Extend Your Healthspan and Lifespan, with Dr. Sandra Kaufmann

So at the bottom of my period are things that you should do every day. The next level up are things that you should do a little less frequently. So I put that in the once a week category. Then there are things in the once a month category and maybe once a year, and then so on and so forth until you keep getting farther and farther into this, like, sort of wormhole of longevity.

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Hello and welcome to the five Journeys Feel Freaking Amazing podcast. I'm Wendy Trubo. Ed's not here today. No star celebrity sighting, obviously, but we have Dr. Kaufman, who is a longevity physician, author, creator of the Kaufman Protocol and the it's the only scientifically rigorous methodology for creating personal longevity programs. Her information is presented in two popular books, the Kaufman why We Age and How to Stop it and Aging Solutions. Sandy, welcome. I'm so excited to have you on the podcast today.

Thank you. I am thrilled to be here.

Let's dive in. I mean, look, longevity is important because the alternative is worse, right? But you're not. It's not just longevity. It's healthy longevity. It's really, truly having a health span, not just a long lifespan.

I am so glad you just used those words exactly, because I was just going to say just that whenever I say longevity, people like, I don't want to be 150 in a wheelchair with a trach, et cetera, et cetera. It's not about that at all. It's about living as well as you can, as long as you can. And that's how I think what we all want. I mean, who could possibly, you know, poo poo that idea 100%.

So let's talk about. What I really understand is why do we age? Like what? Why? What goes on here?

Oh, my gosh. So you just opened the biggest Pandora's box ever. Why do we age? So, you know, people who, whenever that you say that, everyone looks at it from different levels. There's the, you know, the social level, there's the what you eat level, there's the exercise level. There's like, you know, theoretical levels. I was a cell biologist before I went to med school. I got a master's in cell Biology. I'm an anesthesiologist, so everything I do is cell and organ based. And I deal with a lot of pharmaceuticals and molecular biology and that sort of thing. So my answer is sort of framed in that way of thinking. So here's. Here's the reasons that you age. Drumroll okay, here we go.

Get ready.

So let me actually, before I say that, a lot of people in my world live by what's called the hallmarks of aging, which is a mish cellular things and some non cellular things. And the list just keeps getting longer and longer, and it's just not very organized. So before even people knew that there was a hallmarks of aging, I decided about 10 years ago that you could clump all of the reasons that cells age into seven big piles. And I call those the seven tenets of aging. So if you think about them sort of like in a very methodological perspective, they're very easy to remember, and they're always in the same order for a reason. And you'll understand that at the end. So reason one or tenet one has to do with DNA alterations. DNA go awry for many reasons. Number one is telomeres get shorter. Number two, you get epigenetic modifications, some of which are good, but most of which are bad or detrimental. And then thirdly, we talk about chromatin structure, and there's stuff called heterochromatin and euchromatin and the ratios of this change over time, which leads to structural changes in your DNA and thus anomalous things in your DNA. DNA get loose and leads to transposons and increased risks of cancer and that sort of thing. So that is tenet one. Anything that can go wrong in your DNA tenant two has to do with your mitochondria. So this is energy production. And energy production in your mitochondria can fail for roughly seven reasons. And I won't bore you with all of them. But it's structural changes, it's biochemical reasons. It's because we use oxygen in the electron transport chain, and that develops into what we call free radicals. And those are little bombs around your body. You get a. There are endogenous free radical scavengers that fail over time. So that's another one of the reasons you get a shortage of some of the basic ingredients that mitochondria use. The biggest one, of course, is the precursors to NAD are very, very important. Anyone over the age of 40 is generally deficient in NAD. But again, there are. There are many reasons why your mitochondrial fail and that's all in Tenet 2. Tenet 3 is what I call pathways. And there are many pathways throughout your body that monitor things and then respond accordingly. So the sirtuins fall into this category. Sirtuins monitor how much energy you have, how many nutrients you have, and they dictate what you do. And they, in fact, control all cellular homeostasis. And there are seven mammalian sirtuins, and if anyone's curious, what they are is histone deacetylases, right? So that's a big enzyme, but essentially it turns proteins on and off in your body, and by the time you were 40, these aren't working very well, so you lose cellular homeostasis. So things that go wrong because of this have to do with how you repair your DNA, where you store fat. You know, it's the stereotypical question, or, you know, everyone says, well, I eat the same thing that I used to, and I exercise the same. How come I knew now have a big abdominal ring of fat? Right? That's. Everyone always asks that. And the answer is, you're sirtuin deficient. So your body stores fat differently, which is awesome, because it means that there's a reason and we can fix it. But other pathways. So there's the AMP kinase pathway, measures energy. There's the MTOR pathway, and then I've recently thrown the circadian pathways in there because they're extremely complex. And it's not just not sleeping. It has to do with. Roughly 30 to 40% of all of your genes are activated by the same proteins that cause you to fall asleep. So if you're not sleeping, 30 to 40% of your entire genome takes a hit.

Wait, I think. I think we should pause here. I know you're in the list of the seven things, but I think we should pause here because not sleeping is such a tremendous risk factor for everything. If you don't sleep, you don't detox, you don't repair, you don't rest. That's then a risk factor for other sequelae like heart disease, diabetes, Alzheimer's, degenerative disease, autoimmune disease. So you cannot overstate the importance of these pathways 100%.

And so what's really interesting about this is the traditional belief is that because you sleep, you put that at the top of the pyramid. All of the other things happen because of it. And what's interesting is that's not the way it happens. There are two proteins that put you to sleep, and there are two proteins that wake you up. And as those get made and destroyed, and made and destroyed. The overlapping pattern causes you to sleep. But the production of these proteins also trigger clock control genes. So 30 to 40% of your entire genome is controlled by the clock BMLA proteins. Therefore, sleeping is a symptom of the problem, or it's a part of the problem, but it doesn't dictate it. So if you're not sleeping and you take a sleeping pill, you go, oh, I feel so much better. You don't, because you're not making the proteins that you would have that would have caused you to sleep in the first place.

Okay, so this is like a whole podcast unto itself. And maybe we'll set that aside. Oh, it.

It is. And I love this. But like, so every. Every tenant is honestly a huge monster podcast. But I recently put that one in there because I took a deep dive into circadian rhythms. And I was like, hm, where do I put it in the tenants? I'm like, oh, my God. Of course. It's a pathway, right? So it's pathways. Next. Pathway next. Anyway, so that's those. That's tenant three. Those are the pathways. Tenant four is what I call quality control. So if you think of your cell as a factory, things go wrong and you have to fix them. Right? So in this category are DNA repair mechanisms, protein repair mechanisms, or the process of proteostasis, and then autophagy. And these are lumped together simply because you have to fix things. And if you can't fix them, then you recycle them.

Right.

People always think, well, DNA repair can't possibly be that important. And I point out that you have 10 to the 4th to 10 to the 5th errors in your DNA per cell per day. That is a lot of zeros.

That's ten thousand to a hundred thousand.

Errors every day per cell, per cell, per cell.

And then there's something like 25 billion cells, or I don't even know how many cells are in our body.

Yeah, so you have, because of this, you have five essential DNA repair mechanisms to fix them. So your body's constantly patrolling your DNA, finding the problem, fixing the problem as well as they can. And past the age of 40, these systems just don't work very well. So when you can't repair your DNA, your incidence of disease, decay, death, cancer, all of those things skyrockets, Right. Pretty horrible. Okay, so that is tenant. Where are we?

4?

So we are on a tenant 5. So 5 is your immune system that then turns into your inflammation system. Right. When you are young, this very complex immune system fights infection and it's just wonderful, wonderful things for you as you get older. And it does not do that. Right. You are more likely to have infections. You're more likely to get autoimmune diseases because it turns on yourself. You're also more likely to become systemically inflamed because it basically activates all of these inflammatory cytokines and it doesn't know how to turn them off. So there's a whole science of your inflammasome and inflammating and how to control that. And, of course, inflammatory issues precipitate DNA errors and protein errors leading back to the old disease to ze, you know.

Blah, blah, blah, which stresses the mitochondria and then has the management go. Go off. I mean, like, it just feels like you're circling the drain with all of these. That it.

It ab. Absolutely. And I talk about them as if they're separate, but whenever I do a lecture in person, I always start with this diagram that looks like this, like, unbelievably chaotic net of, like, arrows and circles and overlaps because it's all intricately entwined. But the only way to totally kind of understand it is to segregate a piece of it, knowing full well that nothing lives in isolation.

Right.

Right.

I always say to people, it's like that movie Wall E. You're not eva. You can separate your arms from your head from your body. It's all intertwined. Even though we're carving it out so you can understand it, it really is. It's separate.

Yeah. No good. I gotta love that movie.

All right, so that was, like five. Or I think that was six.

So that's five. So six is individual cell needs. So throughout everything else, I pretend that the cell's a cell, and it doesn't matter what cells they are. But as it turns out, of course, reality is reality, and different cells need different treatments. So a senescent cell, for example, is something you want to get rid of. We do not need our senescent cells. A stem cell, on the other end of the spectrum is something we absolutely need, and we need to baby them and care. Right. And give them everything that they need. In addition, it recognizes the idea that a blood, you know, red cell is different than a liver cell, which is different than a kidney cell, which is different than a brain cell. They all have individual stresses and requirements based on what they do, what they're exposed to, and how long you expect them to live. Right. Red cell turns over every three months. A neuron in your head lives. Your Entire life. So they have different requirements.

Is there anything that unifies them that you can say, okay, here's the common thread that runs through them. All cells need this. And then we stratify it to that next layer of individuality. Is there anything you can talk to there?

Oh, yeah, yeah, yeah. Well, the first five categories responds to like all of them. Okay, right. This is where you go, okay, These are these little, you know, nuances that we need to sort of deal with. So every cell has DNA issues, every cell has mitochondrial issues and pathway issues and blah, blah, blah, blah, blah. This is where we sort of go. They're not exactly the same. So, for example, inflammatory issues cause your bone cells. So there's osteoclasts and osteoblasts, right? You're constantly remodeling. So osteoclasts break down your bone and osteoblast B for build builds more bone.

Right.

And it turns out that inflammatory issues make you break down bone and block building of new bone. But that's very particular to bone. That's got nothing to do with your kidney or your brain. So that's a very particular thing to look at. And there's agents that specifically cause your osteoblast to be more active and then you can delay osteoporosis as an example. So that's individual cell requirements. And then the last category is what I call waste management. Right? Because if this is a factory, you have to take out the trash and most of the garbage we produce as side products of the entire metabolism. And the worst thing are the sugars. And of course, sugars. Everyone points to glucose, but glucose is not as bad as some of the other ones, such as fructose or ribose, but they create something called age or advanced glycation. Endpoints, products. Sorry. And these destroy your tissues. Absolutely destroy your tissues. But there are ways around that, of course. And then the last thing is this stuff called lipofusion, which is like the junk that is left in the back of your cell when your body undergoes autophagy and it's recycling bits and pieces. There's always a bit of goo that your doesn't know what to do with. And the cell goes, well, hell, I'm just going to do what everyone does and squash it in the back and just ignore that it's there. Right. So for short lived cells, it's not a big deal, right? It just leaves with the cell. But for long lived cells, you're stuck with it. So if you look at the neurons of very old People, half of their brain is filled up with this gooey garbage, which, of course, no cell is going to function very well if you're stuck with gooey garbage anyway. So soup to nuts. That is roughly why you age.

Everybody is looking for the magic pill. And I've kind of figured out that the magic pill is like a thousand magic pills. But, but basically, what are the things people can do before they get to things they're putting in their mouth as an extra. Right. Something they're going to. Before you spend money on something. What can you do to help your aging on those seven tenants that doesn't require you to purchase something?

Okay, so. Excellent question. Well, let me, let me tell you. I have this thing that I call the longevity pyramid. Okay. And much like the fifth grade food pyramid that we all saw very, very.

Long ago, by the way, you shall be throwing that pyramid out because it sucks.

Oh, it's terrible.

We're throwing it out. We're just, just using it as a reference.

Oh, I know. It's just, it's. I just remember because I was in the fifth grade, I'm like, really? There's a cupcake at the top. But it was that the idea is good, right? The idea is at the bottom, it's things that you need to do more frequently than the stuff that you do at the top, right? So I thought, well, this makes sense in longevity. So at the bottom of my period are things that you should do every day. The next level up are things that you should do a little less frequently. So I put that in the once a week category. Then there are things in the once a month category and maybe once a year, and then so on and so forth until you keep getting farther and farther into this like sort of wormhole of longevity. So what can you do every day? Exercise is the cheapest thing to do that everyone should be doing baseline. There is no doubt that none of this works without exercise. People always say, well, aerobic or non aerobic, and you have to do both. Your body responds differently to aerobic versus resistance training, so you don't have to be a weightlifter for it. But in order to maintain bone density and a variety of other things, you need compression and you need to activate your muscles. You also need the cardiovascular activity to keep your lungs healthy, to keep your endothelium of your entire vascular system down busy. So exercise, without a doubt is the cheapest thing to do. Of course, diet falls into this category. I am not a nutritionalist in any way, shape or form. I think all These crazy diets that people on are a little bit nuts. People tend to be just absolutely all over the place. I'm a vegan, I'm a this, I'm a that. I believe in moderation, right? Because every diet has its fallback.

There's sort of a bunch of ways to look at that. So I believe that what you eat makes a profound difference on the function and structure and ability of your body to perform well. And so I was thinking about. Michael Pollan has such a great line, eat real food, not too much. Right? Like that to me is sort of the epitome. And then, however you then make that work in your life, you don't eat meat, you don't eat sugar, you don't eat dairy, you don't eat gluten, whatever you're going to drill down into it. But the basis of that eating plan is that it's real food and you can recognize it. And you don't necessarily need a label to tell you what's in it because you go, oh, I see celery and I see carrots. You can recognize the food, that it looks recognizable. Okay, so we, we did exercise, we did food. What's next thing? Things in the pyramid that you don't need to purchase necessarily.

It gets a little harder from then on because I do a lot of light therapy. So it's not something you purchase every day, but red light and infrared therapies, eight minutes a day I think is just fantastic. Clearly there's an upfront purchase, but then once you have it, then it's, you know, it's sort of free. Ish. Some people put peptides into this category, but again, that's something that you have to purchase. Oh, you know, here's something that I do do, and this is sort of. Everyone makes fun of me. Well, we live on a golf course. I, I only walk it in bare feet because I am a big believer in energy and grounding and that is utterly free to take off your shoes. Unless, of course, you step on something and then you end up in the er. But beyond some crazy disaster, you should absolutely ground on a daily basis.

What, when you were talking about the red light therapy and the sauna. What about the. I mean, I'm a huge fan. We have a sauna. You know, instead of going to Italy when I turned 50, we finish the basement and put a sauna in. So I'm a huge fan of it. But what about it?

The heat sauna or the light sauna.

Or both near mid far red light and infrared Heat sauna, it's like a big mouthful.

So infrared and red light are really amazing. And I think this is completely cool on a molecular level because what they actually do, and it's two very, very, very specific wavelengths. If you look at your electron transport chain, there are five complexes that move the little electron along to create a gradient. And at the very last one, because you have a gradient of protons, they spin from one side to the other of this lipid bilayer and it causes the last complex called atpase, to spin. And the faster it spins, the faster you make ATP. Right? Red light and infrared light at those very specific frequencies causes it to spin faster. So you are making more energy free of charge. So as a consequence, all of a sudden, your cells are jacked up for six to eight hours, because that's sort of the time components. So you haven't burned any energy. And yet your regenerative ability or your performance ability, whatever tissues you are affecting is better. That's what the light therapy does. Now, the heat part, you ask yourself, what does heat therapy do? Right? And it activates heat shock proteins. This is why people do it. They don't know why they do it, but this is why they do it. And you have to spend 30 minutes per day at a reasonably high temperature to activate your heat shock proteins. And heat shock proteins are important because they are molecular chaperones and they fall into the protein stabilization business. It's proteostasis. Right? The cool thing about that is there's actually a Japanese drug called Cellbex and it is sold for gastritis, but it is one of the strongest heat shock protein activators that we have. And there actually was a study demonstrating that if people were on this drug for their gastritis, they have less incidence of Alzheimer's, because Alzheimer's is a protein misfolding disease, or that's one of the components of it. Therefore, if you can, you know, upregulate your heat shock proteins, you can reduce relative risk of most neurologic diseases, including Alzheimer's. Therefore, you can either sit in the sauna half an hour a day, which is great, feels wonderful, but I don't have that kind of time. I take cell backs.

It's interesting because I was just saying to someone, like, I love being in the sauna. The only challenge is when you're in the sauna, then you have to wash your hair so that you wash the toxins that came out of your body. You know, your head is full of sebaceous glands which are storing the Fat. So if you don't wash your hair, then you just reabsorb the toxins. So you have to wash your hair. And it's not the sauna, it's actually the shower and do my hair part that I'm like, oh, I don't feel like dealing with it.

It's a lot of work.

It's a pain in the butt, It's a pita. So, okay, so we're doing these things. What else is in the pyramid of things? And is it that these things. And maybe we can't untie it, but is it that these things are promoting long term longevity or that they're reducing illness?

Like are you.

It's both.

Right, so it's, it can Absolutely both. Absolutely both. Because so if you think about it as simple example, let's look at glucose, right? Glucose causes age, age, glob onto collagen and other proteins. But they love collagen. And my analogy is always if you take like a cloth tablecloth and if you look at the little fibers, they're cross linking and you can slide them, right? And that's what our skin does, or our bone or the tissue in our heart, anything collagen based, and they slide. As soon as you put an age on there, it's sort of equivalent to a drop of superglue. And then when you slide the fibers, they break, right? So this is why your collagen fails over time. Thus your skin droops, thus your bones become fragile, thus you get congestive heart failure without coronary disease, right? Happens to everyone. It is just more advanced. If you are diabetic, thus the statement that pissed a lot of people off that I said is, I think everyone is pre diabetic because everyone has glucose, therefore everyone has ages. And everyone's skin droops over the course of time. If you can prevent that early on, and I have seven steps to blocking age production, you just do better. So you reduce morbidity and mortality. So it's a spectrum. So all of these things do both.

I want to make sure that we're doing justice to your pyramid. Is there anything else?

Okay, so that's every day. It's every day, every week. I recommend that people get a full body massage. And the reason for that is you, every time you're massaging muscle, it's, it's basically it's helping your muscle, right? It's bringing blood flow to your muscle, which is bringing nutrients to your muscle as well as getting rid of toxins. It's increasing blood flow to the skin, it's reducing relative stress. All these things are amazing, right? It's fantastic. And when you work out a lot, you kind of hurt. So it's just perfect. So that's once a week. Once a month, it gets a little bit more goofy. I believe in IV glutathione once a month.

Why only. Why only once a month? Why not once a week?

Or I'll tell you why. Because glutathione is a naturally occurring substance in your cell. If you take glutathione every day, your feedback loops will tell your body, oh, I already have enough. I'm not going to make it. So you're going to shut down your glutathione production. That is really bad. If you do a high dose once a month, it doesn't do it. And conveniently, I'll already have an IV in once a month because I do IV exosomes every month to get a twofer. You get a twofer. And I said, and I inject spermidine IV and I inject methylene blue iv. So I just have a good old time once, you know, Saturday morning once a month. And my kitchen looks like, you know, disaster.

I mean, you're an anesthesiologist and you're. You're in Florida. So those are two sort of very rare things that go together. Because, like, in Boston, we can't. Like, we can't do ozone. We have to go to New Hampshire. Like, there's a. There's a fair number of restrictions or whatever you can do. So it feels like it's. Some of this is dependent where you are in the country, but it sounds awesome. I'd love to have, like, one Saturday a month where I can just do it.

Oh, it was. Well, it's. You know, the nice thing is I don't have to go anywhere to do it. It's my kitchen.

Right. You do it on yourself, of course. So. So that's once a month.

What Ha.

And then what's the next ring on the pyramid?

So I'm not done. So the other thing that you have to do once a month is eradicate your senescent cells. And it's not there. There's various things that do. So senescent cells are basically any normal cell that morphs from DNA damage into a senescent cell. So people call them zombie cells. I call them grumpy old man cells because they get kind of fat and globby and they just release a whole lot of, like, negative energy or negative cytokines. And I Just picture like some old fat guy whining in the corner and just being a dick. But anyway, because they come from different cell types, you have to get rid of them with different therapies. So once a month, I will rotate. I either do quercetin, I do desinotib, I'll. I'll do roxithromycin. And then a new one I just ordered is fenofibrate, which is an anti cholesterol medicine that also has been demonstrated to clear out senescent cells. So I rotate those, but I do one one of each. That's not true. I do one of them every month so that I rotate them as we go. So that's once a month. As you go higher up the pyramid, this is sort of where money starts getting in there. Then you've got plasmapheresis issues, maybe you've got stem cell infusions, that sort of thing. Then there's a whole lot of other clinical. The crazy stuff that I'm not a huge believer in. Like, I think hyperbaric will kill you. I actually think ozone will kill you. And then at the top of the pyramid, I always put cryogenics, because when the worst comes to worst, the last thing you could possibly do is freeze yourself, because I just think it's funny.

So where would you put a cold plunge?

I don't. I think that's. I mean. Well, that's not true. Probably would be once a week. I don't do it because it sounds miserable. And I've gotten medications to sort of substitute for that, but it would be in the once a week category.

Okay, got it. Okay. When you're looking at longevity, are there separate things to do to decelerate aging pro the aging process, or is it essentially the things that promote longevity also decelerate the aging process?

Of course, all of the things I've listed in the seven tenants, if you can reduce the incidence of any of them, you just decelerated aging. If you can separate each of them just a little bit, then it's synergistic. Right? But you can't just do one. You have to sort of do them all to get, you know, biggest bang.

For your buck when people do these things. Aside from, you know, I always say to my patients, look, the absence of a problem is really hard to track, and you can't study yourself. So you don't know what you would have done if you hadn't done or if you did do. You don't know the other outcome that happens from the opposite behavior. So when People do these. Aside from that, they live and they don't feel badly necessarily. Are there things that they'll notice that they go, oh, oh, oh, that's meaningful.

Oh, 100%. And it depends. Well, so let me address this in several ways. There are a lot of blood tests that will test certain aspects of aging. So you can track it to a certain degree numerically. Is it completely accurate? No. But you can do a methylation test, you can do a telomere test, you can do a glycation test, you can do a variety of things. So to some degree it's trackable. But what most people notice is things that they wanted to get rid of in the first place. So, for example, most people in their 40s and 50s start realizing that their vision is going, I can reverse that. Most people complain that they don't have a lot of energy. I can reverse that. Those are the easy stuff. This is, you know, if someone feels amazing and they sleep eight hours a day and they feel perfect and their skin is perfect and they're perfect, they're not going to notice the goddamn thing because they're perfect, will it help? Yeah, it actually does still help. They just haven't noticed it yet. But definitely people with defined symptoms are the ones that benefit the most.

And where do people find you, Sandy?

Easiest place to find me is my website. It is kaufmanprotocol.com I have an email address on there, which is kaufman aai gmail.com which is. No one's going to remember that, but it is on the email. I answer every email myself. I have no staff and this is not my primary job at the moment. I'm an anesthesiologist, but I answer absolutely every question. It takes me some time to get to it and people get mad, but it is what it is. I answer questions on Instagram, I am Kaufman anti aging. Otherwise books are on Amazon and I'm on a bazillion podcasts.

Awesome. All right, well, thank you, Cindy. Thank you for being on this because, you know, it's very refreshing and you're very clear and it's all, you know. You told me you rambled before I started. I'm like, you have not rambled at all. You've been very, like, very on to the point. So thank you. Thank you for being on the podcast and to the listeners, thanks for listening to another episode of the Feel freaking amazing podcast. Have a great day. Inspire and empower someone else by leaving a five star review so they can transform their lives too.