What If Aging Did Not Mean Slowing Down?

One of the more important things that I learned in the early 1990s was that to give the other person agency, I had to break down the hierarchy of the doctor patient relationship. They were conditioned by their upbringing to just come to me and surrender to whatever I said. But surrendering what I was telling them to do was not going to do it. They were going to have to participate. And it wasn't until I created those partnerships and gave them that agency that we both really understood what our relationship was about.

Welcome to Modern Thyroid and Wellness, where we talk about all things thyroid, hormones, and honestly, anything that can help you live a longer, more vibrant life. Well, thank you so much for being here, Dr. Rena, and taking time out of your day and I know very busy schedule to just share a message of hope and healing and understanding for our listeners today. So thank you for taking the time.

Oh, you're very welcome. And it's just coincidental, the timing that this is the season of hope. The world celebrates the birth of hope over the next few days, and I think that's very important for us to hope for something better in the future. But maybe even more importantly, not only hope for it, but actually do the work necessary to achieve it.

Absolutely. So some of our listeners might not be familiar with your work. I am. I'm a big fan. But I would love for you to share with people what you do about lifespan medicine, fill us in on kind of the longevity aspect that your career has led you to. And also, I'm selfishly very curious how your path led you to that and when you knew that, you know, wanted to look at medicine a little differently.

Yeah. Thank you for that. I've thought about this over the years on a number of occasions. And I entered family practice with a great deal of enthusiasm and exuberance in 1980. And I felt that this is great. You know, like, I did very well in medical school, and I did very well in internship and residency. And now I'm ready, and I hit the ground running, and I started to see a lot of patients with a lot of different diagnoses, and I started to write a bunch of prescriptions. And a few years into that process, I thought to myself, you know, I'm coming to this conversation way too late. Like, I'm coming in the room when these people already have a list of two or three different diagnoses. And really all I'm doing is managing their diseases. I'm not helping them be any healthier at all. And then I thought about, well, what do I focus on? When I want to be healthier, I eat. When I do a period of reform, like every January, I eat better. I work out on a regular basis. I turn off whatever I'm looking at or listening to or reading at certain hours. So I get to bed, I just impose self discipline. But in these behavioral habits. And I thought, okay, as a doctor, I need to know how to tell them about this. So I need to tell them about their diet and about their movement and exercise patterns and help them with their sleep habits. And really I need to change their perspective. So it was with that orientation of I'm going to re educate myself through a bespoke process throughout the 1980s that enabled me to have the courage to launch a practice of preventive medicine, integrative medicine, lifestyle medicine, what's now called longevity medicine. It's been given many different names over the years, but I launched that practice in 1990, and it's been very rewarding. And I won't say it's more rewarding than my colleagues who still manage diseases. It's just been really much more engaging. And it's become more of a relationship practice now where I'm collaborating with the person. It's not that hierarchy of doctor, patient, I tell you what to do and you go do it. I write a prescription and you go fill it. Now it's kind of an interaction. And together we're going through this. It's been really great career.

And I think that just creates win wins on both sides. Right? Like, that partnership makes people more invested in their health. It makes them feel empowered to be able to change the trajectory of their health. I also think, like, as a clinician, it fuels our reason and passion of why we went into medicine in the first place. Right. Like we, we want that connection with our patients. And I think, sadly, it's lost so much in the current paradigm. But what I think is really cool about right now, I'm curious if you feel the same. I think there's a cultural shift where people are beginning to realize, hey, regular medicine, our medical system doesn't make us healthy. Like, it treats conditions and diseases. And it's amazing for all these tools and acute care and surgery and cancer, but it's not made to make us healthy. And that's where personalized medicine and lifestyle medicine really comes in. And I think society is finally ready for that, which I think is incredibly special for us and them.

I agree conventional medicine in the United States is best when it's dealing with infectious disease and emergency conditions. And there is no place I Would rather be if I had an infection or an emergency than the United States. That's what the system is built for. But it really breaks down when you have these kind of gradual processes that erode your functionality, erode your comfort level in life. The system really breaks down and says, look, I don't have anything other than my prescription pad for that. So let me try you on this and this and this and this. And we all know where that leads, so. Yes, exactly. Right. This collaborative practice that you've set up, that I've set up where we partner with people. And one of the more important things that I learned in the early 1990s was to give the other person agency. I had to break down the hierarchy of the doctor patient relationship. They were conditioned by their upbringing to just come to me and surrender to whatever I said. But surrendering what I was telling them to do was not going to do it. They were going to have to participate. And it wasn't until I created those partnerships and gave them that agency that we both really understood what our relationship was about.

Absolutely. And then they can freely communicate and you can develop plans, etc together, which is so empowering.

Yeah. And they take responsibility for it.

Exactly.

Now they feel like they've got a partner, someone they can actually call and say, you know, this isn't working out. I don't know what I'm gonna do. I get hungry at 3 o' clock and I. The only thing I can do is drink a coke or have a Snickers. You know, what am I, how do I get around that? It's like, okay, let's talk it over. Really. It's what you ate at one o' clock that sets you up for and it's when you went to bed the night before that sets you up for that. So let's kind of make these changes in behavior and see if we can just dull that sensation that I need some kind of sugary stimulation, caffeinated stimulation at 3 in the afternoon. I get it. I understand.

Yep. So I know my answer to this because you know my niche. It's like hyper specific. But I'm curious in your perspective where you see people for such a broad range of things. What are the most common or some of the most common ways or things that is actively kind of being missed in the traditional medicine or approach or misunderstood and people are coming to you with symptoms, questions, desperate for help. Do you see certain patterns of things that are the most common drivers or like what are people generally coming for? Is it like fatigue or they just Want to be healthier.

Yeah. So the. Almost universally people want more energy.

Yeah.

And you and I have some very common ideas about how that energy is generated and how, you know, the body creates it for ourselves and where it goes, how it's utilized. One of the things that. That I talk about with patients is the fact that the body is rhythmic and that all of its management is arrhythmic management, and that setting up their lives in a very consistent rhythm can create a melody of life that's much more pleasing to the ear than the cacophony of disrupted events. So being consistent about your exercise habit, being consistent about your meals, being consistent about your sleep time, putting things in perspective, not allowing the busyness of our life to be stressful. We were al. When we were younger, whether we were getting out of high school or getting out of college or whatever transitional point we were in life, we had nothing to do. And we were so scared about that that we wanted to fill our lives with busyness. And we knew that if we were busy, we would be productive and we'd be accomplished, and, you know, that would be our goal. And then when we accomplish that, it becomes stressful. We confuse busyness with stress. And busyness is a gift. The fact that I have lots to do today and the fact that I have lots to do tomorrow, that's all a gift. It's something that I worked hard to achieve. So just maintaining perspective. I think the body is dependent on what you eat, how much you move, how well you sleep, and what your perspective is at the core of that, you know, the mind is created by an inseparable interaction among immune system chemicals, which is a conversation. The immune system contributes to neurochemicals, which is a conversation that the brain sort of mediates and hormones. And hormones are particularly rhythmic. And as you recognize and made such a great impact in is the fundamental driver of energy is thyroid hormone. And so when people come to me and say, look, I need more energy, I think, okay, examine what you eat and how you move and when you move and how you sleep and what you think of yourself, your place in the world. How is your life going? And then let's take a look at your hormones and let's take a look at your immune system and see where are you helping your immune system and where are you provoking it? And are your hormones still in rhythm with each other, and are they in the rhythm of your life? And you and I know that there are ways that you can read that on a person. There are tests that you can do and, and procedures you can go through that can tell you all about that. I'll tell you that men are beautiful in their simplicity.

Right.

And women are exquisite in their complexity. And as a practitioner, one has to realize that.

I love that you recognize that.

Yes. One has to tune the instrument to that note. To the simplicity of male hormone replacement and male hormone stimulation or male hormone support, the simplicity of male behaviors, the complexity that it takes on in the female. And we see that females have or hold the gift of life. Yes, men are the catalyst, but women hold the gift of life. And so they have to be more complex. And it's just the, the appreciation of that and being able to apply that in simple practical terms. You know, being able to give people clear guidelines that can help them with those fundamental areas of diet, exercise, sleep, perspective, hormone continuity and hormone interaction.

I'm curious to put a pin in a couple of those areas. What would your advice be when thinking about trying to elicit a shift in your perspective of your life where you're really busy, but that does feel stressful and you have a hard time balancing your perspective? Because I think that that's almost a universal struggle with a lot of at least motivated, driven people or people who are struggling from a health perspective because any busyness can be overwhelming. What piece of advice would you give to people struggling with that?

Sure. I would say in terms of recognizing it first come to the realization like, okay, I surrender. I surrender to my own thoughts and how I view my life and what I'm going to do in that's in the peace negotiation now that I'm surrendering is rethink this and I'm going to look at this practically and I'm going to say okay. If not on paper, I need a detailed plan in my mind of how I'm going to meet the commitments that I work so hard to achieve with regard to my purpose in life, which is usually my job, my family, which is the real value and myself which is necessary for me to support everything else. So I'm gonna allot time for work, time for family, time for self care and I'm gonna have the self discipline this year. I'm gonna have the self discipline necessary to stick to it. And in order to do that, I need to learn to say a kind and gentle no to anyone or anything that wants to co opt my schedule. And I'm going to stick to the schedule. So I am going to go to bed early enough so that I can wake up, work out and move on. If I leave My workout to the afternoon or the middle of the day or the Pilates class or the yoga class in the evening, someone else is going to invade that time. Someone else is going to create a priority that in the moment I'm going to think, okay, I'm going to give it up this one time, and then I will stop going, and then I'll get out of shape and I won't have the energy necessary to. I'm not going to do that. I'm really going to respect that. The second piece of advice I would give people, very often busy people are tired, and as soon as they turn the light out, they're ready to go to sleep. Sometimes they have a moment to think. And in that moment, after you turn the light out, the last thoughts you should have on each day are the things for which you're grateful. Like, you know, I'm just so grateful to be in this comfortable position. I love my pillow. The comforter is just right. I'm so happy that I'm here and that I have all the things that I have that have brought me here. And that's just the last thought of the day. The first thought in the morning is, isn't this wonderful? I get another day. We all know that there will come a time in life where those days are questionable. And nobody likes to think about that. And I'm not. You know, I don't want to be morbid or morose about this, and we don't need to think about it. What I can say is that if you awaken each day and welcome the day and be thankful, express some gratitude, just think to yourself, okay, I'm so grateful for today. All right, I got to get up. I got to get ready. I got to go. Super. You've ended each day with a thought of gratitude. You've begun each day with a thought of gratitude. You have a plan. You're going to stick to it. You're going to look better, feel better, have more energy. And sure, there are things, biochemically that you and I know to do. We can support the mitochondria. We can support cell to cell communication. We can organize this symphony of all these different instruments through hormones. They become the conductor of the music. And then we can sound beautiful. We know we can do all that. And when a person comes to us, that's really what they're asking us for, is, look, I need some help. Yeah. And this is the type of help that they need. Okay, let's take a minute. Let's calm down, think about it in Our mind. Let's create a detailed plan, a reasonable timeline. Let's enlist the expert help we need. Do we need a yoga class? Do we need a yoga mat? We need a reformer in our home. Do we just need a room that we can do these exercises in? Yes, I need one of those, Many of those things. Okay, great. And then have the self discipline necessary to stick to it, value ourselves and value the different parts of our life that give us so much reward enough to be respectful of them and to give them the time that they're due.

Yeah, I love that. And I think if someone as busy and with a schedule as demanding as yours can accomplish all of that, then I think there's hope for all of us. Right. I want to switch gears a little bit. I want to talk about the concept of healthspan. I'd love for you to intro this concept because the reality is some of our listeners might not know this as like a meaningful metric for our health. So can you define it and how is it different than living longer than lifespan?

Yes, of course. It's really about function. It's about the freedom that we gain when our body is able to do the things that our mind wants to do. And in order to preserve that, in order to achieve that and then preserve that through a lifetime, we have to deal with the work. You know, that's what's required. This morning before we had this meeting, I spoke to an 82 year old gentleman about his workout. And I told him that I really admired the fact that he was able to reduce his body fat, increase his muscle mass through measurable terms, and that he was able to increase his strength measured by the number of push ups that he could do. This is an 82 year old guy. Wow. And he spent the last year in a reconditioning program, all self derived. He's used for the most part a pair of dumbbells and his body weight to do this. So it require, you know, a membership at Equinox and it didn't require special clothes from Lululemon. It just required going into that room and doing these things. And this 82 year old guy, not without rest periods in between, but this 82 year old guy does 100 push ups a day. 100 pushups a day. And I think to myself, I don't know when I could have done that. Like I don't know at what point in my life. Okay, so this is healthspan. It's maintaining function over a long period of time. And one of the things that we are awakening to is we not only need the information necessary to be our healthiest, but we also need it somewhat customized to us. You know, I'm seeing that right now the offering is 500 laboratory tests, 120 laboratory tests, and I think those are great. I look at those panels and I think, wow, that's so smart. You know, they've broken down all these little incremental parts of how our body works and they're going to tell me if I'm in the normal range or the abnormal range. But what does it really mean? And is that, you know, should I buy these 500 lab tests or this 150 lab tests, how am I going to know how it applies to me? That's the key. And right now we're on the threshold of entrusting that information to machine learning. And it may work out. I haven't seen it yet, and I'm not a doubter or a naysayer, and I'm not stuck in my own model. I'm very eager and interested in seeing how AI can assist me and you in doing what we already do. Now can we make it more detailed and more efficient? But bottom line is health span. So health span is about maintaining function over time and aging is the loss of function over time. And in order to maintain health span, we have to understand and be respectful of the body. It needs adequate amounts of protein. It needs nutrient dense foods. Nutrient dense foods mean whole foods, not processed foods. They often mean prepared at home. So you know the ingredients. Yes, I love restaurant meals too, but they're in business to make a profit. They're not in business to keep me healthy. And so I can once in a while eat a restaurant meal as a luxury or a treat. But I really need to be in the kitchen cooking and I need to be in the grocery store, the perimeter of the grocery store and stay out of the aisles. These kind of axioms that really make up healthy practices, you know, they're not just goals, they're actually things we can do. So focusing on a whole foods diet, freshly prepared at home whenever possible, to guarantee ingredients organically grown if it's possible. You know, farm to table, if you have farmers markets in your area, all of that stuff I think is really valuable. And that's the cornerstone then movement, which can involve 6,000 steps a day, or it can involve 20 minutes of resistance training. I think both are necessary. Sleep. The Los Angeles Lakers paid the Stanford sleep center to evaluate their players and determine how much sleep they needed. Was a long time ago, but it was At a time when sleep medicine was really being refined in the early 2000s and the Stanford Sleep center decided that for a player to completely refresh his himself to all male team required seven hours and 20 minutes. And the Lakers made changes in their schedule, especially when their players travel to distant cities to play multiple games in different places to allow their players the minimum of seven and a half hours. Take the advice, get seven and a half hours at least. Spend eight hours in bed giving yourself a chance at seven and a half hours. Maintain a healthy perspective, be aware and be grateful for all the things that you have as well as ambitious about achieving more. When it comes time and you and I know that it can surprise you. You can be 19 years old and have hormonal imbalances. You can be 49 years old and very probably have hormonal imbalances. The acceleration point in aging, which again is the loss of function over time, is between 45 and 55. And the reason that we age so much between 45 and 55 is because nature abandons us on that hormonal rhythmic scale. And it does so for very good reasons. By the time we reach 45, we will have done everything we can to ensure the human trust has been preserved and that more humans have followed us as a result of us compelling them to life. Okay, so we don't need our hormones anymore. Not in Today's world, maybe 10,000 years ago, but today we need those hormones more than ever. In fact, we can be our strongest and Most productive at 55 if we seek specific individualized medical attention. And you and I are offering that one person to one person at a time, we're both likely to finish our careers as avatars. I have my fingers crossed that that works out because it'll enable us to help a lot more people and perhaps inform us of some things that we sometimes forget.

Absolutely. A couple follow up questions. I want you to go back to the exercise piece so I know strength training is so incredibly valuable for healthspan lifespan. Talk with me about what your feelings are on cardio and HIIT layered into that.

Sure. I think that cardio, depending on what zone you're trying to achieve, if what you're trying to do is a measurable improvement, for example, increase your VO2 max or oxygen utilization capability, then you have to apply high intensity interval training to your cardio routine. And there are programs online with any stationary bicycle that you can implement. You can also implement it with sprints. If you're not a bicycle stationary bike rider, you want to be Outside. Okay. There are lots of programs that we can access online to improve that. But if what we're doing is fitting exercise into our lives so that we support our physical health and function while we're working very hard and taking care of our families, like many of us do, then cardio can really be a minimum of 6,000 steps a day. If I get to, if I get to 9:40, because I need to be asleep by 10:30, that's my goal. So if I get to 9:40 and I've got 4800 steps, what am I going to do? You know, am I going to keep the sleep routine or am I. What am I going to do? I'm going to get my steps.

You are?

Yeah.

I'm going to get.

Listen.

Okay.

For most of us, we're paid to sit. And the reason we sit so much is because we get rewarded for that in ways that are very fundamental to our lifestyle. We need to get up and move around and whatever I'm reading, whatever I'm doing, you know, I can prop it up on that treadmill and walk those 1200 steps. And sure, now it's 1020 and I only have 10 minutes to fall asleep. All right? That day I still got my steps, so I must sleep at 10:45 instead of 10:30. Big deal. You know, it's about prioritizing that cardio in terms of resistance. At your stage in life, you do resistance exercise to feel strong and to look good, to feel good in your clothes, to feel good without your clothes. That's why you do those exercises. That's a great motivation because I'll tell you that that covers your base for when you're 55 and 65 years old, because you need to build muscle tissue before you arrive at that point. So you need to do those 20 minutes of resistance exercise twice a week, three times a week. If you're really trying to shape your body, you can do it more than three times a week. But even if you can only fit in 40 minutes a week in two 20 minute segments, you've got to do it. And there are plenty of high intensity interval 20 minute workouts online that you can access. Find one that fits you and do that workout. It's true that some people are just physically built to bench press and others are physically built to do ballet. But as we've all seen, the guy who bench presses could benefit from taking a ballet class once in a while and the ballerina could benefit from doing a few bench presses. So we've got to combine both I don't know if I've answered your question with enough detail, but 20 hours of high intensity interval training twice a week helps maintain bone density in perimenopausal women. It builds muscle strength and connective tissue strength in both andropausal and menopausal men and women. And it is necessary to have a full, fit, free life in your 70s. Picture this. This is what I tell my clients. Let's make our goal 100th birthday party. And that you drive to your 100th birthday party on your own. You go into your hundredth birthday party and you thank everyone who's gathered. The cake has a hundred candles. You blow them out with three breaths. Because if you look at pulmonary function, it takes three breaths to blow out three candles. 100 candles. You blow out the hundred candles with three breaths. You have a glass of wine, a little bit to eat. You thank everybody for coming, and then you go on to your. To your next event. That's your 100th birthday party. It's not the one where somebody wheels you in with crocheted afghan on your lap and you kind of stare off into the distance. Nobody wants that hundredth birthday. They want the one you drive to yourself and they want the one that you're going to something different after the party. And in order to do that, you got to do 20 minutes of resistance exercise twice a week. I love it.

Let's all work towards that. Absolutely. Okay. I want to switch gears a little bit more. I want to talk about some of the really cool tools and therapies that you all use or that you love for longevity medicine. I know you have access to quite a few. Can you give me a couple that maybe you see as valuable to a wide variety of people? I know one that I definitely want to talk about is therapeutic plan plasma exchange. Pick your brain on that a little bit. But any that are your particular favorites or that you see truly contribute to health span lifespan.

J. Let's start from the bottom up. We won't go into this during this meeting. Perhaps we can meet again and talk about it at some length. But historically, the United States made some changes in its farming practices in the 1960s and 70s that changed the nutrient density of our food. And unfortunately, it took away a good deal of that nutrient density, making the nutritional supplement industry not only possible, but necessary. So three nutritional supplements that everyone should take. A vitamin D supplement, an omega 3 oil supplement, and cover your bases. You think you eat great, Take a multivitamin. And the more natural the ingredients, the better. I don't want to push anybody's brand, but one multivitamin a day can sometimes address the micro deficiencies that you might need to address in order to get the most from your workout. In order to get the most from your sleep cycle. Yeah. Okay, so basic nutritional supplementation. And then we can elaborate on that. There are things you can, you know, google mitochondrial nutrient support and see all the list of things that you could take. You can take those. Google brain fatty acid support. It goes beyond omega 3 oils, but omega 3 oil, multivitamin, vitamin D are bare essentials. You got to take those. Yep. Is there enough vitamin D in the multi? Probably not. Probably not. You need to supplement it. Okay. Building from there, because that's fundamental. Building from there and going above food and exercise and sleep, maintaining healthy perspective into tools and tricks. Oh. Every day before our 30th birthday, we wake up and we're completely knitted back together. We've repaired everything, we're brand new. And on our 30th birthday, we wake up, we figure out what we're going to do for our 30th birthday. And that's the first day that not everything got done and it never gets completely done again. Every day thereafter, there's something undone. And the process of being undone creates all types of obstacles that uses up all kinds of energy that we used to have and feel now that energy is going into moving waste around, circumventing ways, trying to initiate processes that don't become completed. So we recognize that and we think, okay, let's move the waste through filtration process. That's total plasma exchange. Plasmapheresis. I've learned that it's not fair to tell people about things they can't afford. It's not fair. Plasmapheresis will become affordable. It's not necessarily affordable right now, although it's available. You can go to clinics throughout the United States and individual clinics in your town. You can Google who does plasmaphoresis in Tulsa, Oklahoma, and find of place. Right. Just a little hard to climb that to. To make that fit into your budget. But it's a wonderful treatment. It's a treatment that passes all of your blood volume over a period of about 90 minutes through a series of filters that removes all kinds of stuff, microplastics, antibodies, damaged proteins, amyloid, the stuff that we're all concerned about building up over a lifetime, causing dementia and other types of problems. Plasmapheresis can clear a great deal of that out of your body. And yes, your body's going to create more of that waste. So you're going to do plasmapheresis how many times a year? In your 30s, maybe you don't need to do it at all. Maybe you could do it once in your 40s, maybe you want to do it twice a year. In your 50s, maybe you want to do it three times a year. And certainly north of 60, you'd want to do plasmapheresis four times a year or more. There's a poor man's plasmapheresis is called EBO2.

Huh?

It's a process of hyper oxygenating the blood. And what happens is that if you hyper oxygenate the blood, you expose a lot of this stuff that your body doesn't recognize as waste. You expose it as waste, and your body says, oh, I can get rid of that. And you end up eliminating it after an EBO2 session. You end up eliminating a great deal of it on your own. You don't get quite the microplastics or the pfas chemicals out of your body, only some of them with EBO2, but you get a lot of the other stuff out. And EBO2 is a lot more affordable than plasmaphoresis. Exosomes is a word that's going that we're all going to become more familiar with. Exosomes are the language your body uses to speak to itself. Think about this. You cut your finger, and as soon as you cut your finger, the first thing that happens is white blood cells immediately rush to that scene and they get a. This, the damaged cells to secrete and their own white blood cells, platelets, secrete fibrin so that you start to build a clot and the blood stops. Okay, so now one of the white blood cells has contributed fibrin. Fibrin is not exactly an exosome, but it's. It's a start. It's the process. Then the immune system cells that have been gathered at the site of the. Of the laceration, stem cells that have been called in by the IMM that place. And the damaged cells have to have a conversation to heal that cut. And you see it heal over a period of three or four days, and that's fine. That conversation, the communication between those cells is carried out by packets of information that each cell secretes that the other cell takes in and reads. Those packets are exosomes. Well, if that's a conversation that our body has when we heal, then could we take a sample of our blood out of our body, Stimulate the blood to make the healing exosomes, give it back to us, and maybe we could sleep one night and wake up the next day completely healed. It's possible if we had enough exosomes, we could do it. And you can see if that's the riches of this cell to cell communication process. And we know what they are. How in our future is going to be enhanced by having access to our own exosomes and other types of commercially produced exosomes to heal us in many different ways, to heal sun damaged skin, to restore our ability to create elastin so that we don't need cosmetic surgery in our 60s to heal heart tissue, to heal the gut, heal kidneys. You know, exosomes are going to create this boom in healing processes and restoration of functionality. We all think that there's a magic in stem cells, and there is a magic in stem cells. We hear about people going abroad and receiving stem cells and being rejuvenated. Currently, it's a little overblown. And what I mean by that is stem cells are valuable for their contents. If you went abroad or now in some states in the union and received umbilical cord stem cells, they would come into your body and for the most part they would die and they would spill their contents. And their contents may be valuable for a period of time, but they're not going to come into your body and do the work that you need done. Only your stem cells can do that. So I believe over the next decade, we're going to really refine the process of stem cell therapies. And I think that 10 years from now, we're all going to have access to stem cell therapies that we don't realize now. And those could be rejuvenating. If you envy the people who go abroad and can afford to have stem cells, I wouldn't envy those people, believe me. They might have felt better for a little while, but they weren't going to get any real permanent improvements from it. And in this next 10 years, I think we'll develop sophistication of stem cell therapies to where that will be very helpful. And again, some of the most important ingredients in a stem cell are the exosomes that it uses to speak one cell to another. Hyperbaric oxygen. So the Israelis published a study out of University of Tel Aviv a number of years ago that showed that spending 60 hours in 90 days in a hyperbaric oxygen chamber of 2 atmospheres or greater improved your lifespan. Like it increased your lifespan. And the way it did it was by extending the chromosomes at the end, which is called the telomere so, basically, as we get older and our cells divide, the telomeres shorten, and at some point, every cell reaches its last division in life, and that becomes a senescent cell. And they're problematic. It's a whole other conversation. If you could extend the telomeres of all cells, you would never reach that end point, and you would theoretically stay young forever. Hyperbaric oxygen can extend the telomeres. So it became a very interesting therapy. Do we really need 60 hours in 90 days? Like, could we do it with 10 hours? Well, they didn't do that study, so we don't know the answer for sure. But the answer that I got from the authors of the study was probably it wouldn't take that many hours. There are hyperbaric oxygen chambers available for you to buy and bring into your home. They're pricey. Unless you can achieve two ata or greater, they're not going to reproduce the telomere extension. And those chambers are hard shells, much more expensive. They're the ones that you can access at a local hyperbaric oxygen place. And you'd be surprised if you Google hyperbaric oxygen in Tulsa, Oklahoma. I'm picking Tulsa in Omaha, Nebraska. In any city in which you live, there's probably going to be a place that you could go. So those are kind of the innovative things that most people hear about or don't hear about might be helpful.

Fascinating. Are there any of these, or even ones that we haven't talked about that you feel like in 10 years they'll probably be standard of care, like we'll evolve that much, that they'll be the norm?

I do. And the reason I think that is, you know, the vision I have, the future. I've lived a long time, and I've been able to learn that I'm pretty good at predicting the future. What I was not good at was the timeline. Meaning I always thought that things would be accomplished sooner than they were. Like in 1990, I thought that we would already have sophisticated stem cell therapies by the year 2000, and we were moving in that direction. We got derailed, and we didn't get there. And we still haven't gotten there. So I was very wrong about it. I think it will still come true. But you're asking about innovations or things that we will adopt in the next 10 years. I think in the next 10 years, we're going to have wearable devices that speak to us and give us health support on an ongoing basis, day in, day out, whether it's an ear pod, Or a little speaker in the arm of our glasses, or it's something that we turn on and turn off. We're going to have a health assistant, a health coach, and that health coach is going to be reading our wearables and telling us, speed up, extend your strength, extend your stride, use your feet. You don't think about it in your 30s and 40s about extending your stride or using your feet. But if you think about your grandmother and her contracted stride and the fact that she was losing her balance just walking on a flat surface, those are the coaching cues that we're going to get from our wearables. So I think wearables are going to become very common. I think that those wearables are going to be linked to, to an app and a website. And I think the app and the website is going to give us ongoing metrics. We're going to be testing ourselves on a regular basis and getting that individualized health coaching, the type of health coaching that you and I do one on one, that makes it really so exclusive and so expansive. I think that'll be universalized. And I think there'll be superpower followers that will have these, you know, superpower abilities and access to this information. I think the treatments that I just described, plasmapheresis, EBO2 exosomes, are going to be democratized. They're too valuable to remain elite. And one of the reasons that they're too valuable to remain elite is because they will help us prevent diseases. It'll help prolong our functional lifespan, our health span, as you referred to it earlier. And that's going to be much less expensive to the nation and to each of us as individuals. So, exosomes, stem cell extracts. Imagine this, because there are companies experimenting with this right now. We would take stem cells from you, we would load them with mitochondria, that is, the batteries that produce energy in the cell. So let's say we extracted your stem ce, your age, and just pick a number. You had a thousand mitochondria in each stem cell. We would put 9,000 more in that stem cell. Then we would clone those stem cells. So then we would have, let's say, 500 million or a billion of your stem cells with all those mitochondria, and then over the year, give them back to you. Your listeners may not know this, but stem cells will sometimes contribute mitochondria to cells that need more energy, so they can actually be traded with other cells. Okay, that's a type of sophisticated autologous from me. For me, types of individualized treatments that might be completely affordable.

I would love that one day for myself. So I'll look forward to that happening. Absolutely. Well, I could literally talk with you for another whole hour. I would love to pick your brain on so many other things. So I might have you come back for another episode. But I do want you to tell listeners where they can find you, where they can find out more about lifespan, just how they can stay connected with you and your mission.

Of course they can. Find our webpage at www.lifespanmedicine.com. pretty simple. Lifespan medicine. That was the goal of the practice in 1990. My wife and I debated whether we should call it healthspan because we recognize the value of healthspan over lifespan. You know, lifespan as you get wheeled into that hundredth birthday party, healthspan as you drive it and walk in yourself. But we opted for Lifespan thinking. Well, it's a more universal title. So www.lifespanmedicine.com you can search me online for podcasts. I always welcome the opportunity to speak to well informed and exquisitely prepared people like yourselves who are doing the same work that I'm doing, just in a different location and geography. And I would love to be invited back.

I'll absolutely have you anytime. Well, thank you, Dr. Rena. Thank you for the work and the lives that you've changed. You've been at this mission for a long time. You're a man very far ahead of your time. So thank you for all the energy, wisdom, effort, learning that you've put in to help so many. And it was lovely having you.

You're very welcome. Thanks so much for hosting me and for making it so easy. Absolutely.