The Jordan B. Peterson Podcast - 409. Keeping Death at Bay

00:00:00.940 Hey everyone, real quick before you skip, I want to talk to you about something serious and important.

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00:00:57.420 Hello everyone. So today I have the opportunity to speak with Dr. Adil Khan.

00:01:13.600 Adil is a physician that I've worked with. He offered Tammy and I a treatment, a couple of different treatments.

00:01:20.540 The treatment for her was particularly successful. It helped her deal with chronic osteoarthritic condition in her forearms and was quite remarkably successful.

00:01:30.540 And so that's very interesting. And it deals a young Canadian physician, very, very sharp character.

00:01:35.460 Seems to be on the cutting edge of the expanding field of regenerative medicine, which is, what would you say?

00:01:43.060 It's developing not precisely in opposition to, but in parallel to, standard allopathic medicine that's more symptom-based in its approach.

00:01:51.460 So the regenerative medical types are attempting to get to the root cause of chronic health problems and to address them.

00:01:57.700 And so there's much advance being made on that front.

00:02:02.500 And so we're going to talk through the potential of these new treatment protocols for depression, chronic pain, degenerative diseases like osteoarthritis, multiple sclerosis, fibromyalgia, and a variety of chronic pain conditions.

00:02:20.120 We talk about gene therapy, stem cell usage, and tissue engineering.

00:02:25.160 So stay tuned if you're concerned about your health and about, you know, living happily and healthily, and even just living.

00:02:35.880 Well, thank you for coming in, Dr. Kahn.

00:02:38.860 You treated Tammy and I a while back, and so maybe you could start by telling everybody who's watching and listening what you did and why.

00:02:48.560 And then we'll talk a little bit about what you do more generally and about who you are and the way we'll go.

00:02:53.580 Yeah. So in your wife's case, she had a very common issue, which is chronic pain.

00:03:00.520 Chronic pain is something that the medical industry has grappled with for years.

00:03:05.640 And traditionally, they've used cortisone, which is an anti-inflammatory drug.

00:03:09.740 They've used narcotics, opioids, and then if that doesn't work, surgery.

00:03:13.760 So what we do is we identify that there's a gap where people don't get better necessarily with just cortisone and therapy, and they don't always want surgery.

00:03:24.540 And so this is kind of that gap of patients who are just suffering or living with chronic pain.

00:03:28.960 And taking pain meds, as we know, OxyContin and so many other pain meds, what they can lead to with addiction and all these risks.

00:03:36.820 And so what we do is what's called regenerative medicine.

00:03:39.860 So we use different types of regenerative molecules, whether that's stem cells, PRP, exosomes, which we'll talk about, to repair the tissue back to a previous state.

00:03:51.120 So in your wife's case, she had what's called osteoarthritis, which is degradation of the joint, cartilage loss, and you get inflammation.

00:03:59.360 And then she also had some small tears in the tendons around the joints.

00:04:02.880 And it bothered her for 10 years, as you know.

00:04:04.580 And she couldn't garden, and she loves to garden.

00:04:06.400 So what we did is we used an ultrasound, as you saw, and we go directly into the tears and into the joint where the inflammation is to repair the tissue back to a previous state.

00:04:16.700 And so that's how we got rid of her chronic pain.

00:04:18.240 When was the ultrasound for diagnosis?

00:04:20.660 Diagnostic and intervention.

00:04:22.500 And intervention.

00:04:23.500 Yeah.

00:04:23.840 So how does the ultrasound intervene?

00:04:25.720 Because it allows us to guide the needle directly into the area of damage.

00:04:29.660 Right.

00:04:29.900 And how can you see what's damaged?

00:04:31.980 Because the ultrasound, and that's the skill.

00:04:33.920 So it's telling gray from gray on ultrasound.

00:04:36.280 And that's the steepest skill set.

00:04:38.020 To give you an example, I treated Mohamed Olavar.

00:04:41.980 He's the guy who owns the Burj Khalifa and the six tallest buildings in Dubai.

00:04:45.520 So he had a shoulder issue for 15, 20 years.

00:04:48.740 And he did an MRI.

00:04:49.540 MRI was normal.

00:04:50.920 So they just did cortisone.

00:04:52.140 They did physio.

00:04:52.700 He was living with chronic pain for 15 years.

00:04:54.120 And he's arguably the most, he's the wealthiest man in the Middle East.

00:04:57.380 And he's a very well-renowned businessman.

00:04:59.700 So he has access to any doctor in the world.

00:05:01.100 Right, right.

00:05:01.520 And so he found me, and I flew down.

00:05:04.400 I did an ultrasound, and we found some small tears that were missed on MRI.

00:05:07.720 And then we injected them, similar to what we did with Tammy, and we fixed it.

00:05:10.340 But the principle is the same, which is that sometimes you need to do diagnostic, dynamic

00:05:14.900 ultrasound to find the issue.

00:05:17.340 And that's...

00:05:17.640 How did you learn to distinguish, as you said, gray from gray?

00:05:20.860 And are the AI image systems getting good at that?

00:05:23.500 We're training.

00:05:23.980 We're developing a machine learning neural net to do that.

00:05:26.700 But that hasn't been developed yet.

00:05:28.140 That's actually something we're doing.

00:05:29.280 Because we're kind of set the standard for it.

00:05:31.300 Because my mentor, Dr. Anthony Gallia, he was the first one in the world to do this stuff.

00:05:34.900 He did it for Tiger Woods, Alex Rodriguez, a lot of A-list athletes.

00:05:38.480 So he was the one who taught me all this.

00:05:40.060 And he was the one who pioneered this field.

00:05:41.660 So I learned from him, and I was fortunate because I got to learn from the best.

00:05:45.980 And because of that, I was able to kind of take it and translate it into my own patients.

00:05:50.180 How much exposure to image data did you have to undertake in order to start to be able

00:05:56.140 to distinguish?

00:05:56.800 Thousands of hours?

00:05:57.820 Thousands of...

00:05:58.340 Yes.

00:05:59.000 It's not...

00:05:59.980 The learning curve is so steep.

00:06:01.780 Yeah, right.

00:06:02.160 And we have ultrasonographers, if you remember, I brought her with me at the time, who are specially

00:06:07.700 trained by us.

00:06:08.880 And they're the ones who actually guide us.

00:06:10.540 Because there's so much nuance between telling what's a tear and what's not a tear, that

00:06:16.240 you really need a specialist.

00:06:17.720 And unfortunately, most people...

00:06:18.860 Yeah, and a really trained specialist who actually knows what they're doing.

00:06:21.820 I know there's huge difference in radiologists, for example, in their diagnostic accuracy.

00:06:25.920 I know on the AI front that they have trained AI systems now, from what I understand, to be

00:06:31.380 able to be pretty good at distinguishing lung cancer lesions, for example.

00:06:34.880 Yeah, they're pretty good at x-ray and cancer.

00:06:38.160 But musculoskeletal is still a big gap.

00:06:40.420 And so that's what we're developing, because that's our specialty, is we're going to develop

00:06:43.480 a machine learning neural net using what's called supervised and reinforcement learning

00:06:47.600 to teach the machine learning algorithm to detect what's a tear and what's not a tear,

00:06:52.240 and then guide the physician on how to do it.

00:06:53.920 So that's kind of how we're going to scale what we're doing.

00:06:56.020 And how do you get the data sets set up properly?

00:06:58.720 Because you need a training...

00:07:00.200 If you're going to reinforce the proper response, you have to be sure that the material that

00:07:04.620 you're training the machine on is actually accurate.

00:07:06.640 Exactly.

00:07:06.900 How do you solve that problem?

00:07:08.240 Because we have a brilliant radiologist on our team who's going to be training the AI

00:07:11.940 on what's not a tear and what's a tear.

00:07:13.880 And then you have normal...

00:07:14.940 You have to first get the...

00:07:15.580 Use more than one radiologist?

00:07:17.420 No, we're just going to use the one who's specially trained by us, who does our MSK interventions

00:07:21.960 and diagnostics, and she's obviously exceptional at what she does.

00:07:26.140 And she can train the AI to say, but the AI needs thousands of normal before it can recognize

00:07:31.060 abnormal.

00:07:31.680 Right, right.

00:07:31.940 And that's the data sets that you have to build into at first.

00:07:34.720 And then she has to train it over time to say, hey, this is a tear and this is not a tear.

00:07:38.180 And then eventually it learns.

00:07:39.200 Right, right, right, right.

00:07:40.600 And what did you inject TAMI with?

00:07:42.520 So we use something called exosomes.

00:07:44.900 So the way I explain exosomes, imagine if you're going...

00:07:49.840 So let's talk about stem cells first to explain exosomes.

00:07:52.620 So most people have an intuitive concept of stem cells.

00:07:56.180 They understand that they rebuild tissue or they repair tissue.

00:07:59.180 So they can come from umbilical cord.

00:08:02.100 They can come from fat.

00:08:03.720 They can come from the bone marrow.

00:08:05.280 They can come from amniotic fluid.

00:08:07.300 There's so many different sources where we can get them.

00:08:09.060 We use something specifically called mesenchymal stem cells, which is just an embryological

00:08:13.120 term to explain their origin of where they're being derived from.

00:08:16.800 And so, and the reason we use mesenchymal is because they're easy to access.

00:08:20.140 So for example, the most easiest place to access is after birth, right?

00:08:24.180 Then you take the umbilical cord tissue or you take the amniotic fluid and you can isolate

00:08:28.640 the mesenchymal stem cells or stromal cells is technically the right word.

00:08:32.800 But anyway, most people call it stem cells, but MSCs for short.

00:08:36.940 And so what you do is you isolate those and then you can grow them in a lab for three

00:08:41.880 to four minutes.

00:08:42.180 Why are they in umbilical cord tissue?

00:08:44.460 Why?

00:08:44.920 Yeah.

00:08:45.420 Because they're just a rich source of repair and regeneration of the mesenchymal stem cells

00:08:53.440 from that.

00:08:54.220 So meaning the umbilical cord tissue is just rich in MSCs.

00:08:58.260 So why are they rich in MSCs?

00:09:00.140 Well, I read that babies actually send stem cells into their mother's body to help the

00:09:05.740 mother repair her own tissue.

00:09:07.360 Right.

00:09:07.740 Yeah.

00:09:08.000 There is that mechanism built in.

00:09:09.480 So I think a lot of it is probably that crosstalk between the placenta and the mother, right?

00:09:14.920 So I believe, and the cool thing is your body has stem cells too, right?

00:09:19.660 So, and you have stem cells in your bone marrow and in your fat.

00:09:22.720 And they're basically cells that are undifferentiated that can turn into any tissue.

00:09:26.860 So there's different types of stem cells.

00:09:30.000 If you have embryonic stem cells, which is from the fetus, then they can turn into any

00:09:33.980 type of tissue.

00:09:35.060 But as you know, embryonic stem cells during the Bush era and everything, it was controversial,

00:09:39.180 right?

00:09:39.420 Yeah.

00:09:39.720 And the reason for that was because they were saying, are we going to be harming fetuses?

00:09:43.860 Obviously that becomes ethical issues.

00:09:45.900 And so no one, that never really took off.

00:09:47.920 But luckily we figured out, hey, wait a minute, we have something that's almost as good as embryonic

00:09:52.320 stem cells.

00:09:53.200 Not as good, but it's called pluripotent.

00:09:55.920 Meaning it has the ability to turn into many different types of tissue, but not every

00:09:59.760 type of tissue.

00:10:00.460 I see.

00:10:00.840 So they're slightly farther down the developmental chain?

00:10:03.160 It's not totipotent, it's pluripotent.

00:10:05.100 And so those pluripotent stem cells, mesenchymal stem cells, are pretty ubiquitous.

00:10:09.400 You can get them from dental pulp, you can get them from fat, umbilical cord, as you talked

00:10:14.100 about bone marrow.

00:10:14.600 There's a lot of different sources.

00:10:15.900 And so they're easier to harvest and easier to source.

00:10:19.400 And because of that accessibility, that's where the research really took off in the last 10

00:10:23.460 to 15 years is with the MSCs.

00:10:24.840 So are there variants of cells, like is it a continual variant from the cells that are

00:10:30.560 omnipotent?

00:10:31.680 Did you say the ones that can turn into anything?

00:10:35.080 And then there's the ones that are, what was the next level?

00:10:37.820 Pluripotent.

00:10:38.520 And do the totipotent cells turn into the pluripotent cells?

00:10:43.540 Is that the developmental sequence?

00:10:45.380 And then into specific tissue?

00:10:47.060 Yeah, exactly.

00:10:47.720 Yeah.

00:10:47.940 And that's kind of how it can differentiate down the line.

00:10:50.180 And so the-

00:10:51.900 What's the difference between a stem cell and a cancer cell?

00:10:55.340 So a cancer cell has some similar properties.

00:10:58.960 Yeah.

00:10:59.320 Because it can essentially, it loses a signal, or in a sense, it gets kind of hijacked and

00:11:05.480 it loses the ability to stop killing itself.

00:11:08.020 So meaning it stops apoptosis.

00:11:10.660 So it keeps replicating.

00:11:11.680 Right, right.

00:11:12.560 And it has an infinite amount.

00:11:14.600 It can keep going.

00:11:15.360 Right.

00:11:16.060 Right.

00:11:16.500 And it's undifferentiated to some degree, too.

00:11:18.660 Right.

00:11:18.680 And so that's why there's actually something called cancer stem cells.

00:11:21.460 And so if we can target cancer stem cells and stop that process, that's an active area

00:11:26.120 of research.

00:11:27.060 So not all stem cells are good, right?

00:11:28.680 Because people think, and that's the problem with stem cells.

00:11:30.740 Well, undifferentiated tissue in the wrong place could be a real pullback to cancer.

00:11:33.160 Exactly.

00:11:33.540 And lead to tumor.

00:11:34.160 And lead to tumor.

00:11:34.920 And that's actually the problem with embryonic stem cells, too.

00:11:37.600 They have too much stemness, meaning they can keep replicating and grow into tumors.

00:11:42.500 Right, right.

00:11:43.220 Whereas mesenchymal stem cells, they have a finite ability to grow.

00:11:47.780 So they don't keep growing, which is why they're safe.

00:11:50.120 And so when we grow the mesenchymal stem cells, the soup that they grow in, so imagine

00:11:55.060 How do you say that?

00:11:56.620 Mesenchymal.

00:11:57.280 How do you spell it?

00:11:58.280 M-E-S-E-N-C-H-Y-M-A-L.

00:12:03.100 Yeah, wow.

00:12:04.060 And it's going to take me a while to get that one right.

00:12:05.600 Yeah, I know.

00:12:06.140 It's an embryological term.

00:12:07.040 So just call them MSCs.

00:12:09.480 MSCs.

00:12:09.940 Yeah.

00:12:10.280 Okay, I'll do that.

00:12:11.380 So MSCs, when they're grown, imagine the MSCs are the chicken meat and the soup, the

00:12:19.580 broth is the exosomes.

00:12:21.620 So the broth has all these nutrients and cytokines in there, but there's no actual stem

00:12:26.460 cells.

00:12:27.380 And why is that important?

00:12:29.260 Because those exosomes can send all the signals, which are the proteins, the cytokines

00:12:33.840 and growth factors to reduce inflammation and repair tissue without the risk of having

00:12:38.900 cells, which sometimes can not survive or can cause reactions in certain people.

00:12:43.920 So that's what you used on TAMI with exosomes.

00:12:45.940 And that encourages the cells that are already there to what?

00:12:51.000 To repair themselves?

00:12:52.500 Exactly.

00:12:53.040 There's growth.

00:12:53.440 It's a signal.

00:12:54.180 It's a signal that says to your body, okay, start repairing this tissue.

00:12:57.320 So it sends signals to your endogenous.

00:12:58.820 So does it essentially signal to the body that something's wrong?

00:13:03.220 It sends to the body to start healing and regenerative pathways.

00:13:07.460 Well, I know that, for example, and correct me if I'm wrong, but part of the reason that

00:13:11.720 your face skin doesn't repair itself when it wrinkles is because your body doesn't actually

00:13:16.860 note that the damage has occurred.

00:13:19.200 And I know that some of the therapies that regenerate skin, like intense pulsed light,

00:13:23.540 produce enough damage so that damage is now signaled, right?

00:13:26.740 Your body has to figure out, so the cross-linking that occurs as a consequence of sun damage

00:13:31.540 is so subtle that it can accumulate across time with no indication of damage.

00:13:36.400 And so the exosomes signal to the body that something needs to be fixed.

00:13:40.760 Exactly.

00:13:41.440 And that's what this really is all about.

00:13:43.520 And especially the first generation of stem cells, we'll talk about second generation,

00:13:46.860 but first generation of stem cells is really about paracrine signaling, which is basically

00:13:50.960 signaling to the local tissue, hey, there's something wrong here, start fixing it.

00:13:55.120 And that's really what it is.

00:13:57.280 And so exosomes, in the case of Tammy's case, they send a signal to reduce inflammation,

00:14:02.220 and then they send growth factors to help repair and regenerate the tear.

00:14:05.860 And then you can actually see, if you do a follow-up ultrasound, which we do all the

00:14:09.500 time, that the tissue is actually repaired and regenerated.

00:14:12.460 Can you do that systemically?

00:14:14.480 Yeah, exactly.

00:14:15.540 So intravenous stem cells or intravenous exosomes are being used a lot for a variety of neurodegenerative

00:14:21.780 conditions, autoimmune conditions, chronic pain, chronic inflammation.

00:14:24.980 There's so many different things that are being done for it.

00:14:27.080 There was a recent trial done for inflammatory bowel disease, which is a really terrible condition.

00:14:32.480 Yeah, yeah.

00:14:32.700 And right now, the only really medications are like methotrexate or immunosuppressants.

00:14:36.940 Carnivore diet.

00:14:38.140 Yeah, carnivore diet.

00:14:39.220 It does work, actually.

00:14:40.180 Yeah, yeah, yeah.

00:14:41.160 But not everyone's going to stick to it.

00:14:42.680 Yeah, right.

00:14:43.080 It's a hard diet.

00:14:43.980 And a lot of doctors don't really know about it.

00:14:46.440 So they're not going to recommend it to their patients.

00:14:48.220 Yeah.

00:14:48.400 And so patients have to self-educate, right?

00:14:50.420 Yeah.

00:14:50.660 And so instead of just suppressing your immune system, what the intravenous stem cells do

00:14:55.340 is they do what's called immunomodulation.

00:14:57.760 So they actually reset or repair your immune system from a pro-inflammatory state to an

00:15:02.540 anti-inflammatory state.

00:15:03.340 And is that the exosomes or the stem cells per se?

00:15:06.900 It's more the stem cells.

00:15:07.940 The stem cells have a strong immunomodulatory effect.

00:15:10.740 The exosomes don't have a strong immunomodulation.

00:15:12.940 That's why you have to do intravenous stem cells if you want to treat something systemic

00:15:16.600 autoimmune conditions.

00:15:17.540 And there's trials done where patients have actually gone into remission.

00:15:21.920 And that's incredible to see because...

00:15:23.560 Yeah, you've treated MS?

00:15:25.420 We have.

00:15:26.080 But MS is much more tricky because it's not just...

00:15:29.860 There is an autoimmune component to it.

00:15:31.740 But then there's also...

00:15:32.980 There's a lot of other components to it.

00:15:35.360 And that's where it becomes...

00:15:36.480 You have to take a holistic approach.

00:15:38.040 So the way we're going to treat MS, which we're working on, is we're going to have the

00:15:42.160 second generation of stem cells.

00:15:43.520 So what that means is instead of just using umbilical core stem cells, we create what

00:15:48.320 are called gene-edited stem cells.

00:15:50.180 So we can actually take...

00:15:51.620 So this is what Professor Yamanaka in Japan, he won a Nobel Prize in 2014 for what's called

00:15:58.860 discovery of induced pluripotent stem cells, IPSCs.

00:16:03.500 So what he discovered was that you could take any somatic cell in your body, like a muscle,

00:16:08.960 a skin cell, and you can reprogram it using genetic reprogramming and turn it back into

00:16:14.060 an embryonic stem cell state.

00:16:15.480 Oh, yeah.

00:16:16.000 So that's...

00:16:16.560 So to revert to an earlier form, essentially.

00:16:18.940 So I like to call it the Yamanaka stem cell.

00:16:21.520 And basically, it's a pretty crazy discovery if you think about it.

00:16:24.720 The fact that you can...

00:16:25.540 Your body has this almost innate ability to go back to like an infant state.

00:16:29.880 And...

00:16:30.680 But you just have to overexpress certain transcription factors to do that.

00:16:34.080 And so that discovery was pretty incredible.

00:16:35.760 You know, the immune system does that too, A, is that when it's mutating, when it's adapting

00:16:41.560 to the presence of a new virus or a bacteria, it'll produce more and more accurate gripping

00:16:47.240 mechanisms, right, at the cellular level.

00:16:50.540 But it stores representations of the ones that were part of the developmental sequence.

00:16:57.000 So you can imagine that an immune cell is trying to get purchase on a bacteria.

00:17:04.100 It'll sort of go like this first, right?

00:17:06.580 It's not doing it very well, but it'll stick a bit.

00:17:08.940 And then those...

00:17:09.760 What sticks a bit varies, and then it'll stick a bit better.

00:17:12.680 And then that'll vary, and then it'll stick a bit better like that.

00:17:15.820 Well, then if the thing mutates, this grip might not work, but this one might.

00:17:20.580 And so that information is still stored.

00:17:22.740 And if this one doesn't work, well, this one might.

00:17:24.740 So it stores that developmental...

00:17:27.640 So there's more early variability and less fine accuracy.

00:17:32.320 There's a trade-off, right, between...

00:17:33.680 And it sounds like the same thing is happening with the stem cells, is that they'll differentiate

00:17:38.480 into their final form, which is specialized, but that the possibility for earlier forms

00:17:43.400 with more potential is reserved.

00:17:45.260 Exactly.

00:17:45.840 Yeah, you know, the same thing seems to happen with regards to junk DNA.

00:17:49.700 So I had a friend tell me, for example, if you breed fruit flies, and you breed them

00:17:54.600 so that they don't have eyes, you can do that.

00:17:57.360 You can alter them genetically so they don't have eyes.

00:17:59.620 And then you take the blind fruit flies and you let them breed amongst themselves for seven

00:18:04.020 or eight generations.

00:18:05.240 The eyes will come back because the genome takes information out of the junk DNA and rebuilds

00:18:13.380 the eyes.

00:18:13.960 And so even in the DNA itself, there seems to be additional information stored so that

00:18:19.500 the system can revert to an earlier stage of development and then progress forward again.

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00:19:59.460 So, and that's, that's really what I believe is you have 3.2 trillion cells or so in your

00:20:07.980 body, and I believe they're working for you, but we have to figure out and give it the right

00:20:11.920 signals so that you can heal disease.

00:20:13.840 And that's what regenerative medicine, the promise of it is really about, which is that

00:20:18.580 we can use customized cell and gene therapy to restore your body back to a previous state.

00:20:24.540 And that's the era we're finally in.

00:20:26.140 It took a while to get here, but that's, but you, but you see how there's all these

00:20:29.400 interesting, almost clues from, from fruit flies, from the immune system that tell us

00:20:35.420 that maybe this is possible.

00:20:37.080 And now we're just trying to put piece that together using next generation cell therapy,

00:20:42.140 therapeutics.

00:20:43.240 So can you distinguish, let, let, let's speak more generally for a moment.

00:20:47.800 If you can distinguish between regenerative medicine per se and medicine as it's commonly

00:20:53.300 practiced.

00:20:54.060 And it, it sounds like the regenerative field is much newer and you're obviously at the

00:20:59.480 forefront of that, but how do you distinguish what you do from what physicians typically

00:21:04.000 do?

00:21:04.940 Well, I think the big, the big narrative shift that's hopefully going to happen is instead

00:21:09.740 of giving pills for chronic disease, we want to be giving cells.

00:21:14.040 And what that means is we can make customized cells now to treat chronic disease.

00:21:19.220 Traditional medicine's amazing when it comes to acute care, right?

00:21:23.980 If you get a fracture, you go to the hospital, phenomenal where our surgeons are amazing.

00:21:28.160 They're so good at that.

00:21:29.260 But when it comes to chronic disease, unfortunately, we've been told by regulatory bodies and by

00:21:36.420 guidelines that giving prescription drugs is the best way to manage them.

00:21:40.040 And the reality is those drugs don't really treat the root cause.

00:21:43.300 They're just kind of symptom.

00:21:44.620 Symptom maskers.

00:21:45.560 Exactly.

00:21:45.860 And so, but now, and it was fair, it was not an unreasonable solution, but now we're kind

00:21:51.420 of at this place where we actually have real solutions to get people better using these

00:21:57.900 specific cell therapies and put them into remission or actually, I don't like to say

00:22:02.940 cure, but at least remission, right?

00:22:04.700 Where, where there's diseases controlled.

00:22:07.260 And so they don't, and they don't necessarily have to be on pain meds.

00:22:09.740 And so I think people need to, and this is, I'll give an example, like lupus is a terrible

00:22:15.720 condition.

00:22:16.620 And again, the only way they can traditionally manage it, it's an, it's an autoimmune condition

00:22:21.140 is usually some sort of immunosuppressant.

00:22:23.200 Right.

00:22:23.480 Which brings with it all sorts of other risks, like chronic infection of other sorts.

00:22:27.920 Exactly.

00:22:28.380 And so many other risks with it.

00:22:29.640 And so there was a trial done in Germany where they use something called gene edited CAR T

00:22:34.780 cells.

00:22:35.120 So what they do is they take your T cells out of your body.

00:22:38.840 They add a chimeric antigen receptor, which basically allows these T cells to hone in and

00:22:44.700 kill B cells, which become hyperproliferative in lupus.

00:22:48.700 And so it's called CD CAR 19.

00:22:52.580 It's just, it's, it's a specific type of antigen that they add onto the T receptor.

00:22:56.400 The gist of it is that what it does is just makes it hone in on the problem.

00:23:00.360 So it's, it's really, it's really fascinating because you're, you're gene editing these,

00:23:04.400 you're making these bespoke cells almost that are specifically designed to do a task.

00:23:09.280 And these, and these cells, they actually put everyone in the trial into remission.

00:23:12.980 And, and even, and even a year follow-up, even though their B, B lymphocytes went back

00:23:18.020 up, patients were still doing well.

00:23:19.720 Their, their symptoms didn't come back.

00:23:20.940 So that just shows you the power of these next generation therapeutics.

00:23:24.700 So is that a widely used treatment now?

00:23:26.760 CAR, so CAR T is approved by FDA.

00:23:29.760 However, it's $500,000.

00:23:32.260 And why is it so expensive?

00:23:33.640 Because the pharmaceutical companies, a lot of them just, unfortunately, because there's

00:23:37.780 patented and all this stuff, they just charge a lot of money.

00:23:40.820 And so what we're doing is we're using our technology, which we can talk about to create

00:23:44.700 our own CAR T and hopefully offer it at one 10th the price.

00:23:47.260 And that's, that's kind of the, the goal that we want to take because it's just, it's, it's

00:23:51.660 not like very few people can afford that, obviously.

00:23:54.420 But the point is you can make these customized cell therapies for different chronic diseases.

00:23:58.680 And, and there's so many, it's going to be autoimmune conditions, cancer, and everything

00:24:04.020 in the next few years is going to shift towards gene and cell therapy to actually cure people

00:24:09.040 or put them in remission as opposed to just giving them pills for everything.

00:24:11.560 How far along is regenerative medicine in relation to the treatment of cancer?

00:24:19.480 So CAR T is, so a variant of CAR T is used for different types of leukemia and lymphomas

00:24:26.280 and it's successfully been used for several years.

00:24:28.960 So that's one type of gene and cell therapy that's being used.

00:24:31.660 And then there's also something called natural killer cells, which are part of your innate

00:24:36.600 immune system, as the name suggests, natural killers.

00:24:39.160 They go there, they kill things that don't belong.

00:24:42.500 So what you can do now is you can actually gene edit those natural killer cells with that

00:24:46.920 CAR antigen I was talking about.

00:24:48.460 So you can create something called CAR NK and that CAR NK with that antigen onto it can

00:24:54.740 hone in and kill the cancer.

00:24:56.620 So there's trials being done now where they're using CAR NK for different types of solid tumors

00:25:02.540 as well.

00:25:03.320 And so, and the results are very promising.

00:25:05.080 It's still early stages, but to get, again, this is where the, I think, cross-cultural

00:25:09.040 medicine becomes really important.

00:25:10.240 So when I worked in Japan earlier this year, I learned that they've been using these type

00:25:15.120 of cell therapies to treat cancer for over 10 years.

00:25:18.140 But in the U.S., it's completely new.

00:25:20.540 So it just shows you that there's this disconnect.

00:25:22.980 Why is there a 10-year lag?

00:25:24.560 Exactly.

00:25:24.940 So it's a loaded question because the problem is, there's the biggest problem by far is regulatory

00:25:33.660 bodies.

00:25:35.140 And unfortunately, the regulatory bodies in North America are making it very difficult for

00:25:40.780 cell and gene therapies to be approved.

00:25:42.440 Whereas in Japan, they set a framework.

00:25:44.880 It's called PWDA, which is just a framework for regenerative medicine regulation, which started

00:25:49.960 in 2014.

00:25:50.640 So it's almost nine years.

00:25:52.160 So they actually approved different type of cell therapies nine years ago.

00:25:56.020 Whereas in the U.S., it's technically still illegal to do certain types of stem cells.

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00:27:15.500 So, why do you think that is?

00:27:18.880 Is it merely a matter of, I mean, nine years is long in terms of, nine years is a long time

00:27:25.700 if you happen to be suffering from cancer.

00:27:27.540 But on a historical time frame, it's, you know, a blink, it's a blink in time.

00:27:32.040 I mean, obviously there's going to be some resistance and lag in every system to the introduction

00:27:37.660 of new innovations.

00:27:38.540 And perhaps some of that's useful because some innovations cause a lot more trouble than

00:27:42.600 they solve.

00:27:43.980 But why do you think it is that there is a lag in the United States, which is generally

00:27:47.920 a very dynamic place with regard to innovation on the regenerative medicine side compared to

00:27:52.740 Japan?

00:27:54.120 I think it has to do, unfortunately, with the pharmaceutical companies because a lot of them

00:27:59.480 have lobbyists that influence...

00:28:01.660 Yeah, seven for every member of Congress and senator in the U.S., seven lobbyists.

00:28:06.660 Right, so plenty.

00:28:08.280 And I think they control 75% of mainstream television advertising.

00:28:14.120 I think it's something like that.

00:28:15.220 And I think it's actually higher for news broadcasts per se.

00:28:19.520 And they actually spend more money advertising to doctors than they do to even consumers.

00:28:23.920 So then doctors are inundated with these pharmaceutical reps and with this information.

00:28:29.680 And if you're busy, doctors have really challenging lives, as I'm sure you know.

00:28:34.360 And so they're busy working, they're in clinic, they're trying to just help their patients.

00:28:38.380 They don't really have time to check everything that's going on outside of...

00:28:41.820 And they don't have time to travel, they don't have time to look at what's going on in the

00:28:44.600 whole world of medicine.

00:28:45.160 Or read the journals.

00:28:46.120 They can't.

00:28:46.500 And they're not trained very well to do that to begin with.

00:28:48.680 No, they're not.

00:28:49.400 And they're basically told...

00:28:51.040 What they're trained well to do is follow guidelines.

00:28:53.660 Yeah.

00:28:53.960 And those guidelines, where do they come from?

00:28:55.960 From specialists who have industry sponsors or ties to pharmaceutical companies.

00:28:59.700 Well, it's a tricky business, right?

00:29:01.180 Because the pharmaceutical companies are within their proper purview to attempt to educate

00:29:07.640 physicians about their new products.

00:29:09.700 But drawing the line between that and marketing, per se, and unethical marketing is very, very

00:29:14.940 tricky.

00:29:15.480 And I mean, it's the same with regards to high prices for novel medical interventions.

00:29:20.920 I mean, it can take a lot of time and money to develop a new drug or a treatment.

00:29:26.240 And it's not surprising at all that to begin with, it's expensive, because everything that's

00:29:30.600 introduced into the market to begin with that's novel is expensive.

00:29:34.340 Exactly.

00:29:34.600 Hopefully, then it gets widespread enough so the price starts to come down.

00:29:38.300 I mean, it's easy to damn the pharmaceutical companies, and I'm highly inclined to do that

00:29:42.560 under certain circumstances, you know, because I think, I don't know, it seems to me that maybe

00:29:47.160 a line was crossed when the pharmaceutical companies got the okay to advertise directly to consumers.

00:29:53.200 That seemed to have warped the system pretty badly, and that was about 20 years ago, if

00:29:57.460 I remember correctly.

00:29:59.220 I think they moved from, what would you call it, scientific research enterprises to marketing

00:30:06.040 machines at that point.

00:30:07.560 And it doesn't look to me like the consequences of that were particularly good.

00:30:12.160 So...

00:30:12.600 No, and the reality is that if you're a physician, most of your continuing education comes from

00:30:19.360 once-a-year conferences that are given by specialists who are considered the top in their

00:30:23.920 field from institutions who are usually have some sort of ties with pharmaceutical companies.

00:30:27.440 Right, right.

00:30:28.040 So where are you getting your continuing education from?

00:30:30.500 And it's really difficult for them to get out of that system.

00:30:33.300 And so the only reason I think I was able to get out of that system was because I always

00:30:37.280 looked at prevention, and I always looked at finding cures.

00:30:41.140 That's just the way I was taught, because of functional medicine.

00:30:44.980 And functional medicine is this whole concept of trying to repair your body and trying to

00:30:48.600 heal it.

00:30:50.660 Before cell and gene therapy, a lot of it was just focused on supplements, lifestyle.

00:30:54.780 Like you've obviously, you know, like carnivore, like those type of interventions can be very

00:30:58.140 powerful, but there's no education on the physician side on that stuff.

00:31:02.520 Well, it's also hard to transform them into something that generates profit.

00:31:06.660 And this is, you know, it's easy to be cynical about that, but that's actually a big problem.

00:31:10.040 I mean, I know there are a lot of off-the-shelf pharmaceuticals that are essentially free that

00:31:15.840 can be used effectively for treating various conditions.

00:31:18.840 So there's a lithium, I'm not, this is not medical advice, by the way, for everyone watching,

00:31:24.120 listening, but there's a lithium variant called lithium orotate, which is dirt cheap and has

00:31:29.020 virtually no side effects that appears to be reasonably effective in the treatment of manic

00:31:33.440 depressive disorder.

00:31:34.520 And you can buy it on across the shelf for virtually nothing.

00:31:38.140 And everyone asks, well, why isn't this more widely known?

00:31:41.360 And the answer is, well, if the chemical is widely available and essentially free and

00:31:46.160 no one can generate a profit from it, no one has the incentive to market it or educate

00:31:52.140 people about it, right?

00:31:53.720 You see the same thing for treatments like, what's the precursor to serotonin?

00:32:00.480 5-hydroxytryptamine, which is a good precursor for serotonin.

00:32:05.820 It's also extremely inexpensive and by all appearances, relatively harmless.

00:32:10.680 And you might say, well, why isn't it more widely known?

00:32:13.240 And again, it's the same problem.

00:32:14.700 If there's no market, there's no impetus for the distribution of the product or for

00:32:20.080 education about it.

00:32:20.980 So they just fall by the wayside.

00:32:23.460 And so it isn't merely a matter of the profit-hungry vampires of the pharmaceutical industry.

00:32:28.880 It's actually a very troublesome technical problem.

00:32:31.600 Now, when you're making dietary recommendations too, it's like, well, how do you do that?

00:32:36.900 And at the same time, or any form of prevention for that matter, it's hard to even get credit

00:32:41.960 for prevention, right?

00:32:43.420 Yeah.

00:32:43.700 Now, if you're very good at prevention, then the thing that you could be rewarded for just

00:32:49.480 never happens.

00:32:50.460 And so that's great, but it's very difficult to reward and to note.

00:32:54.540 So how did you get interested in regenerative medicine and why did your educational pathway

00:33:01.780 diverge from the typical physician?

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00:34:12.200 Before I went into med school, I was a personal trainer.

00:34:18.060 So as a personal trainer, my job was to get people moving, exercising, and a lot of times

00:34:23.960 you actually see them come off their medications, diabetes, high blood pressure, just by exercising.

00:34:29.060 So then intuitively I knew, I was like, wait a minute, exercise can solve so many chronic

00:34:34.100 disease problems.

00:34:35.060 And then it turns out in the literature, 80% of chronic disease is preventable.

00:34:38.240 Right, right.

00:34:39.300 With lifestyle.

00:34:40.740 Right.

00:34:41.080 Though it's very hard to get people to make lifestyles.

00:34:43.360 Exactly.

00:34:43.920 And it is.

00:34:44.480 Yeah, yeah.

00:34:45.200 So I was always fascinated by that.

00:34:47.240 And so even in medical school, I was kind of like, why aren't we learning more about nutrition?

00:34:50.580 We had one lecture on nutrition in all of medical school.

00:34:52.840 One.

00:34:53.360 One.

00:34:54.020 And it was the can of food.

00:34:54.640 And it was probably wrong.

00:34:55.700 It was wrong.

00:34:56.320 Yeah, no doubt.

00:34:57.240 It was the can of food guide.

00:34:58.700 Oh, great.

00:35:00.260 Yeah, yeah.

00:35:00.740 Which is what?

00:35:01.460 It was sponsored by dairy, by, you know, it's just, it's like you have to have grains.

00:35:06.300 It's like, it's, it's just ridiculous.

00:35:08.560 But, yeah, but during, but, but then what happened was, I got exposed to this whole like

00:35:14.520 alternative medicine world, because even though I was studying allopathic medicine, I was

00:35:18.140 simultaneously studying functional and integrative medicine.

00:35:20.620 Distinguish those for the people who are watching allopathic.

00:35:23.160 So, right.

00:35:23.940 So allopathic medicine is traditional medical doctorate.

00:35:26.360 You get a doctorate of medicine, and that's a traditional, you know, drug-based, surgical-based

00:35:30.680 interventions that we learn in medical school.

00:35:32.940 So, which is great.

00:35:33.740 Right.

00:35:33.760 So disease treatment.

00:35:35.060 Disease treatment.

00:35:35.640 Yeah, yeah.

00:35:36.400 But then functional medicine and integrative medicine is taking naturopathic stuff that's

00:35:41.180 evidence-based, that has actual science behind it, and lifestyle measurements to intervene

00:35:47.380 and treat chronic disease.

00:35:48.600 So, you know, I went, I went to the Temple of Asclepius in Greece recently.

00:35:55.180 Yeah, it was extremely interesting, a very large compound.

00:35:58.420 And at the Temple of Asclepius, there were rooms where you could, you, they actually had

00:36:04.580 people sit and dream in rooms full of snakes, right?

00:36:10.120 And God only knows what the reason for that was.

00:36:12.960 My daughter used to have snakes as pets, and she said that she would often have nightmares

00:36:17.900 as a consequence of having the snakes in her room.

00:36:20.000 And I suspect it had something to do with their order.

00:36:22.220 So God only knows what dreaming with snakes would produce in terms of visions.

00:36:26.920 But anyways, there was a place set up where you could have a healing vision.

00:36:30.040 But there were also theaters and stadia there and places for massage and for saunas, essentially.

00:36:38.340 Like, it was a compound that was devoted to health that was multidimensional, right?

00:36:43.940 And so, and there were theaters there because part of the healing process was drama, and part

00:36:49.300 of it was exercise, and part of it was vision.

00:36:51.520 And when I went to that temple, I thought, these people were more sophisticated than we

00:36:55.720 are in their approach to disease, right?

00:36:57.900 Because they were, it wasn't merely a matter of, I know there are modern medical miracles

00:37:02.460 and certainly surgical bone setting and that kind of thing, hip replacements and so forth.

00:37:07.120 Some of the things that can be done are absolutely miraculous.

00:37:09.940 But our notion of what constitutes health and how to progress towards it, I don't think

00:37:15.060 is, it's certainly not as sophisticated as what the ancient Greeks managed at their heights.

00:37:19.800 No, and I believe in 30 years, we're going to look back on this era and be like, wow,

00:37:23.860 we did a lot wrong.

00:37:24.940 And the reason is because, just as I was saying, we realize now that the system is broken.

00:37:32.380 The U.S. spends more money per GDP on capita than many developed countries, but they

00:37:37.020 don't have better health outcomes.

00:37:38.300 Yeah.

00:37:38.560 And they're just drowning in debt because of how much their health expenditure is going

00:37:41.980 up.

00:37:42.580 And the reality is, like you were saying, people aren't going to, it's, yes, I think the

00:37:46.340 concept of people promoting exercise, health, and healthy living is great, but the reality

00:37:50.240 is it's really hard to get people to change.

00:37:51.580 And the environment is obesogenic, meaning it's set up, let's be honest, it's set up

00:37:56.080 for failure because of just the accessibility of processed foods and the way the environment

00:38:00.360 massive calorie foods, you know, muffins with 1,500 calories.

00:38:04.700 You know, in, I think, Netherlands, they banned direct-to-consumer advertising of sugar to

00:38:10.400 children, which is great.

00:38:12.200 It's a great start.

00:38:12.880 And Japan, I think, did that as well.

00:38:14.420 So there's starting to be finally this notion that, hey, processed, refined foods like sugar

00:38:19.360 is really, really bad for you, and it can lead to food addiction.

00:38:22.260 And what are the obesity rates in the U.S.?

00:38:23.960 It's 40%, I believe.

00:38:25.000 I mean, I think overall, some states are higher than others, yeah.

00:38:27.700 Yeah, it's stunning.

00:38:29.260 It's absolutely stunning and catastrophic.

00:38:32.600 Yeah, so I think the reality is it's going to be really, really hard to get people to

00:38:36.320 change unless there's huge policy changes, which probably won't happen anytime soon.

00:38:39.820 So what we're doing is we're trying to build resiliency in people's body so that they can

00:38:44.420 get the benefits of healthy living without necessarily doing healthy living.

00:38:48.940 So it sounds kind of crazy, but that's what gene therapy is all about.

00:38:51.540 Well, it's kind of crazy, except, you know, I mean, people also hand wave about the pathology

00:38:59.640 of pill taking, but one of the things you learn as a behavioral psychologist, perhaps

00:39:05.560 above all else, is that behavioral changes are very, very difficult for people to make,

00:39:10.140 even what you would think of as small changes.

00:39:13.440 And everybody kind of knows this because they have their New Year's resolutions, and they

00:39:17.680 decide they're going to go to the gym, and they go for like a week, and then they

00:39:20.860 quit, and people revert back to their old habits.

00:39:23.240 And you might say, well, people should behave better.

00:39:26.480 It would be better for them.

00:39:27.720 But then you think, well, how often do you take that advice for yourself?

00:39:31.040 And so one of the things you learn as a behavior therapist is to help people make behavioral

00:39:35.640 changes very gradually and incrementally.

00:39:38.700 But that's very labor intensive, right?

00:39:40.680 And it's also difficult for the people themselves to do, especially if you're dealing with someone

00:39:46.160 who imagine that they're quite ill and they're in crisis, maybe economically, not least as

00:39:51.620 a consequence of the illness.

00:39:53.040 Then to ask them to make a radical lifestyle change is, maybe it's even necessary, but the

00:39:58.720 probability that they're going to do that on top of everything else they're struggling

00:40:01.800 with is very, very low.

00:40:03.460 So it's a tricky, it's a very tricky thing to get right.

00:40:05.840 It's called social determinants of health.

00:40:07.500 Basically, if you're low socioeconomic status, that's the best predictor of health, long term.

00:40:12.540 So, unfortunately, if you're poor and you don't have access to much capital, then you're

00:40:18.540 more likely to have obesity, more likely to have chronic disease, and then helping those

00:40:22.500 vulnerable populations...

00:40:23.500 You're going to get cheap, fast sources of calories.

00:40:27.060 So how can you tell people, yeah, you just need to exercise more and eat less.

00:40:31.500 It doesn't make any sense.

00:40:33.320 Well, and people also won't do that.

00:40:35.420 The literature on diet is pretty damn clear, is that if you put someone on a diet that actually

00:40:40.080 requires food restriction, so they're chronically hungry, they may diet successfully for a while,

00:40:45.080 lose some weight, but as soon as they stop dieting, they're going to revert not only back

00:40:49.900 to their original weight, but generally gain weight on top of that.

00:40:52.940 And so any diet, it seems to me that any diet that involves protracted periods of hunger

00:40:58.080 is actually doomed to failure.

00:40:59.840 And that's what the fitness industry promotes to people.

00:41:01.920 So they set them up for failure because they see all these people online who are doing these

00:41:05.820 extreme diets, but they're doing it, A, as a profession, and B, a lot of times are enhanced

00:41:10.020 using other things.

00:41:11.040 Yeah, right.

00:41:11.480 But so the regular person sees those people, and then they wonder why it's so hard for them.

00:41:15.640 Well, and those people are actually specializing in doing that, right?

00:41:18.920 Because maybe they make a living doing it.

00:41:20.900 Exactly.

00:41:21.020 So they can put the time and effort into it.

00:41:22.860 One of the advantages of a ketogenic diet or a carnivore diet is that you don't have to

00:41:27.660 be hungry.

00:41:28.780 Exactly.

00:41:28.920 That's a big deal.

00:41:29.800 Because protein is very satiating.

00:41:31.020 And you can eat as much as you want.

00:41:33.440 So that's a massive improvement over diets that involve chronic calorie restriction.

00:41:40.660 Because there's no way.

00:41:42.200 The other thing, too, you see people develop eating disorders this way, too, is if you get

00:41:46.340 in a fight with the systems that mediate hunger, you're going to lose.

00:41:50.400 Because those systems are very, very powerful when they're over-activated.

00:41:54.160 And you see this with people with eating disorders.

00:41:56.000 They get into a war with their hypothalamus.

00:41:58.300 And no one wins that war.

00:42:01.520 No, you're going to be set up for failure.

00:42:03.200 Yeah.

00:42:03.340 Or you develop a very unhealthy relationship with food.

00:42:06.380 Yeah.

00:42:06.760 So it's developing a healthy relationship with food, which means you're eating it for

00:42:09.960 nourishment and not for coping with emotions or stress or so many other reasons why people

00:42:14.860 use food for.

00:42:15.960 And developing that healthy relationship is really what...

00:42:18.760 It takes a lot of therapy, actually.

00:42:20.000 And it takes a lot of work, which is cognitive behavioral therapy, right?

00:42:22.660 CBT.

00:42:23.060 And CBT is one of the few evidence-based therapies out there to help people treat obesity.

00:42:28.920 Right?

00:42:29.640 Yeah.

00:42:29.900 And so...

00:42:30.440 But it's a lot of work.

00:42:31.860 It is a lot of work and a lot of attention, a lot of strategic planning.

00:42:35.080 And it's expensive for that reason, too.

00:42:36.780 Exactly.

00:42:37.020 And time-consuming on the part of the people who are being treated.

00:42:40.140 So...

00:42:40.780 All right.

00:42:41.160 So how did you...

00:42:42.540 Now, you said that you worked as a personal trainer.

00:42:44.700 And so you were already interested in lifestyle modification.

00:42:48.860 And then you...

00:42:50.600 And how long did you do that?

00:42:52.100 And why did you decide to go to medical school?

00:42:55.560 So I was basically doing that from undergrad, like, for three, four years.

00:43:00.000 And then I got into medical school.

00:43:01.740 But the reason I decided to go to medical school was mainly because intellectual stimulation.

00:43:07.020 Because obviously, being a personal trainer, there's only so much you can do.

00:43:09.820 And it kind of becomes repetitive very quickly.

00:43:12.100 And so I wanted to learn more about how I can help and heal people.

00:43:15.840 And being a doctor naturally seemed the best way to do that.

00:43:19.120 But what I didn't realize was when I got into medical school, I was a little bit disillusioned.

00:43:23.200 Because I realized that a lot of these things just don't resonate with my belief system.

00:43:27.680 Which is that I don't believe just giving pills to people.

00:43:30.460 It just never resonated with me.

00:43:32.240 And so I was always kind of trying to learn more about how can I actually get to the root of this.

00:43:37.420 And that was just a question I always wanted to ask myself.

00:43:39.820 I did like surgery because surgery is very gratifying.

00:43:43.260 Because if you have a trauma, if you have someone, you can fix them.

00:43:46.700 You get them on their way and they're done.

00:43:48.540 But then you realize, even in surgery, most of what you're treating is the end stage of chronic disease.

00:43:54.260 Like hip replacements is osteoarthritis.

00:43:56.280 Like ophthalmology, a lot of it is cataracts.

00:43:59.440 And that's related to diabetes.

00:44:01.120 And so many other surgical specialties are actually vascular.

00:44:05.100 It's just chronic vascular disease, heart disease.

00:44:07.140 Like these are just end stage of lifestyle stuff.

00:44:10.360 And so the reality is if you look at even most surgical specialties, a lot of them are just doing what could have been prevented.

00:44:16.420 Yes, exactly.

00:44:17.120 Mop-up.

00:44:17.920 And so that's why I ended up not going into surgery.

00:44:21.260 And then I kind of got into this whole world of, naturally because of personal training, I like sports medicine.

00:44:27.360 So then that's why I went to sports medicine with Dr. Anthony Gallia.

00:44:31.180 And was that a post-medical school?

00:44:33.680 Yes, after residency training.

00:44:35.140 After residency training.

00:44:36.240 Then you do sports medicine with Dr. Gallia, who's kind of the pioneer of the platelet-rich plasma injections.

00:44:40.860 Yeah, sports medicine is the medical domain that probably overlaps most with cognitive behavioral therapy, as it turns out.

00:44:48.380 Interesting.

00:44:48.980 Yeah, right.

00:44:50.020 Well, that would make sense.

00:44:50.860 And so, interestingly, I've had professional golfers I've treated using some, we do something called a vagus nerve injection, which helps with their nervous system to help performance-based anxiety.

00:45:02.860 But anyway, so when I went to sports medicine, I got exposed to Dr. Gallia and kind of the pioneer of platelet-rich plasma, which is where you take your blood, you centrifuge it, you concentrate the platelets in the plasma, and those platelets release growth factors that stimulate healing.

00:45:17.320 This is kind of like a lower version of the exosomes we were talking before.

00:45:21.020 If you were to compare PRP to exosomes, the cytokine profile is about 10 times weaker.

00:45:27.380 PRP is the platelet-rich plasma.

00:45:28.880 Yes, so PRP is still good for like muscle tendon tears, like acute injuries.

00:45:32.460 It's not great for chronic wear and tear.

00:45:35.200 So that's where exosomes and stem cells are more superior.

00:45:38.400 But when I worked with Dr. Gallia, obviously I got exposed to all this kind of alternative stuff.

00:45:42.440 But then I realized he's treating some of the most high-profile people in the world.

00:45:45.880 So I'm like, there must be a reason they're coming to him.

00:45:48.500 So why would these people who can go to any doctor—

00:45:51.540 Right, so is it alternative or is it cutting edge?

00:45:53.620 Exactly, exactly.

00:45:54.800 And the media used to print it as though he's, you know, there's a lot of negative stuff out there about him.

00:46:01.120 So it's hard to discern, right?

00:46:03.520 It's like, what's really the truth?

00:46:05.600 And then you realize quickly, once you're in there, some of the most important people in the world come see him.

00:46:10.640 And so I realized he's obviously doing something right.

00:46:13.640 And then that's when I got into regenerative medicine.

00:46:16.840 In regenerative medicine, PRP was a great starting point, but now it's evolved into cell and gene therapy and tissue engineering.

00:46:22.520 How did you learn to read the relevant scientific literature?

00:46:25.160 I had to just make Google Scholar alerts and just for everything regenerative medicine-based and just reading primary literature sources.

00:46:34.020 And then just reading everything—

00:46:34.660 And was that something you did fundamentally on your own?

00:46:36.680 Yes, yeah.

00:46:37.320 Yeah, because one of the—correct me if you think I'm wrong—but one of the things—I did a fair bit of research with psychiatrists, especially back at McGill when I was doing my PhD.

00:46:47.220 And one of the things I learned very rapidly was that there was a big difference between physicians and scientists in that—so if you're trained as a bolder model clinical psychologist, you're basically a research scientist who does clinical work.

00:47:02.620 So you're trained to evaluate the scientific research, you're trained to learn how to do statistics and to understand them, and to write scientific papers and to evaluate them.

00:47:12.820 And I thought the same was true of physicians, but I soon discovered it wasn't true at all.

00:47:18.160 And even the psychiatrists that I did work with, they often had statisticians do their stats, and I thought that was so unbelievably—

00:47:25.460 Well, you know, even the peer-reviewed process—do you know how that works?

00:47:29.640 The doctors don't actually review the data.

00:47:32.140 They just get the primary paper, and no one vets it to them.

00:47:36.700 They just go through it, and they're just like, ah, it looks good.

00:47:39.080 Yeah, well, it's very—well, it takes a long time to learn to evaluate scientific research.

00:47:43.880 This is why I was wondering how you managed to do it, because it's a very intense training process.

00:47:49.620 Even to understand the jargon that surrounds the statistical analysis, that's years of work.

00:47:56.700 And now the medical literature is doubling so fast.

00:47:59.880 From 1900 to 1950, it took 50 years for the medical knowledge domain to double.

00:48:04.720 Now it takes 73 days.

00:48:07.480 It's 73 days.

00:48:08.680 For the medical knowledge literature.

00:48:09.900 Yeah, I can believe that.

00:48:10.940 You know, I've been reviewing some of the psychological literature pertaining just recently to disgust sensitivity,

00:48:16.460 which is a neurologically based, partly gastrointestinal, partly emotional response.

00:48:22.780 But it has implications for all sorts of things you wouldn't expect.

00:48:26.400 So, for example, societies that are, what would you say, characterized by higher levels of infectious illness

00:48:35.120 are much more likely to have authoritarian forms of local and national government.

00:48:39.420 Like, way more likely.

00:48:40.760 Not a little bit.

00:48:41.520 There's a massive connection between disgust and authoritarianism, as it turns out.

00:48:46.340 Anyways, I was reviewing that literature, and I haven't looked at it for, you know, five years.

00:48:51.240 And I was just absolutely stunned at the proliferation of new papers.

00:48:55.340 It is essentially impossible to keep up.

00:48:58.180 And so, but it's also extremely exciting because there is so much knowledge being generated constantly.

00:49:03.980 And so the big, I think, the key takeaway is you have to be able to look at it from a bird's eye view,

00:49:09.280 because there's too much.

00:49:10.340 So you have to look at trends, and you have to look at where is the science headed.

00:49:13.480 Yeah.

00:49:13.720 And that's the tricky part.

00:49:14.960 Yeah, that's for sure.

00:49:16.240 And the science, and that's the problem with the current medical system, is that everyone's in silos.

00:49:21.280 And then you have scientists, and you have doctors who are in their little silos,

00:49:23.980 but they're not stepping back and looking at, hey, where is medicine headed?

00:49:26.820 And how can we take the best of what the science is presenting to us and bring it into patients?

00:49:32.280 Well, or into public policy.

00:49:33.860 Exactly.

00:49:34.200 And so a lot of that, and there's a huge, what's called a clinical translation gap of 15 to 20 years.

00:49:40.040 Yeah.

00:49:40.220 So meaning that there's data out there to support the use of certain treatments, but a lot of regular doctors don't put it into their treatments for 15 to 20 years, which is crazy, right?

00:49:49.080 And so patients aren't getting access to the best treatments available, and it's very unjust, because a lot of people are living with chronic disease and suffering when there are options for them.

00:49:57.940 And that's really what got me super motivated to get into this field, because I saw people suffering with chronic pain, especially people don't realize how hard it is to live with chronic pain.

00:50:06.220 It is one of the most challenging things, at least to mental health issues, at least to disability.

00:50:11.640 And in fact, chronic musculoskeletal conditions have a greater cost to society than any other disease, meaning the total cost of there's billions and billions of dollars because of missed work days, and because of the disability burden.

00:50:23.840 Yes, heart disease kills more people, but quality of life and economic burden of musculoskeletal is the highest.

00:50:31.900 So it's a very important problem, and that's why I was so motivated to get into this field, because I saw all these people not getting better.

00:50:38.180 And I've been able to help a lot of people that no one was able to help.

00:50:41.120 So it's...

00:50:41.780 Well, let's talk about that a little bit.

00:50:43.100 So when you first see someone, now the regenerative medicine practices that you engage in, that's an element and aspect of lifestyle medicine.

00:50:54.820 So you're looking at sleep and exercise and stress, a broad sort of, I would say, a behavioral analysis.

00:51:00.900 So how do you move from the general behavioral analysis through the diagnosis to the recommendation of the therapies that you can provide?

00:51:09.640 And what they're...

00:51:11.440 Like, how do you step along that?

00:51:12.780 How do you decide who's...

00:51:14.640 How do you...

00:51:15.020 Yeah, well, that's what I mean.

00:51:15.900 How do you lay out the diagnostic process and determine what treatments are appropriate?

00:51:20.740 If someone came to see you, what could they expect?

00:51:23.200 Yeah, no, I have a team who are kind of health coaches and biochemists who can work with the nutrition and lifestyle stuff.

00:51:30.200 So they try to optimize that as much as possible, but sometimes that's not enough, right?

00:51:33.500 And that's why they're coming to me, because they've already tried the traditional things.

00:51:37.160 A lot of them have already seen multiple specialists.

00:51:38.640 And so the most common thing I see by far is osteoarthritis, right?

00:51:43.840 Osteoarthritis is just, like we were talking about, it's cartilage wear and tear, it's chronic inflammation.

00:51:48.060 But now we realize that osteoarthritis isn't just chronic inflammation.

00:51:52.460 There's all these hallmarks of aging.

00:51:55.180 There's 10 hallmarks of aging.

00:51:56.540 And as you probably know, aging and longevity is a huge, hot topic.

00:52:00.000 Because if we can cure aging, we can pretty much treat almost all chronic disease,

00:52:03.700 because they all have the same 10 hallmarks.

00:52:06.160 So I'll list a few of them.

00:52:07.620 There's genomic instability, mitochondrial dysfunction, loss of proteostasis, stem cells.

00:52:12.560 Loss of proteostasis, which is protein regulation, like homeostasis of protein regulation.

00:52:17.580 And you get malfunction of proteins, and they build up, and that can lead to cell dysfunction.

00:52:21.560 And then there's also stem cell exhaustion, chronic inflammation, and senescence.

00:52:25.540 There's all these different hallmarks.

00:52:26.740 So there's about 10 of them.

00:52:27.680 And now we realize those 10 hallmarks of aging actually govern most chronic diseases.

00:52:34.200 So even osteoarthritis, what happens is those chondrocytes, which are the cells that line the joints,

00:52:40.000 they have all these different hallmarks of aging.

00:52:42.200 So they get those epigenetic alterations, the mitochondria start becoming dysfunctional.

00:52:47.040 All those things start happening at a cellular level, which can happen years before the doctor picks it up.

00:52:51.760 Right, sure.

00:52:52.340 And so that's part of the problem.

00:52:54.320 Well, I know with neurological conditions, often you don't see any overt symptoms

00:52:58.780 until 95% of the underlying tissue is being destroyed.

00:53:02.080 And so that's why diagnostics is becoming advanced too.

00:53:05.220 In fact, they're using exosomes, which can be a biomarker for a lot of these diseases,

00:53:09.300 because these cells start releasing these different biomarkers,

00:53:12.580 and you can detect them using exosome technology.

00:53:14.960 So it's becoming, and even the diagnostics is really far behind now in traditional medicine,

00:53:19.000 because they're not doing any of this stuff.

00:53:21.140 But anyway, so to the point, so if you have someone, let's say a knee,

00:53:24.320 that's really bad osteoarthritis, right?

00:53:25.700 Like stage four, they've been told by their regular doctor,

00:53:28.520 they want to get a knee replacement, and they want a second opinion.

00:53:32.180 So that's usually why they come to me.

00:53:33.820 And they want to look at the alternatives, and they've tried the lifestyle stuff.

00:53:37.460 And so what we do is we assess their x-ray, MRI, we do an ultrasound examination,

00:53:42.480 and then we see if they're an appropriate candidate for our procedure.

00:53:45.120 And the way we do that is based off MRIs.

00:53:48.300 So you have to have characteristic findings, for example, like bone edema,

00:53:52.900 which is inflammation in the bone.

00:53:54.580 That's something we can target and treat with stem cells,

00:53:56.740 because they're very anti-inflammatory.

00:53:58.480 And then we also have to make sure their bone isn't too deformed.

00:54:01.000 So for example, and this is a problem with my field,

00:54:04.380 if you Google regenerative medicine doctor, there's a thousand of them in the U.S.

00:54:07.260 And there's so many of them not doing things properly.

00:54:09.940 And the problem is because there is almost a black market

00:54:14.040 where there is a lot of people doing it illegally in the U.S.

00:54:16.640 Because the FDA can't keep up with shutting down all these clinics,

00:54:19.580 there are so many stem cell clinics,

00:54:21.340 even though stem cells are technically illegal in the U.S.

00:54:24.420 So it's become a weird place because it's hard for patients

00:54:28.980 to kind of figure out who's actually telling the truth

00:54:31.120 and who's just selling them a lie.

00:54:33.960 And that's the biggest problem with the whole stem cell field.

00:54:36.420 You see the same thing with plastic surgery?

00:54:38.240 Exactly, exactly. It's the exact same thing.

00:54:40.460 Yeah, well, it's a Pareto distribution problem,

00:54:42.680 which is that in every field,

00:54:44.820 only a tiny minority of people actually know what they're doing.

00:54:47.660 Right.

00:54:48.100 And so you always have a signal-to-noise detection problem.

00:54:51.440 It's like, who are the people who actually...

00:54:53.380 And then, of course, often the people who don't know what they're doing

00:54:56.400 genuinely think they know what they're doing.

00:54:58.520 The Dunning-Kruger effect.

00:54:59.140 It's even tricky. Yeah, absolutely.

00:55:00.420 It's really problematic, yeah.

00:55:01.920 And that's exactly what happens.

00:55:05.020 So why should people trust you?

00:55:06.960 Because I'm a Canadian physician.

00:55:10.160 And in Canada, we were never taught about money.

00:55:13.420 We were never taught about the business side.

00:55:17.180 We were always taught about patients first and making them better.

00:55:20.120 And I think that's...

00:55:21.480 Being on the global stage, as I am now,

00:55:23.500 we're in traveling and treating people around the world.

00:55:25.560 My focus is never on the monetary stuff.

00:55:28.000 And I always focus on treating the patients first.

00:55:31.100 Yes, some of the treatments are expensive,

00:55:32.520 and that's just because the market price is expensive.

00:55:34.500 But as we talked about earlier, anytime there's a new technology,

00:55:37.900 over time, the price is going to come down.

00:55:39.740 And there's always going to be early adopters.

00:55:41.520 And over time, we want this to be accessible to the average person.

00:55:44.360 In fact, we want it to be covered by insurance, which in Japan it is.

00:55:47.240 So if Japan's doing that already,

00:55:49.800 I think eventually there's going to be an impetus for this stuff to move over here.

00:55:53.080 It's just going to take time.

00:55:53.960 But I think that's because I went into medicine generally to make a difference and help people.

00:56:01.040 That's always been my motivation.

00:56:02.420 It has never been anything more.

00:56:05.580 And the big thing, too, is honestly, if a lot of patients who see me,

00:56:09.200 they can tell I'm pretty...

00:56:11.100 Like, I'm honest and I'm transparent.

00:56:12.420 And I don't promise the moon.

00:56:13.540 Like, there's certain things that we can fix, certain things that we can't fix.

00:56:16.600 Stem cells aren't a magical cure for everything.

00:56:18.400 But the next generation of cell therapy, like we were talking about,

00:56:21.980 like the genetic cell therapy,

00:56:23.540 that really will be allowing us for custom cell lines for almost every medical condition.

00:56:28.180 Like diabetes, cancer, dementia.

00:56:30.700 There's Parkinson's disease.

00:56:32.020 There's a clinical trial done this year.

00:56:34.000 Those iPSCs I was talking about earlier.

00:56:36.020 And they are iPSCs are?

00:56:37.800 The induced pluripotent stem cells.

00:56:39.300 The Yamanaka stem cells.

00:56:40.920 So they created what are called iPSC dopamine-producing neurons.

00:56:44.320 Oh, yeah.

00:56:44.700 And then they transplant them surgically into the areas where they lose those dopamine neurons.

00:56:50.240 And then they did a one-year follow-up.

00:56:52.000 And so many of the patients basically go into remission.

00:56:54.100 Their symptoms get so much better.

00:56:56.020 And they actually regrow new neurons that produce dopamine.

00:56:59.160 This was a Blue Rock therapeutic clinical trial.

00:57:01.140 So this shows the power of iPSCs.

00:57:03.620 And this is just the beginning of iPSC.

00:57:04.940 This is what I'm going to call the iPSC revolution.

00:57:07.360 There's going to be so many different iPSC cell lines

00:57:09.680 that are going to allow us to treat specific medical conditions.

00:57:12.460 So in the future, people will think about cells to treat their conditions as opposed to pills.

00:57:19.040 Let's go back to osteoarthritis because that's a very interesting place to dive into.

00:57:23.560 Because generally, when people have rheumatoid arthritis and use anti-inflammatories,

00:57:31.460 you can slow down the degenerative process.

00:57:34.180 But often when you see people in late stages of osteoarthritis,

00:57:37.920 they've already suffered a tremendous amount of loss of cartilage, for example.

00:57:41.280 And so you evaluate people using MRI.

00:57:45.300 And you said there are times when their joint damage is too far gone for you to be able to intervene.

00:57:50.980 But so at what level of severity can you intervene?

00:57:55.960 And what sort of responses have you seen?

00:57:59.180 And how widely generalizable is that?

00:58:02.000 Yeah.

00:58:02.420 So there's four kind of stages of osteoarthritis.

00:58:06.520 And so we can even treat stage three, stage four, which is the more advanced one.

00:58:10.800 As long as their bone, like I was saying earlier, if their bone is actually deformed,

00:58:14.500 where they need some sort of alignment or corrective, where the problem is mechanical.

00:58:18.440 If it's mechanical, then stem cells aren't going to fix that, right?

00:58:20.940 They need some sort of surgical correction.

00:58:22.280 So, but if it's more inflammatory-based, or if it's more based off like the cellular dysfunction

00:58:28.400 we were talking about, then that's something stem cells work really well for.

00:58:31.780 So for example, people who have chronic daily pain, night pain, it's affecting them all the time.

00:58:38.220 That's very inflammatory-based.

00:58:39.740 And that's where stem cells work really well for.

00:58:41.600 And even MRI, we can correlate if they have inflammation in the bone, then we have a specific target.

00:58:46.440 So it is generalizable, because if we have patients like that, we know it's going to work.

00:58:50.740 Cool. So it brings down the inflammation.

00:58:52.640 And it can help to regrow a little bit of cartilage.

00:58:55.360 Oh, yeah.

00:58:55.780 This is the first generation of stem cells, which are the umbilical core stem cells.

00:58:59.240 Now we're transitioning.

00:59:00.700 Over the next six months, actually, we just licensed it.

00:59:02.760 We just have this technology now.

00:59:04.280 It's the second generation of stem cells.

00:59:05.780 So they're the Yamanaka stem cells, but specifically for osteoarthritis.

00:59:09.420 So they're the iPSC-derived MSCs.

00:59:12.880 So they're mesenchymal stem cells, but they're iPSC-derived.

00:59:15.720 And they're gene-edited to overexpress certain transcription factors to target osteoarthritis.

00:59:20.920 So see how specific the cells are getting?

00:59:23.400 It's becoming a really cool technology, because it's not just like, okay, stem cells.

00:59:27.940 It's like, no, this is a very specific iPSC-derived MSC product for osteoarthritis.

00:59:32.920 So that's the era we're in now.

00:59:34.740 So you can treat muscle tears and damage, and tendon tears and damage?

00:59:39.900 Yes, yeah.

00:59:40.140 And you can treat osteoarthritis.

00:59:41.840 What other conditions do people suffer and come to you for that you have had success in treating?

00:59:50.240 I've had, I get a lot of, so because of the online world, I get patients from all over the world.

00:59:56.700 And most of them are chronic complex conditions.

00:59:59.280 So a lot of them are like fibromyalgia, which is just like chronic pain everywhere.

01:00:02.760 There's chronic fatigue syndrome.

01:00:04.780 There's people with toxic mold who don't get better.

01:00:06.740 There's people with rheumatoid arthritis who just have chronic inflammation and joint pain everywhere.

01:00:11.420 And they've tried all the meds.

01:00:12.480 Inflammatory bowel disease.

01:00:13.860 So we're getting a lot of chronic complex conditions.

01:00:15.840 And now we're building out a team of specialists.

01:00:17.820 So these are long-term systemic dysfunctions.

01:00:20.460 Exactly.

01:00:21.060 And so it's about restoring your immune system and getting it to be functional again.

01:00:25.440 And that's kind of what we can do with the combination of the systemic intravenous stem cells

01:00:29.700 and with the different peptide protocols we have.

01:00:32.560 And even where now we're manufacturing and we have our own what are called fecal microbial transplant pills, FMT pills.

01:00:39.220 But basically, FMT, as you know, is to repopulate the gut bacteria.

01:00:43.320 And the gut is where most of your immune system is stored.

01:00:45.900 And so if we can restore the immune system, we can treat a lot of chronic diseases.

01:00:49.620 Even Parkinson's.

01:00:50.580 So tell me what you're doing with those.

01:00:52.760 So we have our own process to manufacture FMT.

01:00:55.620 I have a human microbiome.

01:00:56.980 Is this in Canada?

01:00:57.860 No, Mexico.

01:00:58.780 In Mexico.

01:00:59.340 So we have a manufacturing plant there.

01:01:00.780 That's where we do stem cell manufacturing.

01:01:01.800 But is that product available already?

01:01:04.220 It'll be available in the next few months.

01:01:05.600 Oh, yeah.

01:01:06.200 And so our scientist, her name is Dr. Caroline Gannabis, great PhD, human microbiome specialist.

01:01:12.180 And this is her specialty.

01:01:13.260 And she has her own proprietary process on how to manufacture these pills, select for the donors, and give them to patients.

01:01:18.960 And the beautiful part about these treatments are only one week long.

01:01:21.800 Right.

01:01:22.000 And they can have a huge impact on your body.

01:01:24.160 And who do the fecal transplant pills work best for?

01:01:27.280 So you can use them for even anti-aging and longevity, because in mice, FMT has been shown to extend lifespan by 30%.

01:01:35.000 So I think there's going to be a lot of people who are just going to use it for longevity.

01:01:37.540 And that's a consequence of gut biotic proliferation.

01:01:40.200 Because the gut microbes produce so many different metabolites and help with so many different cellular processes.

01:01:45.080 They're not just...

01:01:46.040 And that can be used post-antibiotic treatment as well, right?

01:01:48.720 Yes.

01:01:49.100 And so we're going to make one for children as well, because a lot of toddlers and a lot of young kids, unfortunately, get antibiotics like crazy.

01:01:56.480 Yeah, yeah.

01:01:57.080 And there's actually...

01:01:58.040 Well, and cesarean birth actually is a problem, right?

01:02:00.860 Do you want to explain that?

01:02:01.940 Yeah, because you don't get exposed to the vaginal flora, which is the bacteria.

01:02:05.100 So I recommend anyone who gets a C-section just take the stuff down there after your baby's born and rub it on their face.

01:02:10.700 Right.

01:02:11.040 And just get them that exposure to the good bacteria.

01:02:13.380 So the reason is because...

01:02:15.900 That's a good example of just how bloody complex things are.

01:02:19.260 Exactly.

01:02:19.460 Because who the hell would have ever guessed that a cesarean birth would cause post-birth trouble years later because there wasn't the proper trip through the vaginal canal?

01:02:30.640 Man, that's unbelievably complicated.

01:02:32.920 It is.

01:02:33.440 And that's why...

01:02:34.940 But what we got to learn are principles.

01:02:37.240 What's the principle of the human body?

01:02:39.580 Immune dysfunction is one of the most important principles that governs so many different chronic diseases.

01:02:44.360 So if we can train your immune system properly at a young age...

01:02:47.300 I always say your immune system is like a teenager.

01:02:49.680 If you don't train it properly, it's going to misbehave when you're older.

01:02:52.240 Yeah.

01:02:52.420 So now we're learning how to train it properly, which means you have to get exposure to certain bacteria.

01:02:58.140 You have to play with pets.

01:02:59.480 You have to play with soil.

01:03:00.680 You can't be afraid of germs when you're young because that actually leads to more issues older.

01:03:04.440 And antibiotics...

01:03:05.140 Too much cleanliness.

01:03:06.400 Too much cleanliness.

01:03:07.140 And we know that antibiotics, for every antibiotic course that children take, it increases the risk of autoimmune disease by 1%.

01:03:14.160 So it can become a cumulative...

01:03:15.280 Is that right?

01:03:15.940 Yeah.

01:03:16.260 And so it can become...

01:03:17.080 It was NIH research...

01:03:19.080 That's interesting because I was chronically treated with antibiotics for recurrent tonsillitis.

01:03:24.240 Right.

01:03:24.560 Probably 20 times.

01:03:27.300 So I think a problem...

01:03:29.040 And we talked about at the beginning of the interview what we did for you.

01:03:31.380 I think you have a component of immune dysfunction, which is why we're going to be doing these different cell therapies to get your immune system functioning again and get you out of this chronic pro-inflammatory state.

01:03:40.160 Now, you've also treated depression.

01:03:42.420 Yeah.

01:03:42.780 Yeah, so let's talk about that a little bit.

01:03:44.460 Because the first thing people who are watching and listening should understand is that there isn't any such thing as depression.

01:03:50.900 There are multiple medical and physical conditions that produce decrement in mood.

01:03:56.300 And some of those are lifestyle-associated.

01:03:57.460 And some of them are a consequence of not having a functional life.

01:04:02.740 And some of them are pure consequences of physiological malfunction.

01:04:08.740 So there's a lot of evidence, for example, that chronic depression is an inflammatory condition.

01:04:13.280 And there is evidence as well that part of the reason that SSRIs work is not directly because of their neurochemical consequences, so on serotonin function, but because they're actually anti-inflammatory.

01:04:24.400 Right, right, and there's a big overlap between…

01:04:26.480 That's like statins, too, by the way.

01:04:27.860 Oh.

01:04:28.260 Yeah.

01:04:28.920 Oh, so, no, I don't know that.

01:04:30.640 So statins, for people who don't know, are cholesterol-lowering drugs.

01:04:33.680 Yeah.

01:04:33.880 But the reason they actually have an effect on mortality, we believe, is because they reduce inflammation.

01:04:39.180 Aha.

01:04:39.920 So what's the underlying cause?

01:04:41.960 Right.

01:04:42.400 Chronic inflammation.

01:04:43.180 Where does that come from?

01:04:44.060 Chronic immune dysfunction.

01:04:44.860 Right, right.

01:04:45.460 And where does that come from?

01:04:46.200 Your gut.

01:04:46.920 Right, well, there's a huge overlap, too, between depression and immunological problems.

01:04:53.540 Exactly.

01:04:53.760 And so, okay, so what have you done with regard specifically to the treatment of so-called depression?

01:04:59.500 So let's come back to the fundamental principles of what causes depression from a cellular level.

01:05:04.220 It's neuroinflammation, there are some chemical imbalances, and then there's the gut-brain access.

01:05:10.300 You have more serotonin receptors in your gut than you do in your brain.

01:05:13.040 Right, right.

01:05:13.480 Right?

01:05:13.740 And so it's looking at this from a holistic approach.

01:05:16.580 And so for me, as an interventional physician, what we can do is we can reduce neuroinflammation by using intravenous exosomes.

01:05:24.260 They cross the blood-brain barrier.

01:05:25.680 They reduce inflammation in the brain.

01:05:27.320 And then we can also help with the nervous system.

01:05:29.180 What are the symptoms of brain inflammation?

01:05:30.740 If you look at this data out there, if you go to the literature, almost every neuropsychiatric disorder is linked to neuroinflammation.

01:05:38.880 It's hand-in-hand.

01:05:40.060 It's almost kind of like autoimmune conditions and intestinal permeability or leaky gut.

01:05:45.020 Right?

01:05:45.580 You've heard of leaky gut?

01:05:46.400 I know there's Michaela interviewed a psychiatrist at, what's the big hospital, McLean's.

01:05:53.420 McLean's in Boston, who's been using dietary manipulations to treat like schizoaffective disorder.

01:05:58.260 Right.

01:05:58.400 And I think it's very probable that the really catastrophic neuropsychiatric diseases like schizoaffective disorder or schizophrenia, we're going to find out they have a physiological basis.

01:06:08.160 Exactly.

01:06:08.680 And so we're starting to learn—

01:06:09.580 Depression, too, manic depression.

01:06:10.660 Exactly.

01:06:11.020 And so we're starting to learn about those physiological basis, and that's what we intervene on.

01:06:14.400 So the way we do that is reducing neuroinflammation.

01:06:17.460 And that's with exosome treatment primarily?

01:06:18.920 Yes, intravenous exosomes.

01:06:20.260 And then what we do—because we know so many mental health disorders are rooted in unresolved emotional trauma.

01:06:26.820 And a lot of that comes from—do you know Paul Conti?

01:06:29.460 No.

01:06:29.880 He's a psychiatrist.

01:06:30.640 He wrote a book about this.

01:06:31.660 But he talks about how many depressive and anxiety disorders are rooted in this unresolved emotional trauma from childhood.

01:06:38.940 And sometimes it's in the unconscious mind, and they don't even know it.

01:06:41.460 And so what we do, intravencially based, is we actually do something called the stellate ganglion block and inject into the vagus nerve.

01:06:47.880 Because the stellate ganglion integrates into your sympathetic nervous system, and a lot of times your sympathetic nervous system—

01:06:54.060 It's over-activated.

01:06:54.620 Exactly.

01:06:55.160 It's overdrawn.

01:06:55.520 That's chronic, chronic fight or flight.

01:06:57.620 Exactly.

01:06:58.240 And that's also because of that unresolved emotional trauma.

01:07:00.420 And then the vagus nerve, the vagus nerve is kind of this master nerve regulator of your parasympathetic nervous system.

01:07:06.000 And that's the one that helps you to relax and calm down.

01:07:08.500 But a lot of people, what happens in neuropsychiatric disorders is they can't relax.

01:07:12.700 Yeah.

01:07:12.940 They're just jittery.

01:07:14.380 They're just irritable.

01:07:15.580 Yeah.

01:07:15.820 You tell them to relax.

01:07:16.700 It's like telling an obese person to stop eating—to eat less.

01:07:20.380 Or someone on cocaine.

01:07:21.820 Exactly.

01:07:22.440 It's just not helpful.

01:07:23.580 Yeah.

01:07:23.720 So it's just telling people who are anxious and depressed to relax is not helpful.

01:07:28.500 And so what we do is we're trying to intervene.

01:07:31.280 And so what we actually inject directly into the stellate ganglion, we inject something called peptides and anesthetic, which calms it down.

01:07:38.160 And then into the vagus nerve, we inject peptides and actually some exosomes, which help to remodulate the signaling of the vagus nerve.

01:07:45.060 So this can have a dramatic effect on their nervous system, make them more calm, make them more resilient, and deal with stress better.

01:07:51.860 And just make their bodies—

01:07:53.880 So you help with parasympathetic activation.

01:07:56.440 Exactly.

01:07:57.200 And so—

01:07:57.540 So I have a diagnostic question for you.

01:07:59.300 Yeah.

01:08:00.040 One of the things I noticed when I was practicing as a clinician in concert with physicians who were prescribing SSRIs—

01:08:06.600 I mean, I had clients who showed, like, a miraculous response to SSRIs upon occasion where they would be chronically depressed for months or even for years.

01:08:14.780 And they'd start a course of antidepressants.

01:08:17.180 And if they were fortunate, their symptoms would remit in, like, well, between three days and a month.

01:08:22.740 And it's not supposed to remit that quickly.

01:08:24.880 Yeah, it's been six weeks.

01:08:25.420 Yeah, but there's a neurochemical effect as well as the neurophysiological effect.

01:08:29.660 But here's one of the things I noticed.

01:08:31.500 I want you to tell me what you think about this.

01:08:33.520 So, as we already discussed, there's a lot of different disorders in the depression bin.

01:08:39.680 And one of the things I would do with my clients is do an evaluation of the dimensions of their life.

01:08:45.080 So imagine this.

01:08:48.000 Do you have a long-term partner?

01:08:49.840 Do you have friends?

01:08:50.760 Do you have a job that you enjoy or that at least is functional and providing for you, you know, economically?

01:08:57.880 Do you have plans for your education?

01:09:00.220 Do you take care of yourself physically?

01:09:01.640 Do you have an alcohol or drug or other, like, abuse problem, et cetera?

01:09:06.340 So multidimensional analysis of functionality along all these different, well, dimensions of life.

01:09:14.100 Now and then, I'd have a client who had no problem with any of those but was depressed, right?

01:09:21.240 And those were often people who showed a stellar response to an antidepressant as opposed to the people who, well, they didn't have a partner.

01:09:28.520 They didn't have any friends.

01:09:29.560 They didn't have, like, their life was just an absolute bloody catastrophe.

01:09:33.760 Then you could imagine two different forms of depression.

01:09:36.480 There's many different forms, but two classic forms.

01:09:39.680 One would be you're not depressed.

01:09:41.720 Your life is in absolute shambles.

01:09:44.040 And you're miserable because nothing you're doing is working.

01:09:47.240 And then there's another person.

01:09:48.460 It's like, oh, no.

01:09:49.260 Like, you work hard.

01:09:50.840 You're well-educated.

01:09:51.840 You have goals.

01:09:52.780 You have a partner you love.

01:09:54.020 You have friends.

01:09:54.660 But your mood is just absolutely dysregulated.

01:09:57.500 You're worse in the morning.

01:09:58.980 Something's wrong with those people physiologically.

01:10:01.740 So I'm wondering if when you do your diagnostic process, if you look at, because I could imagine that there's a subset of people whose lives are in functional order but are suffering dreadfully for whom a physiological intervention like exosomes would work particularly well.

01:10:18.640 And those are the ones we're primarily treating.

01:10:20.720 Yeah, okay.

01:10:21.680 And so why are those the ones that you're primarily treating?

01:10:24.580 Is that just the people who end up coming to you?

01:10:26.220 I was going to say, I think it's just selection bias.

01:10:27.420 Yeah, probably.

01:10:28.260 Probably.

01:10:28.700 I think the people who seek me out are generally those type of people.

01:10:31.540 Right.

01:10:31.720 They have the wherewithal to do it.

01:10:33.360 Exactly.

01:10:33.880 Unfortunately, the people in the other category probably don't even know I exist.

01:10:36.840 Right, of course.

01:10:37.460 Because they're just going to their family doctor, and that's all they have.

01:10:41.480 Yeah, well, and it's of course the case if you have a chronic illness long enough, it's going to start to affect your function and all these other dimensions of life, too.

01:10:50.000 So it's not a clean cut.

01:10:51.840 But I often think, too, that the research literature pertaining to the effectiveness of antidepressants would be a lot cleaner if the diagnostic categories were set up properly.

01:11:00.640 It's like, well, are you depressed?

01:11:02.560 Which means that your life is functional, but your mood is dysregulated.

01:11:06.280 Or are you just merely suffering the consequences of having an absolutely dysregulated life?

01:11:10.620 There's no way that a pharmaceutical intervention is going to fix that.

01:11:15.100 I mean, I did see some of my more seriously affected clients on the behavioral side.

01:11:20.100 Now and then, they'd take an antidepressant, and it would decrease the probability they would commit suicide, which isn't nothing.

01:11:26.200 And maybe it would help them a little bit garner enough energy to start to improve some of the things they could improve.

01:11:32.080 But it couldn't be a magic bullet because an antidepressant isn't going to give you a life partner, for example.

01:11:37.420 No, and for us, it's about restoring the cellular processes as much as possible so they have resiliency to deal with the life stressors.

01:11:46.480 Right, right, right.

01:11:47.020 Well, yes, yes.

01:11:48.120 And that's why we take this approach.

01:11:49.820 And so we were talking earlier, and because the intervention that we're doing is so powerful, we actually have the Canadian military wanting to cover this for their veterans.

01:11:58.640 And that was for specifically which treatment?

01:12:01.580 For the vagus nerve and the stellate ganglion block.

01:12:04.080 It's a combination of that.

01:12:05.360 Because I'll give you an example.

01:12:06.460 Is there any downside to it?

01:12:07.660 No.

01:12:08.360 I mean, for me, it's a five-minute procedure.

01:12:09.880 I've done hundreds of them, and it can have such a big impact.

01:12:12.780 I'll give you an example.

01:12:13.160 And what do people experience?

01:12:13.820 Yeah, I'll give you an example.

01:12:15.220 So I had a special forces operative.

01:12:18.120 He has a world record for the longest sniper in the world.

01:12:21.620 He's 3.2 kilometers, which is crazy.

01:12:24.400 So he's this high-level special forces operative in Canada.

01:12:29.600 He's mid-40s, really, really bad PTSD.

01:12:33.040 To the point that he tried every medication, tried every psychiatrist, psychologist, and he's basically told that you can do MAID, which is medically-assisted suicide, essentially, right?

01:12:45.180 In Canada, that's now allowed.

01:12:47.680 Oh, even recommended.

01:12:48.920 Honestly, it was heartbreaking because he has four children, and the fact that this was the only option that our government is giving to him was really—it just made me devastated.

01:13:00.500 And so I actually wasn't even into mental—I mean, I'm a sports medicine doctor by training, right?

01:13:04.360 So this was actually one of my, you know, one of my friends' friends.

01:13:09.160 So he asked me, is there anything I can do?

01:13:12.180 And so that's how I started getting into this whole interventional mental health stuff.

01:13:15.480 And so that's how I came across these procedures, and I talked to some of my friends in the States.

01:13:19.800 And so he came down.

01:13:21.080 We did the procedure for him, the stellate ganglion, and then the vagus.

01:13:24.260 And what do you do to do that, exactly?

01:13:25.980 So yeah, so we use—so in the stellate ganglion, we're injecting something called bupivacaine, which is an anesthetic, and we mix it with certain peptides.

01:13:34.080 And what the combination of peptides and stellate ganglion do is they suppress that sympathetic overdrive.

01:13:39.020 And then the vagus nerve, we inject some exosomes and peptides, and what that does is it modulates the vagus nerve.

01:13:44.540 And so you do both of those?

01:13:45.580 At the same time.

01:13:46.340 At the same time.

01:13:47.300 Oh, yeah.

01:13:47.760 And then we do—usually we try to do dual.

01:13:49.940 We do both sides.

01:13:51.080 Oh, yeah.

01:13:51.400 And so afterwards, he said, like—he literally said, a weight had been lifted off his shoulders, and he started crying.

01:13:58.300 Wow.

01:13:58.880 Oh, yeah.

01:13:59.360 It was the most dramatic thing I've ever seen.

01:14:01.280 I don't say this happens to every—

01:14:02.480 How long did he cry?

01:14:03.480 How long?

01:14:04.140 Yeah.

01:14:04.760 10, 15 minutes, which his wife was there, too, and he just said he was—and he gave me a coin, which they usually don't give to anyone who's not in the military.

01:14:13.920 So that was, like, a huge honor for me.

01:14:15.840 And I felt—I just felt very privileged to help someone like this.

01:14:18.000 So it was that fast, eh?

01:14:19.020 It was that fast.

01:14:19.700 And now he's doing pretty good.

01:14:20.840 He's back to playing hockey.

01:14:22.500 He's feeling better.

01:14:23.840 He's just—it's hard to explain because there's so much emotional baggage and unconscious reservoir of these different traumas that are built inside of your body.

01:14:34.380 And you can't—

01:14:34.680 I think they lock themselves into something like a positive feedback loop, eh?

01:14:38.460 Yeah.

01:14:38.880 Because, like, once you get anxious to a certain point, every little thing makes you more anxious, right?

01:14:44.840 And then you can start to become anxious about the anxiety itself.

01:14:47.920 And, like, I actually think that most of the things that we regard as psychiatric disorders are positive feedback loops that have gone out of control.

01:14:56.560 So, for example, let's say your mood starts to fall, and then you isolate, right?

01:15:02.240 And then you start performing worse at work.

01:15:04.300 Well, obviously, if your mood is low and you isolate and you're performing worse at work, your mood is going to get lower, and then you're going to isolate more.

01:15:13.020 And so it loops.

01:15:13.940 Yeah.

01:15:14.120 With panic disorder, what happens is people get anxious, right?

01:15:19.120 But then they start to avoid, and that makes their anxiety worse.

01:15:22.240 And so then they're in a loop.

01:15:23.660 And with alcoholism, what happens to people is they start to see that if they drink, it cures their hangover.

01:15:29.680 Well, that's—obviously, that's going to generate a positive feedback loop.

01:15:32.960 And so many of the things that we see as conditions, I think, are positive feedback loops that are self-sustaining and spiraling out of control.

01:15:40.560 Exactly.

01:15:40.960 And so for us, it's creating an intervention that breaks that spiral positive feedback loop.

01:15:45.240 Yeah, yeah, yeah.

01:15:46.580 So how many people have been treated with this particular treatment?

01:15:50.060 At this point, I've done hundreds, including panic attacks for young girls.

01:15:53.880 Like, it's been incredible to see the changes that one intervention can have on people.

01:15:59.020 Is it for everyone?

01:15:59.900 No, but there are a lot of people it can help.

01:16:01.660 Yeah, and so how do you decide who can be helped and who—like, what are your inclusion and exclusion criteria for the treatment?

01:16:08.100 I mean, the biggest thing is a lot of them, if they say yes to—have you heard of Gabber Mate?

01:16:14.260 Yeah.

01:16:14.540 Yeah, so his, like, ACEs, Adverse Childhood Events.

01:16:17.640 He has his questionnaire.

01:16:18.740 So a lot of them, if they're positive to that, that's giving me an indication that they have some sort of unresolved childhood trauma.

01:16:24.760 And almost, I would say it's crazy, almost 90% of them say yes.

01:16:28.620 It's so many of them have these issues that they've just kind of buried in the past.

01:16:32.980 And they're dealing with depression or anxiety, but they actually have something that triggered that maybe when they were younger.

01:16:38.540 So that's a good indication that this—

01:16:40.140 Classic Freudian analysis.

01:16:41.480 Yes, so that, to me, is a big indication that these treatments will work.

01:16:44.780 And for a lot of people who just have anxiety, it can be very helpful, too.

01:16:48.520 So, like, panic attacks or low stress resilience and day-to-day irritability, then that's an indication where they just need some—

01:16:55.340 Do you ever do personality assessment on your clients?

01:16:58.600 I—

01:16:58.960 Well, here's something.

01:16:59.960 This would be a very good thing to do on the research end of things, is that before you do your intervention, have them do a big five personality inventory.

01:17:09.140 And then have them do it six months later.

01:17:11.260 And see if you get decreases in trait neuroticism.

01:17:13.940 Right, yeah.

01:17:14.440 Right, because if you did, that would be absolutely fascinating.

01:17:16.940 Yeah, actually, we are going to start a trial, so I will include that.

01:17:20.560 You bet.

01:17:20.920 Use the big five aspect scale.

01:17:22.700 Yeah, because we're—

01:17:23.540 Because it gives you more differentiated analysis.

01:17:26.140 But if you could show that you could decrease trait neuroticism with a physiological treatment like that, that would be a major discovery.

01:17:33.500 Yeah, no, I think that's great.

01:17:34.900 Because that's a resilience measure, essentially, right?

01:17:37.080 An emotional resilience measure.

01:17:37.800 And I get that feedback all the time.

01:17:39.380 My patients say that I have more resiliency.

01:17:41.120 Yeah, yeah.

01:17:41.540 What used to stress them out doesn't stress them out anymore.

01:17:43.360 Right, right, right.

01:17:43.860 And so I see that anecdotally, so it'd be great to quantify that.

01:17:47.060 Absolutely.

01:17:47.900 Well, and it would be quite the miracle if you could produce a transformation in a personality trait, because neuroticism is actually very stable.

01:17:54.520 Right.

01:17:54.920 Right, and so—and very difficult—well, difficult to ameliorate, goes along with stable.

01:18:00.080 But, you know, there is—there is—there are other indications that such things are possible.

01:18:06.580 So, for example, a single dose of psilocybin that produces a mystical experience produces—I believe it's a half standard—no, it's a one standard deviation increase in trait openness a year later that's permanent.

01:18:19.880 Exactly.

01:18:20.260 Right.

01:18:20.520 One standard deviation.

01:18:21.420 Yeah, I know.

01:18:21.980 We—you just—well, you just took the words out of my mouth, because I was going to say, we call this procedure the V-shot, the vagus nerve shot.

01:18:27.960 And basically, we combine it with psilocybin-assisted therapy, a macrodose.

01:18:31.920 And so that combination is so powerful to kind of reset their—

01:18:35.580 Which do you do first?

01:18:37.120 We usually do this first, and then send them off to therapy afterwards.

01:18:40.000 The psilocybin therapy?

01:18:41.340 No, we do our injection first, calm down the nervous system.

01:18:43.640 Yeah.

01:18:43.940 And then afterwards, they go off to therapy and do psilocybin.

01:18:46.760 Yeah, yeah.

01:18:47.360 So they do the—they do the physiological intervention that decreases stress reactivity first.

01:18:52.520 Right, so that would also increase the probability that the experience they have with a hallucinogenic would be positive.

01:18:58.320 Exactly.

01:18:58.520 Because their nervous systems are calmed down.

01:19:00.160 Exactly.

01:19:00.560 Right, because that matters, right?

01:19:02.020 So if you're in an anxious state, and you take a hallucinogenic, the probability that that state will be magnified into something approximating a bad drip is very high.

01:19:10.760 Yeah.

01:19:11.280 And so we wanted—we're going to start, hopefully, a phase one trial sometime next year for this intervention, so we can actually get some real data behind it, yeah.

01:19:17.880 Yeah, use the big five.

01:19:19.780 I will.

01:19:20.000 Use the big five, right, right.

01:19:21.240 That's great.

01:19:21.800 That's really powerful, because if you could show—

01:19:23.400 Yeah, big five aspect scale.

01:19:24.460 Yeah, right.

01:19:25.460 No, that makes perfect sense.

01:19:26.620 Yeah, yeah.

01:19:27.100 Well, that would be really remarkable if you could manage that.

01:19:29.940 All right, so you—and what sort of—

01:19:31.900 What sort of effects have you seen with the people that you've treated for depression?

01:19:36.160 So—

01:19:36.560 We've talked about anxiety more specifically, so—

01:19:38.740 Yeah, no, depression, I think the big thing with that is combining it with some sort of psilocybin or some sort of psychedelic-assisted therapy, and the combination of that with everything else that we do has been great.

01:19:49.680 And so it can help people who are even—like that veteran now saying, who was PTSD, who was suicidal, and it shifted him from not being suicidal anymore to basically not being suicidal.

01:20:00.920 He was just—he was just—it actually changed his life.

01:20:03.260 And so it's been super impactful on people like that, but he's also the right candidate because he has severe PTSD.

01:20:09.880 And because of that PTSD—

01:20:11.440 Yeah, and he has a life.

01:20:12.500 And he has a life.

01:20:13.320 He has a wife.

01:20:13.920 He has kids.

01:20:14.500 Right, right.

01:20:14.660 He has all that other stuff.

01:20:15.960 So it may not be for everyone, but I think there are a lot of people who fall into that category where they have this trauma and they have these issues that they haven't dealt with, and this intervention can actually make a big difference on their life.

01:20:27.700 And how do you protect yourself against over—like, you know, people say anecdotes are not data, and that always bothers me because anecdotes might not be data, but they are definitely hypotheses.

01:20:39.400 Yes.

01:20:39.820 Right?

01:20:40.140 So but how do you protect yourself against over-interpreting the positive consequences of your interventions as a consequence of this plethora of anecdotal information that you are receiving?

01:20:50.320 I mean, for me, it's all about getting the patient—it's all about clinical outcomes.

01:20:55.860 As a doctor, my job is to improve my patient's health or quality of life.

01:21:00.420 And at the end of the day, if they're feeling better and they're getting—and they tell me that, that to me is what matters the most.

01:21:06.160 Right.

01:21:06.400 And the way I achieve that often is multimodal, meaning that you have to use multiple interventions.

01:21:10.900 And the problem with traditional randomized control trials is they only want to look at really one intervention for one specific body.

01:21:16.900 But that's not how the body always works.

01:21:18.660 Well, it's also a conflict with the immediate necessity of medical treatment, right?

01:21:23.100 Right.

01:21:23.280 Because it's lovely if you can just change one thing, but if you're dealing with people who are absolutely bloody desperate, you're going to be tempted to throw, you know, everything and the kitchen sink at them.

01:21:33.840 And that's the reality of the patients I see.

01:21:35.720 They're refractory to the traditional medical system, so they're looking for alternatives.

01:21:39.300 So it's not often just one intervention.

01:21:41.780 I often have to do multiple things to get them better.

01:21:43.640 And that's why the trials we're going to be doing are going to be—we're multimodal.

01:21:47.820 We're going to have multiple things that we're using to intervene.

01:21:50.300 And when you say trials, like are these actual research trials?

01:21:52.980 Yeah, clinical trials, yeah.

01:21:53.840 So, for example, we already—we're starting a clinical trial for—a phase two trial for our gene therapy, which we haven't talked about yet.

01:22:02.980 But basically, we're going to be looking at—it's called phallostatin gene therapy.

01:22:08.080 So it's basically the world's first reversible plasmid gene therapy.

01:22:11.860 So traditionally, viral vectors were used for introducing a foreign gene into your body.

01:22:17.500 But what we've developed is a plasmid, which is just a circular strand of DNA.

01:22:21.440 It comes from E. coli, but there's no actual live bacteria in there.

01:22:25.340 And the plasmid—the beautiful part about the plasmid is it can target any protein or peptide, up to 10,000 base pairs, with 100% accuracy.

01:22:33.160 And it's—

01:22:33.380 What do you mean by target?

01:22:34.340 What does it do exactly?

01:22:35.260 So meaning it can tell your body to whatever gene of interest to produce more of that.

01:22:41.120 So, for example—

01:22:42.220 Whatever gene of interest.

01:22:43.300 Yes.

01:22:43.620 Oh, yeah.

01:22:44.080 That's promising.

01:22:44.940 Yes.

01:22:45.240 It's very promising.

01:22:46.080 And it's what's called an epizomal vector.

01:22:47.900 So it's non-integrating.

01:22:49.180 So it's not going to go into your genome and make you, like, translocate or have those risks that viruses may have.

01:22:55.440 And it's also, because it's not a virus, you don't have to take immunosuppressants.

01:22:59.040 It's not immunogenic.

01:23:00.200 So there's all these cool benefits to it.

01:23:01.800 So is it temporary?

01:23:03.420 It lasts—and that's the beautiful part.

01:23:05.040 It's reversible because it's E. coli origin.

01:23:07.460 So you can take a tetracycline if you want it out of your body.

01:23:09.960 So it has that safety mechanism.

01:23:11.280 And it lasts for about one and a half to two years.

01:23:13.520 So you can repeat it as needed.

01:23:15.380 Whereas viral vectors, you cannot repeat them.

01:23:17.880 Once you do them, you do them.

01:23:18.880 And you can't really get them out of your body.

01:23:20.480 Right, right, right.

01:23:21.420 So this technology is really beautiful.

01:23:23.400 And we did our phase one already.

01:23:24.700 So we're doing our phase two.

01:23:25.900 Targeting what conditions?

01:23:27.060 So sarcopenia.

01:23:28.280 Because—

01:23:28.640 And what is that?

01:23:29.420 That's the loss of muscle as you get older.

01:23:31.380 Oh, really?

01:23:32.620 Which is probably the biggest driver of aging.

01:23:34.780 Because as you lose muscle, your body to protect itself and regulate your immune system and vitality goes down.

01:23:41.260 You become frail.

01:23:42.280 And that frailty, we know, is such a big predictor of mortality.

01:23:46.500 Like falls.

01:23:47.400 Falls.

01:23:48.040 And even in COVID studies, they found that people who had more muscle mass had better outcomes.

01:23:53.220 Well, you know, one of the best predictors of lifespan is grip strength.

01:23:57.080 Exactly.

01:23:57.620 Yeah, yeah.

01:23:58.140 Which is quite remarkable, right?

01:23:59.100 Which is just a proxy, right?

01:24:00.320 Yeah, it's a proxy for muscular integrity, essentially.

01:24:03.360 Yeah.

01:24:03.620 And so if you look at it, if we can preserve muscle, that can be one of the best ways to have—

01:24:08.280 Oh, yeah.

01:24:08.560 That's a huge deal.

01:24:09.380 Exactly.

01:24:09.880 So folistatin is a peptide that's naturally made in your body.

01:24:14.000 And as you get older, your folistatin levels decrease.

01:24:16.540 And so what we're doing is we're just delivering this through a gene therapy form, the plasmid vector,

01:24:20.640 and it increases your folistatin levels for one and a half to two years.

01:24:23.840 And it's completely reversible if you want to have your body for whatever reason.

01:24:26.520 And it wears off on its own.

01:24:27.760 Well, what happens if you increase folistatin levels?

01:24:29.980 So it inhibits myostatin, which is kind of the enzyme that sets a limit on how much muscle you can put on.

01:24:35.260 So it makes it easier for your body to put on muscle.

01:24:37.920 It also increases—

01:24:39.480 So why does it decrease with age?

01:24:41.340 Because the aging process is cruel.

01:24:43.800 And so so many different peptides as you get—

01:24:45.900 So you think it's just a consequent—another element of degeneration.

01:24:48.680 Exactly, degeneration.

01:24:49.760 Exactly.

01:24:50.520 And so—

01:24:50.940 Entropy.

01:24:51.820 Yeah.

01:24:52.280 And so if we can restore it back to your levels, your youthful levels, not only will you inhibit myostatin,

01:24:57.440 which makes it easier for your body to put on muscle,

01:24:59.800 it'll also activate what's called FOXO3 pathway, which reduces systemic inflammation.

01:25:04.720 So it has this—and so we showed in our phase one trial that patients over the age of 60,

01:25:08.880 on average, reduce their intrinsic biological age by 12 years, which is actually incredible.

01:25:14.480 Wow.

01:25:14.700 Yeah.

01:25:14.920 At 60?

01:25:15.700 Yeah.

01:25:16.140 And then there was actually some hyper-responders who had biological age reduction of access of 60 years,

01:25:22.220 which is crazy to believe.

01:25:23.580 So does that mean they're going to leave 60 years longer?

01:25:25.460 We don't know that yet.

01:25:26.320 Well, probably not.

01:25:27.920 Probably not.

01:25:28.560 There's probably multiple dimensions.

01:25:29.800 Exactly.

01:25:30.140 But still—

01:25:30.780 But their telomere length, which is a proxy—

01:25:33.100 Yeah.

01:25:33.340 We also set a world record for that as well.

01:25:35.120 You showed telomere length increase as well in that patient who was a hyper-responder.

01:25:39.320 And so we're actually applying—

01:25:41.140 Wow.

01:25:41.440 Yeah.

01:25:41.720 So it's pretty powerful.

01:25:43.220 And are there animal studies that have been done with this already?

01:25:45.800 Yes.

01:25:45.900 Follestatin gene therapy has been around for a while in animal studies.

01:25:48.240 And what's it showed with animals?

01:25:49.500 Similar.

01:25:49.880 30%, 32% life extension in mice.

01:25:52.420 But actual life extension, not just the markers?

01:25:54.660 No.

01:25:55.040 Exactly.

01:25:55.540 Like extension.

01:25:56.240 Wow.

01:25:56.600 And so—

01:25:57.160 When people fast, I mean, I know animals that are starved to like 75% of their body weight,

01:26:03.380 they'll live 40% longer, something like that.

01:26:05.460 Does that have anything to do with—?

01:26:07.640 Yeah, because it activates similar pathways, which are anti-inflammatory pathways, regenerative pathways,

01:26:12.280 pathways that help with cellular senescence, like all the hallmarks of aging that we talked about.

01:26:15.740 So whenever you think about any intervention, think about how is it affecting the hallmarks of aging.

01:26:20.220 So now we have an understanding of biology, because in physics, we always had first principles, right?

01:26:26.880 Like Newton's laws.

01:26:28.280 Like we understood first principles, right?

01:26:30.060 In biology, we never had first principles until recently.

01:26:33.080 Now we understand there are what are called fundamental principles, which govern chronic disease and cellular dysfunction.

01:26:38.800 And are those associated with those 10 markers for aging?

01:26:41.460 Exactly.

01:26:41.980 Those 10 hallmarks govern—

01:26:43.000 Right, so that gets you to—

01:26:43.960 That gives you a foundation on how to interpret data and how to figure out if an intervention is actually going to do something for you.

01:26:50.900 And so—

01:26:51.260 And where are you with this trial?

01:26:52.620 So the Phase 2 trial is going to start in spring 2024 in Canada.

01:26:56.300 We have tentative approval.

01:26:57.660 We're just getting the funding together to start it.

01:26:59.520 And so the Phase 2 trial is to look at false statin gene therapy.

01:27:03.460 It's going to be a randomized controlled trial with a placebo group.

01:27:05.780 Yeah.

01:27:05.960 And basically to look at sarcopenia, osteopenia, and then different inflammatory markers.

01:27:10.620 How old are your clients?

01:27:11.940 You'll have anyone from age—it's going to be open to age from 30 to 80.

01:27:16.780 So it'll be a big reach.

01:27:17.100 Yeah, it'll be really interesting to see what it does with people who are particularly old.

01:27:20.340 Yeah, exactly.

01:27:21.040 And that's where it's the most powerful.

01:27:22.720 But even in—I mean, younger people don't need it as much, but a lot of them just do it for the gym.

01:27:26.720 Like, I've done it on myself, just for the benefits of more energy, more strength in the gym.

01:27:30.800 Because obviously, by inhibiting myostatin, it gives you more—

01:27:34.260 Downside?

01:27:36.360 To date, there hasn't been any adverse effects.

01:27:39.340 So that's the beauty of it.

01:27:41.740 That's amazing.

01:27:41.980 Yeah, it's been studied for over—

01:27:42.740 Hard to believe.

01:27:43.560 I know.

01:27:43.980 It's been studied for over six years, and we haven't seen any adverse effects.

01:27:46.920 To add some credibility to it, we are backed by Peter Thiel and Sam Altman.

01:27:52.100 Those are our two seed investors, and they're both well-known names in the world.

01:27:56.280 And I think the reason they backed us is because they understand that this has a potential to revolutionize a lot of gene therapies.

01:28:03.140 Because if you think about it, the only other real big gene therapy competitor is CRISPR, right?

01:28:08.200 And CRISPR—but the problem with CRISPR, it's—yes, it's more powerful than mini-circle, our technology, but it also has off-site targets.

01:28:14.960 So meaning it may hit—it may do something that's unintended.

01:28:17.880 So—and that's the risk with CRISPR.

01:28:19.600 Whereas with the mini-circle vector, it's not as powerful, but it's going to—whatever vector that we want to do, it's going to do that with accuracy.

01:28:25.480 And that's the beauty of this plasmid vector technology.

01:28:28.660 Hmm. Well, that's ridiculously exciting.

01:28:31.000 It is.

01:28:31.560 So I wanted to also ask you about—let me see.

01:28:35.760 I just checked my notes here, too.

01:28:37.640 Yeah, tissue engineering.

01:28:40.020 So we were talking about earlier, can we regrow cartilage, for example, in osteoarthritis?

01:28:45.420 So with the first generation, no.

01:28:46.960 The second generation, what we can do now is we can combine those IPSC MSCs that we're talking about.

01:28:52.640 They're engineered specifically for osteoarthritis.

01:28:55.360 And then we can use a 3D bioprinter, and we can embed them into a scaffolding—basically a scaffold.

01:29:01.900 And then you can implant those arthroscopically, and then that can regrow new cartilage.

01:29:05.980 Uh-huh.

01:29:06.540 The scaffold?

01:29:07.400 The scaffold with the embedded stem cells.

01:29:09.120 So that's called—oh.

01:29:10.840 That's the intersection of gene therapy, cell therapy, and tissue engineering.

01:29:16.160 Is that specifically for cartilage, or can you do that with other organs?

01:29:19.040 No, you can do—and that's the promise of it, right?

01:29:21.060 This is just the beginning of tissue engineering.

01:29:22.680 And how far is that advanced, and what are you doing specifically?

01:29:25.640 So for cartilage, there's already trials being done.

01:29:27.720 It's Dr. Farshad Ghaliak in the University of Washington.

01:29:30.560 He's already been doing trials in humans with the similar technology.

01:29:34.580 And then so we're just starting to do our own trials with that this year.

01:29:37.820 And who's we?

01:29:39.820 The regenerative medicine community.

01:29:41.180 Okay, I see, I see.

01:29:42.320 But you also, you have people that you're working with who are involved in these specific trials.

01:29:47.160 Yes, I have my own group, and we have our own company, and we have our own researchers and scientists we're working with.

01:29:51.840 And where's that company located?

01:29:53.520 So we have our mini-circle technology company that's in Austin, Texas.

01:29:58.220 That's in Austin.

01:29:58.820 And then we also do research in Mexico.

01:30:00.720 Why in Mexico?

01:30:01.580 Because, so you can do phase one trials a lot quicker offshore, and then you can get the approvals and move things along quickly, and then we can move onshore for the phase two.

01:30:12.080 So that's kind of our strategy.

01:30:13.120 I see, I see.

01:30:13.240 That's kind of our strategy.

01:30:14.300 Because if you just go through traditional health care and FDA, it's going to take 10 to 15 years to get anything done.

01:30:19.880 Yeah, yeah, that'll just kill you.

01:30:21.520 Exactly.

01:30:21.880 So we figured out kind of a disruptive model where we can do phase ones quickly, get our trials done, collect our patients, collect our data, show our safety.

01:30:29.220 Risks in that?

01:30:30.920 Are there risks in doing it that quickly, do you think?

01:30:34.760 I mean, the technology we're using already has really good basic science behind it and has lots of animal data.

01:30:41.280 So there's already safety data there, and we're not doing it without unreasonable justification.

01:30:46.340 So there is mechanistic basis for what we're doing, as well as good safety data on animals.

01:30:51.880 So the next logical step is put it in humans.

01:30:55.000 Someone has to do it.

01:30:56.620 So that was the same thing with the plasmid technology.

01:30:59.520 It was just we were the first ones to do it in humans.

01:31:01.300 It was done in animals for a long time, but then we were the first ones to take it into humans.

01:31:04.880 When did that start to happen?

01:31:06.280 About six years ago.

01:31:07.500 Wow, that's ridiculously exciting.

01:31:09.460 Yeah, it took six years of R&D to get it into commercial product.

01:31:13.020 But now we have our first commercial product, and we're doing phase two, but we're also offering the folistatin gene therapy in approved regions like Mexico, Prospera, Dubai.

01:31:20.580 We have approvals in certain areas where we can do it.

01:31:23.100 Do you enjoy the business side?

01:31:24.880 Because it sounds like you do.

01:31:26.340 I enjoy helping people, and creating scalable technologies allows me to help more people.

01:31:31.480 And that's really what it is.

01:31:32.380 Yeah, well, fair enough.

01:31:33.260 But that's the intelligent integration of the business vision into the medical practices, right?

01:31:39.040 If you set up an organization properly, then you can move faster, you can do more things, and you can scale.

01:31:45.260 Exactly.

01:31:46.000 I can only help so many people one-on-one as a physician.

01:31:48.260 Yeah, yeah.

01:31:48.640 But if I create technologies and do trials that are large-scale, eventually we can help millions of people.

01:31:53.340 The dream is, imagine you go to your family doctor, let's say, 20 years from now, and you get these gene therapies, you get these cell therapies, and you keep every two years, and it keeps you healthy, and you never get sick.

01:32:04.420 That's the world I want to see.

01:32:06.460 Yeah, yeah.

01:32:07.500 Where we just eradicate chronic disease.

01:32:09.560 Now, you're going to treat me for something tomorrow, as I understand it.

01:32:12.820 So exactly what are you planning to do to me?

01:32:14.960 Well, as you have talked about publicly, you have toxic mold.

01:32:19.340 You've been exposed to it, right?

01:32:20.700 And I think in Florida.

01:32:21.660 That's the theory.

01:32:22.600 Yeah, that's the theory.

01:32:23.660 And so what happens with toxic mold is it kind of hijacks your immune system and makes it difficult for your immune system to function properly.

01:32:30.540 And so what we did for you the first time was we did intravenous stem cells, which is to help your body to build some resiliency and to strengthen.

01:32:37.400 Right, and that was different than the exosome.

01:32:39.020 Tammy did that as well, but she also did the exosome treatment, which I didn't do.

01:32:42.480 Yes, yeah.

01:32:43.280 Because your problem's more systemic.

01:32:45.780 And so what we're going to do now is we're going to do what are called intravenous natural killer cells.

01:32:49.420 And natural killer cells, as we talked about earlier, are the cells in your innate immune system that can kill chronic, it can kill cancer, it can kill chronic fungal infections, which is kind of what happens with mold.

01:33:00.960 So it's basically giving your body the...

01:33:03.480 What do you make of that sick building syndrome literature?

01:33:06.260 I think it's very underappreciated because a lot of physicians don't test for mold and they have a lot of patients with chronic illnesses that...

01:33:14.040 Well, the literature's horrifying, you know.

01:33:16.160 I mean, I was reading about the state of military accommodations across the United States and the unbelievably high levels of mold toxicity that military personnel are exposed to.

01:33:27.120 It's absolutely horrifying.

01:33:28.340 In fact, you can't read it.

01:33:29.460 I guess it's about as bad as the discovery that asbestos was causing cancer.

01:33:34.160 I mean, asbestos was used everywhere.

01:33:35.760 Exactly.

01:33:35.960 And all of a sudden it was like, uh-oh, we're killing people like lead in gas.

01:33:38.740 Exactly.

01:33:39.280 I mean, these things have happened before.

01:33:40.800 No, and there's a new theory on cancer.

01:33:43.140 It's called cell suppression theory, which now is getting a lot of traction.

01:33:46.980 It's basically that the idea that fungal spores are hijacking the cell and preventing cell apoptosis.

01:33:53.120 So, they're preventing the cell from functioning properly.

01:33:55.720 So, then they're saying that the root cause of cancer is actually potentially fungal infections, in addition to everything else that happens with genomic instability.

01:34:03.340 Right, right, right.

01:34:04.020 But this is one of the potential risk factors because we all get exposed to funguses all the time.

01:34:09.620 It's part of living in a modern environment.

01:34:12.520 Most people's immune system can deal with it, but some people's immune system can't.

01:34:15.940 Well, especially if they're in a place where they're being chronically exposed to levels that they can't actually tolerate.

01:34:20.760 Exactly.

01:34:21.040 So, how do we build the resiliency in your body so you can deal with those fungal infections?

01:34:24.820 We give you the cells to do that, and that's what the natural killer cells are going to do.

01:34:28.600 And eventually, we probably give you the FMT as well, so we can give you your...

01:34:32.180 And FMT is...

01:34:33.140 The fecal microbial transplant.

01:34:34.240 Oh, yes.

01:34:34.620 Because then your body, again, we're strengthening your immune system and we're building resiliency for you to deal with these chronic infections in your body.

01:34:41.720 So, it all comes back to first principles.

01:34:44.420 And that's the biggest, I think, takeaway for people to understand is biology is moving at this point, at this alarming pace almost, where we're understanding down to a single cell function, how cells can operate and target those very specific targeted interventions.

01:35:02.420 As opposed to just being like, take this pill and hopefully your disease doesn't progress.

01:35:08.100 Right, right.

01:35:08.960 Okay, so if people are interested in, the listeners are interested in following up with such things, learning more about it, what should they do?

01:35:17.200 I think scientists are the best people to learn from.

01:35:20.820 Unfortunately, online, a lot of the people who are the loudest aren't usually academic scientists because they just don't get a lot of attention.

01:35:27.140 So, my favorite podcast on these topics, if you're interested, they're very dense, but there's one called the Stem Cell Podcast and there's one called the Immunology Podcast.

01:35:35.820 And there are academic scientists who are top tier, who go bring on different scientists on their show, and they talk about these different topics.

01:35:42.760 And that's where I learned from.

01:35:44.200 And I think that's where you have to go to.

01:35:45.720 You have to go to the scientists who are doing the hard work to make this a possibility for patients to get access to one day.

01:35:52.640 And I talk about it a lot online.

01:35:54.800 I try to take that information and disseminate it in a way where people can understand it.

01:35:59.780 Right.

01:36:00.040 Because it is complicated and there is a lot moving at a fast pace.

01:36:03.320 And so my job as a clinician scientist is to take that information and simplify it and make it digestible so people can access it and hopefully give them hope that there is a brighter future of medicine ahead of them.

01:36:14.000 Right.

01:36:14.300 All right.

01:36:15.100 Well, unless you have something else you'd like to tell people who are watching and listening, that's probably not a bad place to close off.

01:36:22.940 Is there something that you wanted to cover that we didn't discuss yet?

01:36:26.460 I like to tell the world that we're in the world of medicine 4.0.

01:36:31.380 Yeah.

01:36:31.600 And so medicine 4.0 is essentially using cell and gene therapy that's targeted to allow for more longevity, which means a broader lifespan and healthspan where you can do what you want and live a high quality life.

01:36:45.720 So instead of just saying exercise, eat well, we can use these gene therapies like folistatin to allow your body to get all these benefits, even if you're not exercising, of longevity.

01:36:57.260 And that's where the era of medicine we're headed towards.

01:37:00.180 And that's what we want to really share with the world.

01:37:02.140 Well, thank you very much for all the information that we walked through today.

01:37:07.700 That was much appreciated and very enjoyable.

01:37:10.160 And to everybody watching and listening, thank you very much for your time and attention.

01:37:15.160 I'm going to talk to Dr. Khan for another half an hour on the Daily Wire Plus platform.

01:37:21.280 I think we'll go over, well, some of the topics that we've gone over already, but I want to also, as I usually do on that platform, delve into the development of his interests.

01:37:29.740 And so we'll go a little further down that road.

01:37:31.980 And if you want to join us there, please feel welcome to do so.

01:37:36.260 Otherwise, hopefully you'll tune in again in the relatively near future.

01:37:40.140 And thank you to the Daily Wire Plus folks for making these conversations possible.

01:37:44.420 Thanks again, sir.

01:37:45.320 All right. Thank you.

01:37:46.040 You bet. You bet.

The Jordan B. Peterson Podcast - December 28, 2023

409. Keeping Death at Bay ｜ Dr. Adeel Khan

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