Peptides: The Future of Anti-Aging and Regenerative Medicine with Dr. Elizabeth Yurth

I wanted to ask you to kick off was how you learn and stay up to date with what is happening in regenerative and performance medicine. Cuz I find every time we get in a call, I'm just mind blown with the depth of knowledge you have. So how do you, how do you manage to do that?

You spend all these years educating, right? You spend years in medical school and then residency and then fellowship, and then all of a sudden you have to be able to open your mind that, wow, maybe everything I learned wasn't right and there's something more. And I think this is the biggest problem in with medicine in general is that if we can't open our mind to the fact that we're wrong, we don't really ever learn anything new. All my patients, women and men, on either Viagra or Cialis on a daily basis. So small dose on a daily basis. So now I'm increasing blood flow to my brain, to my organs, to my extremities. You basically can improve people's ability to function. When you look at all these biohacks, all these things you hear are good. Morning sun, getting adequate sleep. Those are all great, but are they gonna work as well if I don't have the underlying mechanisms working in my body anymore? If the technology is there and it's safe, should we utilize it? I think so. And not just say, okay, yeah, do all these mindsets, which is obviously very important. I'm not going to, you know, argue that using mindset techniques and all that kind of stuff is so incredibly important to people. But are enhancements useful? Yeah.

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Thanks, Ryan. I appreciate you inviting me.

Yeah, absolutely. So I'm gonna do your bio here, which is a long one, and then we'll dive in. I've been really excited for this conversation for a number of reasons, which I'll mention in a moment. So you are the Chief Medical Officer of the Boulder Longevity Institute, which you co-founded in 2006, and BLI specializes in advanced research-based human optimization medicine, including regenerative peptide therapy, next-generation regenerative orthopedics and foundational health optimization. And you obtained your medical degree from the University of Southern California Keck School of Medicine and completed your residency at, uh, UC Irvine. And along with your 27 years of practicing orthopedist specializing in sports spine and regenerative medicine, you're also a double board-certified, uh, physician in physical medicine and rehabilitation and anti-aging and regenerative medicine. And you have a Stanford-affiliated fellowship in sports and spine medicine and a dual fellowship in anti-aging and regenerative medicine and anti-aging, regenerative, and functional medicine through the American Academy of Anti-Aging Medicine. And you have served on the faculty of and lectured nationally for both A4M and the International Peptide Society and are currently a national lecturer and faculty member of the prestigious SEEDS Scientific Research and Performance Institute, which is one of the premier cellular medicine research and education institutes in the country. And you obtained your 5th and most recent fellowship in cellular and regenerative medicine from there as well. And I know you've been on a number of other shows like Dave Asprey's Upgrade Labs and Pushing the Limits with Lisa Tamati. So really excited to have you here, Dr. Uroth, and The first thing I just want to say is actually thank you personally, because I had— it's weird to even be able to say had rather than have— just crippling long-haul COVID for nearly 2 years, to the point that it felt like Alzheimer's from a cognitive standpoint. And I couldn't work out and was just completely debilitated. And within 6 weeks, you got me pretty much 100% better. So thank you for that. That's been great. And what I wanted to ask you to kick off was Actually about how you learn and stay up to date with what is happening in regenerative and performance medicine. 'Cause I find every time we get in a call, I'm just mind blown with the depth of knowledge you have. So how do you, how do you manage to do that?

That's the, the, maybe the trickiest thing about this field is that, you know, in medicine you're sort of taught, you spend all these years educating, right? You spend years in medical school and then residency and then fellowship and You know, and then all of a sudden you have to be able to open your mind that, wow, maybe everything I learned wasn't right and there's something more. And I think that's the biggest problem with medicine in general is that we're not very open to doing that, and we're not very open to doing that in life. I always equate it to like, let's just say you built the, you know, the house of, you know, you just thought it was amazing and you spent 12 years building this house, and then your friend walks in and goes, you know, this would have been a lot better like this and this and this. And you're like, geez, maybe they're right, but I'm not going to ever go there. And so for anybody to come in and tell your doctor that everything they've been doing for the past 10 years, whatever, is wrong, it's a very a hard pill to swallow. And so the first step in kind of keeping up is admitting that everything you knew is probably wrong or possibly wrong, right? And I think that's probably the biggest— and, you know, and I think this is in line with life in general, right? If we can't open our mind to the fact that we're wrong, we don't really ever learn anything new. So that's the first step is saying, wow, everything I learned that I thought was great and was going to make people better maybe wasn't the right answers. And this was especially true in orthopedics, which was my background, was orthopedics, was, well, we've been doing the same thing in orthopedics really since the 1950s. I mean, there's been some subtle changes in technology in terms of how we replace a hip or, you know, using a computer-assisted approach. But in general, we basically have people come in, we put steroids into their joint, we do some physical therapy, and then we finally replace the joint. And so started to look, you know, what got me into this field in general was starting to look at, is there better ways of doing things and how do you approach health? So then you feel like, oh, now I've done all my functional medicine training and now I know the answers. And then, A year later, you're like, wait, maybe that wasn't the answer. There's something new. So first step, figure out that everything you knew might be wrong. Step 2 is you've got to stay on top of the research. And I'm really benefited by the fact that I have a network of docs. There's about 25 of us who started with, with this kind of this SSRPRC, Scientific Research and Performance Group, where we're actually work together to kind of keep on top of research and developments that are going on not only here but in other countries. And where can we get access to things potentially that are now ahead of the game? So for instance, it takes about 17 years for a drug to actually get proven safe and efficacious and then actually being implemented into practice here in the US. It's a 17-year lag. By that time, most of it is really probably replaceable with something better. So what we try and do is find things that are being done that are shown safe and efficacious, and how can we get access to those and bring them to our patients and our clients at a much earlier state? So by having a network of physicians who are all working together in that realm saying, let's find out what's out there, let's find out how do we get it, let's find out somebody can make it for us, we can actually access things much earlier. So it's looking at research, watching research for a few years to see where that research is going. And when is it really, truly— this is a really good thing we should be looking into. It's safe. It's likely going to be beneficial. Now, how do we access it? And I'll give you an example. For instance, there's a drug that we use for treating arthritis. It's actually been used in Australia since about 2016 for treating arthritis, widely used since 2019. And that drug is— pretty much what we call a DMAO. It's a disease-modifying agent for treating osteoarthritis. So basically, it is at least partly a cure, and yet not available for, you know, since it was already being used in other countries, but not available here. So we found a way to get it, to make it, to be able to bring it to our clients. Now that drug, which is coming to market, is a drug called Xylosol, is going to be available probably in about a year and a half by the time it finishes all its FDA approvals here. But about a year and a half, it'll be available to other people. And it's a game changer in treating osteoarthritis. So by staying on top of that kind of stuff, knowing what's out there, knowing what other people are doing, what other countries are doing that may be ahead of sometimes the game, we can actually bring that technology to people much earlier.

Amazing. Yeah, having the network, I imagine, makes a tremendous difference. There's a, there's a quote by William Gibson, who's a great sci-fi author, which is, the future is here, it's just not yet evenly distributed. And I always find that to be very much—

that's a great quote. You're right. I mean, yeah, the stuff is out there, right? But you have to know about it, and you have to be willing to look for it. And how do you find it? And you're right, by having enough of a network of people that are all working to a common goal, we can actually— for instance, if we have enough people who are willing to say we want this, this drug, we can find somebody. We can find a compounding pharmacist, we can find somebody who will make it for us, you know. And again, we're gonna, we're gonna hit that as soon as that drug is really shown to be very efficacious and very safe. We can go there with it. So this network of experts is really huge for doing that. And because it's very hard to keep up on all this reading. Now, I read probably 3 hours a day, but you have to keep up on this research. You have to be able to interpret the research that's actually good research, and then we have to be able to share it with each other and discuss it. And so you have to have a network of people who are all working to that common goal.

Yeah, that makes total sense. Yeah, I am continually mind-blown by how little people are aware of this stuff. I mean, I was obviously deep into, you know, human optimization and peak performance and everything and had barely even heard of peptide therapy before I had done it, and then it completely changed my life. And so I'm curious if you could give a breakdown for, let's just imagine someone who is a high performer, you know, pretty, pretty healthy, but would like to have higher levels of energy and virility and increase cognitive performance who has, let's just say, an ample budget and 12 to 18 months to take things up a notch. What would the play-by-play look like from a performance or regenerative medicine standpoint for that type of individual?

That's what kind of our focus is. We obviously work with a lot of sick people who just need to get well, but we also have a lot of very high-performing people either in the athletic world or the professional world that really need to be top of the game all the time or want to be top of the game all the time. And this could be even your 75-year-old who still wants to be heliskiing at an extreme level from your professional athletes. And we're working with kind of all spectrums of that. And obviously, in my opinion, they all should get the same access to be able to do things. Cost becomes an issue. These are not inexpensive therapies, right? But people should at least be aware of them and be able to spend their money where they want to spend it, right? If you can't, we can sort of adjust things budget-dependent. But if you want to go all out, what do you do? And the first step is always, obviously, optimize the simple things. And that's, are you eating well? Are you sleeping well? Those are all simple approaches that most of your listeners know. If I'm not getting adequate sleep, I don't have good deep restorative sleep, then is this other stuff going to get me there? It might still be helpful, but it's not going to be as helpful as if we can optimize those first. Now, there's techniques you can use to optimize those using some of these therapies. Next step, and this probably goes even above the step I just described, is making sure hormones are optimized. And I think people start thinking about hormones being optimized when they're, you know, my age, when they're 50s and 60s. And really optimally, hormones actually start declining very young. I mean, we're seeing men, you know, as young as you— we're seeing men in their young 20s even who are, who are hormone deficient. And COVID has worsened that, you know. For instance, after viruses, after bad viruses, things like that, hormones will tank. So we're seeing now a host of young people, both men and women, who are hormone deficient. So first step is you've got to look at some basic labs and say, does this person have enough hormones on board that they can— I can send them to the gym and have them train, right? If they have zero testosterone, they're not going to form muscle. I don't care how much I send to the gym. If a woman has no progesterone, so even a 25-year-old has no progesterone, she can't sleep well, she's irritable, she's not going to, you know, she's not going to get adequate sleep, she's going to be, you know, her appetite's going to be off. So those things all have to be looked at first. And it's funny, we put together this course called What to Fix First, and, and when I was putting together the course, I said, okay, I'm going to start with, you know, people need to optimize sleep and nutrition, exercise. And I thought, actually, I can't tell somebody to optimize sleep and nutrition and exercise if they have no hormones, right? For me to tell you to sleep and exercise if you don't have any testosterone as either a man or a woman, or progesterone as either a man or woman, it's not going to be very beneficial. So I start with know what your hormones are, fix that, and then we can start working on sort of the health-focused pieces. But let's say all, you know, and then we can look at micronutrients and, you know, are all the micronutrients there that you need to be able to get healthy? You know, do you have just adequate vitamins and minerals and amino acids? To form muscle, to form, to make your brain work better. So when we have our patients come in, first thing we do is we don't throw a bunch of, you know, sort of peptide therapies at them. First thing we'll do if somebody's coming in as our, one of our core program clients where they want to just, hey, make me optimal, is we look at a full hormone profile. We look at a full cardiometabolic profile so we know exactly what's happening from a cardiac perspective. What is their metabolism? What is their glucose running? Things like that. We look at a full thyroid panel. We look at a full micronutrient and basically a full panel looking at all the micronutrients that you have inside your cells. So once we have all that together and we know what we've fixed there, then we could take it to the next step, right? So I caution people because we have people all the time, I mean, and they want all these very cool things. And, you know, to do all these very cool things when the basics aren't there is probably a waste of money. But let's say I have somebody now, I do all that, they're great, we've gotten them all optimized. So what is the next steps? And that's where things like peptides really do come in. So peptides, for your listeners who don't know what they are, are basically short chains of amino acids. So protein is 50 amino acids or more. A peptide is less than 50 amino acids. So basically think of it as a small protein. And your body makes thousands of peptides and they have very different purposes in your body. Some are there for your immune function, some are there to help you heal, some of them encourage normal skin growth. So they have all these different functions in your body. And then there are peptides that your body doesn't make, but we know the mechanism so we can utilize them still to have your body do things better. So if somebody is looking at, for instance, peptides that just decline as we age, for instance, when, when you look at somebody, people are actually in their optimal health right around puberty, believe it or not. So pretty young. So people are like, oh, I'm great. I'm 23 years old. Actually, you were, you're already kind of on your decline. And that's because the first thing that starts to go is our immune systems. And the reason that happens is because we have this huge gland in our chest when we're babies. It's huge. It's called the thymus gland. And it sort of tells our bodies how to immune react so that if you get exposed to a virus, your body learns, oh, that's a virus, attack it. And it learns, don't attack me. So don't attack yourself, attack the virus. Okay, so around puberty, so you don't see adolescent kids getting long COVID, for instance, right? Because their body fights COVID and doesn't create this bad immune response and it doesn't kind of go on. So, you know, so getting exposed to COVID for them, yeah, they may get sick, but they're likely to go on and get better and get healthy. Whereas once you're past puberty, this huge gland, the thymus gland in your body, starts shrinking. By the time you're my age, it's almost non-existent. But even at your age, in your late 20s, it's not very big. It's not doing a lot. So now you get exposed to COVID and your body potentially overreacts. It not just attacks the virus, but it starts attacking itself and starts doing damage. So why does that occur? Well, partly it's because your immune system is not as astute as it was when you were at puberty. And that's largely dependent on the thymus gland having gotten smaller and smaller. So the big sort of freaky anti-aging people are looking at, well, how do we get babies' thymus glands and transplant them into us, right? Or people are eating sweetbreads. Like in France, you eat sweetbreads. That's thymus gland. But probably eating sweetbreads isn't going to get you there. But what we can do is say, well, what does the thymus gland make? And it makes some peptides, something called thymosin alpha 1, thymosin beta 4. So it makes these peptides. So I can give you back— the peptides, these small proteins that the thymus gland makes. So I can't give you back a thymus gland, just like I can't give a woman whose ovaries have failed because they're 50 years old— I can't give her back ovaries, but I can give her back what the ovaries were doing. So I can give you back what your thymus gland was doing, make you heal better, get your immune system healthy, help you recover faster, right? So if we keep those thymic peptides up throughout our life, and you can cycle them on and off But if I keep doing that throughout my life, just like my hormones, then I'm going to have the immune function I had when I was younger, and I'll be able to fight off these diseases, react appropriately to things like cancer, diseases like that. And then our body also makes something called BPC, or body protective compound. Body protective compound is made in the gut, and it responds not just when the gut's injured, but when any part of your body is injured. Your body responds by making more of this body protective compound, and it goes to help you heal and recover. So if I'm injured, for instance, you break your leg, you tear, you tear your rotator cuff, these body protective compounds, thymosin beta-4, come into play. They're like, okay, we better go help him heal. So that's why if you look at, you know, when a 13-year-old breaks their leg, they're better in 4 weeks, right? 6-year-old breaks their leg, 3 months later they're not healed. So what if we give them back those healing peptides? Right, so I can give them back BPC and give them back thymosin beta-4. I can make them heal faster. Ultimately, if I keep those at a nice level all the time, all those little injuries we get all the time are going to heal faster. So I can recover better even if I go to the gym and work out, right? Now I can recover better from my workouts. So we sort of have this group of peptides that we like to say throughout life we cycle these on and off. We may use them more if somebody's sick or injured, then we may want to upregulate them more at that time. In general, we like to sort of keep people on a basic where maybe 4 times a year they're getting replenishment of these peptides because their body's not making them anymore, right? No different than hormones. So that's going to keep my immune system healthier. It's going to keep my ability to heal and recover faster, better. And, you know, the bodybuilders have learned— I do a lot of work with bodybuilders, and the bodybuilders have learned these tricks for a long time. The bodybuilder world has kind of been ahead of the game in some of this, you know, and so they've been using peptides for quite some time. Sometimes not the best sources of them, but for quite some time in, in, you know, learning, oh wow, if we take this, I can heal faster, I can recover better, I can train harder. So they've been using them. Now we can actually get them made in much more legitimate ways from compounding pharmacists, people like that. So I can get much safer sources. But, you know, that world has been kind of ahead of the game and optimization. When you look at the bodybuilding world, they've sort of, hey, how do I get my hormones optimized? Sometimes maybe over-optimized, but I get my hormones optimized, my peptides optimized, so I can heal and recover and train at this kind of level. Next things, when you look at where else can you go with peptides is there's other peptides that our body makes that we will lose. One is made by the pineal gland. The pineal gland is your regulation of your circadian rhythm. When your body gets out in the morning and sees light, the pineal gland is one of the things that interprets that and helps set your circadian clock. All great. When you're little and you're young and you've got this nice pineal function, that's all good. But as you get to be my age, the pineal gland starts to calcify. So now when I'm out in sunlight in the morning and do everything right that everybody tells me to do, I still don't get the great results because my pineal gland is partly calcified. So what can I do? Give back some of the pineal peptides. So something called epitalla, which is one of the pineal peptides that helps set circadian rhythm. So what if twice a year, I give my pineal gland back what it's not making. Now, if I go out in the sunlight like I'm supposed to and I wear my blue-blocking glasses like I'm supposed to, well, now it actually is going to have some function because I actually have a pineal gland that works. You can see that when you look at all these biohacks, all these things you hear are good. Morning sun, getting adequate sleep, wearing your blue-blocking glasses so that you're not getting blue light. Those are all great. Right. But are they going to work as well if I don't have the underlying mechanisms working in my body anymore? Probably not. So that makes sense. But to sort of replace all those things that are going away, that makes total sense.

I have a few questions on, on peptides that I want to come back to in a moment. But before we do that, so we've got here, first off, optimize the simple things, make sure your hormones are optimized, then peptide therapy. What would kind of come you know, after peptide therapy? And I know that peptide therapy can go on for good in different ways, but are there other, I don't know, categories of intervention or things that you would be wanting to put someone through who's looking to, you know, optimize themselves with an ample budget?

I think that's where we get into pharmaceuticals. And people, I think, you always think pharmaceuticals are bad, right? There's sort of this general thinking that, oh, I want something natural. And I get that a lot from my patients. Well, I don't want to take a drug. And I always tell them, well, even a lot of drugs come from natural compounds, but pharmaceuticals are not all bad. And there are some really beneficial effects of some pharmaceuticals that have been used for a long time. So for instance, if I understand the pathways, and that's one of the things we teach in our SSRP, it's what we call cellular medicine. I need to understand what's happening at the cellular level as I age, because ultimately every part of my body has the same problem, that my cells are aging and not working as well. So I need to understand every cellular pathway and then look at ways to change that cellular pathway. Hormones will change the cellular pathways. Peptides will change the cellular pathways. But can we use even higher-tech versions of that, right? So that's where sometimes pharmaceuticals can come in. And we're going to see more and more, I think, along this line as more and more money is being spent on considering sort of how do we cure aging. You know, can we actually cure aging? And I think the answer there is a most definite yes. We're getting closer and closer to that. So it's really probably finding maybe the perfect pharmaceutical that's working. And we're not there yet, but there are some considerations there. For instance, rapamycin, generic name sirolimus. Rapamycin, we know it's a drug, it's been around since the '50s. So it was used primarily and has been used primarily as an agent if somebody has an organ transplant. They're given rapamycin on a daily basis to keep their immune system a little bit suppressed so that they don't reject the organ. So it kind of got this sort of bad connotation. It's a bad thing, right? We don't want our immune system suppressed. But what we know is that one of the ways rapamycin works— so again, this is understanding the mechanism of action— is it blocks something called mammalian target of rapamycin, or mTOR. And mTOR, when mTOR is accelerated, we age more rapidly. So we don't want to always turn off mTOR because then we can't build muscle. Yes, you would age more slowly, but you'd be this little loss of muscle, frail-looking person. But what if you can do that just enough? What if we can cycle that to just utilize the benefits periodically? What we do is we use drugs like rapamycin. Rapamycin has been shown in every mammalian species to extend lifespan. There's a great dog study going on. It's been going on for quite some time. That from mice to dogs, every mammalian species, rapamycin works. We don't know because humans live too long. But presumptively, we have very similar mechanics. So basically, should the same thing happen in us, likely. So what we do with rapamycin is we use a very small dose on a once-a-week basis. So now, I consider this like cleaning house, right? I want to get rid of all my bad cells. I want to block mTOR, but I don't want to do it all the time. So think about like your, your house. This is if, if you never take out your trash, which is what happens in our bodies. If we never check out our trash, it starts to fill up in our body and creates more problems in aging and cancer. So, but if you took out your trash, if let's say you had a totally pristine house, then you're probably not living very well. So we do is we take out the trash once a week, right? So we use the rapamycin once a week. We have people take a dose. So now clean out the house, and then they regrow. Clean out the house, regrow. So rapamycin, again, pharmaceutical agent. People would look at it and go, wow, you're taking a drug that's an immune suppressant. Not at a low dose on an occasional basis. So that's what we're going to see more and more in the coming years is drug development, pharmaceutical development is actually designed for the sole purpose of slowing or delaying aging. So that's going to be the next step, and that's going to be where you're going to see in the next years here, because now there's a lot of people with a lot of money throwing, throwing money into this realm— pharmaceutical developments for treating aging as a disease.

That's really interesting. Are there any other pharmaceuticals worth noting just for performance or, you know, optimized health or energy in general?

So from a pharmaceutical perspective, um, yes, you know, you can use— so very interestingly, azithromycin, which is an antibiotic, right? Um, which you guys have all taken Z-Packs for something or another, and antibiotics get a bad sort of bad rap, but azithromycin has some very interesting longevity benefits. So I tell people, you know what, taking a cycle of azithromycin a couple of times a year actually has some very significant benefits in terms of slowing aging, helping with basically our healthspan, not necessarily lifespan, but healthspan. So even drugs like azithromycin where people are like, oh, well, that's an antibiotic. I don't like antibiotics. They screw up my gut. Well, azithromycin actually does not have a huge bad effect on the gut microbiome. And we know at least in other animal species that it actually delays aging and appears to appear to work similarly on markers of aging that we do now. Another drug is an antihypertensive medicine. It's called telmisartan. So telmisartan is what's called an angiotensin receptor blocker. And the ARBs have been used in, you know, as antihypertensives for a long time. And telmisartan, very interestingly, is actually— was put on the WADA drug list, the banned substances list, because it actually increases cardiac performance. So it increases endurance, it increases ability to recover faster. So you can use a low dose. Obviously you don't want to take a high dose if you don't have hypertension because it's going to lower your blood pressure a little bit. With a small dose, you can improve cardiac function in people and help them with their athletic performance, especially for people, you know, I'm in Colorado, so people are coming to altitude here, right? So if you're not altitude adjusted and you're trying to ski at 10,000 feet, You're pretty short of breath. If you use telmisartan, it can really help with that. So we use telmisartan at a low dose. You know, I do this myself. You know, I used to, especially if I'm going to do something more endurance, I'm kind of built more for lifting weights. But if I want to do something that's a little more endurance, like I'm hiking a 14 or something, telmisartan will make a difference in my ability to perform that. I'll just get more oxygen carrying capacity to my cells. My heart will function better. So there's another drug, you know, that would have a bad rap. It's why are you taking antihypertensive medication? But it increases cardiac performance. And we know this because, you know, that's why it's— if you're a professional athlete, you can't take it. It's a tested drug, you know. So those are all cautions we have to give our professional athletes. This is not something you can do if you're a professional athlete. But for people like me who are just recreational athletes, without a lot of our patients who just want to be optimized and don't care, you know, that aren't tested athletes, it's a fine option. Other things, you know, so how about Viagra or Cialis? And people always laugh. Because I'm like, I have all my patients, women and men, on either Viagra or Cialis on a daily basis. So small dose on a daily basis. And if you look at the benefits of that, you know, how do those drugs work to increase erection quality? They, they work. So if you take a big dose before sex, they increase vasal, you know, or they increase blood flow, right? That's why you get a better erection. So if you take Viagra or Cialis, you can perform better in the bedroom. What if you take a small dose all the time? So now I'm increasing blood flow to my brain, to my organs, to my extremities. So by taking a small dose of Viagra or Cialis, you basically can improve people's ability to function. Again, those are also banned substances in sports because they also— I'm going to increase blood flow. If I'm increasing blood flow, I perform better, I have more energy. There's at least 3 studies that show that people who are— again, this is where they kind of figure this out. People who were taking Viagra and Cialis for sexual performance had less risk of Alzheimer's, less risk of dementias. So again, simple drug, inexpensive drug, yes, for drug, but you know, and, and, you know, people laugh because, you know, like, wow, why do you have your woman on Viagra? Because it improves their performance and maybe more importantly, improves their brain function. They have better blood flow to the brain.

Hey, it's Joshua with the production team. Thanks for listening to Flow Research Collective. Active Radio. Before we dive back into our conversation, there's something to consider. It may be that today we are under-challenged. We're drowning in comfort. Now, in his book Antifragile, statistician Nassim Taleb pointed out something that's of key importance. Quote, undercompensation from the absence of challenge degrades the best of the best. The best horses lose when they compete with slower ones and win against better rivals. Now, put another way, who we could be, or our highest potential, is squandered by safety, coddled by comfort. If you want to train with us at the Flow Research Collective, it will require boldness. But what's life without a little adventure, right? To learn more about how you can get more flow in your life and achieve your professional and personal goals in less time and with more ease, go to getmoreflow.com. If you're a good fit, we'd love to train with you. All the best.

Mm, super interesting. Those are amazing examples. So I just wanna come back to peptides in a second. Before we do that, with respect to cognitive performance and things that may increase directly or indirectly ability to enter into and sustain flow state, are there, you know, neuro-specific peptides or other interventions? I know you and I talked about neurofeedback and also TMS and things like that. Are there other kinds of interventions that people should be aware of for cognitive performance that may or may not improve access to flow state as well?

Definitely. There's a lot of what we call neuropeptides or nootropic peptides. So nootropic, think about nootropic as something that's enhancing brain abilities, enhancing brain function. The old movie Limitless, which probably was before your time, but, you know, was basically based on a drug that people could take that just made their brains better, made the— so limitless, their brain could do anything, right? And that's actually very true that we actually do have peptides and some drugs, but peptides that will improve in almost 100% of people the brain's ability to function, its capacity to send messages more rapidly. To learn more rapidly so that you remember better. You know, so, so there's a couple peptides that actually were developed in Russia of, of Kevin's— Dr. Cavinson, who's a Russian scientist, he actually developed these for the Russian army many, many, many, many years ago for the Russian army to help their performance so when they were under these stressed states they could still perform at their best. So that's kind of where they got their start, but They're now again more widely used by the rest of us. And so there's two, and they're used as nasal sprays. And the cool thing about the brain and the nose is you can access the brain pretty easily. Like you can do surgery on the brain through the nose. So there's a very nice ability to get peptides right to the brain simply by using them as an inhaler, right? So what we can do is there's a couple of peptides, one called C-Lanc. And C-Lanc is a, neutropic peptide that works on a couple. Number one, it reduces anxiety a little bit. So when you look at people who have sports, for instance, or jobs that are very, very stressful, and they're, they're, I'm so stressed I can't think. You hear it all the time, right? I'm taking a damn, I'm so stressed I can't think. So what these peptides do, what C-Lang does, is it, it reduces the brain's kind of anxiety level and allows you to focus better. So it's making people less anxious, more focused. So if you look like I have an athlete who's one of those guys who has to do these triathlon things where they're shooting, you know, it's one of the events and, you know, you have to be able to be really, really focused to do that. So you can do something like SeaLynx with those people and help them to focus better. So, you know, shooting guns, things like that can be things that really you need that really fine-tuned ability to really reduce anxiety and improve focus. So SeaLynx is really sort of anti-anxiety, improved focus, and then has a sister peptide called CMAX. A lot of times we'll, we'll kind of alternate these back and forth. But CMAX, on the other hand, makes the brain, um, perform better. So it's not just— it's not really anti-anxiety, it's better for memory and enhancing the brain's ability to utilize more segments, to use more of your brain. So basically, I love those two peptides. There's other ones as well. Something called dihexa. So dihexa is another peptide. Actually, dihexa was investigated primarily for Parkinson's, and it's actually quite effective in Parkinson's patients, but has nootropic benefits in most of us as well. C-Langotinax still probably remains in my kind of favorite list unless somebody does have more of a disease state like Parkinson's, and I'll use things like dihexa. And then kind of, you know, last to that list is there's a peptide that's widely used in Austria, called cerebral lysine. And cerebral lysine is— if you have a stroke or a traumatic brain injury and you're in Austria or China, one of the first things they'll do is they'll give you IV infusions of cerebral lysine. So it is their first-line defense as soon as you come into the hospital with a stroke or traumatic brain injury, with much better outcomes than we have here. So basically, it's a neural repair peptide widely investigated in dementias like Alzheimer's in traumatic brain injuries. So it helps to actually— it's one of the— you know, we always used to say the brain can't— once it's injured, it can't really restore. We know it's not true. We know that your whole life you still have the ability to recover brain function even if it was damaged. So, you know, our old adage that once the brain's hurt, it's hurt forever, you're going to get whatever recovery in the first year— not so. We now know that there's ways to actually make new neurons grow, to form new pathways. And cerebral lysine is one of the ways that you can do that. You can actually grow new neurons. You can actually make the brain function better. It's also really useful for others like, like people who've had nerve damage, sciatica, things like that. You can utilize it in that realm too. So it's a hard peptide to get here in the U.S., um, so I oftentimes will actually fly to a pharmacy in Austria and bring it back for patients because it's, you know, it's that difficult to get here. But, and it's usually best done as an IV infusion because you need larger volumes of it. So we have a program here, so we actually use something called a WaviScan that actually is a little bit like an EEG, but it tells us exactly how the brain's kind of firing. You can see people who had, for instance, old traumatic brain injuries. You can see that the brain, you know, there's portions where the brain's just not working right. Even though the patient may feel— that person may feel fine, you know, it's just not working right. And so then we can say, okay, the only way we're going to fix this person is to try and regrow parts of this brain, try and reactivate parts of this brain. So that's where cerebrolysin comes into play. For instance, we have a Young kid from Montana, every mom's nightmare. Kid goes off to college, it's freshman year. He's riding in the back of his buddy's pickup truck because that's legal in Montana. Kid stops short and he flies out the back of the pickup truck. Horrible traumatic brain injury. Wasn't expected to live, but he survived. It was pretty messed up. He got as far as the general medicine world could take him and arguably much better than anybody thought he would do. He could walk and he could talk and he could feed himself, but he certainly wasn't good enough to really kind of carry on a good conversation with you. He had, you know, his eyes couldn't track together. He definitely could not go back to school or learn anything. So we had him fly out here. We've done like 3 courses now, a week at a time of cerebral lyson, and he's, you know, he can carry on a conversation. He'll probably go back to school in the fall. So, you know, even after a period of time of being, you know, sort of told this is as good as it gets, buddy, We've been able to improve him. So if you can get people more acutely in this realm, even better. It's also really nice for people who have early dementia, cognitive declines. Again, if you do this testing, lots of times people who don't even know they have cognitive decline do. So we can actually start intervening, we hope, earlier on people by doing the testing, knowing they have decline, and then offering them these different techniques. Be it maybe starting with cerebrolysin and then using, you know, some of these other peptides, neural peptides. But I think that, you know, when you look at that, like you sort of your whole flow state sometimes, is there ways to help the body, the brain work in a better flow state? And that's where I think like C-Lanc and C-Max are super helpful for that. If I can get my brain out of that anxiety state into a state where it's very able to really focus to task, I'm going to perform better. And so I think that these are, you know, are they cheater techniques to do that? I think sometimes people sort of think what we do is cheating in a sense. Right? And I would say, you know, if, if somebody told me, you know, from my perspective, that, you know, that I, I could have a little chip implanted in my arm and have superpowers, would I do it? Yeah, I probably would. You know, you know, I think that— I think in, in my mind, if the technology is there, should we— and it's safe, should we utilize it? You know, I think so. I think that we should utilize these, these things that help us perform better and not just say, okay, yeah, do all these mindsets, which is obviously very important. I'm not going to, you know, argue that using mindset techniques and all that kind of stuff is so incredibly important to people. But are enhancements useful?

Yeah. I just, on that note around, you know, risk or safety, how do you think about that? Because I know a lot of people view this sort of world and peptide therapy as a little bit of a wild west, and sometimes there's not necessarily longitudinal data. How do you think about kind risk versus return trade-offs and safety in general with these kind of things. And then especially if someone is using lots of these kind of things and they're doing so over long periods of time.

I think there's a couple of answers to that. Number one is you're right, we don't have a lot of human data on these things. Some of the nootropics like C-Lanc, C-Max that came out of like Cavinson's lab, they have a little bit more human data on those. Um, Dihexa has a fair amount of human data on it. BPC, for instance, thymus and the thymic peptides do not. So we don't have— actually, thymosin alpha 1 does. It's actually used as a drug in other countries. It's called Zidaxin. So in China, they use it. If you're having chemotherapy, you get Zidaxin, which is thymosin alpha 1. Oddly, we don't even have it. So it has a ton of investigational trials behind it. But things like BPC, not. And yet we know that we naturally make it. And we know that people make it in very high amounts when they're younger and lesser amounts when they're older. We know that people who are injured Oftentimes have less. So we know that this is a peptide that if I'm making it myself and it's in very high amounts and declines as we age, can I get it to a, you know, where it's, we're safe? So in my mind, if something has been shown to be safe, it's naturally made by my body, it's been utilized in multiple animal studies, do I feel safe taking it? Yeah. In fact, BPC has been now utilized for quite a number of years. In massive doses in some people, thymosin beta-4, thymosin alpha-1. So I think that there's a lot of peptides that are very safe. But the caveat is, number one, where are you getting them? What else might be in them? Are they actually pure? Most people who are getting peptides are getting them from research chemical sites. You know, arguably, that's not the best source. Yes, they're much less expensive, but research chemical sites are not being investigated by the FDA. You know, the bureaus that are checking out these labs and making sure everything's done in a pure fashion. So I think that that's part of the problem is when we look at these peptides, is people are getting things in— it's sort of like, you know, my bodybuilders who are getting black market testosterone. Do I think testosterone is dangerous? Well, if you take massive amounts of it, probably. But if you're getting black market testosterone and you don't know what's in it, it's going to be a little more sketch. So I think arguably you want to make sure these are good from really good reputable sources. Right? And then you do— there are peptides where you've got to be cautious that a little is good, too much not good. So that's what we have to understand. What is the peptide doing in the body? What am I influencing? And do I want to be influencing that pathway continuously? Or if I influence that pathway continuously, am I actually promoting disease more than curing it? So I think it has to be a very good understanding of, you know, where you needed to sort of tweak the knobs and levers. To make something safe and efficacious. But there are some peptides that— like, like growth hormone, for instance. So, so growth hormone, if you take— you could take growth hormone. Growth hormone is hard to take. So what we use is growth hormone secretagogues. We use peptides that tell your own body to make and release more growth hormone. Now, if I massively just flood— it takes more and more of these secretagogues, I actually do more harm than good. I flood the receptors. Receptors stop working. They can stop work— stop, stop working permanently. So there's a little bit of— there's a certain dose that's going to work. More than that is going to be detrimental. Taking it every day is going to be detrimental. You have to take days off, you have to take time off. There's a lot of peptides like that that we cycle because there's a deficit to— or a problem with doing them continuously. So there's a lot of nuances to that. I, I will say that, you know, from a safety perspective, a lot of these peptides now have been around for quite some time and utilized for quite some time, and we have pretty good safety data, albeit, you know, somewhat anecdotal on most of these. Are you taking— so I saw a big article looking at, for instance, rapamycin, so the drug we talked about for longevity. We know rapamycin has been utilized for a long time as a chemotherapeutic or immune-affecting drug. We don't know, what are we doing with it long-term, taking it the way we are all taking it in the longevity world? We're not 100% positive. We can look at the animal studies and feel pretty secure. But are we 100% positive? And I think that little bit of your sort of risk adversity— I feel pretty confident that when something's been utilized in multiple, multiple animal studies, when we have it shown for an extended period of time to be safe, even if I'm not 100% certain and I know the pathways it's working on, do I feel like it's beneficial to me? Yeah, I have patients who are like, yeah, I'm just still a little too sketched. And that's, you know, that's— those are a little bit of personality things. But I will say that, you know, from a physician's perspective, everything we do, we've got pretty good data on safety and efficacy. Can I be 100% certain that 10 years from now something doesn't get shown to be— to be off? No, I can't be.

That makes sense. Yeah, that's a great That's a great breakdown on it. The other thing I wanted to ask is, are these curative, or are the results, like for example the nasal peptides that you mentioned, timing-dependent, where it's like taking nicotine and you get a spike of performance for, you know, a period of time immediately afterwards? Or are these more curative things that are enhancing?

You are improving cell function with most peptides. So I'm— so it's why, for instance, if you do Like there's a mitochondrial peptide called MOTS-C that repairs mitochondria. My mitochondria are repaired after I take MOTS-C, right? And you may need it for a longer period of time if your mitochondria have been injured by something like a virus. You may need it for a longer time to get your mitochondria back. But at some point, my mitochondria function is back up. Now, will it stay there? It will, because I'm getting older, start to decline, right? So the same thing would be true about, for instance, C-Lang and C-Max. There is an acute effect from them. Yes, but they are doing some neural repair. They are repairing some neural pathways. So I will get long-term benefit from those. But unfortunately, my brain's aging, right? So that's why probably doing these, at least cycling through, is probably going to be an important piece, is to say, okay, the unfortunate thing is I, at this point, I have not stalled my age. I hope that I'm biochemically keeping it all where I was, right? But I can't help that chronologically time is going on and those processes are going on. So if I can stay on top of that to stop aging, but staying on top of that, you know, I would say it's a little bit like, you know, if I give you testosterone, you know, your testosterone levels are going to be better. They may stay better if your lifestyle stays well and you don't get sick. Your testosterone levels may stay very, very good without testosterone, but you're, you're aging, so they're still starting to decline. So I would say that's true with peptides as well. Yes, there's a lot of repair that goes along with them, but you're fighting the fact that you may need to be continuously doing some repair because that's the nature of life. You know, we're, we're beings who are constantly in a deteriorating state, and that's what we want to stop. We want to stop that deteriorating state.

That makes sense. The next question I had is, you know, you mentioned that second level of making sure hormones are optimized. You were mentioning to me as well, which I thought was fascinating, that, that they have literally changed the ranges on a lot of the labs because of how off and declining people's hormones are. So how do you think about the 1:0:1 with hormone optimization? Or of hormone optimization.

So it's so funny, and even in my, you know, 30 years of experience, I've seen this optimal range of testosterone— they just keep lowering it because optimal— so what labs are giving you is not optimal, they're giving you normal, right? And so what is a normal testosterone now for a male would have never been considered normal 50 years ago. So for whatever reason environmental, there's probably other reasons we don't quite completely understand. Males' testosterone levels are dropping quite dramatically, right? So is that normal? Is it okay? Or should you have the same testosterone as you, you know, as you would have when you were 20 and you were 50 years ago? I mean, probably there's something bad that's causing this destruction of testosterone. So you can't look at normal levels of testosterone and say that's normal. So we're always aiming to say what is an optimal range, which oftentimes is either at the very high end of normal or sometimes even a little bit above normal. So there's a big piece to understanding that normal labs— so when your doctor goes, oh, your testosterone is normal and you have a total testosterone at your age of, you know, 400, that's probably not normal, right? And it's funny, I was just lecturing a couple weeks ago at the Mr. Olympia bodybuilding. They started this whole— at the Mr. Olympia competition, which is the biggest world competition for bodybuilding, I was lecturing there because they started this whole Olympia University. So there was obviously a lot of talk about testosterone replacement there. And, you know, and it was very interesting listening to some of the doctors from other countries where it's very, very difficult to get testosterone, talking about what a detriment this was. And there's a whole underground ways to even get testosterone when you're, you know, living in other countries because it's so difficult to get. And how bad that was because we're seeing all these guys who are very obviously testosterone deficient. They can't form muscle well, their sex drive isn't great, they're not You know, when you talk about, you know, that sort of energy to go get things done and I, you know, and feel motivated and, you know, and I mean, think about what men used to be, right? They were the warriors. They were the guys who went and saved the women, right? And now men are not, they're not doing things that boost testosterone. They're not out there being warriors, right? And so that's part of the reason why testosterone levels are lowering. But then secondarily to that, if I don't have any testosterone, I'm going to be a lot more inclined to just want to sit on my couch and play video games. Then I'm going to be wanting to go, you know, fight for my woman. So, you know, I think that there's, there's a piece of looking at symptomatology. So I have a guy who isn't sleeping well, who, you know, has poor sex drive, who basically, you know, is not motivated to do things, is starting to fail at work, and their testosterone levels are not in the optimal range. Even though they're normal, they need testosterone. You know, and, and testosterone is hugely, hugely beneficial to men, to their brains. Brain doesn't function well without testosterone. And to their hearts, partly because testosterone converts to estrogen, which is really important for the heart. So it's important for the brain. So, you know, I think that's where you've got to understand that difference between normal and optimal. And I get this all the time. Your doctor will look at your labs, guys, and they'll go, oh, your testosterone is normal. Well, what is normal? It's, you know, if your symptomatology fits and you're not optimal, then you need testosterone even if you're quote normal.

That makes, that makes sense. And is that the intervention generally?

Is it to, to provide TRT or are there other, you know, so you can sometimes use things of guys younger, sometimes you can use things to just boost their own production. So you can use things that will stimulate their own production of testosterone. So when a guy's young, sometimes they still have enough testicular function. You can use things like— there's some peptides, like something called kisspeptin, um, there's HCG, there's things that you can do to stimulate their own production, right? And sometimes that doesn't work, and you have to basically give them some exogenous sources. Depends on how low they are, how old they are, what other stressors they have going on that are lowering their testosterone levels. So sometimes what we'll do is, you know, and we don't— we don't want, like, somebody like you— we wouldn't want to just suppress your own production. We want to keep your own production up So we would still use things that are keeping your production up while we add on a little bit of extra along with it. And maybe that little extra you only need for a few years because now your health is better and, you know, and life is better and everything's good, you know, and maybe we need a little bit. And so, you know, so, but you want to keep spermatogenesis up and you want to keep their own production up. So you'll usually use alongside testosterone things that enhance their own production so that we don't lose testicular function. In an older guy, that doesn't matter as much, right? If I'm 60, then my own production is pretty limited anyway, and it doesn't really work to stimulate my own production. I have to use exogenous sources. And unless you still want to have kids and keep spermatogenesis up, sometimes you don't need to do things that are still stimulating your own production. Some guys still want it. But so usually it really depends on how low things are, what the cause is, can you boost it up with using other techniques? Like I said, Kisspeptin is a great peptide that sometimes helps increase production. And sometimes people need a little extra. And sometimes people, if they want to run their testosterone a little bit on that higher end, right, sometimes they're, you know, they're still— yeah, we've gotten them as, you know, definitely better. Their points, they went up 100 points with stimulating their own production, but they're still like, I'm still not feeling good. And we might add on a little bit of extra along with that.

Got it. No, that makes total sense. And then the final, final question, Dr. Ureth, is what are you most excited for that's kind of coming down the track? As far as this whole world? What are some of the things, you know, over the next 3 to 5 years that you think we'll be able to use and that are exciting?

Well, piece here is we are learning, you know, um, one of my friends, Bill Seeds, is like a savant about cellular pathways. I mean, the guy is amazing. Cellular pathways are really hard and he is amazing. But we are learning— the cellular pathways I've learned in the past few years didn't exist when I was in medical school. They're still not teaching in medical school. There's so many things we're learning at a cellular level now. And the more we can get this pathways down— how exactly is the cell working— the more we can look at ways to intervene, be that peptides that are going to intervene with peptides. So a lot of it is where we're going with understanding cellular mechanisms, cellular pathways, a little bit more, right? And then I'm, I'm pretty eager— so, so once you know that pathway you can actually figure out ways to make that pathway different. So we find these pathways, we're like the brain, we're finding all this really like tryptophan metabolism kind of running all these pathways in the brain that we knew nothing about, right? And now we're saying, wow, when things are off and the brain switches into this inflammatory state because of the switch in this pathway, how do we intervene in that pathway? And then we can look at what is out there that I could use to intervene. So a lot of it's just understanding these pathways a whole lot more. And you know, and there's some really smart people working pathways. I try and learn from them because I hate studying pathways, but once they explain them to me, I can get there. And then I think the next piece is this whole what we're seeing. Um, you know, so I was just talking to a company that's coming up with, you know, a, a very cool drug if it really pans out. So I do think the fact that we're starting to see more and more big money and companies that are focusing on aging and understanding that aging is not inevitable, it is a disease So that's the first thing is that we are starting to convince the world that aging is a disease and that truly we can stop aging. So as we're seeing more and more, you know, and amazingly, the people who seem to want to live the longest have the most money. And so they're throwing a lot of money into this realm. And so I think we'll see that pharmaceutical side, we find drug interventions that are really working specifically, like when we talk about rapamycin working on mTOR. Well, there is actually a better drug to work on mTOR, not available yet, but we start looking at those kinds of things developing. And it's because people are now starting to work on this. We never looked at drugs to stop aging. Now we're starting to look at drugs to actually stop aging. So we're seeing big money coming in. I think that's what we're going to see the biggest developments in the next few years is these drugs. And, you know, and, and the question is, you know, once that drug's out there, how do we get it, right? Sometimes that's tricky, sometimes it's easier. So how do we get And how do we get access to it earlier and get it to our clients earlier?

Yeah, it's really exciting. I'm incredibly keen to see what happens over the next few years in this world. And I want to mention, Dr. Earth, before we wrap up as well, your academy, because I love the concept behind it of putting this knowledge and these tools into the hands of people directly so that they can navigate undereducated doctors who aren't putting the work in to self-educate. So if you could tell folks about that as well, that'd be great.

Yeah, I think that one of, you know, one of the big problems is that, you know, you and I were talking about this, is doctors are very, very slow to teach and, and to learn. And a lot of times they don't want to. They're doing what they're doing, they're spending a lot of time and energy, and, you know, and they're not going to take the time to learn something new. So, so it's funny, initially it was like, okay, the regular doctors are just doing this, and then the functional medicine doctors came around. And now I'm seeing the functional medicine doctors fall just as behind. And so that's why we started this whole new focus on what we call cellular medicine doctors who are looking at the cellular levels. So how do you find out this stuff since your doctor probably doesn't know it? So we put together, realizing that we were never gonna get very far, we're working on teaching doctors, but they're hard to teach. So we said, you know, people actually, you know, like you and I are more eager to learn this. And so, you know, I think we, you, you picked this up from pharmaceutical companies, right? Where'd they go? They said, well, we'll go direct to consumer. Because getting doctors to change their behavior is hard, but the consumers want this stuff. Well, we'll direct to consumer and then the consumer will push it, right? So what we're trying to do is say, how do you guys learn this from not just Instagram posts from some influencer trying to sell you something, but from a scientific basis? So we started something called Human Optimization Academy. So if you go to bli.academy, you can sign up for it. There's some free stuff on there and then there's some paid stuff on there, content on there. But we have, what we're doing is we put together courses that are based on scientific evidence, all this new research. And we try and get this new research to you guys. I interpret it, I try and go through and figure out if it's good research. And then we've had them post that. Then we have these monthly sessions where we all get together and people throw amazing questions at me, where we look at, you know, somebody may have heard about something that's going on in Russia, for instance, or something like that. And I— and we say, let's, let's investigate this together. So basically, we're trying to teach people in a fashion that's a little bit more medical school-like. Based on research-based, evidence-based medicine from the best newest research, and then bringing that to you guys. So now you can say, oh, I, I get this, I'm going to look for somebody who can give me this, or, you know, how can I get access to this? So that's— so I really encourage that because I don't think you guys can rely on trying to get it from, from your doctor. Potentially there's very few doctors who do what I do. Um, you know, we're— again, we're trying to train more, there's more and more interest there, but it's slow. But you can look at this stuff, understand it, maybe find a doctor who's doing it, or you can always come to us. You just go to Older Longevity Institute. We've, we see people. I'm licensed in almost every state. We have patients all over the world. So we're happy to work with you. And then once you come and you say, okay, I really want this, we can get you, get, get access to it. But learn. The only way you're ever going to get to understand this stuff is to spend a little time learning. And we try and put together nice, easy little courses. So that people can actually learn it. Again, all research-based, and I've made sure I'm not trying to ever sell anything in this. It's really just for you guys to have a learning. So go to bli.academy, sign up there, start learning, and then hopefully you can start teaching other people and this spreads.

Yeah, and I can attest to that personally. I mean, I, I had spent personally over 6 figures and been to maybe 20 or so doctors, um, to try and get the long COVID sorted, and then You got it done within, within a few weeks. So yeah.

Yeah. Long COVID is a lot of understanding cellular pathways. If you look at long COVID symptoms, they're about the same thing happens as we get old, right? We get foggy brained. We have no exercise tolerance or, you know, we feel miserable. Our sex drive goes, everything that happens to the 70-year-old happens to the long COVIDer. So what's happening is, you know, there's mitochondrial dysfunction, there's cellular dysfunction. You have to look at as a cellular disorder, just like aging is, and everybody's trying to target it on this problem, this problem, this problem. It's really a cellular problem. So you've gotta work on fixing the cell. And, and that's the same thing that happens in aging.

Right, right. That's what it felt like as well, which was terrible.

Yeah. Right. You felt like an old man, right?

Yeah. It's awful. Awful. But yeah, thank you so much, Dr. Earth. This is amazing. Incredible wealth of information and definitely recommend everyone check out the academy as well. So thanks so much for your time. It was great.

Thank you, Ryan. Talk soon. Bye guys.

Hey, it's Joshua here with the production team. According to the World Health Organization, poor worker mental health will cost the global economy $1 trillion this year. And without intervention, 122 billion working days, or 500 million years of work, will be lost between now and 2030. Can you believe that? So our mission at the Flow Research Collective is to solve this problem by decoding the neurobiology of flow states and helping humans access peak performance on demand. And that's exactly what we do in our flagship program, Zero to Dangerous. Zero meaning you're distracted, you're on the brink of burnout, and you're rarely in flow. But when you become dangerous, you get into flow reliably, regularly, and surprise yourself with your new capacity. By working with hundreds of thousands of peak performers, we perfected the 3 conditions for inevitable flow. So if you're interested in training with us, just go to getmoreflow.com. .com will free you to thrive in the face of pressing demands and endless distractions. That's getmoreflow.com. Thanks for your time, energy, and attention. All the best.

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