https://youtubetranscript.com/?v=GQWTJGc14EE
Hello everyone. I’m pleased to announce my new tour for 2024. Beginning in early February and running through June, Tammy and I and an assortment of special guests are going to visit 51 cities in the U.S. You can find out more information about this on my website jordanbpeterson.com as well as accessing all relevant ticketing information. I’m going to use the tour to walk through some of the ideas I’ve been working on. My forthcoming book out November 2024, We Who Wrestle with God. I’m looking forward to this. I’m thrilled to be able to do it again and I’ll be pleased to see all of you again soon. Bye bye. You could take any somatic cell in your body like a muscle, a skin cell, and you can reprogram it using genetic reprogramming and turn it back into an embryonic stem cell. So that’s sort of revert to an earlier form essentially. Yeah, but we have to figure out and give it the right signals so that you can heal disease and that’s what regenerative medicine, the promise of it is really about. Hello everyone. So today I have the opportunity to speak with Dr. Adil Khan. Adil is a physician that I’ve worked with. He offered Tammy and I a treatment, a couple of different treatments. The treatment for her was particularly successful. It helped her deal with chronic osteoarthritic condition in her forearms and was quite remarkably successful and so that’s very interesting and Adil is a young Canadian physician, very very sharp character. He seems to be on the cutting edge of the expanding field of regenerative medicine, which is what would you say it’s developing not precisely in opposition to but in parallel to standard allopathic medicine that’s more symptom based in its approach. So the regenerative medical types are attempting to get to the root cause of chronic health problems and to address them. And so there’s much advance being made on that front 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. We talk about gene therapy, stem cell usage and tissue engineering. So stay tuned if you’re concerned about your health and about, you know, living happily and healthily and even just living. Well thank you for coming in Dr. Khan. 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 and then we’ll talk a little bit about what you do more generally and about who you are and away we’ll go. Yeah so in your wife’s case she had a very common issue which is chronic pain. Chronic pain is something that the medical industry has grappled with for years and traditionally they’ve used cortisone which is an anti-inflammatory drug. They’ve used narcotics, opioids and then if that doesn’t work, surgery. 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 and so this is kind of that gap of patients who are just suffering or living with chronic pain 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 and so what we do is what’s called regenerative medicine. 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. So in your wife’s case she had what’s called osteoarthritis which is degradation of the joint cartilage loss and you get inflammation and then she also had small tears in the tendons around the joints and it bothered her for 10 years as you know and she couldn’t garden and she loves to garden. 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 and so that’s how it got rid of her chronic pain. When was the ultrasound for diagnosis? Diagnostic and intervention. And intervention. Yeah. So how does the ultrasound intervene? Because it allows us to guide the needle directly into the area of damage. Right and how can you see what’s damaged? Because the ultrasound and that’s the skill so it’s telling gray from gray. Yeah. And that’s the steepest skill set. To give you an example I treated Mohammed Alavar, he’s the guy who owns the Burj Khalifa and the six tallest buildings in Dubai. So he had a shoulder issue for 15-20 years and he did an MRI. MRI was normal so they just did cortisone, they did physio. He’s living with chronic pain for 15 years and he’s arguably the most, he’s the wealthiest man in Middle East and he’s a very well-renowned businessman so he has access to any doctor in the world. Right. And so he found me and I flew down, I did an ultrasound and we did and we found some small tears that were missed on MRI and then we injected them similar to what we did with Tammy and we fixed it. But it’s the principles the same which is that sometimes you need to do diagnostic, dynamic ultrasound to find the issue and that’s- How did you learn to distinguish as you said gray from gray and are the AI image systems getting good at that? We’re developing a machine learning neural net to do that but that hasn’t been developed yet. That’s actually something we’re doing because we’re kind of set the standard for it because my mentor Dr. Anthony Gallia, he was the first one in the world to do this stuff. He did it for Tiger Woods, Alex Rodriguez, a lot of A-list athletes. So he was the one who taught me all this and he was the one who pioneered this field. So I learned from him and I was fortunate because I got to learn from the best and because of that I was able to kind of take it and translate it into my own patients. How much exposure to image data did you have to undertake in order to start to be able to distinguish thousands of hours? Thousands of- Yes. It’s not, the learning curve is so steep and we have ultrasoundographers as if you remember I brought her with me at the time who are especially trained by us and they’re the ones who actually guide us because there’s so much nuance between telling what’s a tear and what’s not a tear that you really need a specialist and unfortunately- Yeah and a really trained specialist who actually knows what they’re doing. I know there’s huge difference in radiologists for example in their diagnostic accuracy. I know on the AI front that they have trained AI systems now from what I understand to be able to be pretty good at distinguishing like lung cancer, lesions for example. Yeah they’re pretty good at x-ray and cancer but musculoskeletal is still a big gap and so that’s what we’re developing because that’s our specialty is we’re going to develop a machine learning neural net using what’s called supervised and reinforcement learning to teach the machine learning algorithm to detect what’s a tear and what’s not a tear and then guide the physician on how to do it. So that’s kind of how we’re going to scale what we’re doing. And how do you get the data set set up properly because you need a training if you’re going to reinforce the proper response you have to be sure that the material that you’re training the machine on is actually accurate. Exactly. So how do you solve that problem? Because we have a brilliant radiologist on our team who’s going to be training the AI on what’s not a tear and what’s a tear and then you have normal. You have to first get this. Use more than one radiologist? No we’re just going to use the one who’s specially trained by us who does our MSK interventions and diagnostics and she’s obviously exceptional at what she does and she can train the AI to say but the AI needs thousands of normal before it can recognize abnormal. Right. And that’s the data sets that you have to build into at first and then she has to train it over time to say hey this is a tear and this is not a tear and then eventually it learns. Right. And what did you inject Tammy with? So we use something called exosomes. So the way I explain exosomes, imagine if you’re going, so let’s talk about stem cells first to explain exosomes. So most people have an intuitive concept of stem cells. They understand that they rebuild tissue or they repair tissue. So they can come from umbilical cord, they can come from fat, they can come from the bone marrow, they can come from amniotic fluid. There’s so many different sources where we can get them. We use something specifically called mesenchymal stem cells which is just an embryological term to explain their origin of where they’re being derived from. And so and the reason we use mesenchymal is because they’re easy to access. So for example, the most easiest place to access is after birth. Right. You take the umbilical cord tissue or you take the amniotic fluid and you can isolate the mesenchymal stem cells or stromal cells is technically the right word. But anyway most people call them stem cells but MSCs for short. And so what you do is you isolate those and then you can grow them in a lab for three to four months. Why are they an umbilical cord tissue? Why? Yeah. Because there’s a is there just a rich source of repair and regeneration of the mesenchymal stem cells from that. So meaning the umbilical cord tissue is just rich in MSCs. So why are they rich in MSCs? Well I read that babies actually send stem cells into their mother’s body to help the mother repair her own tissue. Right. Yeah. There is that mechanism built in. So I think a lot of it is probably that crosstalk between the placenta and the mother. Right. So I believe and the cool thing is your body has stem cells too. Right. So and you have stem cells in your bone marrow and in your fat. And they’re basically cells that are undifferentiated that can turn into any tissue. So there’s different types of stem cells. If you have embryonic stem cells which is from the fetus then they can turn into any type of tissue. But as you know embryonic stem cells during the Bush era and everything it was controversial. Right. Yeah. And the reason for that was because they were saying are we going to be harming fetuses? Obviously that becomes ethical issues. And so no one that never really took off. But luckily we figured out hey wait a minute we have something that’s almost as good as embryonic stem cells. Not as good but it’s called pluripotent. Meaning it has the ability to turn into many different types of tissue but not every type of tissue. I see. So they’re slightly farther down the developmental chain. Exactly. It’s not totipotent it’s pluripotent. And so those pluripotent stem cells mosaicomal stem cells are pretty ubiquitous. You can get them from dental pulp. You can get them from fat. Umbilical cord as we talked about bone marrow. There’s a lot of different sources. And so they’re easier to harvest and easier to source. And because of that accessibility that’s where the research really took off in the last 10 to 15 years is with the MSCs. So are there variants of cells like is it a continual variant from the cells that are omnipotent? Did you say the ones that can be totipotent that can turn into anything? And then there’s the ones that are what was the next level? Pluripotent. And do the totipotent cells turn into the pluripotent cells? Is that the developmental sequence and then into specific tissue? Yeah exactly. And that’s kind of how it can differentiate down the line. And so what’s the difference between a stem cell and a cancer cell? So a cancer cell has some similar properties because it can essentially it loses a signal or in a sense it gets kind of hijacked and it loses the ability to stop killing itself. So meaning it it stops apoptosis. So it keeps replicating. Right. And it has an infinite amount. It can keep going. Right. And in some differentiated to some degree too. Right. And that’s why there’s actually something called cancer stem cells. And so if we can target cancer stem cells and stop that process so there’s that’s an active area of research. So they’re not all stem cells are good right because people think that’s the problem with stem cells. Well undifferentiated tissue in the wrong place could be a real problem. Exactly. And lead to tumor. And that’s actually the problem with embryonic stem cells too. They’re too strong. They have too much stemness meaning they can keep replicating and grow into tumors. Right. Whereas mosaicomal stem cells they can they have a finite ability to grow. So they don’t grow. Which is why they’re safe. And so. Oh OK. So when we grow the mosaicomal stem cells the soup that they grow in. So imagine. How do you say that. Mosaicomal. How do you spell it. M.E.S.E.N. C.H.Y.M.A.L. Yeah. Wow. And it’s going to take me a while to get that one right. Yeah. No it’s an embryological term. So yeah. Just call them MSCs. MSCs. Yeah. So MSCs. MSCs. When they’re grown. Imagine the MSCs are the chicken meat and the soup the broth is the exosomes. So the broth has all these nutrients and cytokines in there but there’s no actual stem cells. And why is that important. Because those exosomes can send all the signals which are the proteins the cytokines and growth factors to reduce inflammation and repair tissue without the risk of having cells which sometimes can not survive or can cause reactions. So that’s what you used on Tami. And that encourages the cells that are already there to what to to repair themselves. What exactly. It’s a signal. It’s a signal that says to your body. OK start repairing this tissue. So send signals to your endogenous stem cells. So does it tell your does it essentially signal to the body that something’s wrong. It’s a sense to the bodies to start healing and regenerative pathways. Well I know that for example and correct me if I’m wrong but part of the reason that your face skin doesn’t repair itself when it wrinkles is because your body doesn’t actually note that the damage has occurred. And I know that some of the therapies that regenerate skin like intense pulse light produce enough damage so that the damage is now signaled. Right. Your body has to figure out. So the cross linking that occurs as a consequence of sun damage is so subtle that it can accumulate across time. Exactly. No indication of damage. And so the exosomes signal to the body that something needs to be fixed. Exactly. And that’s what this really is all about. And especially the first generation of stem cells. We’ll talk about second generation but first generation stem cells is really about para cream signaling which is basically signaling to the local tissue. Hey there’s something wrong here. Start fixing it. And that’s that’s really what it is. And so exosomes in the case of Tami’s case they send a signal to reduce inflammation and then they send growth factors to help repair and regenerate the tear. So and then you can actually see if you do a follow up ultrasound which we do all the time that the tissue is actually repaired and regenerated. Can you do that systemically? Yeah exactly. So intravenous stem cells or intravenous exosomes are being used a lot for a variety of neurodegenerative conditions, autoimmune conditions, chronic pain, chronic inflammation. There’s so many different things are being done for it. There’s a recent trial done for inflammatory bowel disease which is a really terrible condition. And right now the only really medications are like methotrexate or immunosuppressants. Cardiovascular diet. Yeah, carnivore diet. It does work actually. But not everyone’s going to stick to it. Yeah right. It’s a hard diet. And a lot of doctors don’t really know about it so they’re not going to recommend it to their patients. So patients have to self-educate right. And so instead of just suppressing your immune system what the intravenous stem cells do is they do what’s called immunomodulation. So they actually reset or repair your immune system from a pro-inflammatory state to an anti-inflammatory state. And is that the exosomes or the stem cells per se? It’s more the stem cells. The stem cells have a strong immunomodulatory effect. The exosomes don’t have a strong immunomodulation. That’s why you have to do intravenous stem cells if you want to treat something systemic autoimmune conditions. And there’s trials done where patients have actually gone into remission. And that’s incredible to see. Yeah you’ve treated MS? We have. But MS is much more tricky because it’s not just there is an autoimmune component to it. But then there’s also there’s a lot of other components to it. And that’s where it becomes you have to take a holistic approach. So the way we’re going to treat MS, which we’re working on, is we’re going to have the second generation of stem cells. So what that means is instead of just using umbilical core stem cells we create what are called gene edited stem cells. So we can actually take so this is this is what Professor Yamanaka in Japan he won a Nobel Prize in 2014 for what’s called discovery of pluripotent stem cells, IPSCs. So what he discovered was that you could take any somatic cell in your body like a muscle a scan cell and you can reprogram it using genetic reprogramming and turn it back into an embryonic stem cell. So to revert to an earlier form essentially. Yeah so I like to call it the Yamanaka stem cell. And basically it’s a pretty crazy discovery if you think about it. The fact that you can your body has this almost innate ability to go back to like an infant state. But you just have to over express certain transcription factors to do that. And so that discovery was pretty incredible. You know the immune system does that too is that when it’s when it’s mutating when it’s adapting to the presence of a new virus or a bacteria it’ll produce more and more accurate gripping mechanisms right at the cellular level. But it stores representations of the ones that were part of the developmental sequence. So you can imagine that that an immune cell is trying to get purchase on a bacteria. It’ll sort of go like this first right. It’s not doing it very well but it’ll stick a bit and then those what sticks a bit varies and then it’ll stick a bit better and then that’ll vary and then it’ll stick a bit better like that. Well then if the thing mutates this grip might not work but this one might. And so that the information is still stored and if this one doesn’t work well this one might. So it stores that that developmental. So there’s more early variability and less fine accuracy. There’s a trade-off right between. It sounds like the same thing is happening with the with the stem cells is that they’ll differentiate into their final form which is specialized but that the possibility for earlier forms with more potential is reserved. Exactly. Yeah you know the same thing seems to happen with regards to junk DNA. So I had a friend tell me for example if you breed fruit flies and you breed them so that they don’t have eyes you can do that. You can alter them genetically so they don’t have eyes and then you take the blind fruit flies and you let them breed amongst themselves for seven or eight generations the eyes will come back because the the genome takes information out of the junk DNA and rebuilds the eyes. And so even in the DNA itself there seems to be additional information stored so that the system can revert to an earlier stage of development and then progress forward again. And that’s really what I believe is you have 3.2 trillion cells or so in your body and I believe they’re working for you but we have to figure out and give it the right signals so that you can heal disease. And that’s what regenerative medicine the promise of it is really about which is that we can use customized cell and gene therapy to restore your body back to a previous state. And that’s the era we’re finally in. It took a while to get here but that’s but you see how there’s all these interesting almost clues from from fruit flies from the immune system that tell us that maybe this is possible. And now we’re just trying to put PSAT together using next generation cell therapeutics. So can you distinguish let’s speak more generally for a moment if you can distinguish between regenerative medicine per se and medicine as it’s commonly practiced and it sounds like the regenerative field is much newer and you’re obviously at the forefront of that but how do you distinguish what you do from what physicians typically do? Well I think the big the big narrative shift that’s hopefully going to happen is instead of giving pills for chronic disease we want to be giving cells. And what that means is we can make customized cells now to treat chronic disease. Traditional medicine is amazing when it comes to acute care right if you get a fracture you go to the hospital phenomenal where our surgeons are amazing they’re so good at that. But when it comes to chronic disease unfortunately we’ve been told by regulatory bodies and by guidelines that giving prescription drugs is the best way to manage them. And the reality is those drugs don’t really treat the root cause they’re just kind of symptom symptom maskers exactly. And so but now and it was fair it was not an unreasonable solution but now we’re kind of at this place where we actually have real solutions to get people better using these specific cell therapies and put them into remission or actually I don’t like to say clitoral I don’t like to say cure but at least remission right where there’s some diseases controlled. And so they don’t and they don’t necessarily have to be on pain meds. And so I think people need to and this is I’ll give an example like lupus is a terrible condition and again the only way they can traditionally manage it it’s an it’s an autoimmune condition is usually some sort of immunosuppressant. Right which brings with it all sorts of other risks like chronic infection of other sorts. Exactly and so many other risks with it. And so there was a trial done in Germany where they use something called gene edited CAR T cells. So what they do is they take your T cells out of your body they add a chimeric antigen receptor which basically allows these T cells to hone in and kill B cells which become hyper proliferative in lupus. And so it’s called CD CAR 19. It’s just it’s a specific type of antigen that they add on to the T receptor. The gist of it is that what it does is just makes it hone in on the problem. So it’s really it’s really fascinating because you’re gene editing these you’re making these B-spoke cells almost that are specifically designed to do a task. And these cells they actually put everyone in the trial into remission. And even in a year follow-up even though their B lymphocytes went back up patients were still doing well. Their symptoms didn’t come back. So that just shows you the power of these next generation therapeutics. So is that a widely used treatment now? CAR T is approved by FDA. However it’s five hundred thousand dollars. And why is it so expensive? Because the pharmaceutical companies allow them just unfortunately because there’s patented and all this stuff they just charge a lot of money. And so what we’re doing is we’re using our technology which we can talk about to create our own CAR T and hopefully offer it at one-tenth the price. And that’s kind of the goal that we want to take because it’s just it’s it’s not like very few people can afford that obviously. But the point is you can make these customized cell therapies for different chronic diseases. And there’s so many it’s going to be autoimmune conditions cancer and everything in the next few years is going to shift towards gene and cell therapy to actually cure people or put them in remission as opposed to just giving them pills for everything. How far along is regenerative medicine in relation to the treatment of cancer? So CAR T is so a variant of CAR T is used for different types of leukemia and lymphomas and has successfully been used for several years. So that’s one type of genetic cell therapy that’s being used. And then there’s also something called natural killer cells which are part of your innate immune system as the name suggests. Natural killers. They go there they kill things that don’t belong. So what you can do now is you can actually gene edit those natural killer cells with that CAR antigen I was talking about so you can create something called CAR NK. And that CAR NK with that antigen onto it can hone in and kill the cancer. So there’s trials being done now where they’re using CAR NK for different type of solid tumors as well. And so and there was also very promising it’s still early stages but to get again this is where the I think cross-cultural medicine becomes really important. So when I worked in Japan earlier this year I learned that they’ve been using these type of cell therapies to treat cancer for over 10 years. But in the U.S. it’s completely new. So it just shows you that there’s this disconnect. Why is there a 10-year lag? Exactly. So it’s a loaded question because the problem is there’s the biggest problem by far is regulatory bodies. And unfortunately the regulatory bodies in North America are making it very difficult for cell and gene therapies to be approved. Whereas in Japan they set a framework it’s called PWDA which is just a framework for regenerative medicine regulation which started in 2014. So it’s almost nine years. So they actually approved different type of cell therapies nine years ago. Whereas in the U.S. it’s technically still illegal to do certain types of stem cells. Let me ask you this question. Are you at peace with the mindless screen time you spend on your phone every day? 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Find resources to prepare for Exodus 90 at Exodus90.com slash Jordan. That’s Exodus90.com slash Jordan to start your journey. So why do you think that is? Is it merely a matter of, I mean nine years is long in terms of, nine years is a long time if you happen to be suffering from cancer but on a historical time frame it’s you know a blink and it’s a blink in time. I mean obviously there’s going to be some resistance and lag in every system to the introduction of new innovations and perhaps some of that’s useful because some innovations cause a lot more trouble than they solve. But why do you think it is that there is a lag in the United States which is generally a very dynamic place with regard to innovation on the regenerative medicine side compared to Japan? I think it has to do unfortunately with the pharmaceutical companies because a lot of them have lobbyists that influence. Seven for every member of Congress and Senator in the U.S. Seven lobbyists. Right so plenty and I think they control 75 percent of mainstream television advertising. I think it’s something like that and I think it’s actually higher for news broadcasts per se. And they actually spend more money advertising to doctors than they do to even consumers. So then doctors are inundated with these pharmaceutical reps and with this information and if you’re if you’re a busy doctor, doctors have really challenging lives as you I’m sure you know and so they’re busy working, they’re in clinic, they’re trying to just help their patients. They don’t really have time to check everything that’s going on outside of and they don’t have time to travel, they don’t have time to look at what’s going on in the whole world. Or read the journals and they’re not trained very well to do that to begin with. No they’re not and they’re basically told what they’re what they’re trained well to do is follow guidelines. Yeah and those guidelines where do they come from? From specialists who have industry sponsors or ties to pharmaceuticals. Well it’s a tricky business right because the pharmaceutical companies are within their proper purview to attempt to educate physicians about their new products but drawing the line between that and marketing per se and unethical marketing is very very tricky and I mean it’s the same with regards to high prices for novel medical interventions. I mean it can take a lot of time and money to develop a new drug or a treatment and it’s not surprising at all that to begin with it’s expensive because everything that’s introduced into the market to begin with that’s novel is expensive. Exactly. Hopefully then it gets widespread enough so the price starts to come down. I mean it’s easy to damn the pharmaceutical companies and I’m highly inclined to do that under certain circumstances you know because I think I don’t know it seems to me that maybe a line was crossed when the pharmaceutical companies got the okay to advertise directly to consumers that seemed to warp the system pretty badly and that was about 20 years ago if I remember correctly. I think they moved from from what would you call it scientific research enterprises to marketing machines at that point and and it doesn’t look to me like the consequences of that were particularly good. No and the the reality is that if you’re a physician most of your continuing education comes from one-year conferences that are given by specialists who are considered the top in their field from institutions who are usually have some sort of ties with pharmaceutical companies. So where are you getting your continuing education from and it’s really difficult for them to get out of that system and so the only reason I think I was able to get out of that system was because I always looked at prevention and I always looked at finding cures and that’s just the way I was taught because of functional medicine and functional medicine is this whole concept of trying to repair your body and trying to heal it. Before cell and gene therapy a lot of it was just focused on supplements lifestyle like you’ve obviously you know like carnivore like those type of interventions can be very powerful but there’s no education on the physician side on that stuff. Well it’s also hard to transform them into something that generates profit and this is you know it’s easy to be cynical about that but that’s actually a big problem. I mean I know there are a lot of off-the-shelf pharmaceuticals that are essentially free that can be used effectively for treating various conditions so there’s a lithium I’m not this is not medical advice by the way for everyone watching listening but there’s a lithium variant called lithium orotate which is dirt cheap and has virtually no side effects that appears to be reasonably effective in the treatment of manic depressive disorder and you can buy it on across the shelf for virtually nothing and everyone asks well why isn’t this more widely known and the answer is well if the chemical is widely available and essentially free and no one can generate a profit from it no one has the incentive to market it or educate people about it right you see the same thing for treatments like um what’s the what’s the precursor to cert precursor to serotonin five hydroxy tryptamine tryptamine five hydroxy tryptamine which is a good precursor for serotonin it’s also extremely inexpensive and by all appearances relatively harmless and you might say well why isn’t it more widely known and again it’s the same problem if there’s no market there’s no impetus for the distribution of the product or for education about it so they just fall by the wayside and so it isn’t merely a matter of the profit hungry you know vampires of the pharmaceutical industry it’s actually a very troublesome technical problem when you’re making dietary recommendations too it’s like well you know how do you do that and at the same time or any form of prevention for that matter it’s hard to even get credit for prevention right yeah you know if you’re very good at prevention then the thing that you could be rewarded for just never happens and so that’s great but it’s very difficult to reward and to note so how did you get interested in regenerative medicine and why did your educational pathway diverge from the typical physician before i went into med school i was a personal trainer so as a personal trainer my job was to get people moving exercising and a lot of times you actually see them come off their medications diabetes high blood pressure just by exercising so then intuitively i knew i was like wait a minute exercise can solve so many chronic disease problems and then turns out in the literature 80 of chronic disease is preventable with lifestyle right and so it’s very hard to get people to make lifestyle exactly and it is so so i was always fascinated by that and so even in medical school i was kind of like why aren’t we learning more about nutrition we had one lecture on nutrition in all of medical school one one and it was the can and it was probably wrong it was wrong it was a kind of food it was the kind of food guide oh great yeah which is what it was sponsored by it just by dairy by you know we it’s just it’s like you have to have grains like it’s it’s just ridiculous but yeah but during but but then what happened was i got exposed to this whole like alternative medicine world because even though i was studying allopathic medicine i was simultaneously studying functional and integrative medicine distinguish those for the people who are watching allopath so right so allopathic medicine is traditional medical doctor is you get a doctorate of medicine and that’s a traditional you know drug-based surgical-based interventions that we learn in medical schools so which is great right so disease treatment disease treatment yeah but then functional medicine and integrative medicine is taking naturopathic stuff that’s evidence-based that has actual science behind it and lifestyle measurements to intervene and treat chronic disease so you know i went i went to the temple of asclepias in greece recently yeah it was extremely interesting a very large compound and at the temple of asclepias there were rooms where you could um you they actually had people sit and dream in rooms full of snakes right and god only knows what the what the reason for that was my daughter used to have snakes as pets and she said that she would often have nightmares as a consequence of having the snakes in a room and i suspect it had something to do with their order so god only knows what dreaming with snakes would produce in terms of visions but anyways there was a place set up where you could have a healing vision but there were also theaters and stadia there and places for massage and for uh for saunas essentially like it was a compound that was devoted to health that was multi-dimensional right and so and there were theaters there because part of the healing process was drama and part of it was exercise and part of it was vision and when i went to that temple i thought these people were more sophisticated than we are in their approach to disease right because they were it wasn’t merely a matter of i know there are modern medical miracles and certainly surgical bone setting and that kind of thing hip replacements and so forth some of the things that can be done are absolutely miraculous but our notion of what constitutes health and how to progress towards it i don’t think is it’s certainly not as sophisticated as what the ancient greeks managed at their heights no and i believe in 30 years we’re going to look back on this era and be like wow we did a lot wrong and the reason is because just as i was saying where we we realize now that the system is is broken uh the u.s spends more money per gdp on capita than many developed countries but they don’t have better health outcomes and they’re just drowning in debt because of how much their health expenditure is going up and the reality is like you were saying people aren’t gonna it’s yes i think i think the concept of people promoting exercise health and healthy living is great but the reality is it’s really hard to get people to change and the environment is obesogenic meaning it’s set up let’s be honest it’s set up for failure because of just the accessibility of processed foods and the way massive calorie foods you know and the advertising well yeah 1,500 calories you know in in in uh i think netherlands they ban direct to consumer advertising of sugar to children which is great it’s a great start and japan i think did that as well so there’s there’s starting to be finally this notion that hey processed refined foods like sugar is really really bad for you and it can lead to food addiction and what are the obesity rates in the u.s it’s 40 i mean i think overall some states are higher yeah yeah it’s stunning it’s absolutely stunning and and and catastrophic yeah so i think the reality is it’s going to be really really hard to get people to change unless there’s huge policy changes which probably won’t happen anytime soon so what we’re doing is we’re trying to build resiliency in people’s body so that they can get the benefits of healthy living without necessarily doing healthy living so it sounds kind of crazy but that’s what gene therapy is all about so well it’s kind of crazy except you know i mean people people also hand wave about the pathology of pill taking but one of the things you learn as a behavioral psychologist perhaps above all else is that behavioral changes are very very difficult for people to make even what you would think of as small changes and everybody kind of kind of knows this because they have their new year’s resolutions and they decide they’re going to go to the gym and they go for like a week and then they quit and people revert back to their old habits and you might say well people should behave better it would be better for them but then you think well how often do you take that advice for yourself and so one of the things you learn as a behavior therapist is to help people make behavioral changes very gradually and incrementally but that’s very labor intensive right and it’s also difficult for the people themselves to do especially if you’re dealing with someone who imagine that they’re quite ill and they’re in crisis maybe economically not least as a consequence of the illness then to ask them to make a radical lifestyle change is maybe it’s even necessary but the probability that they’re going to do that on top of everything else they’re struggling with is very very low so it’s a tricky no it’s a very tricky thing to get right social determinants of health basically if you’re low social economic status that’s the best predictor of health long term so if you’re unfortunately if you’re poor and you don’t have access to much capital then you’re more likely to have obesity more likely to have chronic disease and then helping those vulnerable populations you’re going to get cheap fast sources of calories so how can you tell people yeah you just need to exercise more and eat less it doesn’t make any sense yeah so yeah well and people also won’t do that the literature on diets pretty damn clear is that if you put someone on a diet that actually requires food restrictions so they’re chronically hungry they may diet successfully for a while lose some weight but as soon as they stop dieting they’re going to revert not only back to their original weight but generally gain weight on top of that and so any diet it seems to me that any diet that involves protracted periods of hunger is actually doomed to failure and that’s what the fitness industry promotes to people so they’re set them up for failure because they see all these people online who are doing these extreme diets but they’re doing it a as a profession and b a lot of times are enhanced using other things yeah right but so the regular person sees those people and then they wonder why it’s so hard for them well and those people are actually specializing in doing that right because they maybe they make a living doing it so they can put the time of effort into it one of the advantages of the of a ketogenic diet or a carnivore diet is that you don’t have to be hungry you know that’s a big deal because protein is very satiating and you can eat as much as you want so that’s a that’s a massive that’s a massive improvement over diets that involve like chronic calorie restriction because there’s no way that like the other thing too you see people develop eating disorders this way too is like if you get in a fight with the systems that mediate hunger you’re going to lose because those systems are very very powerful when they’re over activated and you see this with people with eating disorders they get into a war with their hypothalamus and like they don’t no one wins that war no you’re going to be set out for failure or you develop a very unhealthy relationship with food yeah so it’s developing a healthy relationship with food which means you’re eating it for nourishment and not for coping with emotions or stress or so many other reasons why people use food for and developing that healthy relationship is really what it takes a lot of therapy actually and it takes a lot of work which is cognitive behavioral therapy right cbt and cbt is only what is one of the few evidence-based therapies out there to help people treat obesity right and so but it’s not but it’s a lot of work it is a lot of work and a lot of attention a lot of strategic planning and it’s expensive for that reason too and time consuming on the part of the people who are being treated so all right so how did you now you said that you worked as a personal trainer and so you were already interested in lifestyle modification and then you and how long did you do that and and and why did you decide to go to medical school so i was basically doing that from undergrad like for three four years and then i got into medical school but the reason i decided to go to medical school was mainly because intellectual stimulation one because obviously being a personal trainer there’s only so much you can do and it kind of becomes repetitive very quickly and so i wanted to learn more about how i can help and heal people and being a doctor naturally seemed the best way to do that but what i didn’t realize was when i got into medical school i was a little bit disillusioned because i realized that a lot of these things just don’t resonate with my belief system which is that i don’t believe just giving pills to people i just it just never resonated with me and so i was always kind of trying to learn more about how can i actually get to the root of this and that was just a question i always wanted to ask myself i’d like i did like surgery because surgery is very gratifying because if you have a trauma if you have someone you can you know you can fix them you get them on their way and they’re done right so but but but then you realize even in surgery most of what you’re treating is the end stage of chronic disease like hip replacements is osteoarthritis like ophthalmology a lot of it is cataracts and that’s related to diabetes and so many other surgical specialties are actually vascular like a lot of it just chronic vascular disease heart disease like these are just end stage of lifestyle stuff and so the reality is if you look at even most surgical specialties a lot of them are just doing what could have been prevent yes exactly mop up and so that’s why i ended up not going into surgery and then i kind of got into this whole world of i i naturally because of personal training i like sports medicine so then that’s where i went to sports medicine with dr anthony gallia and that was that a post medical school yes after residency training after residency training then you do sports medicine with dr gallia who’s kind of the pioneer of the platelet rich plasma injections sports medicine is the medical domain that probably overlaps most with cognitive behavioral therapy as it turns out interesting yeah right well that would make sense yeah and so interestingly i’ve had yeah i’ve had professional golfers i’ve treated using some we do something called the vegas nerve injection which helps with their nervous system to help performance-based anxiety so but uh 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 this is kind of like a lower version of the exosomes we were talking before if you’re to compare prp to exosomes the cytokine profile is about 10 times weaker prp is the platelet rich so prp is still good for like muscle tendon tears like acute injuries it’s not great for chronic tear wear and tear it’s so that’s where exosomes and stem cells are more superior but when i worked with dr gallia obviously i got exposed to all this kind of alternative stuff but then i realized he’s treating some of the most high profile people in the world i’m like there must be a reason they’re coming to him so why would these people who can go to any doctor right so is it alternative or is it cutting in exactly exactly and that’s and the media used to predate printed as though he’s you know something there’s a lot of negative stuff out there about him so it’s hard to discern yeah right it’s like what’s what’s really the truth and then you realize quickly once you’re in there some of the most important people in the world come see him and so i realized this he’s obviously doing something right and so i’ve and then that’s when i got into regenerative medicine the regenerative medicine prp was a great starting point but now it’s evolved into cell and gene therapy and tissue engineering how did you learn to read the relevant scientific literature i had to just make google scholar alerts and just for everything bridge out a medicine base and just reading primary literature sources and then just reading every day that’s something you did fundamentally on your own yes yeah yeah because one of the correct me if you think i’m wrong but one of the things i i did a fair bit of research with psychiatrists especially back at mcgill when i was when i was doing my phd um and one of the things i learned very rapidly was that there was a big difference between physicians and scientists so if you’re trained as a as a boulder model clinical psychologist you’re basically a research scientist who does clinical work so you’re trained to evaluate the scientific research you’re trained to learn how to do statistics and understand them and to write scientific papers and to evaluate them and i thought the same was true of physicians but it’s but i soon discovered it wasn’t true at all and even the psychiatrists that i did work with they often had statisticians do their stats and i thought that was so unbelievably well you know even the peer reviewed process yeah do you know how that works the doctors don’t actually review the data they just get they just get the primary paper and that’s and then no one vets it to them right they just go through it and they’re just like yeah it looks good yeah well it’s very well it’s it takes a long time to learn to evaluate scientific research it’s not this is why i was wondering how you managed to do it because it’s a very intense training process even to to to understand the jargon that surrounds the statistical analysis that’s years of work and now the medical literature is doubling so fast and from 1900 to 1950 it took 50 years for the medical knowledge domain to double yeah now it takes 73 days it’s 73 days for the medical knowledge literature yeah i can believe that you know i’ve been reviewing some of the psychological literature pertaining just recently to disgust sensitivity which is a neurologically based partly gastrointestinal partly emotional response but it has implications for all sorts of things you wouldn’t expect so for example societies that are what would you say characterized by higher levels of infectious illness are much more likely to have authoritarian forms of local and national government like way more likely not a little bit there’s a massive connection between disgust and authoritarianism as it turns out anyways i was reviewing that literature and i haven’t looked at it for you know five years and i was just absolutely stunned at the proliferation of new papers it is essentially impossible to keep up and so but it’s also extremely exciting because there is so much knowledge being generated constantly and so the big the big i think the the key takeaway is you have to be able to look at it from a bird’s eye view because there’s too much you have to look at trends and you have to look at where is the science headed yeah and that’s that’s the tricky part where a lot that’s for sure and the science and that’s the problem with current medical system is that everyone’s in silos and then you have scientists and you have doctors who are in their little silos but they’re not stepping back and looking at hey where is medicine headed and how can we take the best of what the science is presenting to us and bring it into well or into public policy exactly and so a lot of that and there’s a huge what’s called the clinical translation gap of 15 to 20 years yeah 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 and so patients aren’t getting access to the best treatments available and it’s not it’s very unjust because a lot of people are living with chronic disease and suffering when there are options for them 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 it is one of the most challenging things it leads to mental health issues at least to disability 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 yes heart disease kills more people yeah but quality of life and economic burden of musculoskeletal is the highest 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 and and i’ve been able to help a lot of people that no one was able to help so let’s talk about that a little bit so when you when you first see someone now you’re the regenerative medicine practices that you engage in that’s an element an aspect of lifestyle medicine so you’re looking at sleep and exercise and stress a broad sort of almost i would say a behavioral analysis so how do you move from the general behavioral analysis through the diagnosis to the recommendation of the therapies that you can provide and what they’re like how do you step along that how do you decide who’s how do you yeah well that’s what i mean how do you how do you lay out the diagnostic process and determine what treatments are appropriate if someone came to see you what could they expect yeah no i have i have a team who are kind of health coaches and biochemists who can work with the nutrition and lifestyle stuff so they try to optimize as much as possible but sometimes that’s not enough right and that’s why they’re coming to me because they’ve already tried the traditional things a lot of them have already seen multiple specialists yeah and so the most common thing i see by far is osteoarthritis right yeah osteoarthritis is just like we’re talking about is cartilage wear and tear is chronic inflammation but now we realize that osteoarthritis isn’t just chronic inflammation there’s there’s all these hallmarks of aging there’s 10 hallmarks of aging as and as you probably know aging and longevity is a huge hot topic yeah because if we can cure aging we can pretty much treat almost all chronic disease because they all have the same same 10 hallmarks so i’ll list a few of them there’s genomic instability mitochondrial dysfunction loss of proteostasis stem cell proteostasis which is protein regulation like homeostasis of protein regulation and those you get malfunction of proteins and they build up and that can lead to cell dysfunction and then there’s also like stem cell exhaustion chronic inflammation and senescence there’s all these different hallmarks so there’s about 10 of them and now we realize those 10 hallmarks of agent aging actually govern most chronic diseases so even osteoarthritis what happens is those chondrocytes which are the cells that line the joints they become they have all these different hallmarks of aging so they get they get those epigenetic alterations of mitochondria start becoming dysfunctional all those things start happening at a cellular level which can happen years before the doctor picks it up right sure and so that’s part of the problem i know with uh with neurological conditions often you don’t see any overt symptoms till 95 percent of the underlying tissue is being destroyed and so that’s why diagnostics is becoming advanced too in fact they’re using exosomes which are can be a biomarker for a lot of these diseases because these cells start releasing these different biomarkers and you can detect them using exosome technology so it’s becoming and even the diagnostics is really far behind now in traditional medicine because they’re not doing any of this stuff but anyway so to the point so if you have someone let’s say a knee that’s really bad osteoarthritis like stage four they want it they’ve been told by the regular doctor they want to get a knee replacement and they want a second opinion so that’s usually why they come to me and they want to look at the alternatives and they’ve tried you know the lifestyle stuff and so what we do is we assess we assess their x-ray mri we do an ultrasound examination and then we see if they’re an appropriate candidate for our procedure and the way we do that is based off mris so you have to have you have to have characteristic findings for example like bone edema which is inflammation in the bone that’s something we can target and treat with stem cells because they’re very anti-inflammatory and we also have to make sure their bone isn’t too deformed so for example because there’s and this is a problem with my field if you google regenerative medicine doctor there’s a thousand of them in the u.s and and there’s so many of them not doing things properly and the problem is because of the lack because there is almost a black market where there are a lot of people doing it illegally in the u.s yeah because the fda can’t keep up with shutting down all these clinics there are so many stem cell clinics even though stem cells are technically illegal in the u.s so it’s become a weird place because it’s hard for patients to kind of figure out who’s actually telling the truth and who’s just selling them a lie and that’s and that’s the biggest problem with the whole stem cell field you see the same thing with plastic surgery exactly exactly it’s the exact same thing and so it’s a Pareto distribution problem which is that in every field only a tiny minority of people actually know what they’re doing right right so you always have a signal to noise detection problem is like who are the people who actually and then of course often the people who don’t know what they’re doing genuinely think they know what they’re doing the dunning-cougar effect tricky yeah absolutely it’s really problematic yeah and that’s that’s exactly what happens and so why should people trust you because i’m a canadian physician and in canada we were never taught about money we were never taught about the business side we always taught about patients first and making them better and i think that’s being on the global stage as i am now we’re in traveling and treating people around the world my focus is never on the monetary stuff and i i always focus on treating the patients first yes some of the treatments are expensive and that’s just because the market price is expensive but as we talked about earlier anytime with there’s a new technology over time the price is going to come down and there’s always going to be early adopters and over time we want this to be accessible to the average person in fact we want it to be covered by insurance which in japan it is so if japan’s doing that already i think eventually there’s going to be an impetus for this stuff to move over here it’s just going to take time yeah but yeah i think that’s because i went into medicine generally to make a difference and help people that’s always been my motivation it has never been anything anything more i i and and the big thing too is honestly if a lot of patients who see me they they can tell i’m pretty like i’m honest and i’m transparent and i don’t promise the moon like there’s certain things that we can fix certain things that we can’t fix stem cells aren’t a magical cure for everything but the next generation of cell therapy like we were talking about like the gene and a cell therapy that really will be allowing us for custom cell lines for almost every medical condition like diabetes cancer dementia there’s parkinson’s disease there’s a clinical trial done this year those ipsc’s i was talking about earlier and they are ipsc’s are the induced pluripotent stem cells the yamanaka stem cells so they created what are called ipsc dopamine producing neurons oh yeah and then they transplant them surgically into the areas where they lose those dopamine neurons and then they did a one-year follow-up and so many other patients basically go into remission their symptoms get so much better and they actually regrow new neurons that produce dopamine this was a blue rock therapeutic clinical trial so this shows the power of ipsc’s and this is just the beginning of i this is what i’m going to call the ipsc revolution there’s going to be so many different ipsc cell lines that are going to allow us to treat specific medical conditions so in the future people will think about cells to treat their conditions as opposed to pills let’s go back to osteoarthritis because that’s a very interesting place to dive into because generally once people have when when people have rheumatoid arthritis and use anti-inflammatories you can slow down the degenerative process but often when you see people in late stages of osteoarthritis they’ve already suffered a tremendous amount of loss of cartilage for example and so you evaluate people using mri and you said there are there are times when their joint damage is too far gone for you to be able to intervene but so what what at what level of severity can you intervene and what sort of what sort of responses have you seen and how widely generalizable is that yeah it’s so even for so there’s four kind of stages of osteoarthritis and so we can even treat stage three stage four which is the more advanced one as long as their bone it like i was saying earlier if their bone is actually deformed where they need some sort of alignment or corrective where the problem is mechanical right if it’s mechanical then stem cells are going to fix that right they need some sort of surgical correction so but if it’s more inflammatory base or if it’s more uh based off like the cellular dysfunction we’re talking about then that’s something stem cells work really well for so for example people who have chronic daily pain night pain it’s affecting them all the time that’s very inflammatory base and that’s where stem cells work really well for and even mri we can correlate if they have inflammation in the bone then we have a specific target so it’s very it is generalizable because if we have patients like that we know it’s going to work so it brings down the inflammation and it can help to regrow a little bit of cartilage oh yeah this is the first generation of stem cells which are the umbilical cord stem cells now we’re transitioning over the next six months actually we just licensed it that we just have this technology now it’s the second generation of stem cells so they’re the yamanaka stem cells but specifically for osteoarthritis so they’re they’re the ipsc derived mscs so they’re mesenchymal stem cells but they’re ipsc derived and they’re gene edited to overexpress certain transcription factors to target osteoarthritis so see how specific the cells are getting it’s becoming a really cool technology because it’s not just like okay stem cells it’s like no this is a very specific ipsc derived msc product for osteoarthritis so that’s the era we’re in now so you can treat muscle tears and damage and tendon tears and damage yeah and you can treat osteoarthritis what other what other conditions do people suffer and come to you for that you you have had success in treating i’ve had i get a lot of so because of the online world i get patients from all over the world and most of them are chronic complex conditions so a lot of them are like fibromyalgia which is just like chronic pain everywhere there’s from chronic fatigue syndrome there’s people with toxic mold who don’t get better there’s people with rheumatoid arthritis who just have chronic inflammation and joint pain everywhere and they’ve tried all the meds inflammatory bowel disease so we’re getting a lot of chronic complex conditions and now we’re building out a team of specialists so these are long-term systemic dysfunctions exactly and so it’s about restoring your immune system and getting it to be functional again and that’s kind of what we can do with the combination of the systemic intravenous stem cells and with the different and different peptide protocols we have and even we’re now we’re manufacturing and we have our own what are called fecal microbial transplant pills fmt pills but basically fmt as you know is to repopulate the gut bacteria and the gut is where most of your immune system is stored and that so if we can restore the immune system we can treat a lot of chronic diseases even the parkinsons so tell me what you’re doing with those with those so we have our own process to manufacture fmt we have a human microbiome is this in canada i know mexico in mexico so we have a manufacturing plant there that’s where we do stem cell man are you are you is that product available already it’ll be available in the next few months oh yeah and so our scientist uh her name is dr caroline gannibus great phd human microbiome specialist and this is her specialty and she has her own proprietary process on how to manufacture these pills select for the donors and give them to patients and the beautiful part about these treatments are only one week long and they can have a huge impact on your body and again who do the fecal transplant pills work best for so you can use them for even anti-aging and longevity because in mice fmt has been shown to extend lifespan by 30 so i think there’s going to be a lot of people who are just going to use it for that’s a consequence of gut biota proliferation because the gut microbes produce so many different metabolites and help with processes so many different cellular processes they’re not just we know can be used post antibiotic treatment as well right yes and so we’re we’re going to make 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 yeah yeah and there’s actually well in caesarian birth actually is a problem right do you want to explain that yeah because you don’t get exposed to the vaginal flora which is the bacteria 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 right and just get them that exposure to the good bacteria so the reason is because that’s a good example of just how bloody complex things are exactly who the hell would have ever guessed that a caesarian birth would cause post-birth trouble years later because there wasn’t the proper trip through the vaginal canal man that’s unbelievably complicated it is and that’s why but what we gotta learn are principles what’s the principle of of the human body immune dysfunction is one of the most important principles that govern so many different chronic diseases so if we can if we can train your immune system properly at a young age i always say like your immune system’s like a teenager if you don’t train it properly it’s going to misbehave when you’re older yeah so now we’re learning how to train it properly which means you have to get exposure to certain bacteria you have to be played with pets you have to play with soil you can’t be afraid of germs when you’re young because that actually leads to more issues older and antibiotics too much cleanliness too much cleanliness yeah and we know that antibiotics for every antibiotic course that children take it increases the risk of autoimmune disease by one percent so it can become a cumulative is that right yeah and so it became like it was uh it was um nih research that’s interesting because i was chronically treated with antibiotics for recurrent tonsillitis right probably 20 times so and i i think a problem and and we talked about the beginning of an interview what we did for you 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 now you’ve also treated depression yeah yeah so let’s talk about that a little bit because the first thing people who are watching and listening should understand is that there isn’t any such thing as depression there are multiple medical and physical conditions that produce decrement and mood and some of those are lifestyle associated and some of them are a consequence of not having a functional life and some of them are pure consequences of physiological uh malfunction so there’s a lot of evidence for example that chronic depression is an inflammatory condition and there is evidence as well that part of the reason that ssri’s work is not directly because of their neurochemical consequences so on serotonin function but because they’re actually anti-inflammatory right and there’s a big overlap between that’s like statins too but yeah oh so i know i don’t know that so statins for people who don’t know are cholesterol lowering drugs yeah but the reason they actually have an effect on mortality we believe is because they reduce inflammation so what’s the underlying cause right chronic inflammation where does that come from chronic immune dysfunction right right and where does that come from your gut right well there’s a huge overlap too between depression and immunological problems and so okay so what have you done with regard specifically to the treatment of so-called depression so let’s come back to the fundamental principles of what causes depression from a cellular level it’s neuroinflammation there are some chemical imbalances yeah and then there’s the gut brain access you have more serotonin receptors in your gut than you do in your brain right right and so it’s looking at this from a holistic approach and so for me as an interventional physician what we can do is we can reduce neuroinflammation by using intravenous exosomes they cross the blood brain barrier they reduce inflammation in the brain and then we can also help with the nervous system what are symptoms of brain inflammation what how every neuro if you look at this data out there with if you go to the literature yeah almost every neuropsychiatric disorder is linked to neuroinflammation it’s hand-in-hand it’s almost kind of like autoimmune conditions and intestinal permeability or leaky gut right you’ve heard of leaky gut it’s i know there’s mckayla interviewed a psychiatrist at what’s the big hospital mcclain’s mcclain’s in boston who’s been using dietary manipulations to treat like schizoaffective disorder right 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 exactly and so we’re starting to learn depression to manic depression exactly and so we’re starting to learn about those physiological bases and that’s what we intervene on so the way we do that is reducing neuroinflammation and that’s with exosome treatment primarily intravenous exosomes and then what we do because we know so many mental health disorders are rooted in unresolved emotional trauma and a lot of that comes from do you know paul conti no he’s a psychiatrist he wrote a book about this but he talks about how many depressive and anxiety disorders are rooted in this unresolved emotional trauma from childhood and they and sometimes it’s in the unconscious mind and they don’t even know it and so what we do interventionally basis we actually do something called the stellate ganglion block and inject into the vagus nerve because the stellate ganglion interferes into your sympathetic nervous system and a lot of times your sympathetic nervous system is overactive exactly it’s overdrive that’s chronic chronic exactly exactly and that’s also because of that unresolved emotional trauma and then the vagus nerve the vagus nerve is kind of this master nerve regulator of your parasympathetic nervous system and that’s the one that helps you to relax and calm down but a lot of people what that happens in neuropsychiatric disorders is they can’t relax yeah they’re just they’re just jittery they’re just irritable yeah you tell them to relax it’s like telling it’s like telling an obese person to stop eating to eat less or someone on cocaine exactly it just it’s not helpful so it’s just telling people who are anxious and depressed to relax is not helpful and so what we do is we’re trying to intervene and so what we actually inject directly into the stellate ganglion we inject something called peptides and anesthetic which calms it down and then into the vagus nerve we inject peptides and actually some exosomes which help to remodulate the signaling of the vagus nerve so this can have a dramatic effect on their nervous system make them more calm make them more resilient and deal with stress better and just make their bodies until you you help with parasympathetic activation exactly and so i have a diagnostic question for you yeah one of the things i noticed when i was practicing as a clinician in concert with physicians who were prescribing ssri’s i mean i i had clients who showed like miraculous response to ssri’s on occasion where they would be chronically depressed for months or even for years and they’d start a course of antidepressants and if they were fortunate their symptoms would remit in like well between three days and a month and it’s not supposed to remit that yes with six weeks yeah but but there’s a neurochemical effect as well as the neurophysiological effect but here’s one of the things i noticed i want i want you to tell me what you think about this so as we already discussed there’s a lot of different disorders in the depression bin and one of the things i would do with my clients is do an evaluation of their of the dimensions of their life so imagine this are do you have a long-term partner do you have friends do you have a job that you enjoy or that at least is functional and providing for you you know economically are you do you have plans for your education do you take care of yourself physically do you have an alcohol or drug or other like abuse problem etc so multi-dimensional analysis of functionality along all these different dimensions of life now now and then i’d have a client who had no problem with any of those but was depressed right 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 they didn’t have any friends they didn’t have like their life was just an absolute bloody catastrophe then you could imagine two different forms of depression there’s many different forms but two classic forms one would be you’re not depressed your life is an absolute shambles and you’re miserable because nothing you’re doing is working and then there’s another person it’s like oh no like you work hard you’re well educated you have goals you have a partner you love you have friends but your mood is just absolutely dysregulated you’re worse in the morning something’s wrong with those people physiologically so i’m wondering if when you do your diagnostic process if you look at could you 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 and those are the ones we’re primarily treating yeah okay and okay and so why are those the ones that you’re primarily treating is that just the people who end up coming to you i think it’s just selection bias yeah probably probably i think the people who seek me out are generally those type of people right unfortunately they have the wherewithal to do it exactly unfortunately the people in the other category probably don’t even know i exist right right because they’re just going to their family doctor and they’re just that and that’s the means that’s all they have yeah well this is 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 so it’s not a clean cut 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 it’s like well are you depressed which means that your life is functional but your mood is dysregulated or are you just merely suffering the consequences of having an absolutely dysregulated life there’s no way that a pharmaceutical intervention is going to fix that i mean i didn’t see some of my more seriously affected clients on the behavioral side now and then they take an antidepressant and it would decrease the probability they would commit suicide which isn’t nothing and maybe it would help them a little bit garner enough energy to start to improve some of the things they could improve but it couldn’t be a magic bullet because an antidepressant isn’t going to give you a life partner for example no and for us it’s about restoring the cellular processes as much as possible so they have resiliency to deal with the life right right right that’s why yes yes and that that’s why we take this approach and so we’re 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 and that was first for specifically which treatment for the vagus nerve and the stellate ganglion block the combination of that because i’ll give you an example any downside to it no it’s a for me it’s a five-minute procedure i’ve done hundreds of them and it can have such a big impact i’ll give you what are people yeah yeah i’ll give you an example so i had i had a special forces operative he has a world record for the longest sniper in the world he’s in 3.2 kilometers which is crazy so he’s but he’s but he’s so he’s this high level special forces operative in canada his mid-40s really really bad ptsd to the point that he tried every medication tried every psychiatrist psychologist and he was basically told that you can do made which is oh yeah medically assisted suicide essentially right uh in canada that’s now allowed and oh even recommended it’s it’s 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 and so i actually wasn’t even into mental i mean i’m a sports medicine doctor my training right so i this was actually one of my you know one of my friends uh friends so i so he asked me is there anything i can do and so that’s how i started getting into this whole interventional mental health stuff and so that’s how i came across these these procedures and i talked to some of my friends in the states and so he came down we did the procedure for him the stellate ganglion and then the vegas and what do you do to do that exactly so yeah so we use so in the celly ganglion we’re injecting something called bupivacaine which is an anesthetic and we mix it with certain peptides and what the combination of peptides the cell ganglion do is they suppress that sympathetic overdrive and then the vegas nerve we inject some exosomes and peptides and what that does is it modulates the vagus so you do both of those at the same time at the same time yeah and then when and then we do it usually we try to do dual we do both sides oh yeah and so afterwards he said like he literally said a weight has been lifted off his shoulders and he started crying wow oh yeah it was the most dramatic thing i’ve ever seen i don’t say this happens to every cry how long yeah 10 15 minutes with his wife was there too and he just said he was and he he he gave me a coin which they usually don’t give to anyone who’s not in the military so that was like a huge honor for me and i felt i just felt very privileged to help someone like it was that fast it was that fast and now he’s doing pretty good he’s he’s back to playing hockey he’s feeling better he’s just it just it’s it’s it’s hard to explain because there’s so much emotional baggage and unconscious reservoir of these different traumas are built inside of your body and you can i think they they lock themselves into something like a positive feedback loop because like once you get anxious to a certain point every little thing makes you more anxious right and then you can start to become anxious about the anxiety itself 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 so for example let’s say your mood starts to fall and then you isolate right and then you start performing worse at work 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 so it loops yeah with with panic disorder what happens is people get anxious right but then they start to avoid and that makes their anxiety worse and so then they’re in a loop and with alcoholism what happens to people is they start to see that if they drink it cures their hangover well that’s obviously that’s going to generate a positive feedback loop and so many of the things that we see as conditions i think are positive feedback loops that have that are self-sustaining and inspiring and so for us it’s been creating an intervention that breaks that spiral positive feedback loop yeah yeah yeah so how many people have been treated with this with this particular treatment i at this point i’ve done hundreds including panic attacks for young girls like it’s been it’s been incredible to see the changes that one intervention can have on people is it for everyone no but there are a lot of people it can help yeah and so how do you decide who can be helped and who like what are your inclusion and exclusion criteria for the treatment i mean the biggest thing is a lot of them if they say yes to have you heard of um gaber mate yeah yeah so his like ace you know aces adverse childhood events he has his questionnaire 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 and almost i would say it’s crazy almost 90 percent of them say yes it’s so many of them have these issues that they’ve just kind of buried in the past and they’re dealing with depression or anxiety but they actually have something that triggered that maybe when they were younger so that’s a good indication that classic freudian analysis yes so that to me is a big indication that this these treatments will work and for a lot of people who just have anxiety it can be very helpful too so like panic attacks or low stress resilience and day-to-day irritability then that’s an indication where they just need you ever do personality assessment on your clients i well here’s something 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 and then have them do it six months later and see if you get decreases in trait neuroticism right yeah right because if you did that would be absolutely fascinating yeah you could actually we are going to start a trial so i will include that because that use the big five aspect scale yeah because it gives you more differentiated analysis but if you could show that you could decrease trait neuroticism with a physiological treatment like that that would be a major that would be a major discovery yeah no i think that’s great so what we’re doing that’s a resilience measure essentially right an emotional resilience and i get that feedback all the time my patients say that i have more resiliency yeah what used to stress them out doesn’t stress it out anymore right right and so i see that anecdotally so it’d be great to quantify that absolutely and well and it would be quite the miracle if you could produce a transformation in a in a personality trait because neuroticism is actually very stable right right and so and very difficult well difficult to remit ameliorate goes along with stable but you know there is there is uh there are other indications that such things are possible so for example a single dose of psilocybin that produces a mystical experience produces i believe it’s a half standard you know it’s a one standard deviation increase in trait openness a year later that’s permanent exactly right one standard deviation 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 vegas nerve shot and basically we combine it with psilocybin assisted therapy a macro dose and so that combination is so powerful to kind of reset their which do you do first uh we usually do this first and then send them off to therapy afterwards this the psilocybin therapy no we do our injection first calm down the nervous system yeah and then afterwards they go off to therapy and do psilocybin yeah yeah so they do that they do the physiological intervention that decreases stress reactivity first right so that would also increase the probability that the experience they have with a hallucinogenic would be positive because their nervous systems are calmed down right because that matters right so if you’re in an anxious state and you take a hallucinogenic their probability that that state will be magnified into something approximating a bad drip is very high yeah 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 yeah use the big five use the big five right that’s great that’s really powerful because if you get five aspect scale right no that makes perfect sense yeah yeah well that would be really remarkable if you could manage that all right so you and what sort of what sort of effects have you seen with the people that you’ve treated for depression so we talked about anxiety more specifically so yeah no uh depression i think i think the big thing with that is combining with that 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 and so it can help people who are even like it’s like that veteran i was saying who was ptsd who was suicidal and it shifted him from not being suicidal anymore to basically not being suicidal he was just it actually changed his life and so it’s been super impactful on people like that but but he’s also the right candidate because he has severe ptsd and because of that ptsd and he has a life and he has a life he has a wife he has kids all that other stuff 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 they need this intervention can actually make a big difference on their life 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 yes right 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 i mean for me it’s all about getting the patient it’s all about clinical outcomes as a doctor my job is to improve my patient’s health or quality of life and to at the end of the day if they’re feeling better and they’re getting then they tell me that that to me is what matters the most right and the way i achieve that often is multimodal meaning that you have to use multiple interventions and the problem with traditional randomized control trials is they only want to look at really one intervention for one specific but that’s not how the body always works well it’s also a it’s also a conflict with the immediate necessity of medical treatment right 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 and the kitchen sink at them and that’s the reality of the patients i see they’re refractory to the traditional medical system so they’re looking for alternatives so it’s not it’s not often just one intervention i often have to do multiple things to get them better and that’s why the trials we’re going to be doing are going to be where multimodal we’re going to have multiple things that we’re using to intervene and when you say trials like are these actual research yeah clinical trials yeah 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 but but basically we’re going to be looking at it’s called fallostatin gene therapy so it’s basically the world’s first reversible plasmid gene therapy so traditionally viral vectors were used for introducing a foreign gene into your body but what we’ve developed is a plasmid which is just a circular strand of dna it comes from e coli but there’s no actual live bacteria in there and the plasmid the beautiful part about the plasmid is is it can target any protein or peptide up to 10 000 base pairs with 100 accuracy and it’s what do you mean by target what does it do exactly so meaning it can tell your body to whatever gene of interest to produce more of that so for example whatever gene of interest yes oh yeah that’s promising yes it’s very promising and it’s what’s called an epizomal vector so it’s non-integrating so it’s not going to go into your genome and make you like a translocate or have those risks that viruses may have and it’s also because it’s not a virus you don’t have to take amino suppressants it’s not immunogenic so there’s all these cool benefits to it so is it temporary it lasts and that’s the beautiful part it’s reversible because it’s e coli origin so you can take a tetracycline if you want it out of your body so it has that safety mechanism and it lasts for about one and a half to two years so so you can repeat it as needed whereas viral vectors you cannot repeat them once you do them you do them and you can’t really get them out of your body right so right so this technology is really beautiful and we did our phase one already so we’re doing our phase two targeting what conditions so sarcopenia because and what is that that’s the loss of muscle as you get older oh which is really which is probably the biggest driver of aging because as you lose muscle your body to protect itself and regulate your immune system and vitality goes down you become frail and that frailty we know is such a big predictor of mortality and this is falls falls and even in uh covid studies they found that people who had more muscle mass yeah had better well you know one of the best predictors of lifespan is grip strength exactly yeah yeah which is quite remarkable which is just a proxy right and so it’s a proxy for muscular integrity essentially yeah and so if you look at it if we can preserve muscle that can be one of the best ways to have oh yeah that’s a huge deal exactly so fallout so fallout is a peptide that’s naturally made in your body and as you get older your fallout statin levels decrease and so what we’re doing is we’re just delivering this through a gene therapy form the plasma vector and it increases your fallout statin levels for one and a half to two years and it’s completely reversible if you want to have your body for whatever reason and it wears off on its own well what happens if you increase fallout statin levels so it inhibits myostatin which is kind of the enzyme that sets a limit on how much muscle you can put on so it makes it easier for your body to put on muscle it also increases why does it decrease with age because the aging process is cruel and so so many different peptides as you think it’s just a consequent another element of degeneration exactly degeneration exactly and so entropy yeah and so if we can restore it back to your levels your youthful levels not only will you inhibit myostatin which makes it easier for your body to put on muscle it’ll also activate what’s called fox o3 pathway which reduces systemic inflammation so it has this and so we showed in our phase one trial that patients over the age of 60 on average reduce their intrinsic biological age by 12 years which is actually incredible yeah at 60 yeah and there was actually some hyper responders who had biological age reduction of access of 60 years which is crazy to believe so does that mean they’re going to leave 60 years longer we don’t know that yet but they’re telling me probably not probably probably multiple dimensions exactly but still but but their telomere length which is a proxy yeah we also set a world record for that as well you showed telomere length increase as well in that patient who was a hyper responder and so we’re actually applying yeah so it’s pretty powerful it’s as another animal studies that have been done with this already fall saddened gene therapy has been around for a while in animal studies and once it showed with animals similar 30 32 life extension in mice but actual life extension not just the markers no exactly like extension wow and so when people fast i mean i know animals that that are starved to like 75 percent of their body weight they’ll live 40 percent long or something like that does that have anything to do with with them yeah because it activates similar pathways which are anti-inflammatory pathways regenerative pathways pathways that help with cellular senescence like all the hallmarks of aging that we talked about so whenever you think about any intervention think about how is it affecting the hallmarks of aging so now we have an understanding of biology because in physics we always had first principles right the like newton’s laws like we understand first principles right in biology we never had first principles until recently now we understand there are where it calls fundamental principles which govern chronic disease and cellular discharges associated with those 10 markers for aging exactly those 10 hallmarks govern so that gets you to 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 and so where are you with this trial so the phase two trial is going to start in spring 2024 in canada we have tentative approval we’re just getting the funding together to start it and so the phase two trial is to look at false data and gene therapy it’s going to be randomized controlled trial with the placebo group and and basically to look at sarcopenia osteopenia and then different inflammatory markers how old are your client you’ll have anyone from age it’s going to be open to age from 30 to 80 so yeah really interesting to see what it does with people who are particularly old yeah exactly and that’s where it’s the most powerful but even in i mean younger people don’t need it as much but a lot of them just do it for the gym like i’ve done it on myself just for the benefits of more energy more strength in the gym because obviously by inhibiting myostatin it gives you more uh downside there to date there hasn’t been any adverse effects so wow that’s that’s amazing yeah it’s been safe for hard to believe i know it’s been safe for over six years and you haven’t seen any adverse effects to add some credibility to it we are backed by peter theil and sam altman those are our two seed investors and they’re both well-known names in the world and i think the reason they they backed us is because they understand that this has a potential oh yeah to revolutionize a lot of gene therapies because if you think about it the only other real big gene therapy competitor is crisper right and crisper but the problem with crisper it’s yes it’s more powerful than mini circle our technology but it also has off-site targets so meaning it may hit it may do something that’s unintended so and that’s the risk with crisper 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 and that’s the beauty of this plasmid vector technology well that’s ridiculously exciting it is so i wanted to also ask you about um let me see i just checked my notes here too yeah tissue engineering so we were talking about earlier can we regrow cartilage for example in osteoarthritis so with the first generation no the second generation what we can do now is we can combine those ipsc msc’s that we’re talking about they’re engineered specifically for osteoarthritis and then we can use a 3d bioprinter and we can embed them into a scaffolding basically a scaffold and then you can implant those arthroscopically and then that can regrow new cartilage uh-huh so that scaffold the scaffold with the embedded stem cells so that’s called oh that’s the intersection of gene therapy cell therapy and is that specifically is that specifically for cartilage or can you do that with other organs no you could do then that’s that’s the promise of it right this is just the beginning of tissue and how far is that advanced in what are you doing specifically so for cartilage there’s already trials being done is dr farshad ghaliak in uh university of washington he’s already been done doing trials in humans with the similar technology uh and then so we’re we’re just starting to do our own trials with that this year and who’s we the regenerative medicine community okay i see i see but we also you have people that you’re working with who are involved in these specific trials yes i have my own group and we have our own company and we have our own researchers and scientists we’re working with and where’s that company located so we have our mini circle technology company that’s in austin texas that’s in austin and then we also do research in mexico why in mexico because so you can do phase one trials a lot quicker offshore yeah and then you can get the approvals and move things along quickly and then we can move onshore for the phase two so that’s kind of our strategy that’s kind of our strategy because if you just go through traditional health canon fda it’s going to take 10 to 15 years to get anything done yeah yeah that’ll just kill you exactly 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 risks in that are there risks in that in doing it that quickly do you think i mean the science the technology we’re using already has really good basic science behind it and has lots of animal data yeah so there’s already safety data there too and we’re not doing it without unreasonable justification so there is mechanistic basis for what we’re doing as as well as good safety data on animals so okay the next step logical step is put it in humans yeah someone has to do it yeah so it’s and that was the same thing with the plasmid technology it was just we were the first ones to do it in humans it was done in animals for a long time but then we were the first ones to take it into humans when did when did that start to happen about six years ago wow that’s ridiculously exciting yeah it took six years of rnd to get it into commercial product but now we have our first commercial product and we’re doing phase two but we’re also offering the follow-up stat in gene therapy in approved regions like mexico prospera dubai we have approvals in certain areas where we can do it so do you enjoy the business side because it sounds like you do i enjoy helping people and creating scalable technologies allows me to help more people and that’s really yeah well fair enough but that you know that’s the intelligent integration of the business vision into the into the medical practices right as if you set up an organization properly then you can move faster you can do more things and you can scale exactly right i can only help so many people one on one as a musician but if i create technologies and do trials that are large scale eventually we can help millions of people the the dream is imagine you go to your family doctor let’s say 20 years from now yeah 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 that’s that’s the world i want to see yeah yeah where we just eradicate chronic disease now you’re going to treat me for something tomorrow as i understand exactly what are you planning to do to me well as you have talked about publicly you have toxic mold you’ve been exposed to it right and i think in florida that’s the theory yeah that’s the theory 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 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 straighten that was different than the excess tammy did that as well but she also did the excess own treatment which i didn’t do yes yeah yeah because your your problem is more systemic and so what we’re going to do now is we’re going to do work called intravenous natural killer cells 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 so it’s basically giving your body the what do you make of that sick building syndrome literature i think it’s very under appreciated because you do a lot of physicians don’t test for mold and they have a lot of patients with chronic illnesses that well the literature is horrifying you know 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 it’s absolutely horrifying in fact you can’t read it i guess it’s about as bad as the discovery that asbestos was causing cancer i mean asbestos was used everywhere exactly it was like oh we’re killing people like lead in gas exactly i mean these things have happened no and there’s a new theory on cancer it’s called cell suppression theory which and now is getting a lot of traction is basically that the idea that fungal spores are hijacking the cell and preventing cell opoptosis so they’re preventing the cell from functioning properly 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 right right right but but this is one of the potential risk factors because we get exposed we all get exposed to funguses all the time it’s part of living in a modern environment most people’s immune system can deal with it but some people’s immune system can well especially if they’re in a place where they’re being chronically exposed to levels that they can’t actually tolerate exactly so how do we build the resiliency in your body so you can deal with those fungal infections we give you the cells to do that and that’s what the natural killer cells are going to do and eventually we probably give you the fmt as well so we can give you your an fmt is the fecal microbial transplant 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 so it all comes back to first principles and that’s the biggest i think takeaway for people to understand is biology is moving at this point at this alarming pace almost yeah where we’re that’s for sure where we’re understanding down to a single cell function how cells can operate and target those inter make very specific targeted interventions as opposed to just being like take this pill and hopefully hopefully it doesn’t hopefully your disease doesn’t progress right right 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 i think scientists are the best people to learn from 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 yeah 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 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 and that’s where i learn from and i think that’s where you have to go to 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 and i talk about it a lot online i try to take that information and disseminate it in a way where people can understand it right because it is complicated and there is a lot moving at a fast pace 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 right all right well that’s 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 is there something that you wanted to cover that we didn’t discuss yet i i like to tell the world that we’re in the world of medicine 4.0 yeah 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 health span where you can do what you want and live a high quality life 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 and that’s where the era of medicine we’re headed towards and that’s what we want to really share with the world okay well thank you very much for all the information that we walked through today that was much appreciated and very enjoyable and to everybody watching and listening thank you very much for your time and attention i’m going to talk to dr conn for another half an hour on the dailywire plus platform 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 and and so we’ll go a little further down that road and if you want to join us there please feel please feel welcome to do so otherwise hopefully you’ll tune in again in the relatively near future and thank you to the dailywire plus folks for making these conversations possible thanks again sir all right thank you you bet you bet