Age Rejuvenation: Optimize Your Health Through Epigenetics & Lifestyle with Dr. Daniel Stickler

They call it the last man, and this is the people that choose to minimize pain and maximize comfort throughout their life, which is the majority of our population around the world. It's a boring life, but it's a safe life for most people. And, um, and that's what they want. For me, for my clients, none of them want that. My clients want to truly live the experience and, and push those limits of human potential to see what's possible.

What does it take to do the impossible? What does it take to level up your game like never before?

What does it take for individuals, organizations, for even institutions to achieve paradigm shifting? Nothing is ever the same again. Breakthroughs.

Our mission is to decode the neurobiology of flow and cognitive peak performance, access the minds of maverick scientists, groundbreaking innovators, and world-leading experts to understand what it takes to ultimate human performance so you can feel your best, perform your best, and accomplish your boldest goals. I'm your host, Rhian Dorris, and together with bestselling author Steven Kotler, I present to you Flow Research Collective Radio. Dr. Daniel Stickler, welcome to Flow Research Collective Radio. Really great to have you here.

It's exciting to be here and really dive into the topics I'm so excited about.

Super, super. Yeah, I'm going to give you a quick, uh, intro so that everyone who's listening has, has full context on, on you and all the things that you have done and accomplished here. So you are an MD, a future-focused visionary and human potential evolutionary thought leader. And you're the co-founder and chief medical officer of the Apiron Center for Human Potential and chief science officer for Apiron Academy. And you've been a pioneer behind systems-based precision performance medicine, which is a new paradigm that redefines medicine from the old symptoms-based disease model to one of limitless peak performance in all aspects of life. Physician to high-performing executives and entrepreneurs who want to upgrade their current state, along with being an author, a speaker, a blogger, and a podcaster. And you're also the medical director for the Neurohacker Collective, which I know a lot of our clients know of, a Google consultant for wearable technology, epigenetics, and AI in healthcare, and guest lecturer at Stanford University on epigenetics in clinical practice. Amazing bio, litany of different accomplishments and really fascinating fields that you played at the intersection of. So yeah, really appreciate you taking the time to be here with us today. And to kick us off, I wanted to read a quote that I found from doing my research before this interview. And that goes, stress is not a bad thing at all. Stress can be an amazing factor for performance. However, when the stressor is removed, you want to be able to go back to the calm state to recharge and be able to go back at it again. And we see a lot of people having a difficult time trying to go back to a state of a calm baseline and gradually accumulate more stress throughout the day. That's when decision fatigue sets in. So I would love a little bit more context on how you think about stress and effective stress management in lieu of that quote.

Yeah, I mean, I, I really think people should embrace stress. They should look at it as a performance enhancer in that, that regard, because That's the way it can be used. It's just most people aren't looking at it that way, so they don't have access to being able to do it that way. And once you understand the benefits of stressing the body, I mean, you know, everything we do— I mean, take exercise. It's the— it will create the most stressful response in the body in the course of a week, a session of exercise. And yet we know that's healthy for us, right? And so what's happening is, so the body, and we call this the familiar zone. So there's this little zone where the body fluctuates in, you know, a little sine wave through this zone. And there's an upper border and a lower border. This is where we are in our everyday lives and saying, you know, I can handle anything within this zone. What happens is you, when you stress, you take little excursions outside of that zone. And the more times you do that, the body goes, wow, I need to adapt because this environment is different than the environment I was in. So suddenly the body upgrades itself to a higher, uh, zone being the familiar zone. We see this a lot with people that go through weight loss programs. So, uh, let's say they're sedentary, they eat poorly, so they go on a diet, they start exercising, and for 3 months they've lost 20 pounds. And then the next 3 months they continue doing the same workouts and eating healthy and their weight doesn't budge. And they're like, what happened here? And what it is, is this is epigenetics at work. The body adapts, it adjusts the functioning of genes, of the proteome, all of this in order to adapt to that new style to make it your new normal, I guess is the best way to say it. But we see this with every aspect of human life. I mean, we are defined as a human system. We are a complex adaptive system. And that means we adapt as we go through life and we have emergence of new properties. So emergence of a new state. And this is what we do when we stress the body. I mean, you think about You just think about vegetables. I mean, most people will tell you vegetables are healthy, but what they don't realize is vegetables are also toxic in the body. But that's one of the benefits of them. This is the hormetic effect where the phytosterols get in the bloodstream, go to the liver. The liver says, whoa, this is not a healthy sterol, and they have to detoxify it. So what it does is it causes the liver to upregulate the CYP450 enzymes that detoxify the body. Well, when it's upregulated, it can cleanse the blood even better. So it's actually doing a positive thing for the body by doing so.

It's a great breakdown. Vegetables are actually a fascinating example as well. You've talked a lot down about the difference between performance medicine and sick care, and I'm curious if you could give us breakdown on what you see as the problems with the conventional healthcare system, and then how you define and think about the other lens and approach you're bringing to the table, which is performance medicine.

Yeah, and I, I really didn't understand systems and the human system when I was in medical school. I learned the anatomy, the physiology, the biochemistry. I learned all about the liver and the heart. You know, we learned about individual pieces within that. But nothing was about creating a, a more enjoyable life for people. It was all about let's, let's postpone death as long as we can, but it's a stepwise drop that you just try to slow down. And that didn't go well for me. So I ended up going into general vascular surgery, did that for about 10 years, but I started doing what was called back then age management medicine, where it was the only form of medicine I knew of that was about taking pretty normal or healthy people and helping to boost them to a higher level of functioning. And so after doing that for a couple of years, I just said, this is what I want to do. This is the way medicine was supposed to be practiced. And I just walked away from surgery one day and I said, I'm done. And started, started this, this company with my wife. And, you know, it's been a passion of ours to really help change the medical paradigm because we're in a paradigm where we look at a very linear aspect of this system. And, you know, in simple and complicated systems, linear is the way it goes. So you have this system going to this system. So if you double this input, you double this output over here. That's the simple or complicated system. And that works fine for like airplanes, robots, whatever you're dealing with from a programmable aspect. But the human system, it's complex, adaptable. And when you look at the definition of that, everything is about interrelationships, interdependence, all these different systems within the body, and you need to take all of that into consideration. I mean, you know, we know this, just like if we give epinephrine, well, we can give epinephrine and the heart will increase. Now, if we give twice the amount of epinephrine, does it double? No, it doesn't double at all. In fact, it barely goes up much higher, and that's because there's local feedback mechanisms at the heart level. And each organ system and subsystems within those have feedback loops, and they get input from a dozen, sometimes hundreds of different areas that are— they have to summate the signal there. So you never get an output that is directly correlated with an input in that regard. And that's one of the problems I had with with the mantra of functional medicine, which I got into because I saw it as an alternative to, you know, the current system of algorithmic medicine. But what I found is that in functional medicine, there was a lot of disease care. It was just done with supplements and all that. It wasn't about increasing performance and keeping— I mean, my feeling is, and it's the feeling in most of the age rejuvenation industry, is You know, what is the one thing that we can do that will make a huge difference in diseases in the future? And that's to optimize the system now, make the system so it's antifragile. So when it hits stress, not only does it just survive, but it can get back to baseline, it actually gets stronger through that. And, you know, that's our philosophy in approaching really the human body aspects of optimization.

Amazing. Thank you for that breakdown, Dan. I think a lot of people get a little bit confused about all the different terms that can come before medicine, so I'd love to get a clarification from you because you hear about functional medicine, you hear about concierge medicine, which I think actually just refers to a business model, you hear about regenerative medicine, performance medicine, obviously conventional medicine. What are— what is the full set of categories there, and it'd be really helpful just to get a bit of a breakdown on what distinguishes each from each.

Yeah, so conventional medicine is evidence-based medicine, which is a good thing, but it's very linear, you know, and that's why we have algorithms and that's why we have standards of care now. But the thing is, the body doesn't behave by an algorithm. It just, you know, you can get close, you can get some probabilities, but it's not going to be absolute. It's just like when we have a blood pressure medication that's approved for blood pressure. A lot of people assume, oh, it's approved for blood pressure, so it'll work for me. Well, it may work for 80% of people who try it, but there's going to be 20% that won't have much of a response or have a negative response from it. So it's not that just because it's, it's approved by the standard of care doesn't necessarily mean it's right for you. I mean, each of us is an individual. I mean, think about this. When you look at research when they do animal research, they are doing research on what's called a monoclonal line of rats or mice. This means that every one of them has identical DNA. They're raised in the exact same environment. They're fed the exact same meals. So it's one individual. And when we look at humans, this is why nutritional studies are so poorly indicative of what's good or bad. But we're all different. We all have different contexts. And this is what people miss, is the context of you as a person versus the context of you. And you want to take that into account. You want to individualize. I mean, this is all this N of 1 stuff where we, we can use current research to get probabilities, but it's not an absolute truth. So that's where traditional medicine is, or current medicine. Functional medicine, they claim to be a more holistic approach, is the approach, and they are. They're definitely more complete of looking at contributions to other organ systems and all of that. But the thing that I emphasize with people is they are not necessarily about making the system better when it's fine. When you're normal, what can you do? It's just not something that's brought up in discussion. And they have the mantra of look for the root cause. But by defining the system as a complex adaptive system, there is no root cause. It can't be. So in complexity medicine, we say when you focus on the roots, you miss the contributions of the soil. And you have to take into account the entire aspect. I mean, think about the human being. I mean, we can say holistic where we're looking at mind, body, spirit, but that comes up short too because we're not looking at the environment and the biosphere that we're living in and how that actually impacts us. So that's where I kind of found functional medicine fell short. Then there's anti-aging medicine, and that, that one, you know, that's where I first got into it. But what I found with that is that was more about it just was not complete. It was fitness, nutrition, which were great, and hormone replacement for low hormones. But that's about where it ended. There was not much in the way of lifestyle work. There was not much— I mean, in lifestyle, I mean, when we look at our medical practice, lifestyle is 90% of the work we do. You know, the peptides, the medications, the technology we use. I mean, that, that's just secondary. Lifestyle is first and foremost. In fact, I think there was a study done not too long ago that they said biosocial factors were the biggest predictor of longevity when compared with every other biomarker. So the, the biosocial aspects were So important, but it's never addressed. Then you have the regenerative medicine, and regenerative medicine is more of the people that are using the stem cells. They typically will call themselves regenerative medicine practitioners, and they're injecting stem cells. Sometimes they'll inject peptides, sometimes they'll inject medications, sometimes they'll inject exosomes. But that's what they're essentially doing, is doing a lot of processes that are designed to rejuvenate specific tissue. And then you have the age rejuvenation industry. And this one is where I kind of sit right now, where we look at age rejuvenation as the ultimate way to go to take care of everything all in one swoop. It's just Are you going to— let's say you come in and say, oh, we're going to put you on this heart prevention diet. Well, what about the kidneys? What about the liver? What about the digestive tract? What about the cognitive function? And it may be all good for those, but to specifically address that— and this is the problem in a complex adaptive system— experts are not the top person. Our saying is we want deep generalists and we want people that can look at the landscape of all this stuff and see how it comes together, the relationships, not the specifics. You keep experts on tap but not on top. So you use them as reference within the system. But this is why even then, and this is coming from me who was a general vascular surgeon, the, the medical generalist is— should be the highest paid person in the system. They're the ones that can integrate everything. But the way it's worked now is they're not paid well enough, they have too many clients, so they send people to a specialist. And the way it should work is specialist sends recommendations back to the gatekeeper. But what they do is they just put people on it. And, you know, if you're a cardiologist, your goal is that this person not die of a cardiac issue. You know, it's not that they're saying, damn the kidneys, I'm going to put you on this medication. They're just saying, oh, I know this medication works really well for, for the heart and what we're trying to treat, without even really thinking about the fact that they might have some renal insufficiency or they might have had some markers that would suggest that. So really, that, that gatekeeper is the key. In the medical system. And, you know, for me, it doesn't have to be a physician either. You know, there's a ton of physician extenders out there— the PAs, the nurse practitioners— but there's also health coaches that can work under licensed medical people. And they, you know, like I said, 90% of what we do is lifestyle coaching. Why don't we start using health coaches to do the, the the coaching for people and getting their lifestyles lined up. And the docs are overseeing it, but they step in when they need a medication or something bigger to impact the system.

I love that breakdown. It's the first time I've heard those all differentiated, so I appreciate that. So when it comes to performance medicine or age rejuvenation, let's just say hypothetically you are someone who, for whom, you know, money is not necessarily no object but less of an object, and you want to maximize your performance, your mood, your cognition, your energy levels, even aesthetic elements, and you're willing to put in the time and the resources, what would be an example of a protocol there? Assuming, again, assuming there's actually no active complaint besides just knowing that you don't feel you're your best. I'm curious what some of the tools are, what an 80/20—

Yeah, that's a deep question. It's a lot of stuff. Um, you know, what, what we do with people is we work with, with all lifestyle aspects, so sleep, nutrition, fitness, um, environmental health, um, hormones, and we collect data. I mean, we just, we get as much data as we can. We try to create a picture of This is the human system in this state, in this moment. A lot of people like to attach to stories, and stories are just good. They're good because they give you a background, but they try to get people to get rid of the stories of why they are in the state that they're in now, because I'm assessing current state. What's the system look like and what can we do for it? But we use extensive battery of tests from blood tests, urine tests, We do epigenetic testing for methylation age. We check the Dunedin Rate of Aging score. We do glycan age testing. We're just getting ready to add proteomics to our assessments. We have a cancer test that screens for 50+ cancers just from a blood sample. And we map the brain. We get a full clinical-grade EEG on every client. And that's been beneficial lately because people with the post-COVID brains, it's been a significant issue with our clients. And we've been able to see what their brains look like before they got COVID and then after COVID. And there are significant impacts. I mean, if somebody's saying, you know, I just don't feel like I'm thinking the same way, or my thought processing— my wife was saying, you know, I can't find words for stuff sometimes. And so we do neuromodulation with them, with brain stimulation to try to recreate a baseline state or enhanced state that they're in. But we do a DEXA scan for body composition and for bone density. We do a neuromuscular mapping of the whole body to see how each muscle group is firing and if it's doing it the right way. So yeah, I mean, that's— It's a lot of data. The other thing we do is all of our clients are given a Garmin Fenix watch. I have no relationship with Garmin other than being a medical provider that gets a discount when I get it for my patients. But the Garmin has been one of the greatest tools that we've ever encountered for dealing with optimizing people. We get on our practitioners get on a call once a month with each of their clients. And in that, we pull up their Garmin dashboard and we're looking at the month and we're saying, you know, what happened this week with the sleep? Sleep structure was off, or, you know, the, um, the stress. Why was the stress so high? I mean, I can, I can tell every client exactly which nights they had alcohol because I can see the change in the stress and the recovery. Um, I mean, one, even one glass of alcohol shoots stress through the roof and the recovery, which is designed to onset at sleep, just doesn't have the ability to do it when stress is that high. So they wake up the next day and not only did they not get great sleep, but they also didn't recover. And so we monitor their recovery scores and make sure that they don't go and stress the system when they're already pretty depleted. But we can look at their resting heart rate. I mean, we could, When people call us and say they got COVID, I can look back at their data and say, oh yeah, I noticed this is when it started to happen. About 3 to 4 days before they even had symptoms, we could see it in the metrics that they had. Their heart rate would go up, oxygen saturations at night would start to drop a little bit. And sure enough, their stress level is going through the roof by the third day, and that's when they start showing symptoms. But that's it. I mean, we get every— all this data, and then we present it to our whole team. Everybody on the team contributes, and our team includes anesthesiologist, a nephrologist, primary care physician, nurse practitioner, PA, and dietitian, and a psychologist. This is a big piece that I haven't really talked about, is the biopsychosocial aspects of life. Our biggest metric in knowing whether the person's getting benefit is what's called the quality of life score. And this assesses areas of like health, love, relationships, children, family, community, learning, creativity, all of this. And every year we look to improve on that quality of life score. And that's— we've consistently done that. I've only had Jeez, in probably almost 20 years, I've only had maybe 4 or 5 that went down, uh, in that— even during COVID I mean, the people were coming in still, they were improving over the previous year. So that, that's a great metric for me to look at.

That's really interesting. I want to come back for a second to the Garmin Fenix watch. I actually haven't heard I don't think people mention that specific wearable that often. I'm curious if you have found it to be superior in certain ways to the Whoop strap or the Oura ring or other wearables, because I know people will find that really interesting. Does it have heart rate variability? And yeah, how does it compare in your experience to Whoop, Oura, Apple Watch?

Well, with all of these metrics, the one thing to keep in mind is they are not absolute metrics, but we're using them as a dynamic. You know, you can say this is my heart rate variability, but, you know, the, the watches, the rings, they're the wristbands, they're using pulse plethysmography in order to determine this. So it's an indirect measure. And sometimes, you know, when we do a clinical grade HRV assessment in the office, it can be very different from what we're seeing on the wearable devices. But what is important about it is to look at consistency and dynamics. So here's their baseline. Their stress averages 27 every day, stress score on the Garmin, and then suddenly they're hitting 45. We've got a problem. Something's going on. Same with resting heart rate. I mean, I can look at my resting heart rate over the last 5 years because I've worn this continuously. I don't have it on right now because my watch actually lost its communication with the phone and I had to send it back for repairs. So I'm waiting for that. And it's crazy how attached you get to the data. I mean, after 5 years of collecting data and not having any, it's a little freeing actually, but I still miss the data. But this is the dynamic. Is your sleep— are you getting more deep sleep now? I'm not saying that the deep sleep was accurate to the exact deep sleep that you get, but the fact that your deep sleep is improving That tells me something's working. Heart rate's coming down. But I mean, heart rate, if you look at resting heart rate across the board, I mean, most people, years and years, will fall into about the same average for themselves. And then something takes them out of that. And that's when we pay attention and we say, okay, something's happening here. In comparison to, um, Oura and Whoop, uh, so The data content of the Garmin is what I love. I mean, they, they did this with using First Beats technology, which is probably the most accurate in the field right now. Different, different pieces are more accurate on different things. Like the Biostrap is really the best sleep one that I've seen so far, although we're working with the Muse S also to see because, you know, that's got a high correlation with polysomnography. And I've worn 3 wearables simultaneously for weeks at a time to compare data. And they're very different. Whoop, I found, was very different. And I'm not saying which one's better. It's just you got to focus on dynamic and not look at it and say, oh, this is exactly right. No, it may not be because it's an indirect measure overall. Got it.

That makes, that makes sense. And definitely will be interesting for folks to check out the BioStrap as well. That looks compelling. Um, thanks for that breakdown, Dan. And then the next, the next question I have for you is with respect to tools within this space that are more on the medical intervention side, I would love to get a similar breakdown there around the different buckets they fall into and just what the what the menu looks like, because as I was mentioning before we started recording, people hear about peptides, they hear about ozone, they hear about stem cells and exosomes and all these different things. So I'm not sure if there's some way that you think about these different tools in terms of categories. If so, maybe you could give us a breakdown of that. Otherwise, would love just a breakdown of, you know, what is on the, uh, the age rejuvenation menu with You know, folks like yourselves, it varies a lot by the individual.

Um, you know, the— some— we have 3 categories. So we have foundational work that we do, we have biospecific work that we do, and then we have enhancement or optimization work. And so those are the 3 categories. Even in our supplement store, I mean, each of the supplements is labeled according to those categories. So foundation, that's the thing everybody should be doing. Biospecific is, you know, oh, your genetics indicate this, or your lab work indicates this, we've got to work on this piece of, of health. We have the, the performance line of the supplements, and those are for taking somebody who's at a baseline and enhancing what— where they are from a healthy standpoint. They're, they're in a point of health, but we're going to improve upon that. So when it comes to age rejuvenation, I mean, there's so many things that are on the market right now that are showing promise with that. I mean, the biggest movers I think right now from the medication standpoint would be rapamycin and, and dasatinib. So rapamycin, it hits several of the hallmarks of aging, but the biggest thing we've noticed with rapamycin is it rejuvenates a lot of the skin. It works really well with inflammation in the body, especially when it's related to things like in the joint space. So as we age, we accumulate what we call senescent cells. They're zombie cells that are in each organ system. And these cells take up resources even though they're not functioning anymore as to the type of cell that they should be. They're taking up resources and not putting out any production. In fact, they're actually putting out more toxic elements they call SASPs. And they've recently found that these SASPs are a major contributor to the pain and inflammation with arthritis. And I've seen that, you know, I, from all those years of surgery, I got a little arthritic discomfort in my wrist right below the thumb. And when I started on rapamycin, it went away, which was good. N of 1 for me. And then dasatinib, we use that in combination with quercetin. You just do basically 3 days a week for 3 weeks, twice a year. That's been shown in a lot of data on this. They were talking about 30% reduction in the body of these senescent cells. It's in a class called senolytics. And that's a big category because I mean, that is so huge in really reversing a lot of the aging process. And, you know, metformin is there, but it's been the darling of the age rejuvenation industry, but it's kind of fallen a little bit towards working with things like dasatinib. And then we have, you know, some really cool peptides out there like Um, you know, semaglutide is a big one right now for people to lose weight. I mean, it's a paradigm changer for weight loss. The semaglutide has, has created a whole new category for, uh, weight loss interventions. And, you know, we use this in people even that, you know, they're 25% body fat but they want to get to 15, we can use this for a month or two and they'd do great. I mean, it's a once-a-week injection. And the other thing it does though, is it's an insulin sensitizer. So when we sensitize insulin receptors, we lower blood sugar levels, which is a positive thing for aging. And that's what we're trying to achieve. Uh, so there's some people looking at semaglutide now as an aging intervention. Um, the one I'm most excited about right now though, is young plasma or plasmapheresis. So, um, we just got approved to, to do a study here in Texas, where we're going to have access to young plasma to infuse into people. And we're also looking at getting a plasma apheresis machine since we have a nephrologist as one of our docs. Uh, and plasma apheresis is where you actually draw off blood, spin it down, remove the, the plasma layer, and then rehydrate the blood cells with, um, with artificial plasma, which is essentially albumin and, uh, and Ringer's lactate, and then put those cells back in the body so that the person doesn't lose any red blood cells, but they're— we're replacing their plasma in there. This is huge though. I mean, we're seeing huge changes in methylation age and rate of aging scores with people that go through these processes. And this is our best way of measuring, you know, biologic age right now, is the methylation age clocks or the Dunedin rate of aging. It's my favorite to really look at. But, you know, you could even start thinking about, let's take off this plasma and then let's reinfuse with young plasma, not just synthetic plasma. What will that do? Or even adding exosomes from amniotic fluid back into what you're putting back in. And the reason for all of this, uh, the Conboys, um, were researchers at Stanford and husband-wife team. They hooked an old rat and a young rat's circulation together, and this was back in 2009 or '10, I believe. And the old rat got younger, got rejuvenated. And so that sent them on a course over the last 12 13 years of finding why that happened. And they've isolated it down to factors that are in the plasma. And as we age, we gradually start secreting more factors that are telling the cells in the body to age. It's like a programmed aging that we're seeing. And it's saying, you know, let's not function optimally, let's not repair as well as we used to. And some people say that's a process because of the accumulation of cell and DNA damage that's occurring, that we're doing that. But it's also why we're aging. And this whole new area of, of this rejuvenation through plasma factors, and it's huge right now, a lot of researchers in it. Some of the, the really cutting-edge stuff is now on cellular reprogramming, so going in and actually reprogramming cells to to behave in a younger style. That's that one. I mean, you know, we're talking about things, uh, just kind of slowing the aging process or having minor impacts on reversing aging, but this cellular reprogramming is probably going to be the thing that really kicks us into that real potential of true age reversal.

Incredible. That's absolutely fascinating and really, really interesting to hear about. If I'm pronouncing it right, semaglutide as well. I'm imagining that especially for people who have dysregulated insulin sensitivity would potentially be very profound and impactful for cognitive performance.

Yes. I mean, I was talking, I was giving a talk at the Age Management Medical Group, one of the medical conferences on age rejuvenation. And I was talking to another physician that has been doing age management for as long as I have, and she was telling me that prior to COVID— because I had mentioned the plasmapheresis and the young plasma in my talk— and she said prior to COVID she had gone to a company that was doing young plasma. They subsequently were shut down by the FDA because it's not really approved. You have to do it under an IRB. But she had that done and then 6 months later she repeated her epigenetic age. And it's one thing to repeat it right after it happens because you've already got young factors in there, so you're probably going to pick up on those. But 6 months later and she tested over 10 years younger than she had been on the test prior to that. That doesn't mean she's 10 years younger, but it means that the needle is moving in the right direction and 10 years is huge when we talk about the changes in methylation age, because methylation age is really the biological clock that is ticking on us.

That is absolutely fascinating. You mentioned as well post-COVID brain and being able to see the stark pre and post contrast with EEG. A lot of our clients and people in general at the moment obviously are suffering from long-haul COVID and post-COVID brain. I'm curious, If you woke up tomorrow with long-haul COVID, knowing everything you know, what would be your first sort of 3 to 5 moves to try and recover your brain, your performance, your energy back to pre-COVID brain?

Yeah. I mean, the first thing to really do, I mean, if you're serious about this and it's having a significant impact is get your brain mapped, get a brainwave map with an EEG. That can look at areas where it's not optimized. Also, neuroinflammation ongoing is a common factor in long COVID, and we found that low-dose naltrexone has been working really well to minimize the inflammation that people are getting. The other thing we do is electrical brain stimulation. We'll use either AC current, DC currents, transcranial magnetic stim along with global PEMF. And we'll run that. And we do have a COVID protocol that we've worked out based on what we've seen with our own clients. So we were seeing this and we had implemented this before all the data really came out on the brain and COVID. And just in the last, what, 3 weeks, It's been all these articles on the, the impact of the brain. Even mild COVID had significant impacts on the brain, and they saw, I think the big UK study, they saw a 0.3% loss of volume in the brain. And that doesn't sound like much, 0.3%, but that's actually huge when you look at it. And within the next 20 years, we'll probably see a tsunami of dementia if we don't address this. So, it's really important. I mean, if you're having ongoing memory issues, finding words, smell dysfunction, visual dysfunction, and there was a recent study that the people who got COVID in the eye, I don't know if you know of anybody that's had that, but I had 2 clients that got it. It was just, they had like a red eye. Um, or pink eye, they, uh, what it looked like, but it was most likely COVID eye. And they're finding significant issues long term for people that have had that. So all this stuff is coming, coming out right now. And majority of people, I mean, you know, you're talking about 70% of people are going to resolve those symptoms over time, but we can accelerate that recovery process typically, or or the people who have it chronically that aren't getting rid of it, you know, start looking around for some neurostimulation because that's been the thing that we've really noticed as the biggest needle mover in our own clients. And having the before COVID EEGs on all of our clients was really nice to be able to then reassess their post-COVID EEG and then institute a protocol and then do the EEG again and see if we had achieved that. So we were getting both symptomatic relief, but we're also seeing the positive changes in, in the QEEG.

That is, that's fascinating. The mention as well of low-dose naltrexone is, is really fascinating for neuroinflammation. So I'm curious if you could break down what low-dose naltrexone is, and then a little bit more context on the brain stimulation approaches would be really helpful, maybe specifically differentiating between neurofeedback and what intervention you've found to be successful for COVID and also where people can learn more about that and potentially undergo an intervention like that.

Let's start off with the brain stuff because these brain stimulation protocols are really where we've had huge impact. So what we do is we do the brain mapping and we, we spend a lot of time interviewing the client and then we do cognitive testing on them. Once they have their brain mapped, then we get with a psychologist. My wife and I are both approved to read EEGs, but just because we don't do a huge volume of them, we want somebody who looks at them several a day. And so we get on a call with them, we go over what the patient's experiencing, what their symptoms are, you know, what they'd like to improve upon. And she can look at it and identify areas where, where she's seeing that this can, this can have an impact. And then she sets up, she gives us feedback, gives us a specific protocol just for that person of stimulation to the brain. And sometimes it may be stimulation to increase activity in certain areas. Sometimes it's to decrease, sometimes it's both. So we have people with high beta, they're the very, we call them beta heads. They're the very anxious, nervous people that are constantly, constantly moving. And, um, and we, we can adequately get that turned down through neurostimulation. But one of the things that we do with that that has been really amazing is we combine the training with ketamine nasal spray. So right before they do training, they do two, two squirts of the ketamine nasal spray. And we've been able to accelerate the process of embedding these new patterns because the ketamine will disrupt what's called the default mode network in the brain, which is this— it's where we put all of our patterns and it's designed to keep things very efficient. So the more times you do a repetitive task, then it suddenly gets locked into the default mode network and you don't even have to think much about doing it. It just happens. But that can also cause a depression program and anxiety program. So you don't want any of those. But when we disrupt that default mode network, it allows the brain to say, okay, let's look around for other options. So it starts looking around. I was doing an interview with Bo Lotto the other day. He's a neuroscientist researcher. And he said, it's like you have a river running And along that river you have these little whirlpools and eddies. So the river's running at this constant rate and you're always going to have these whirlpools and eddies that are consistent. These— this is the default mode network. And so if we drain it and then start the water back again, it will reestablish those, those eddies and whirlpools. But if you take that river and you shake up the riverbed, suddenly the, the brain can find new pathways, new ways of doing things that may be more efficient than the way that they had locked in previously. So we'll, we'll do either AC stimulation with AC current, we'll use a DC current, we'll use a transcranial magnetic stimulation current. It all just depends on what we're trying to achieve with the individual. That's the main thing. So Are we trying to do X? Then we will use this protocol with this one. Are we trying to do Y? Then we'll use this protocol. Now, getting to that neuroinflammation piece, I mean, naltrexone is what they call an opiate antagonist, which means it kind of works at the brain to prevent the opioid receptors from being targeted. So they've used this in alcoholics to reduce their behavior. But this is really on the higher side of it. But one of the things that was discovered with it was that it diminishes neuroinflammation. I mean, this is an off-label use of it, but there's a lot of people using it in neuroinflammation right now and having good results. I mean, it's like all those off-label medications that people will say, oh, it works for this, this, and that. I mean, naltrexone, if you search the internet, it works for everything, which I know isn't true. But I have seen the actual results with the neuroinflammation after I had heard about it for that purpose. We started doing it and then we get to see the feedback. From our clients and the changes in their cognitive function and their brainwaves. So that's why we like that one.

Does it take a while to work, the naltrexone, or is it—

No, not generally. I mean, within 3 days of starting it, they notice some improvement if it's going to work for them. So within 3 days of starting it, they'll start noticing improvement. I've had people notice it even the first day they took with it.

Wow, that's fascinating. And then on the electrical stimulation front, if someone's wanting to explore doing that for a variety of different reasons, what would be— what is a good next step to be able to actually undergo an intervention like that for folks who are listening?

Well, most people right now are still doing neurofeedback, and there is a role for neurofeedback, but we did that for years, and what we found is you know, you have to do 40, 50 sessions to really get the brain to move and hold the pattern. And with the neurostimulation, one is it doesn't take very long. It's not just depressingly boring. In neurofeedback, you have to watch a screen and, you know, when your brainwave gets in the right pattern, the plane will fly. And then when it isn't in the ideal pattern, the plane stops. So that's how it's training the brain that— but you have to like pay attention. With neurostimulation, we just, we just put people on a breath pacer and we stimulate the brain while they follow the breath pacer. So it's really cool because we get them in great HRV while they're also getting the stimulation. So the system is really, really getting jazzed up with all aspects of it. But neurofeedback does work. Neurostimulation generally only takes 10 sessions and we can do 2 a day with those because they're only like 20, 30 minutes. But there's not many people doing neurostimulation right now in the United States. It's kind of a fairly new toy for us to be using in the biohacking world when it comes to that. I mean, there's a lot of people doing research on it, but from a clinical standpoint, it's It's just not ubiquitous right now. Got it.

Got it. Thanks for that breakdown. The final thing I want to ask you about, and then we'll go to the very last question, is stem cells, which I feel are one of the most used buzzwords or phrases within this space. A lot of people don't know what they are or whether they're any use or whether they're safe. And I'm curious if you could give us a quick breakdown just on your take on stem cells, where they're useful, if they're useful, and whether you all use them as well.

Uh, you know, that's a, that's a triggered question. It's, it's, it can be triggering, um, because there's people who swear by them and there's people who are like, yeah, not that great. Um, I think there's a yes and a no. They're great when you're talking about joint injections or local injections of the stem cells to create response. The people that are using stem cells intravenously, I don't think those are viable. I mean, you'll get a bit of an effect, but the cells are so big they're going to get stuck in the lungs on the first pass. So they're not going to the system to go to areas where they can migrate, which is what a lot of people argue about, but they're just getting stuck. Now, Generally, these stem cells will live 2 or 3 days, and during that time, they're going to secrete some factors into the blood. Even when they're lodged in the lung, they can still do that. And so you're getting some of those factors, and there may be some benefit there from that. But the science is still undecided on that piece of it. Injection piece, pretty, pretty clear. But what those stem cells are secreting are exosomes. They're little tiny fatty packets that contain the microRNAs, the mRNAs, and other proteins that are being sent out around the cell, around the body, to signal the body of what to do, to tell cells what's going on elsewhere. And, um, and so a lot of people are actually using intravenous exosomes instead of the stem cells. And they'll use the stem cells for the joint injections and the musculoskeletal pieces and use the exosomes from stem cells. So these are these packets and you can get 4 billion of those in one little cc that you inject into the body and they will circulate all the way throughout the body and can migrate into other areas. So I'm biased. I mean, I have a definite preference towards exosomes and I just have not seen good enough data on the on the stem cells at this point.

Got it. Thanks for that breakdown as well, Dan. That makes sense. And I've been hearing more and more about exosomes as well. The, the final question, Dan, that we like to ask guests is a question about a question. Um, and the question is, if you could click your fingers and instantly have all of the randomized control trials done to fully and legitimately answer any open question you have, what would that question be that you would have answered instantly?

Uh, I don't think my question can ever be answered though. So what is consciousness is my question. So I mean, we can do all these tests and everything, but it's not gonna, not gonna give us the answer. Uh, you know, I just I just want to enjoy the experience. I mean, I want to go through life and say I truly experienced it. Nietzsche used to call— he had the Übermensch or the overman. That was the person who took the risks for the rewards. And I look at that as you live on the edge so that you can experience things that are just at the edges of human potential as we know it. And that's a line that keeps spreading, getting greater and greater. So really just living life and enjoying it. I mean, it's not about just pursuing happiness. It's having joy and having a life of excellence where you can experience sadness, but you experience it to its most emotional depths. It's painful when you do it, but when after you're done with it, you're like, wow, that was almost orgasmic. But you also get the bliss on the other side that's even better than what you had before. So you can experience this whole range of emotions. This is the Ubermensch. He seeks that out. And Nietzsche also referred to last man. They called it the last man. And this is the people that choose to minimize pain and maximize comfort throughout their life, which is the majority of our population around the world. It's a boring life, but it's a safe life for most people. And, um, and that's what they want. For me, for my clients, none of them want that. My clients want to truly live the experience and push those limits of human potential to see what's possible.

Love it, Dan. Thank you so much for this. It's been a phenomenal breakdown on some of the cutting-edge tools out there and the amazing work you're doing. So I appreciate it. And where can folks find out more about you and all the work you're doing?

Um, at appearonzoh.com, A-P-E-I-R-O-N-Z-O-H.com. That's our, our main website. And, you know, a lot of people will ask me, uh, you know, for financial resources are not optimized because, I mean, we do a lot of stuff. I mean, we're spending $20,000+ a year per client and our programs run $24,000 to $60,000 and it's not accessible for a lot of people. So we put out videos, we put out educational pieces, but we're actually just launching a new telehealth program at an affordable rate for specific categories of work. Like our first program is the body composition program. And then we've got a female health optimization program. And then we've got a preconception— we do a lot of preconception and pregnancy work with, with couples, getting them prepared to really have the optimal opportunity to maximize the baby's outcome. So we're going to have all those in a telehealth platform called morebeing.com. So more-being.com. That's actually launching in 3 days. But that work is done with the physician and the lifestyle coaches that we use. And we're excited about it because a lot of people don't have access to, like, the semaglutide. I mean, most docs don't even know that exists. And yet it's the best drug on the market for weight loss that I've ever seen without stimulation. And other things in the age rejuvenation industry. There's a lot of people that just, they read about these things and they want them, but they can't access them. Like the, the saponin for a senolytic or the rapamycin, they don't have access to them because the docs will say, I have no idea what that is and I'm not going to prescribe it for you because I'm not treating anything, is the look they get. So when we put this as telehealth platform, it'll open up access for people who didn't have that ability before.

Amazing. Well, thanks so much for your time, Dan. Appreciate it, and I know everyone's going to have loved listening.

Well, thanks for having me. I enjoyed it.

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