. Don't drink from a plastic bottle that has been sitting out in the sun. Don't, yeah, just expose yourself to a lot of these unnecessary sources. How much is from, like, clothes? I do think that clothes can be quite, let's say, significant route of exposure because you're wearing the clothes all day, so your skin is rubbing against that and from there you break off this, you know, nanoplastics even and very extremely small things. And you inhale them from there and through the skin. So, yeah, I do think that it would be wise to try to, let's say, wear more natural fabrics and materials. Use a stainless steel cooking ware, wooden spatula, another plastic spatula, glass food containers. You try to use glass bottles when possible. You know, okay, if you're in a airport, they don't have glass bottles. Maybe you have your own water container. But, you know, buying a plastic bottle, drinking it, it's not going to kill You. Right. But unnecessary things you can try to remove. Because unfortunately I do think there are ways to excrete them. So last two years ago or something, it was said that you just can't excrete them at all. You just keep accumulating them. Well, that's not true. There's plenty of evidence to suggest that there are many ways to remove, at least from the blood, these microplastics. So. Yeah.

And what would be the best way to remove them from the blood?

Well, the best way is probably blood donation. So you just take out your blood and you know, blood donation, you're giving it to someone else. But obviously that's a life threatening situation and it's better to save a life than to not give them the blood. But there's also this therapeutic plasma exchange which takes out the blood, filters, separates the plasma, filters the plasma. I mean, there are certain of these machines that also filter the blood. And EBO is exocorporeal blood ozonation and oxygenation. So they also shoot ozone through the blood, which has antiviral effects mostly and they shoot like blue light through the blood as well. And that could also eliminate some extra microplastics from the blood. So yeah, just kind of filtering the blood and then directing it back into your body. And that's probably the most effective way aside from blood donation, where you're just taking out the blood.

Right. So. But has there been evidence that either IBU or plasmapheresis can actually remove microplastics?

Yeah, yeah. So there's studies on firefighters where there's. I mean it just makes sense from a physics perspective that you just take out the blood that. Where the microplastics are inside. So you would just remove them by virtue of that. But yeah, and that applies to any other. These forever chemicals and heavy metals as well. Now obviously you, you know, with a filtration, I guess there's less evidence that it. The filtration would work. But there is some evidence for that.

Yeah. Well, let's talk about, you know, food sensitivity. Should everyone test for food sensitivity? Because I've heard of people who were having some health issues and then they checked food sensitivity and realized, oh my goodness, so my body doesn't do well with this particular item, has high sensitivity. Once they remove it, a lot of the problems go away. But we also know there's a lot of false positives and a lot of red herring and, and the test can eliminate a lot of very healthy food. So what's your take on that?

Yeah, so the ig, IGE test that supposedly measures your allergy allergies to different foods. So that is very dependent on what you're eating. So if you eat a lot of eggs, you're gonna get red flag on the eggs. If you eat a lot of dairy, you'll get a red flag on the dairy. Or like, you know, at least every this IGE test I've seen, everyone gets red on like eggs and dairy and grains or something like that. So not everyone is allergic to eggs, grains and dairy. So it's just that your body produces these antibodies when you're eating them. And if you eat a lot of certain foods, like a lot of nuts or a lot of, I don't know, spinach or something, then you might get this red or orange flag on that. So it doesn't necessarily mean that you are actually allergic to it. And you might not even get symptoms. So I would only remove certain foods if you actually get some symptoms from them. I don't see a reason, if someone isn't allergic to gluten, why they would need to necessarily remove gluten. I mean, yeah, it doesn't have any significant nutritional value, but I guess you don't have to be necessarily worried about it. If you don't have an actual gluten allergy and you don't get any symptoms, and that applies to eggs and dairy as well. Eggs are very nutritious. If you don't have an egg allergy, you do fine. You don't get any symptoms, then you know, why would you really remove it? Maybe if you see some of your blood markers getting worse from eating eggs, then maybe it makes sense to reduce them or remove them. But there's generally eggs aren't going to move a needle on a lot of biomarkers in a negative way. So the dietary cholesterol is not really going to raise blood cholesterol for most people. There are some people for who it does, but for most people it's not gonna do it. So, you know, unless something like that, then I don't see like a reason to really remove eggs from, from that perspective.

What about NAD testing? So now, I mean, it's a newer test and some people are getting into it. Everyone is talking, well, in the biohacking world, talking about NAD levels, but I've also heard that when a person is older or even sicker, they have a higher level of nad. So what's your take on whether or not this is worth testing?

Yeah, well, with nad, what of the latest, I guess, input I've heard from some experts Is that these tests, they measure blood nad, but they don't measure intracellular or tissue specific nad. So it's not going to be that useful as a biomarker. So it doesn't really tell you what your actual NAD status is because the intracellular NAD is what actually matters. So personally I wouldn't do an entity test. So the commercial entity tests, they're all based on blot, like a blood spot. So personally I'm not going to do an NAD test for that reason at the moment.

I see. Okay.

And I mean, yeah, it's one of those things that you might feel. So if you feel very tired, then that can be a sign of a lower NAD and vice versa. If you feel just, you know, great, you feel very energized, then you probably don't have NAD problems because NAD is mostly a coenzyme for energy metabolism. So it is related directly to ATP production and ATP is the energy currency of cells. So if you control for your sleep quality and duration and then you can identify that, yes, I'm feeling tired irrespective of my sleep and irrespective of my diet and sunlight and those things, then you know, that might be a sign that you have lower nad. But I wouldn't yet test like blood based NAD tests at the moment.

I see. Are there any other tests, you know, blood, urine, you know, whatever, hair, any tests that you think are really important that you often suggest to people?

Yeah, so I'm a big fan of just a regular comprehensive blood panel because most of people I'm, I guess, interacting with are, you could call them like hobbyists, longevity enthusiasts or you know, people who are preventively just trying to take care of their health and are curious about it. So, you know, for most of these individuals it just comes down to just optimization and trying to optimize all of their health and try to get as healthy as possible. So I'm not really dealing with the sick population that much. For these individuals, specific imaging and advanced tests is more common for a general health optimization person than for them. You know, they don't necessarily need to go into very advanced testing because the basic tests already can be very insightful and you know, you're already following also the healthy lifestyle and following the fundamentals, then there's a very low likelihood that you need to do advanced imaging.

Yeah. So for me, one of the most crucial ones is the glucose parameters. So the, the glucose, the hemoglobin A1C and insulin level, those will give me really great indicator of their blood sugar metabolism. Thus Metabolic health. So, and of course, thyroid is really important and, and hormones. To me, these are kind of the bread and butter. Right, for a, A general test.

Yeah, I, I'm, you know, definitely agree with metabolic health and blood sugar. So a lot of people struggle with that. And it's one of those things that it's better to be optimized rather than normal with. So let's take. Blood sugar isn't the best marker, but triglycerides are a good example of that. The triglyceride reference range is 150mg per deciliter. Anything below that is normal, but anything above 100 is associated with higher mortality and higher cardiovascular disease risk. So a normal triglyceride level is actually already putting you into increased risk. So with triglycerides, which is a form of lipids, but it's the best reflection of your metabolic health and insulin sensitivity. So a lower triglyceride below the reference range is much better than, like, just a normal result. The same with, like, inflammation, CRP levels, normal CRP in like, let's say 1.5 milligrams per liter. That is already also in a higher risk category than something like 0.1, so close to zero.

And I want to ask you about imaging, because I know these longevity programs, they take people around and do a bunch of imaging. What do you think is the biggest bang for your buck? What do you think is important or what tests are you excited about?

Yeah, so for scans, DEXA scan, I think, is the. Something that most people would benefit from as an information source. So you can, you know, measure your bone density with the blood test. You can measure your bone density with any, like, fitness tests specifically. But yeah, the DEXA scan is very useful for measuring what your bone density. And bone density is very underrated, I think, because people with higher bone density, they're less likely to die from fractures and falls if they do fall. And that is one of the leading causes of accidental deaths among the elderly people. So having high bone density is very important as you get older. For women especially, I think it should be kind of mandatory, ideally before menopause. But if they haven't done that to then just after menopause as well, to see, okay, are they with very low bone density or do they have high bone density that can be insightful to what they need to do? Do they need to start really taking their resilience training more seriously, or do they need some hormonal therapy to support that? So there's a lot of valuable information you can get from a DEXA scan for bone density. Now, the DEXA scan also measures things like visceral fat, your body fat, muscle mass, et cetera, but for at least the visceral fat. It's a bit less accurate than a full body MRI visual fat. But it's still, you know, better than guessing what you, what would your visceral fat be?

I see. Okay, that's great. I bet you most people have not had a DEXA scan. It would be a really, really helpful information. Any other scans?

Yeah, so there is, you know, more specific medical scans that are popular in like longevity clinics, like CT scan, full body mri. Those are very popular now. Although, like a full body MRI is safe in the procedural sense. Like there's no radiation, there's no harm. Maybe some people might get claustrophobic or something like that, but you know, there's no, you don't get radiation like you do from a CT scan. But I guess, yeah, with an MRI there is also the risk of false positives or getting some result that isn't an actual cancer or something like that, that there's nothing wrong with you. Actually, there's always the risk for that. But, you know, generally there's no, like direct harm from an MRI. And I've gotten two in my life, two full body MRIs. And yeah, it's just kind of interesting, at least for me. The longitudinal data that I would collect from that would be quite valuable if I'm gonna do like, maybe not every year, but every five years or something. If I do one, then I'll have a pretty good database to look at once I get older. A CT scan is usually recommended for people over their 50s to see what's their coronary artery calcification score. And that is a very valuable test because you'll see if you do have actually calcium in the arteries or not. And for heart disease, that is the kind of, maybe not the ultimate biomarker, but it's a sign of already existing heart disease and calcification, which is a significant concern. But the problem with the CT scan is that you can't do it very often. So if you do it in your 50s, you don't know when did that calcium come and what could have possibly caused it? Because for most people it's going to be their first CT scan. So when did it happen? Did it happen in their 20s, 30s, or is it the only recent phenomenon? So it's hard to see or hard to interpret, what would the history of that specific score be? Because it's a lot of it's not like very dangerous amounts of radiation, but it's I think like a few X rays in one test. So you wouldn't want to do it like every year you would want to probably do it. If your doctor recommends you or tells you to do it, then they usually would recommend you to do it every few years after the age of 50 and only if you have a non zero score. If it's zero, then they generally don't recommend it that often. But if it's very high, let's say 500 or 1,000, which is extremely high or significantly high, then just to monitor the progression, they would probably recommend you do it in a few years as well. But I think what I feel like is that the CT scan is slowly being replaced with other tests or scans that have either less radiation or almost no radiation at all. So I think in a few decades probably we will have much better technology that will be able to identify the calcium in the arteries with little to no radiation. There is one form of, I guess calcium testing without radiation. It's the coronary intima media thickness. So it's an ultrasound of the carotid arteries in the neck and with the ultrasound you can see like narrowing of the arteries. It has zero radiation and it has pretty good value. You can see if the carotid arteries are narrowing or if they're extremely narrowed. And you can do it very frequently, you can do it several times a year with no radiation.

So I know you have organized retreats and I'm very excited about your next retreat which will be in India. Can you tell us a little bit about what's offered in this retreat in January?

Yeah. So I'm partnered with this clinic in India called AIVO and they have a seven day program, health occasion where people come to this five star hotel in Chennai and they'll follow through different types of tests and scans over the course of these seven days. So things like a blood comprehensive blood panel that has 180 blood markers, DEXA scan, VO2 max test and there's full body MRI. The carotid intima media thickness, the CT scan is also an option there or it's a part of the program. There's a lot of other tests like echocardiogram, liver scan or like a fibroscan looks at this, the stiffening of the liver and also things like physical training, physiotherapy, dental screening, eye exam, skin analysis. So is a very comprehensive package, covers.

Your V2 Max as well.

Yeah, the VO2 Max test as well. So yeah, they cover all of them, kind of essential biomarkers and health markers, plus a bit more advanced ones. And they also support with these, let's say physical, basic physical functions. So like you have a PT who helps with your form, you have a physiotherapist, et cetera. And yeah, all of it at this five star hotel with the group that I bring and other individuals who also might join. So yeah, I've been doing that for a few years now. It's, I think this January is going to be my sixth time. So, yeah, I like it a lot myself. People who joined have had very positive feedback about it. The staff is very meticulous and professional. They're extremely helpful. It's a very high quality clinic. The owner is also very interested in longevity. He's consulted with a lot of top doctors in, in the States and elsewhere and they've created this program with very relatively cheap cost. So in United States having this kind of a program would be 20,000, 25,000 with the accommodation. But in our retreat in Chennai it's going to be 1/4th of that.

So yeah, the price is remarkable, I mean, considering what you're getting. So you said, is it a six day retreat?

It's seven days and six nights.

Seven days, six nights, yeah. And in a luxury resort and getting this full array of tests, it's pretty remarkable because I've seen prices around the world and so what you're offering is really, it's so affordable and really exciting opportunity for people, I think and I definitely want to be there. So after the test, what else is offered in the program? Are there basically protocols put together for people? Are there therapies provided? What else is available?

Yeah, they do have consultations with also specialized doctors. So Chennai is called like the medical capital of India. They've got pretty much every medical expert you can think of and based on the results of your tests, you can consult with a cardiologist, nutritionist, physical therapist, eye doctor, neurologist, psychologist. So yeah, they have pretty much every doctor that you can think of available, therefore consultation from a therapy side. So it's not that much about, you know, treating diseases. They're not obviously going to help. So whatever test result you get, they're not going to be, you know, providing professional medical services or like medical treatments. Certain treatments they do provide, you know, physiotherapy treatments and they have IVs, so, so vitamin IVs, glutathione IVs and et cetera. They have some skin treatments, so hydrafacial and some other like CO2 laser and various skin treatments, dental treatments, so, you know, less medical treatments. So I guess the value is that you go there, you spend that week and you're getting pretty much, you know, first of all, I think 99% of people haven't done that comprehensive testing. So they'll get pretty much, not to mention not only the MRI, which scans your entire body, but also your heart test, your VO2 Max test. You're getting a lot of this valuable information about your body that you haven't probably gotten anywhere else. So that just establishes a very helpful and solid baseline of what your current health status right now. And with that information, you can, you know, if there are some things that need to be improved or something that is, let's say, requires additional care, then with that at least you have the information that you can use back in your home country with your, with your GP or whatever the case may be.

Yeah, amazing. And, and you were so kind to offer my listeners a, a discount. If they put in Dr. Joy, they can get a discount off their attendance, their, their program. So very cool, very excited. I, I really look forward to being there. I love India and look forward to going back and visiting. This is in south of India, right? It's a. Is it close to the water?

Yeah, you can see the ocean. The hotel is next to the beach. You can see the beach and the ocean from there. And yeah, they pick you up from the airport with a car. Like the hotel chauffeur picks you up, takes you to the hotel. You go through the treatments. You'll always have a staff member from the Aiwa clinic helping you and taking you to the different tests and doctors. During the day, you know, during lunchtime, we'll have everyone in the program so the guests from different parts of the world. We've had from Argentina, South Africa, Australia, Vietnam, Sweden, Finland, uk, Canada, US So yeah, every, every time there's just people from different parts of the world and we have a few seminars as well where me, some staff, like a medical doctor or someone else is giving a presentation. So yeah, it's educational, it's very insightful in terms of your biomarkers. And it's also a lot of fun because you'll meet a lot of different people from different parts of the world.

And will the food be very specially designed for biohacking purposes?

Yeah, so there's three restaurants in the hotel. There's a Chinese restaurant, an Indian restaurant, and I guess like more a standard buffet. Yeah, you can. The food is very high quality and you can ask for pretty much anything and they'll make it. So if you want. Okay, I want sugar free chocolate cake. So they'll go and actually make it for you.

That sounds amazing. Wow. Okay, that's wonderful. So the dates will be January 5th to 11th, correct?

Yeah, the first week of January. The first actual week, the first Monday of January.

Okay. And where do people go to find. To sign up?

Yeah, it's a Seamland Co retreat. So my website, that's where you'll find it. So your website is www.siemland co. That's.

S I, I M L A N D. Yeah. Dot you say CEO.

Yeah.

Okay. Oh, okay. Wonderful. Yeah. Thank you so much for sharing this. And it's wonderful that you put these retreats together. I think, you know, that's definitely what some people are looking for. For one, I was looking for something that's comprehensive, that's, that's accessible, and it's amazing that it's not going to cost an arm and a leg to be able to do that and to be able to experience a beautiful country. So. Yeah, thank you so much for putting that together.

Yeah, my pleasure.

Okay. All right, Sim, again, appreciate your expertise and your pioneering spirit in this space. So I look forward to chatting with you again sometime.

Yeah, my pleasure.