Your Genes Are Why You're Still Sick (And What To Do About It) with Kashif Khan

And I was working with a client in Toronto where I live, and she was struggling. Then I started working on some other people. It just seemed to be this like unraveling of this thing that nobody was talking about. So why do women say, "I'm gaslit, nobody's listening, I'm being blamed"? The goal is prescribe. You can't prescribe without diagnose. So first I have to give it a name, then I have to diagnose. Just because you can't give it a name doesn't mean there isn't something wrong. So the single greatest contributor to the expression of disease-causing aging genes is negative emotions. And the single greatest contributor to the anti-aging genes and the turning off of the disease-causing genes is positive emotions.

Welcome to the show, Kashif Khan. Kashif and I have known each other for quite a while. He was very instrumental in helping me in my, uh, I would say curiosity about genetics, which started in university. And, you know, throughout medical school, we were learning little bits. And the Genome Project was happening, but didn't complete until I was well out of med school and out of surgical training and into plastic surgery training. So I believe we'll say the completion is like 2003, relatively speaking. And Things have changed.

Changed a lot, right? Yeah, it's not just the sequencing of the genome. Now it's the interpretation of it. How do you make it functional and actionable? And that's actually, you taught me a lot there, even though you didn't know what you knew. The work that you were doing around breast implant illness and how that showed me to look at it from a different lens. You know, we're always forced to solve problems and every time we solve a problem, we learn more.

We should go back because it's hilarious. This, you know, I mean, you know all of the beginnings of this and the commercialization of it with you know, 23andMe and all the random little things you used to have to do to get an interpretation of the code. And I remember, I can't even go through all the people and vendors that I've had over time, but one in particular said, hey, you should learn, or you should meet Kashif Khan. He's the CEO of the DNA Company. And this is more of what you're looking for in terms of understanding about genetics. Because I kept asking different vendors and getting different answers. And you remember things like nutrigenomics and all the different things. And I was always interested in nutrition and its application, not just for how we live, but how we should do it based on our code. And then I remember meeting Kashif at a meeting in Scottsdale. I remember talking to him and I said, you know, I'm working on this breast implant illness problem. And you looked at me dead in the eye and he's like, well, I can help you with that. I understand that pretty well. And I was like, what? Yeah.

And I just had started at that time. I didn't know it was a problem. And I was working with a client in Toronto where I live. And she was struggling. Then I started working on some other people. It just seemed to be this like unraveling of this thing that nobody was talking about. And I felt the same way 'cause I met you and you were working on this thing. I was like, well, nobody's working on this properly, right? So that's where, you know, everything came together. And I think, you know, this now genetic understanding of who's susceptible to breast implant illness, the lack of recovery, you know, how to actually help somebody recover. There's so much to it now that makes things so much more precise.

So, uh, we won't get too off track because I can jump around today if you give me a chance. But we have a pretty good collection of results from the DNA company which we initially used and transitioned to different folks, and now we've actually circled back to them. But we have an IRB. So everybody listening, an IRB is what you basically apply to get authorization to review your results, to publish data. And so we submitted an IRB. So we want to compare our understanding or our patients' results with Eric Topol's WELDERLY study because they determined there's no quote unquote specific anti-aging gene.

Yeah.

Which makes sense. But all those people in their study lived in the 7th, 8th, 9th decade, I believe, without any chronic disease.

Yeah.

So to me, that screams of people who detoxify extremely well. And live in probably good community and eat well and rest and do the things that we talk about a lot. But I always go back to like, you know, like, if you didn't pick your parents right, that's gonna be a problem. So to me that, you know, we know from all the data what our patient profile is. I'm just super anxious that if I understood all the code and stuff they sent us for the study, we would already know the answer, but I'm not smart enough.

So we have to hire somebody. The answer they're looking for— so, the way people were looking at genetics was wrong. And this like, I want to find the fountain of youth anti-aging gene, you can argue both sides all day long. It exists, it doesn't exist. And why would there be an argument? Somebody listening in, it's a gene, how do you not know? Because the interpretation of this gene equals that, this gene equals that is what the researchers think they're looking for. Like, here's a gene that equals anti-aging, here's a gene that equals autism. That's not how the body works. There are a whole bunch of genes that equal how you detoxify chemicals, plastics, how you make hormones that might actually cause inflammation, how you deal with your metabolic health. And each one of those are longevity genes or systems, right? Because what are we talking about? Preventing or reducing inflammation, right? Right. There is a gene pathway called FOXO3 that's responsible for cellular regeneration. So as we're sitting here, cells are becoming senescent, mutating, dying off, being replaced. The efficiency by which you drive that regeneration is driven by a gene pathway. So that's technically an anti-aging gene, right? Because if you have a superhuman version of that, which some people do, you just age slower. So looking for the secret miracle gene, maybe there's something in our 22,000 genes that somebody's going to find one day. But we can be so much more actionable, functional today, just thinking about everyday biology and just addressing it properly.

That's why I talk about sleep and quality of food and fluid and air and your genetics. Really, you taught me a lot about really being very specific about supplementation as it relates to your genetic detoxification pathway. So I'm still very rooted and staunch in that. I don't have, and at one point I probably had 100 supplements on my desk every day, but I don't anymore. I'm pretty basic now, and I think the more I go along, the more basic I try to become with like less ingredients all the time because there's just too many opportunities for fillers and other things to get involved. You know, I still concentrate on methylated B, vitamin C, D3, K2, glutathione, and I use those for my patients because they have so many absorptive problems already. Typically, I think he gets already a problem for them and/or a host of other things from mold exposure or whatever, whatever they've gotten into. So I try to keep it super simple all the time versus I see a lot of people promoting things that are pretty complex for somebody to digest or they have proprietary blends of things that I think are just probably not gonna help.

Yeah, and I agree with you. So I went through the same journey of, I was sick, had so many problems taking all this stuff. And it's kind of the converse where people think— people think my DNA will tell me what to do. It will also tell you all the stuff you're doing that you don't need to do, what you're wasting your time and money on. Because yes, when you listen to a podcast or watch a video, whatever, it sounds great, and maybe it was great for the person that did it, right? But does your body need that, right? So what is— what should DNA inform? Where is your biology broken? Your production of hormones, your production of neurochemicals. What job does your body not do well? If that job's not happening well, you have two things you can do. Either stop some context, like, "Hey, I am wired to create trauma. I'm not going to go work on the front lines in the military." Or, add something, a nutrient or supplement to upregulate that biology to make you capable of doing what you're doing. And that's it. Those are your habits. You don't need a giant supplement drawer, right? You need to fix the broken biology, which would allow inflammation to happen. Aging is slowed down.

If you've been listening to this podcast, you know I take these conversations seriously, and some discussions simply don't belong in short clips or public comment sections. That's why I created Dr. Rob's Circle. It's a private community for those who want a deeper level of education and dialogue. Inside Dr. Rob's Circle, I share extended clinical insights, structured guidance around surgical planning and recovery, and conversations that go well beyond what I post publicly. This is a more focused environment. It's more thoughtful, more detailed, more direct. If you value careful evaluation and want access to a higher level of discussion, I invite you to apply to join us. You can learn more at drrobscircle.com. I look forward to continuing the conversation with you inside. Yeah, I think that's— and when I read the study that they performed and looked at it, they didn't find anything, but they described these people and how they were living. It just reeks of what you said, like they didn't have a lot of inflammation.

Yeah.

Therefore, they didn't get chronic diseases of organ systems, which are the result of inflammation.

Yeah. Yeah. And then you look at these populations that are like aged well. And you start to look at what they claim is the reason, and the stuff they say is not the answer people want, right? People want the founder of youth magic pill. You go to Japan and you ask them, they'll tell you it's ikigai. Like, what is ikigai? It's sense of purpose. I have a sense of purpose. I don't— my brain and body doesn't retire. And what you feel— you're sorry, I should say what you think will drive your biology, right? So if you actually live if against your sense of purpose or lose your sense of purpose, you will age faster. And it doesn't sound like the sexy answer people want, which— here's the magic injection. So the single greatest contributor to the expression of disease-causing aging genes is negative emotions, and the single greatest contributor to the anti-aging genes and the turning off of the disease-causing genes is positive emotions. And you'll see that these people that live a long time have community. They sit at the dinner table together. They have love, pleasure, joy. So their lifestyle, the secrets are just look at how they live.

Right?

Right.

That's the other part of Eric Topol. When you hear him get interviewed and he talks about the people, he had trouble tracking some of them down.

Yeah.

Not because they passed away, but because they were too busy.

Yeah.

'Cause they, you know, maybe they go and have a club they attend or they go in the community and they participate. And one was an artist. So they were constantly doing these activities. They stay busy and they stay engaged. And to your point, they're not isolated. And isolation is certainly a recipe for disaster. That breeds a ton of problems if you can't have community. So, I, um, I try to talk to the, you know, the patients and I introduce, you know, just basic concepts because I think kind of— and you may agree with this— like the, the methylation pathway has been like overblown in terms of visibility versus the other pathways, which are— I mean, 36% of the population typically doesn't methylate well. That's— I don't It's not like a novel thing, but it's been made out to be the, the thing. And it seems like, yes, you know, the contributing factors we talked about previously, plus your HLA type, but those all contribute to, you know, why we experience things in terms of inflammation the way we do. So I try to explain it to patients in a, you know, very straightforward, very honest way. Like, you're not indicted by this Yeah. It's just, okay, this is the— now you know, and habitually, what can we change just to help you navigate that?

Yeah.

It's not— I don't find it that problematic. Like, my son doesn't have great detox pathways, but, you know, then he's like, oh, well, what am I going to do? You know about it.

Yeah.

You're going to make changes based on that. And be mindful of it.

Yeah, and you can take those detox pathways and break them down to what really— what are we trying to determine?

I—

every choice you make is a choice towards good health or a choice away from it, right? Everything you eat, you breathe, you touch is always going to take you further or closer. So for your son, for example, you can take that, you know, my— I don't detox well, and then break it down into how does that mean I relate with the toxins. For example, some people don't detoxify well in their gut. So now, the priority becomes what am I eating and what am I doing to maintain and repair leaky gut? What am I doing to maintain my microbiome? That becomes the work that I have to focus on, right? Versus some people genetically don't do a good job of filtering airborne toxins, inhalation-based toxins. So, imagine somebody who has the GSTP1 gene drives glutathione activity in the lungs. So, imagine you're that and you live in LA where you're within the thoroughfare of a highway and there's pollution all the time, right? Now, you know that that's not the right choice for you. Either you stop or you add the nutrient that supports that respiratory detox. So, this is where what used to be a generic answer and used to be a disease-centric answer is now more functional. We can actually look at biology and then put it into practical context, right? Here's all the stuff I got to do. What's good? What's bad? Right?

And for our patients, we did an audit so that everybody listening is aware that we know that 83% of our patient population has deficits in all four of those fundamental pathways we were talking about. And so it makes sense, right? Yeah. They're very predisposed to consequences of chronic accumulation of inflammatory, you know, either biomarkers in their system or just constant overload and it makes a lot of sense when you hear the patients. And if you listen to them, they're telling you exactly what's going on. Just like you said, they may live a place that has just got horrible air quality, or you listen to what they eat or what they can have consumed throughout their life. Because it's not just what you had yesterday that's affecting you. Like, if somebody's got a high glyphosate burden, that could have came from early on in life and they just don't detox it well. You grew up in the Central Valley of California before it was cool there to have organic things. They were sprayed, just so everybody knows. And I have tons of people who grew up in the Central Valley who come to us who, you know, augmented, and I have to un-augment them for the AI and breast implant illness folks. And they have incredibly high glyphosate levels. And one of them in particular had an interesting problem. They had shingles. And the breakout extended onto their face along the nerve distribution over the mandible. And, they got all these sores and everything and they wouldn't recover. They couldn't recover. And so, they went and saw the dermatologist multiple times and they gave them the appropriate therapy. But, in reality, they have a a level that really affects DNA repair and they have a genetic problem with methylation. So, it really makes it over—

Yeah.

It's not that what the therapy was being prescribed was incorrect. They were doing all the things appropriately, but they didn't understand the biology of the patient. Genetically, the patient didn't methylate well, wasn't taking any methylation-type supports. So, So, even if you gave them the right drug, had the right therapeutics, they wouldn't be able to utilize it in a way that would solve the problem. And then, I said— and we happen to have all of her data because she's a patient of ours from, I think, a couple years before this incident. And, we look back, genetic data doesn't change and we already knew what her glyphosate level was and she chose not to do anything about it, which is everybody's right. I was like, well, It's all basically right here. Yeah. You had this problem genetically and you have this level of an environmental toxin. Those two things make it so whatever they gave you, whatever they, you know, it makes sense why a lot of things don't work in that context when you understand it.

You remind me of every client we're dealing with who's stuck, right? It's like, I did all the stuff. I do all the things, I listen to all the podcasts, I took all the supplements, right? Why did nothing change? Because the terrain and body is not ready. So, the medical answer or the toolkit is diagnose and prescribe, right? The goal is prescribe, you can't prescribe without diagnose. So, first, I have to give it a name, then I have to diagnose. The success check mark is you're not complaining about the pain anymore. But, we're never asking if there's a skin condition from psoriasis to eczema to the flare-ups to whatever, like all these potentials you said people might have skin issues, is toning down the skin issue solving a problem? And if that were true, why do I need to refill the prescription? Why do I need to get it again? Right? Right. Because I did.

That's what you had. You had eczema.

I had eczema and psoriasis.

And psoriasis.

Right? So autoimmune and inflammation. So, I see them as check engine lights. I see them as if your skin is inflamed, it's telling you dig deeper.

Oh, yeah.

The number one periodontal is like that's the number one inflammatory condition is we get it in our teeth and the skin is very sensitive, right? Then, it goes to other places. So, here's an example of using skin cancer, right? This thing that we think I need to put on sunscreen to protect myself from the sun or I'm going to get skin cancer. So there was research that was done, and I'm just saying this to give you an indication of how the functional insights lead to the level of inflammation where the disease is possible, but the exact same context of sunlight would not cause inflammation and actually heal you from sun if the inflammation wasn't there, right? So there was a study done at Baylor College, not too far from here, I think it's in Houston, right? They, um, they took animals, same breed, half of them they fed them an American diet of glyphosate and seed oils. They made sure the food had a lot of glyphosate and seed oils. So, they fed them what an American would typically eat, right? The other half had a carnivore, grass-fed, organic, pasture-raised beef diet, right? They put them out in the sun for what is like the clinical warning sign for skin cancer. The animals that ate the American diet, 25% got skin cancer. The animals that ate the carnivore, zero. Yeah, zero.

Yeah.

So does the sun cause cancer, or does your bad methylation genes— and why 25%, why not 100% got skin cancer? Because some of those animals probably had good gut detox genes and good methylation genes, a good— but the 25% that had the bad detox, the bad gut formation, the bad gut microbiome, that then added an insult that caused dysbiosis and leaky gut, that then got systemic inflammation, now put out in the sun when their skin was already at 8 out of 10, right? So this shows you disease is optional. Chronic disease, right, is optional. We can predict where it comes from, and not everyone is susceptible to the threat causing the inflammation, which is why a pharma can argue all day long it's not true. And the difference is genetics. The 25% were the cohort that had the bad genes that couldn't tolerate that choice of the— that diet. Right.

I think it's interesting too. I mean, you've— you're in Canada or Canada-based still. And so when you watch TV at night in the United States, it is literally dominated by drug commercials.

Yeah.

They own the marketing. And it's interesting because I don't know if you remember a man's name. He's a pediatric surgeon named Judah Folkman.

No.

So basically, he's the person that came up with all the anti-angiogenic inhibitors.

Okay.

From his lab. At, he's a pediatric surgeon at Boston Children's. And so when Judah Folkman came to speak to our surgical residents at Indiana University, Dr. Grossfeld, our chairman, rented out a hotel instead of a regular conference room because everybody wanted to come hear him speak. And all these drugs that MAB, any drug that ends in MAB ultimately came from his lab because he showed that you could suppress tumor growth with anti- and basically monoclonal antibodies to angiogenic markers. Anyway, so I bring it up like all I do is sit there at night and I see all these drugs pop up. They're all anti-angiogenic or they're all immunosuppressive. So what does that ultimately— so everybody listening, I tell my patients this all the time. So Joseph Murray was a plastic surgeon who transplanted the first kidney.

Okay.

And the reason it worked is because it was from an identical twin and needed no immunosuppression.

Okay.

They first did skin from one twin to the other to prove that it wouldn't get rejected.

Okay.

It's the exact same genotype. No, identical twin. They did the transplant successfully, which is artery, vein, ureter. That's the hookup. No immunosuppressive medications needed. Yeah. And it works for over a year, I believe, and the patient dies unrelated to the kidney transplant. And the next step then, of course, is a non-identical twin. So that requires, at that point, they used total body irradiation because they didn't have the drugs. And then the next step after that is, of course, a cadaver kidney transplant. So that's like Kashif giving his kidney to me or vice versa. So that requires immunosuppressive therapy after the crossmatch is negative. So there has to be blood type compatibility and then crossmatch negative. So there's no preexisting antibodies that are cytotoxic to cause acute rejection. I say all this because Now, you know, we've implanted devices in patients and they will continue to be implanted for life-saving, limb-saving, heart-saving, whatever the condition. Devices are not going away. Now, the reaction to devices is very different depending on the device and where it is. And, you know, I used to spend a large part of my time planning surgeries for cancer patients and multiple interdisciplinary cancer group. So that was incredible opportunity for me in my career. But I took— I think I had a more than a healthy respect for what we were doing. So when you had to replace someone's femur because they had a bone cancer, the musculoskeletal oncologist who's an orthopedic surgeon would do that surgery. And then they would do either a titanium replacement or catavaric allograft replacement. It's a big deal. Patient is either going to lose that leg, lose the ability to walk, be confined to a chair or crutches or what have you. So there's a lot riding on getting that right. And they were excellent. The people I worked with were tremendous. And they would go into these meetings, plan these surgeries, and then call me at whatever time of day or night to come in and close over that because now they had removed this big tumor plus minus the bone, whatever structures now are missing, and they have this implant in place now. And it has to be protected. Otherwise, if it got infected, then the patient would potentially lose their life, but definitely lose that device and all this, you know, ramification. And I think it always led to me to be very, very conscious of the reactions caused by devices and the protection of those devices with, you either a tissue transplant that I could do or something to help protect and cover it. I say that because now, like, there's research coming out of Denmark that shows there may be more of an organ rejection picture at the tissue level of a breast implant. So if someone has a thicker, firmer, harder scar around the implant— so the capsule that forms around a breast implant is a collagen sac, basically. It's not impervious. There's communication between it. And we published a big paper, as you know, a couple years ago, 694 consecutive explant specimens, PCR tested. 29% have bacterial contamination, predominantly with Staph epi and Cutibacter magnus. Both of those readily produce biofilm. The biofilm interacts through that non-impervious collagen sac with the oleic acid and the fatty, uh, or I'm sorry, the oleic acid, which is fatty acid in the breast tissue. So Mathun Sina, who's the scientist at Indiana University Medical Center, showed that interaction leads to downstream macrophage polarization and ultimately more of those symptoms. And there's a biomarker, oxylipentinum, you can measure in the blood in those patients. So they did that in the lab and showed it's higher in those patients with all the worst symptoms of breast implant illness, which are— for everybody listening, breast implant illness, you know, as I define it, is a chronic inflammatory process of which a medical device in this case, breast implants playing a role. It's the same type of picture that, uh, uh, Kauschew or I would see if someone had Lyme disease or mold, chronic mold exposure, or some other chronic inflammatory process. Um, and, and to me, like, it makes sense, right? Because if you go back to what I said about the kidney transplant, there is no rejection if it's identical. Everything else is not self. And when it's recognized as not self, your body reacts to it. So it's always going to react to the things we put in it, the things we put on it, things I implant in it or take out of it. And it makes sense to me that those patients who are more genetically susceptible, their archetype is such that they're really susceptible to inflammation. They would respond more to that.

Far more aggressively, yeah.

So it makes sense. Like some people, like, I recently had a patient. This is always a tell for me. And they come in and they're like, you know, I don't think I can make it to surgery. I'm like, I can't walk. I feel worse. I really, I have a lot of pain. And this happened recently. And the patient, you know, was very upset. And I said, well, have they done anything that's helped you in the past with this? She says, sometimes they give me a little bit of steroid and a And I said, is it a little package of steroid? Like you take 5 one day and 4 and then 3. She's like, yeah. And I said, that helps? She's like, yes, it does. And I said, okay, well, we'll do that for you and we'll just— we won't cancel the surgery. We'll just see how you do. And a week goes by. She comes in for a pre-op appointment. Totally fine. She's like, I feel great. So to me, that Tells you everything you need to know. The level of rejection that's happening at the tissue level is not the same as an organ transplant because your body would just get rid of it. But it's still there. It creates that feedback. The scientists have shown that if bacterial contamination is there, it's worse. And if they're creating a T-cell response, which ultimately is what leads to the anaplastic large cell lymphoma from breast implants, plants that are textured, is it really that big of a stretch to think that there's more happening at the tissue level? I honestly don't think it's that complex when you think about it. Instead of just a T-cell response, if you're having an organ rejection response, that means you have plasma cells and you have B-cells. And that's what the research showed. So I'm like, it makes a lot of sense at that. When you think of it like that, I wish there was a commercially available test like we did for PCR testing of the— scar tissue specimens, because it would make my day to be able to send it to a lab to show that the RNA element there is really elevated as it pertains to the plasma cell, B cell, and the T cells. That would, that would confirm and reinforce that. Like, and it would take somebody who has a high volume practice like mine, seeing that all the time, to really just, you know, we already have the largest experience in the world with PCR-tested samples. Of people explaining 4 symptoms. If I could add to that an eRNA test sample of that size or magnitude, uh, I think it gives further validity to what our patients experience and what they tell us. And then when I hear that they do better with a little bit of immunosuppression, I'm like, well, yeah, makes sense, right?

I think the testing is possible. It's not even something, you know, I would love to— just the impact of what you're saying, I'd love to help you find and build that. Let's just say that it's possible, you know.

We're a lot closer than our discussion several years ago.

Yeah, yeah, yeah, yeah, for sure.

But now it makes a lot more sense. The things we talked about in September of '21, I believe, is when we met.

Yeah, yeah, way back when.

Uh, it's far more, uh, in sight now, and it makes more sense to me even more now than it, you know, certainly it did not make a ton sense back then, but now it makes a lot more sense. And, uh, I, I know we could add and, and, and do more work with HLA and everything, but just putting those little puzzle pieces together and hearing the feedback from patients— because yeah, I tell everybody, and everybody listening who's a doctor or practitioner, if you listen to your patients long enough and intently enough with Enough intention, they'll tell you exactly what is wrong.

Yeah, and our challenge has been, so why do women say, I'm gaslit, nobody's listening, I'm being blamed, right? It's because there's no diagnosis, right? Right. So what's the next step is prescribed, so in the first step is diagnosis. So this is where the functional thinking, all the stuff you just talked about, Just because you can't give it a name doesn't mean there isn't something wrong, right? Let's think more functionally about system biology versus symptoms. If you think about system biology, things start to make sense. And then the thing that somebody's complaining about becomes a very real thing, as opposed to just, it's your hormones, you know, which is what a lot of these women get. It's like, you know, all women, yeah, menopause is rough and mood is, you know.

I think it highlights a big gap, right? So the understanding of the immune system is minimal. Yeah. And our diagnostics to measure what's going on, really primitive.

Yeah.

Like, we know very little. Like, you know, I remember when the pandemic happened and I was seeing, you know, x-rays get posted on what was Twitter then, now X. And I looked at them and I was like, oh, that looks a lot like adult respiratory distress syndrome. And if they're unable to treat it, Zygris doesn't work, which is monoclonal antibody to TNF-alpha. That just means it's another cytokine storm that we don't understand. And that's why things got so out of hand so quickly, because a drug like Zygris didn't work because it was a new, you know, cytokine storm. But it just highlights what we just don't know. Enough. Yeah, it's very— I think it's just super— like, when I hear people talk about the immune system, I just— I'm baffled by, like, the certainty with which they say things, which, you know, is not— like, you can't prove it.

Yeah.

And each— the paper I, I commented on from Denmark, somebody wrote a commentary about it said you can't say this. Yeah. And I'm like, well, why? Yeah, what is your interest in saying that they can't say that? And it was somebody who was a composite tissue— I'm sorry, composite tissue allograft transplantation expert. And I was like, okay, so your body has T cells that go through training in your thymus. You recognize self versus not. Everything, you know, that's what protects you. And these things, T cell receptors are all over the body on our cell types and they protect us. If you have a device that rubs inside of you and debris comes off that device, 'cause we know that happens, your body's gonna recognize that. As foreign and it's gonna pose a response. It doesn't need to be that the T cell receptor is receptive, uh, seeing something from Kashyap Khan. It's just recognizing something that's not self. So I don't even understand why somebody would write a commentary and say that it's not possible for that to happen.

Uh, well, it's again lack of functional thinking. It's like, here's what I've been taught. And I am the source of truth and nothing else is true. That's one of the major challenges. So I come from this world where we are a research company, so we're constantly innovating and coming up with new theories and new insights. And the challenge of the practical application of that being adopted, you know, I heard the other day that it's 27 years is the average time it takes to adopt new science to like be on a doctor's desk. It's the slowest progression because of The moat of protecting the industry versus innovating, right?

Right.

So it's, you're taught to thought, not you, but in general, this industry is taught to think that way. Yeah. Right? Which is what you know is all that's true. You know? And so, and then the way that it gets proven and believed, it's more important who said it than what was said. Which is another failure, right? It's more important where did the information come. If I tell somebody something new in a conference, I'll speak on stage about breast cancer. A doctor will come up to me and say, where was that published? I'll say, can you pick apart the words I said and tell me what I said wrong? Is there anything that I described in the biology of cancer that was wrong? Right? And they don't think that way. But not their fault. They've been trained to think that way, to maintain the moat.

Yeah, it's one of those things where I read that paper and I was— if you would have seen me the day I read that paper the first time, I was like, whoa. Yeah, this is really exciting. Yeah, because this makes, when you think about it, a lot of logical sense.

Yes.

But then I read this commentary and I was like, oh, what a buzzkill. But not, not for me personally, but I just think for the people who respond to like that and can't really think, not even outside the box, but just like think. Yeah, you, you have to not be comfortable and step outside the comfort zone of like, ah, yeah, maybe what he's saying is actually really accurate. Yeah. And we should think about it.

Let's at least investigate it, right?

Yeah. Let's dig. And it's hard for us. We're private, of course. And for us to get an IRB and then get all the work done. And I'm not a data scientist, as we know. So we have to go pay third-party data scientists to review data and help us understand it. You know, our— I think our understanding of our patients' experiences and their results, we're very comfortable with that. I, I would be disappointed if it didn't hold up against the WELDERLY study because I would tend to think those people have better detox pathways. It would make sense. Yeah. As well as living in a, you know, community and having better quality, we'll say, food, fluid, air.

And the lack of toxic burden, the lack of hormone disruption, and the lack of, you know, what, you know, yeah. It's also what are you taking away that takes years away? Yeah.

And, you know, the biobank study, I went and looked at all the data that I could on that. And it's interesting, but like, I lived in the UK. The diet's trash. Yeah. So I don't know about that. Um, you know, they, they're a socialized group so that it's easier to collect the data and then, you know, make some kind of interpretation. The problem with us is like it's very challenging for us to review, you know, data, especially in this country, especially on cosmetic patients, because like There's no randomized controlled trial. Like, you can, you can poke holes in that all day long, and the things that exist are really, you know, limited. So it's more like large personal studies like mine, or age-matched cohort studies would be probably next best, you know, type of, of option. But I definitely, um, I look forward to more work like, uh, that was done in Denmark. And I talked to the scientist who did the oxylipotinohyme studies. And he's like, oh yeah, we already wrote a grant. We're very excited about that paper. Because that's what you want. You want somebody who's not satisfied with that answer. You want them to question that and say, oh, I didn't think of it like that.

Yeah.

And then they will press and figure something out, right or wrong. You know, they'll get, you know, that's how, I mean, research is not easy.

Yeah. And it starts with how can you possibly believe we know everything, right? Oh yeah, we know we're nowhere close.

No. So everybody listening, since the 19— what is it, we'll say the '50s, right? Uh, the parameters by which we measure and categorize an infection have existed since 1950, and they were done on urine specimens based on symptoms. Yeah, so when someone, you know, for instance, patient comes to us and they're like they have recurrent urinary tract infections, I'm like, well, we can send the urine off and get a PCR analysis of it so you'll know exactly what's in there. I cannot tell you whether or not that's exactly what's causing your continued problem. If you have interstitial cystitis, then that's a whole different problem. But if it's from bacteria, fungus, mycobacterium, it will show up on this. And they're like, really? Like, why don't they have us do that? It's not the standard of care. Yeah. But for me, it's my standard is not to use things from 1950 to make an interpretation of data.

Yeah.

We've moved beyond that. So I don't, you know, for everybody listening, PCR testing, sensitive-specific, It's been around, you know, forever, became commercial, you know, not that long ago, but we really haven't caught up to what we should be doing at the, you know, standard patient care level with it since it's a commercially available testing platform, really. I find it to be kind of odd. Now, it doesn't give you what you said, a diagnosis plus a drug.

No.

So maybe that's why it doesn't do anything.

The reason, which is functional medicine, right? And this is why it's the antithesis of medicine. It's like, there is a world called functional medicine out there, and there are practitioners doing that work, uh, but it's not part of the insurance system, it's not part of the payer system. And so there's— the system itself blocks and prevents, you know? Yeah.

Um, That's a good transition. So, you know, my clinic has blended those and we have a program that runs now for patients that I don't operate on that I wrote my book about, the Sharp Method. It just blends what we know about functional genomics, gut health, food sensitivities, toxicity burden, hormone balance. And then we have our functional practitioners, you know, work with patients from around the country to help them, you know, recover. I can't operate on everybody. And, you know, more and more people want to take advantage of what we've learned over time. So to your point, we, we try to implement our protocols to help others. And they're mostly— I would, you know, consider them functionally based. But I— to me, genetics is like its own separate thing. I don't think it should be owned by the functional medicine space. That seems a bit odd. I think genetics is still very untapped in terms of its ability to help us and whether it's therapeutic or just understanding things.

Yeah, I mean, so far of the, you know, 20,000+ genes, I'm using less than 100 of them.

Right.

Right. That are driving the functional pathways. And a lot of it is noise, but there are definitely insights in other genes that we sequenced and understand the human genome, but we haven't practically applied it and given an interpretation yet for all of it, right? So there's no, yeah, we're far away from like, but when we get there, when we get there, the personalized mapping that we're gonna have access to of like, you name it, like every decision is personalized, every decision. We're already at the place where, should I be a vegan? I can tell you. Does carnivore work for me? I can tell you. You know, what dosage of vitamin D do I need? I can tell you. So we're already getting there in a lot of these day-to-day choices, but there's more choices to talk about. Peptides, like what peptides do I use? Is it good for me, bad for me? All of that can be driven through genetics. Peptides.

Yeah. So like Kashif and I have been around long enough. I was using peptides, oh my gosh, how long ago? 2019 maybe.

Yeah.

When nobody understood what it meant, yeah, what to do and how to do it. And you could give yourself, um, just because the dosing was really poorly understood. Yes, too much, way too much in terms of a dose. Uh, but of course they work. I mean, it makes total sense. I mean, it's just the— like anything, it's always to me a quality issue. Like, who's making it? Yeah, what's actually in the products? So I'm always, you know, very careful about, you know, people want to ask me, is this good? In general, of course, I think peptides are very good. It's where you source that and what is actually in that.

Yeah. What is it? Dosing, protocol, stacking, all of that matters, right? Yeah.

Yeah. I'm a big— I'm amazed by how unregulated that environment is in a highly regulated, you know, drug situation. That has become a really unregulated— I mean, they're trying to tighten it up now. And as we, you know, uh, record this episode, there's been a lot just recently about peptides, and, um, I'm sure there'll be much, much more.

Yeah, yeah. And then, for— I mean, there's some stuff that are you're all of a sudden seeing FDA approvals out of the blue, they're coming, but you're also seeing major shutdown. You know, the payment processors like Stripe and Shopify, they hired entire peptide task force just to shut down all the peptide websites. I think Stripe hired, I think, 100+ people just to survey all the websites who's selling peptide and shut them down, right?

So that can only come from a government.

Yes, exactly. Yeah.

Nobody would do that. Yeah, that's just the threat to put you out of business.

Yeah, it's a mandate. Yeah. And then where does the government demand come from? Well, who works at the FDA? Like, where do they come from?

Exactly. I, you know, it's— that's a whole nother problem. Um, so we have the code. You said we have a limited— and, and to your point, you know more than 99.9% of the patients— I'm sorry, people— about this. In the next— well, we'll just go a few years here. What's on the horizon? What are you excited about in terms of learning about the code?

I think not the code itself, but the therapeutics that will be driven by code. Because what— so right now we have CRISPR, we have genetic editing, right? What we don't have is targeting. Right? And I think the functional insights, just like what you describe about implants, you understand the cascade of what actually happens, like where's the problems, right? So now we know how to actually support the problem. It's not about how do I fix BII, which is a load of symptoms, right? It's about what got someone there. That's the biology to work on. So now that we understand that, the functional genes show us which ones are broken that lead to the outcome. Now, genetic therapeutics— I think Goldman Sachs said that By 2030, genetic therapeutics are going to be a $4.3 trillion industry, you know, the same size as the entire American healthcare industry. So that's what I'm excited about. Not for some of the nefarious stuff that might be out there, but just the simple ease and elegance of you make a toxic hormone that ends up in your fatty tissue that could create breast cancer. Let's shut that gene off. Functional thinking. You don't build tissue quality in the endothelium or in the kidney or in the liver. The actual physical structure of the organ isn't so resilient. Let's upregulate that gene so the tissue is less prone to inflammation. So solving the functional issues and with a simple therapeutic that just keeps a gene upregulated, the expression is higher, so it's doing the job better. So I think we've been working on the targets. Now there's the therapies and sort of tools that we didn't have. And I think that's gonna lead to like literally How do we shut off Alzheimer's? Take a pill, take an injection. It's going to get to that. Yeah. Yeah.

So that's interesting because gene therapy failed at University of Pennsylvania, I believe, because they had liver— really did not do their study with enough rigor.

Yeah.

And that led to, uh, kind of where we are now. Uh, we should have, and really everybody clamors for the top of the pyramid is stem cell therapy, your own stem cells. But, you know, we were talking about all these other things and there's all these products you can go online and see. But if you're someone like me who's operated for almost 30 years now, you know the value of your own cells over anybody else's cells. So there is no other product at the top of the pyramid outside of your own stem cells. MSCs are usually what I favor. And we can do that. We have the technology now, but there's currently a lot of regulatory— I don't want to say guidance, but you can't do anything. That's why everybody goes out of the country. And then you have people who nearly die out of the country because they get an infection because the standard of care is very different outside of North America for certain treatments. And not to disparage anybody, but I don't like hearing about that. And I don't like people having to go to Mexico or South America to get a treatment we should be doing at a high, high level because we have incredibly talented operators, right? Like if I need my neck injected, I want to go, my neck's pretty important and pretty worth a lot to me. Me. I'm not a big fan of a lot of people messing with my neck, and the product that goes in my neck is my own product. So my stem cells are banked. Um, like, what do you think in terms of that for the future? Because as much as gene therapy excites me, uh, I really like to see the domino of stem cell therapy.

Yeah, regenerative medicine and biologics are also being more refined. So, right now we say stem cell, general shotgun, right? Also with precision, if someone like you knows how to target with ultrasound and fix something, for example. Then, we're finding that the regenerative tools themselves are being altered. So, for example, there's a program going on right now, I think it's in the US, there's studies going on here to reverse type 1 diabetes, which we don't think is reversible. And, it's a specific stem cell therapy that will help redevelop the pancreas and all of a sudden you don't have type 1, right?

For the islet cells.

Yeah. So now that's where things are going is we know the tech works. There's too much proof of people doing so much better, right? And now it's a tech issue. Yeah, yeah. It's regulatory. The challenge is whenever something works that well, you're going to have regulatory issues, right? Not because it's not safe. Not because for the wrong reasons. And so how do you bring it back home? I don't know. I think that we have the guys that are doing it well aren't here, right? Meaning when I say doing well, that are the loudspeakers that are talking about it, that are creating the attention. But a lot of the research is happening here. The work gets done overseas. For example, there's a gene therapy that was funded by Peter Thiel around follistatin. So there's a system in the body called myostat, which is like the genetic cap to how much muscle you can develop. And follistatin is a signal that lifts the cap. So now muscular dystrophy or even just fitness and beauty, you can add muscle, right?

Atrophy.

Yeah. And so—

Sarcopenia.

These guys now do it in Ecuador. It's an American science and American tech funded by Americans, but you can't do it here. You just have to fly down to Ecuador.

Um, so that's, that's brilliant. We all need to get on planes to go.

Yeah.

Get these things.

Yeah. So that's my hope is that the regulatory environment changes. We can bring it back home. Uh, but also the targeting gets better like this type 1 therapy. I think there's going to be a lot of other things that there's more precise targeting.

Yeah.

Yeah.

That would be great for things like lung disease or things like brain disease. Specifics, you know, I know they've— and a lot of people talk about all the different filtration. I, if I see another filter advertised, um, I mean, I've seen blood filters, I've seen plasmapheresis and different, you know, filtration systems to catch things. And certainly, you know, as it relates to something like amyloid, that helps a ton. But to see somebody kind of suffer and lose their ability to, their cognitive abilities and their memories and things, being able to affect that would be obviously huge amongst other things. Like I always look at these chronic diseases, lung disease, terrible, just, you know, kidney disease, liver disease, all the chronic things that lead to a transplant or, a death, you know, advanced cardiovascular disease, you know, something like you mentioned, turning off inflammation in the endothelium.

Yeah, in terms of the blood filtering, I think, uh, the whole post-COVID blood clotting reality made that big because it's just very visual on Instagram to see somebody getting their blood clean. And in the, the The EBO treatment, for example, people misinterpret. I think, as you know, it's oxygenation. It's not really a filter per se, right? There is one tech in Europe which isn't here yet. It's called Innos frenesis. It's incredible. That one, actually, the outcomes are great, right? But there is a company here that's trying to bring it to the US. They're working with the FDA right now. And apparently early 2027, Americans will be able to get it here, right?

I'm, you know, it's available in Germany and Switzerland.

Germany, Switzerland, I think in Dubai and UK. That's it for now.

Yeah, right.

Yeah, yeah, yeah. And the place in Dubai is actually hilarious. It's this little hole in the wall you would never think about and never imagine. It's not some big fancy clinic, it's just some guy that's been there forever. And but he just— people know that he knows what he's doing, right? So he deals with all the right people. But anyways, uh, so there is— so that's what I mean, the tech keeps getting better, right? The tech keeps getting better. We need regulatory, like we need open doors for this stuff works, right?

Yeah, it's disappointing the things that at a high level that work well, that we just can't access without travel, obviously. And then that makes it prohibitive. I guess, you know, we've covered a lot. You and I have chatted so much offline about different topics. Let's see if there's something. So we talked about like some next steps and things that we see in the future. Let's like, I always like to give people actionable things. You know, I talk about prioritizing sleep. Give us some like habits that you think are like super actionable. Everybody can just from a behavioral standpoint help themselves right away.

I would say when we, you know, we have hundreds of people coming through our genetic programs, right? And when I say program, I don't mean the test, I mean like clinical work, like helping them resolve their problem. And there's these standard blocks, like, I'm stuck, I did everything, it didn't work. The standard blocks are nervous system regulation. It's like when somebody's living in fight or flight, high anxiety, chronic stress, trauma, go ahead and throw all the supplements and everything at it, your body's not conducive to repair in that moment. So unless you regulate the nerves, things don't work. So, and simple things as breathwork, you know, even things like theanine and GABA just to get your brain to a better place, right? So that's one. Uh, second I would say is the leaky gut, where given American food, even if you're being careful, it's difficult, right?

Yes.

So it's, it's very, you, it's very hard to find somebody that has a chronic condition that doesn't also have a dysbiotic gut. Yeah, it's almost exclusively always true, right? They're just— they're connected, right? So gut wall repair, microbiome management, uh, what are you intaking, right? And I would say the third big one, um, is the toxic burden that people don't realize they face. Um, it's 140,000+ chemicals now that we're surrounded by. It's not supposed to be like that. We have not evolved as humanity. The genes are the same, various sort of variants have been passed around. There's no evolution in our detox pathways, right? And I would say of the toxic burden, the big one that gets ignored is EMF and all the electronic pollution, all the Wi-Fi. And so, how many times have I had somebody filter their EMF or I shouldn't say filter, mitigate and harmonize the wave and unplug their Wi-Fi and then all of a sudden they're sleeping better? Right, it's just that one little tweak, and then all of a sudden their brain fog is gone. And so it's a constant trickle. The EMF wave, when it hits your body, doesn't pass through. And so that— it's— it acts as any other toxin just lingering there, right? So, um, those are the big simple things that are like purge your environment first, right? Before you start adding a bunch of supplements, did you even look at your cleaning products, your plug-in air fresheners. And there's data out of Belgium. They're trying to compare chronic disease in Belgium versus Americans, and they're trying to identify why are Americans so much more sick. Their healthcare budget is tripled, but why are they so much more sick? And one of the things they identified is indoor air pollution in American homes is 5 times worse than outdoor pollution. Yeah, the total accumulative load, all the fragrances and candles and dry cleaning and all the stuff, right? So purge, purge, purge, eliminate, come back to simplicity, then start rebuilding, right? That's where I would start.

Yeah, we don't walk in North America.

Yeah.

Like in Europe, I lived in and worked in the UK and you get to walk. I mean, you just, and when you're on vacation there, you walk. Yeah. When you're just out, seeing the sights or whatever, but everybody's walking. Yeah, they're taking the tube, or yeah, and you know, Belgium, or if you're in the Netherlands, they're on bikes, and it's just a much different, you know, environment. I always tell everybody, you know, I'm in Austin, Texas, and the entire country of Spain fits inside of Texas. Yeah, so it's not exactly a small place. Our country is enormous with, uh, and makes it obviously phenomenal, but it's also a challenge that each of us has to overcome. Well, it's been awesome to have you on. I thank you for dropping by, sharing time with us.

Yeah, that was good to be here. Just, uh, yeah, I was here for the date, had to show up, so here I am.