Kyle Kingsbury Podcast - #106 Dr. Peter Attia

Episode Date: September 6, 2019

Dr. Peter Attia is physician who focuses on lifespan. In this episode we dive into a ton of topics including hunting, sleep, mitochondrial health, fasting, NAD, rapamycin, ego,  psychedelics and more.    Connect with Peter Attia: Website | https://peterattiamd.com/ Listen to The Peter Attia Drive Podcast | https://apple.co/2MO58Jj Subscribe to the Peter Attia Newsletter | https://peterattiamd.com/newsletter/   Show Notes Marvin Hagler vs Tommy Hearns | https://www.youtube.com/watch?v=rOZZoaUWf34 The Peter Attia Drive episode about Aryton Senna | https://peterattiamd.com/formulaone/ John Dudley | https://www.youtube.com/watch?v=rTO0inCV1Fo Dr. Rhonda Patrick | https://www.foundmyfitness.com/ Stealing Fire by Wheel & Kotler | https://amzn.to/2Ki2NUR Rise of Superman by Steven Kotler | https://amzn.to/2KksgNo Flow by Mihaly Csikszentmihalyi | https://amzn.to/2WDJfMo The Peter Attia Drive w Robert Sapolsky | https://peterattiamd.com/robertsapolsky/ Dom D’Agostino | https://www.youtube.com/watch?v=LfZ56d2qfr0 The Complete Guide to Fasting | https://amzn.to/31x9mZ2 Zero Fasting App | https://www.zerofasting.com/ Jason Fung | https://bit.ly/2WL6nbK Rapamycin | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972801/ MAPS | https://maps.org/ Rick doblin on podcast |  This is Water | https://www.youtube.com/watch?v=hAECOcmul2o Kyle Thierman | https://www.youtube.com/watch?v=_kJvCo2Z3vo   Show Sponsors: MindBullet https://mindbullet.com/kingsbu (Use code word KINGSBU at Checkout for 20% Off)    Waayb CBD www.waayb.com (Get 10% off using code word Kyle at checkout)   Onnit Foods & Supplements Get 10% off all foods and supplements at Onnit by going to https://www.onnit.com/kyle/   Connect with Kyle Kingsbury on: Twitter | https://bit.ly/2DrhtKn Instagram | https://bit.ly/2DxeDrk   Subscribe to the Kyle Kingsbury Podcast Itunes | https://apple.co/2P0GEJu Stitcher | https://bit.ly/2DzUSyp Spotify | https://spoti.fi/2ybfVTY IHeartRadio | https://ihr.fm/2Ib3HCg Google Play Music | https://bit.ly/2HPdhKY    

All right, y'all. Today is a very special day. There's not many guests that I have on that are absolute bucket list guests. I know we had Ramit Sethi on. Before I got into podcasting, long before that, when I had just retired and never thought about podcasting as a career choice, I loved listening to podcasts. And in 2014, I retired from the UFC. I started listening to a lot more podcasts because I had a lot more time available. And of course, that included largely and still does to this day, the Tim Ferriss Show and the Joe Rogan Experience. And I had heard on the Tim Ferriss Show that year, Dominic D'Agostino, Dr. Peter Attia, I guess Dom's also a doctor, and Jim Fadiman,

who's a doctor as well. There you go, three doctors. I heard those three guys and was blown the fuck away by each of them. And between Dr. Dominic D'Agostino and Dr. Peter Attia, that's what fueled me to want to get into ketosis and really start diving into longevity and cognitive function and how we heal the brain through fasting and other really dope mechanisms. So to say this guy's been on my radar is a fucking massive understatement. And I got to meet Peter out on a hunting trip in Hawaii, which was also a bucket list experience. And just truly one of the best weeks of my life. And we bonded.

We had a great time. We got to know each other. I can say he's a friend, which is huge in my mind, because he's somebody that I've looked up to and learned so much from for a very long time. And I continue to learn from him. As anybody who's listened to his podcast, The Drive, will tell you, I think the only complaint

would be that there's just so much fucking gems, so much information. It's hard to take notes if you're driving your car or running when you're listening to the podcast. But I just have a wealth of respect and love for Peter. He had us over at his house in San Diego. We got to get dialed in on the bow. He brought out a JR, a buddy of ours that was hunting with us and works at the local archery shop down there. And he just dialed us in. It was the first time I could shoot accurately at 60 plus yards. All that to say, I am so fucking thrilled to have Peter T on the show today. I jumped on his podcast as well, The Drive, that I think that'll release in a month or two, but I couldn't be happier with this one. I know you guys are going

to get a lot of it. Have your fucking notepad ready because he means business when he's talking and he's got a lot of amazing things to talk about. We cover all sorts of stuff, a lot of things he has not talked about on podcasts before, and a lot that you may have heard that I needed some clarity on. I needed clarity on the NAD stuff. I needed clarity on some different things. And he was able to illustrate everything beautifully. I learned a lot in this one. I know you will, too. So thank you guys for listening. There's a few ways you can support this show, one of which is to click subscribe.

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We're clapped in and I'm quite giddy. You got Dr. Peter Attia here in front of me. We're in your guest house where we've been staying for the past night. We've been shooting some bows already and we're getting ready to dive in. So it's an absolute fucking pleasure to be here, brother. Oh man, it's an absolute pleasure to have you here and to be with you.

Awesome. Well, let's get some background. I like opening up the show with the backstory of childhood, what life was like growing up for you. Do it. You can go as deep or as shallow as you want into the waters, because I know that's a loaded one. Yeah. I grew up outside of Toronto. And your parents are Egyptian, right? My parents are Egyptian. Came to Canada in the 60s. And yeah, grew up sort of in the...

People think Toronto is a glamorous city. I think it is, except it has five boroughs. But one of the boroughs really sucks. That's the one I grew up in. And even my wife, who grew up in Baltimore, thinks it's disgusting. That's the one I grew up in. And even my wife who grew up in Baltimore thinks it's disgusting, which is like, that says it all. Um, and I lived in Canada till through college. And so I'm now, I think I actually just this year eclipsed the 50% of my life in Canada versus out of Canada. Wow. So I'm, uh, I'm, I'm truly of two countries now,

I suppose. You got dual citizenship. Yeah. Very cool. Two passports. So talk about growing up and when you got into boxing, because I was, I was blown away by this and your wealth of knowledge in boxing, I think is, is on par with anybody that I've met in MMA or boxing. Well, thank you. I appreciate that. It's probably only true until the 90s. Okay. So I think I know nothing about boxing today.

I mean, I know as much as a casual person would know today. But yeah, so I started boxing when I was 13. And so there was a fight between Marvelous Marvin Hagler and Tommy Hearns. And when I saw that fight, which was in April of 1985, that was, I just realized like, that's the guy I want to be, you know, Marvin Hagler. Um, and most people today would still regard that as one of the greatest fights in boxing history. And I think most people would say that the first round of that fight, um, would be certainly on most people's short list for the greatest rounds in any boxing match.

And I think of that round as sort of a metaphor for life. I have a friend who's going through a very difficult lawsuit right now. And, um, I sort of said, look that, that, that lawsuit that you're in, you're on the right side of the, you're on the right side of this thing. So you're Hagler. You will win this thing. But right now, you are in the first round of that fight. And I mean, Hagler was almost killed in the first round of that fight. Certainly in the first 90 seconds of that fight, Hearns almost took his head off his shoulders. talked, I was talking to him the next day after that little pep talk. And he was like, dude, I went back and watched that. He's also a boxing fan. He's like, I went back and watched that three times. And he's like, you're so right.

That is exactly what this is like. I just got to get, you know, it's eight rounds of, or eight minutes of, you know, sheer destruction. So anyway, seeing that fight, I just, I fell in love with Hagler. And, and then also once I started boxing, I realized I didn't have any natural ability. You know, there are some people like the first time they get in the ring, they just have blinding speed or their power is staggering. Dynamite in their hands. Yeah. They jump like that. I didn't have any of that stuff. I mean, I was just like, probably slower than average, probably hit a little harder than average, probably had a slightly above average chin, all of those intangibles. But I also sensed that Hagler wasn't supernatural on any dimension,

but what he was supernatural and was disciplined. I mean, that guy trained all the time. You know, most fighters would spend six weeks in training camp and they'd be out of shape the rest of the time. Hagler was just never out of shape. And I think what you saw in the Hearns fight was this is a guy who, I mean, Hearns hit harder. There's no question about it. And Hearns was faster. And Hearns was bigger and lankier and had a longer reach and had all of these advantages.

But Hagler was just in better shape. And he had the best chin, I think, in the history of boxing. Certainly, you could make the case that of five boxers with the greatest chin, I think, in the history of boxing. Certainly, you could make the case that there are five boxers with the greatest chin. Hagler is one of them. So I was like, okay, that's the guy I want to mimic. That's the guy I want to emulate. And that was sort of the beginning of it. When did you, and this we'll have to skip around here, but when did you make the realization that you were no longer going to box and you were going to focus on medicine well it actually wasn't medicine but so when i finished 12th grade so now i'd been boxing for

i think that would be five years um and and also doing martial arts so i was doing um kickboxing taekwondo boxing they all sort of flowed into one. And I just sort of had an epiphany. So up until that point, all I wanted to do was become a professional fighter, which obviously, you know, is super upsetting to my parents because immigrants that leave a bad place to come to a better place have this vision of their, you know, kid doing something like going to college or whatever. And because I didn't want to do that, they were very upset. And they just, you know, they couldn't understand like my maniacal training in high school. I was training six hours a day.

But then I had this sort of epiphany at the end of 12th grade, which was, I mean, it's actually kind of interesting story where a teacher who I really liked, and I couldn't say that of many teachers in high school at the time. I was generally a mediocre student who just got into a lot of trouble. And this teacher called me in one morning and he's like, hey, I want to, can you come in in the morning? And I thought, oh, you know, what did I do now? And he said, look, you know, I heard you're not going to college. And I said, that's right. In Canada, we say university,, you know, I heard you're not going to college. And I said, that's right. In Canada, we say university, by the way. You're not going to university. Yeah. I said,

that's right. And he, and I really thought he was going to sort of lean in with a huge lecture, but he didn't, you know, instead he said, I get that man. Like I really get pursuing your, your dream. He said, you know, when I was your age, I really wanted to play in the NHL. Like that was the only thing that mattered to me. And ultimately, you know, I didn't, then I did this, but don't let anybody take your dream away. But I just want you to know, I actually think you have a real talent for mathematics. And I think that you should at least consider that. And when his name is Woody, and when Woody kind of planted that seed in me, I think that was the thin end of the wedge that had me realize within the next couple of months that, you know,

probabilistically I was not going to be the middleweight champion of the world. And boxing's a brutal sport. You know, you can be the 20th best pitcher in the world and you have an amazing career that spans 18 years and you'll make tens of millions of dollars. If you're the 18th best middleweight in the world, you were brain damaged and broke. I mean, it's just an, it's a brutal reality. And I think I realized like there's a chance I'm not going to be the best ever. So everything else is really a, is, is, is sort of not a good outcome. So, so then I just, that's when I decided, okay, I got to really shift gears big time. I've spent the last five years

exclusively focusing on this one thing and I've spent no time focusing on this other thing. And now I need to do a one 80. So as strange as it sounds, I did a total one 80. I mean, overnight. It's not that I stopped exercising and training, but I wasn't training six hours a day. Now I was just sort of training for the sake of exercise, maybe a couple hours a day. And then all of that energy went into basically catching up on all the stuff I'd missed because now I had one year to basically try to get into college. And so that's what I did is just kind of busted my ass to sort of change gears and go and study math and engineering, which is what Woody did himself. Okay. So that was the next chapter. So then I went off, went to the same university he went to. I mean, he was like really my, you know, such,

just such a huge influence in my life. Four years later, when I did graduate with the degree in math and a degree in mechanical engineering in Canada, there's a ceremony where engineers get a ring made out of iron. And the reason for that is there was a bridge that had collapsed in Quebec many years ago, and it was a horrible engineering error. And then you would take the iron from that actual bridge that had collapsed and they made these rings that were shaped in a, beautiful, distinct manner. And every engineer in Canada wears that iron ring on the pinky of their

working hand as a reminder of the hubris and carelessness that led to such a devastating error. I believe that by the time we were getting our rings, they were now stainless steel and not iron, but they weren't coming from the original bridge. Yeah. But it's the ceremony is you have to be presented to it by someone who themselves had an iron ring. So of course, Woody came from Toronto all the way out to give me my ring. And then I had kind of this other change of heart, which at the very end of that, as I was just getting ready to start a PhD in aerospace engineering, that I actually wanted to do medicine. So then I had to sort of putz around for a year and teach calculus to the college students because

by that point I was, you know, I had been involved in sort of redesigning the calculus curriculum at the university and then take my prerequisites for med school and take the MCAT and do all that business. But I always stayed very close to Woody until he died. Actually, he died very prematurely, 2013, 2014. But I always sort of credit him for being one of the most important figures that, you know, I don't know. I sometimes wonder like, you know, what would my life have been if I didn't sort of run into him. And there were two other teachers I had in high school that I think were great people. And they sort of saw through my issues and realized that I could do well if I applied myself. Yeah, I can count on one hand the people in my life that

came from academics or coaches that really saw more in me than I saw in myself. These people don't get enough credit. I mean, I, I, I'm back in touch, very close touch to one of them. Who's my, who was my English teacher in 11th and 12th grade. And we, I mean, I just talked to her on the phone like two weeks ago and, um, I'm writing a book right now and I've actually asked her to help me with one of the chapters to, cause I, you know, it's sort of about stuff in my childhood. And I feel, I feel like she would be the most able to help me navigate how to tell a story that is a hard story to tell. And it's just been amazing to be back in touch with her. Um, because again, I, and she, and she's told me, she's like, look, I, I didn't know what was going on with you,

but I knew, you know, there was more to you than the front page story, which was kind of a shithead. I had that front page story for quite a bit of my life, for sure. Well, let's talk, let's shift gears to swimming because I didn't even realize this about you. We were on our hunting trip in Hawaii and somebody mentioned to me that you didn't even start swimming until your 30s is that correct 31 yeah and then like you what's the three island swim that you pulled off in Hawaii well I didn't pull it off I wanted to yeah I wanted to swim from Maui to Lanai to Molokai back to Maui so and and now remember we flew there. So you can sort of see what that looked

like. You can see why that makes a beautiful triangle. That's about 30 miles. Um, the problem with said triangle is nothing is there to buffer those waves. See, at least when you swim between Maui and Lanai, um, you you're only sort of unbuffered east to west, but north south, there's a bit of a buffer cause you have two huge islands. So it's more the wind that you're only sort of unbuffered east to west, but north south, there's a bit of a buffer because you have two huge islands. So it's more the wind that you're facing when it's blowing west and east. With the triangle, one, you don't have that. Two, to swim 30 miles is going to take, you know, 15 to 18 hours. And you really don't want to be on that water from about noon to 8 PM. You got to be off that water. It's just the winds are brutal. So you'd have to start the swim at sort of 10 PM. But the problem is I couldn't find a boat captain who was willing

to start at 10 PM because of the tiger sharks. Cause you have to put these little glow sticks on your bathing suit. So the boat can see you cause it's otherwise it's super dark out there. So, and then I'd done, I'd done more swims than I can count in the Pacific ocean, like here in California with those glow sticks in the middle of the night. Cause you're always trying to basically optimize for least amount of wind possible. The wind makes these swims really tough. But you have to sort of go by what the boat captain wants. They're really the one in charge. And I found a great captain, but he said, look, dude, putting a glow stick on you at midnight in Hawaii in the time of year you're going to do that swim, I mean, I might as well put chum in the water. I'm just going to be bringing tiger sharks to you. So he said, we should start at 5 a.m. and be done with it. And

I was like, well, if we're starting at 5 a.m., there's no way we can do that. It's just guaranteed to fail. So then we decided to shift to do Maui to Lanai and back, which had not been done. Or at least it's funny, we thought it had never been done. And so when I did that swim, you know, the record book said for quite a while, first person to ever do it. And then very interestingly, six or seven years later, somebody found an obscure record of a woman who had done it before and somehow it had gone completely, her swim had just gone completely unnoticed. Wow. So yeah, which was cool. I mean, I was glad that my swim, and then there was another woman who went and swam it after me, whose claim then became the first woman to do

this swim. But it was, I think her, I forget her name, Meredith something, but her swim then became, I think in some ways, sort of the motivation for people to go back and figure out, no, this other person had actually done it first. That's cool. Marathon swimming is sort of a weird cultish, cult is the wrong word, but it's just kind of a weird, obscure sport where there are a handful of swims you want to do because they're just the swims that, you know, the big swims. But then people are always looking for something that's never been done and so yeah yeah it's one of those little feather in the cap yeah yeah so when did your love affair with racing start and you've you've already you've published the podcast you did about center yeah all right we'll link to

that in the show notes yeah yeah i think it's it's awesome i mean i just grew up really enjoying motorsports in the sense that i loved cars. I mean, I just loved cars growing up. We never had a nice car, but I remember there was like, you know, a crappy old used car place, you know, five miles from our house that like had, you know, the guy used to repair old Porsches and just loved it and, you know, loved seeing nice cars, loved the sound of nice cars, had posters of cars all over. In Canada, motorsports are pretty popular. You don't have NASCAR, but Formula One and IndyCar were quite popular. There are actually a couple of pretty good drivers that came out of Canada. Probably the most famous of all is, again, Gilles Villeneuve,

who some would argue is the greatest Formula One driver that never won a championship. He died in 1982 before he had a chance to win one. His son, of course, would go on to win the Formula One World Championship in 1997. There were a couple of good IndyCar racers as well. So I don't know. It's just sort of like I I just, just loved it, but I didn't really get into it as for myself as far as driving until, uh, I want to say I didn't, I don't, I got my license and my racing license in 2013. Okay. So pretty recent. I mean, whatever that is six years ago. And that was more just, uh, you know, it's really fun to watch this, but I want to do it too. And I didn't get my license to then spend all of my time racing. Cause I understood the time commitment of that is probably

just more than I'd be willing to put into it. Um, you know, the races take four days, just like the races would take that you're watching where there's a practice and a qualifying and a race and stuff. But yeah, I was just sort of hooked the moment I started. I was like, oh yeah, this just takes it to a whole new level. Now my appreciation for watching it has gone even higher. And, you know, I just, I hope one day my kids want to do it too. My daughter really loves it actually. That's awesome. Like for her birthday party this year, she wanted that. We're just going to do go-kart racing for her birthday. And she just, you know, she rides the simulator, like she drives the simulator that you were in yesterday. And you train with a coach on that. Yeah. So my coach, Thomas Merrill, who's really great, you know, great coaches. I'm sure you can relate to this and all the stuff you've done. Great coaches aren't just telling you what to do. They're telling you what you should feel

when you do it correctly. And that to me is like, like, that's why I know I'm not a good coach. Like I, it's very hard for me to coach people because I have a hard time articulating what you're supposed to feel when you do something correctly. But, you know, I've been working with Thomas for five or six years now, and it's incredible. And the simulator is a very big part of that because we can do it any day. So we use this software program called iRacing that as you saw yesterday, I mean, it's, you're there. I mean, it's, it's, it's, you don't realize you're playing a computer. Um, and Thomas is in the car functionally with me because he's, we set up a joint session. So we're, we're doing this thing together and you know, he's in the headset talking to me the whole time and I can talk back and we can take turns. Like I can quote unquote,

get out of the car, get in the car, watch him do it. We can lead, follow, have two cars in so we can practice some more technical stuff. I mean, it's just, it's really amazing. It's such a technical sport. And that was sort of like archery, right? People say, why are you so obsessed with archery and race car driving? And I think they have something in common, which is they're very easy to understand, like the concept of what you're doing. And within 10 minutes, you can take an average person and have them do something. Like you could take a reasonably competent athletic person and in, whatever, 10, maybe 10 is an exaggeration, but within 30 minutes, you could have a reasonably competent athletic person and in, you know, whatever, 10, maybe 10 is an exaggeration, but within 30 minutes you could have them shoot a compound bow.

So they could get a feel for what it is, but then you will spend the rest of your life trying to become Dudley. Yeah. Right. Yeah. So yep. Anybody can do it. It's a lifetime to become John Dudley. Similarly in 30 minutes, like I could put you into a race car, teach you, this is how you shift up, this is how you shift down, this is how you brake, throttle, turn around this way, blah, blah, blah. Great. And you could drive a couple laps. Then have you sit in the car while a professional drives it and go, okay, it would take you the rest of your life to become Lewis Hamilton. And you won't just like I'll never become John Dudley, but, but the pursuit of that is so incredible. And once you dial into that, you start to, you'll, you'll take that one degree of improvement every couple of months. And that

becomes for some people, at least for people with my personality, that's, that's like heroin. Yeah. It's the ultimate obsession. Yeah. I think they taught, I know I've talked about this recently a lot, but obviously flow states are like a big term getting thrown around these days. And between the book stealing fire and previous to that, the rise of Superman, like it's, it's becoming better known, I think. But, um, what was that guy? McHale? Um, there's a guy who wrote the, I, the book I always thought of as the original flow book. They reference him. I forget. I know. Yeah. I have that book. I read it like 10 years ago.

I'll have, I'll have Ryan Giles pull that up for people who will stick it in the show notes. It's, it's something like to, just to go back to what you're talking about. Like you can say the nuts and bolts, like, yeah, if you challenge yourself and maybe your life's on the line or, or it's, there's some fear element, you might rise in that state of flow, but it has to be just right. And I was just chatting with Andrew Huberman about this. Like if you're overly qualified for something,

like if Michael Jordan is playing an eighth grader in basketball, there's not enough challenge there to put him in flow. It's not fun. Right. But if you, if you have some degree of expertise and you match that with the challenge or slightly harder than you're, than you're good at, then that's an easy way to drop into flow. But more importantly than that, like why the fuck flow? It's the feeling behind it, right? It's the feeling of timelessness. It's the feeling of all your fucking troubles just washing away. And that's something I first gathered with archery. I was like, this is active meditation. I'm not thinking about a damn thing else. And if I am, I suck, right? So like just to dial in like that.

Let's chat about archery here. You got into this a couple years ago, 2016? I got my first bow in 2017, actually. Okay. The winter, like January, February, something like that. What was the draw from that? Well, so six months earlier, one of my best friends, Tim, you know, you know, Tim Ferriss. Do you know Tim? I know you guys are both in Austin, but do you guys?

We've partaken in some things before and had a bonding experience. So yeah. So you know Tim well. So Tim basically just kind of got me interested in it through his own experience. So he was getting ready to do a trip, which is actually funny, came full circle. He was going on a trip with Jonathan Hart. Oh, no shit. Now at the time, even if he mentioned that I wouldn't have known who, I'm sure he didn't say who he was going on a trip with because it wouldn't have meant anything to me. So he, we were talking about the training for it because he was asking me some of my thoughts on like, how would you train for this

just physically and nutritionally? So I said, well, you know, help me understand like the parameters of the sport. So as he, the more he told me about it in an effort to allow me to help him think about how to train for it, the more I was like, dude, that sounds unbelievable. And I'll tell you the thing that most impressed me, it wasn't just the physical challenge. It was the degree of perfection that was necessary. It was this idea that you can't take a shot and wound an animal. He really emphasized this, which is how good you have to be. Because I think at some point I asked, well, how far do you have to be able to shoot from? And he says, your range is determined by the distance and conditions under which you are guaranteed. And we would say guaranteed might be 99 out of

100 shots you would take at that range. You're confident that that animal dies almost instantaneously. And double lung shot. And I said, well, what happens if you don't? And he goes, well, it's the most inhumane thing in the world. And you could be chasing that animal for two days to try to find it. And I was like, oh, wow. Think about that for a minute. That's really impressive. There's no screwing around here. And so over the next couple of months, so Tim went on his trip, which again, at the time I didn't know it was with heart, but you know, so he's out there with one of the best hunters there is, um, comes back, we talk about it and it just sort of planted this seed in my head. And, um, and then sometime a few months later, I literally just

Google like archery San Diego and find this store performance archery. And I pick it up, dial the phone. I'm like, Hey, you know, I'm kind of thinking about getting into this stuff. Like, what do you recommend? And this guy named Jr answered the phone and he's like, well, um, why don't you come on in take an archery class you know at least see if you like it and we'll go from there so i came in did an archery class which was on a recurve loved it and the rest is sort of history man it just it just it became an immediate and total obsession and obviously to have been so lucky to have met JR on that first day, who himself is just such a student of Dudley, which then immediately put me on a path to, you know, being very rigorous in how

we trained. You know, it's, that's the reason that, you know, I immediately went with a handheld back tension release first day out of the gate. He's like, it's easier to start with these other things, but that's not what we're going to do. gonna start you on this path and um and then of course you know now i'm friends with like literally every like when you go in today because you're gonna go like i know everybody in that store i just go there it's like you know in in cheers like when everyone just shows up to the bar like it's my cheers like i'm norm i'm just norm i just walk in there everybody knows yeah it's the place where everybody that's the only place where everybody knows my name. The guy who owns it is himself a legendary hunter, Bob Fromm.

So when you go in there today, you will see things you've never seen before. But what's really interesting is when you look at the taxidermy and you look at all these things, I remember Bob one day pulling me aside and pointing to an axis deer and he goes, that's actually the most impressive kill in here, you know? And he's got like, he has a world record grizzly in there. Wow. But he's like, you know, that axis deer is everything. Like that is the most switched on, difficult to stalk animal there is.

And it doesn't look that impressive, you know, that buck relative to all these other things. But so, so that seed was sort of planted that that's, you one day want to be at the point where you could do that. And when I started, I had no interest in hunting, not to say I didn't want to hunt or just that I was more interested in this mastery. Like I don't care, like I'll sit here and shoot 20 yards forever. I would go in there and just shoot 20 for days until we could dial it. And then of course now I'm in, you know, I shoot in my backyard and it's just sort of evolved from there. Yeah. Your backyard setup is, I mean, it, you can, it's hard to mimic the terrain of any particular place you're going to go, whether there's snowy conditions or, you know, the mountains that we were in and Hawaii, but

it's fucking awesome like we could have a tournament here it's like we could have a tournament yeah it's incredible it's incredible and virtually any distance you want yeah i mean our longest shot we could take here is probably 125 yards um which again is just interesting if you're really trying to gauge what your limits are but the more fun shots like what we'll be doing this afternoon is you know it's the you know behind the tree up the hill down on the thing you know 60 yards here and sometimes honestly it's just as fun to be like taking these 20 yard shots and seeing like can you be within a quarter yeah how tight can you be at you know at those ranges because as we learned on that hunt i mean you know the if I learned one thing on that hunt, then

I learned 100 things on that hunt. But it was how important the spotting and the stalking is relative to the shooting. The shooting is the most trivial piece of the hunt. The actual kill shot is 5% of it. It's those guides who are one with the animal. Like they know where the animals are going to go for shelter. They know where their water is. They know where their food is and they know how to get you into a place where you don't make a mistake when you take that shot. And that, that just blew my mind. And that's what made me realize, like, I'm not even at the tip of beginning to understand

this sport. Yeah, I was taking a lot of mental notes and quite literally taking notes every single day. I think what was cool about the arc of our trip was the ability to go from something fairly easy, like boar up to sheep and goat, and then finally finishing with axis. And I was the only guy on the trip that didn't get an axis. And I was the only guy on the trip that didn't get an axis. But if anything, that just made the fire light even harder. I mean, that just poured gasoline on the fire, especially being able to taste all the axis that you guys had gotten. It was like, wow. Yeah. And you realize, look, it's there's a lot of luck involved in getting that animal. It's it's I mean, I'm not telling you something you don't know, but not getting one is not a statement of you versus me. It's a statement of, I mean,

you know, J and R, J R and I got lucky with Jonathan to be able to be in an area and to be with guides who are like beyond switched on. And we just happened to get to a place where, okay, that's where they are. And we're going to get you in a position where you can do this. But, um, I remember the first two days we were up in the Hills, like didn't, we saw lots of deer couldn't get within a, couldn't get within a distance of them. They just, they could always see us, smell us, you know, hear us coming. Yeah. Wind shifts, you're done. Oh, it's amazing. And that, that, you know, to me, there was like, there were moments when I felt like frustrated. I was like, God damn it. Like how, how am I supposed to get a shot off? Like I can't even get within 50 yards of these

things. They always know. But then I was like, dude, why should it be easy? Like, like this is nature, man. The animal deserves to have this advantage over you. And it will make it that much sweeter when you finally manage to sneak up on this animal. It's, I don't know, it's changed a chickens here. So I, now it's like sort of awkward for me and weird for me to go to a grocery store and want to buy eggs. I'm like, why would I buy eggs from a chicken that I don't know anything about that I haven't fed? You know, these chickens, like they're eating like our, you know, when we make food and whatever scraps we have, like they're eating them. And I, I know what, I know how clean they are. I know all of this stuff. And similarly, eating this meat from animals that are like living in the wild and I mean, living beautiful, amazing, fun, healthy lives until the second they die. And again, I'm being a bit facetious because nature's cruel. I'm sure their lives suck sometimes too, when they're, you know,

can't find food or whatever, um it really makes it harder for me to think about like i just find myself eating much less meat that is not meat that has been killed in this fashion yeah i think that's that's something joe talked joe rogan talked about was having us enough supply of meat to live solely off the food that you kill and hunt and that's that's i mean that's a great goal it's 100 my goal i mean by this time next year i want to be in that situation where i never have to eat a single uh piece of meat that i didn't that me or my friend didn't kill in the wild you know under the most natural setting possible um and then you know one day to be able to have a garden that would, you know,

foster being able to eat all your own vegetables. And with Reese, we might actually get there. Yeah, that's awesome. Reese is definitely the gardener of the house for sure. Well, let's shift gears here. Obviously, a lot of people know you for performance and longevity. I think it would, I didn't even write this down, but I did want to talk a bit about, I think it was Rhonda Patrick. There's, is it the five keys to longevity? There's like five things that people are focused on when it comes to longevity. And those are, yeah, I mean, I think there's five sort of categories of tactics and I've, I've been struggling to think about a way to explain this, to come up with an analogy to explain it.

And maybe the best analogy I have, which I still think sort of sucks, is a table. And so a good table will have four legs. And those four legs, then, if all four of those are strong, that table is pretty strong. And if three of them are strong, it can be okay. If two of them are strong, it's not a very strong table. And if it's one of them, forget about it. So those four legs and then the, and then sort of, you know, like think of the tablecloth or whatever that you lay on the top of it. So, um, and again, this, this analogy I'm going to continue to work on. So I, I hope by the time my book comes out, I've come up with a better way to do this. But the gist of it is basically everything that has to do with nutritional

biochemistry, everything that has to do with sleep physiology, everything that has to do with exercise physiology, everything that has to do with emotional health. And that's where it gets a little unparalleled because, you know, it's easy for people to understand sleep and exercise and nutrition, but emotional health is so broad broad but that includes so many things that range from meditation to you know practices of relational um living to psychedelics like all the things that fit into the health of you as a person emotionally and then the last one is just this you you know, waste bucket of what I call exogenous molecules, distinct from the molecules that we've just talked about as far as like psychedelics and stuff. But, you know, your standard pharmaceutical drugs, hormones and supplements. So those are

basically the five broad categories of tactics. Those are the things that you can manipulate to try to improve. I love that. And I want to, if you have a better way for me to explain it, I don't like that way that much. I will. I want to link to your podcast that you did with Robert Sapolsky, which is excellent. And I think that's a great, why zebras don't get ulcers is such a fantastic book. We'll link to that in the show notes as well, but to get people, he's an awesome dude, by the way, he's incredible. Unreal. Yeah. Just to get people in a broader idea of what we mean by stress and emotions and how to handle that and really seeing like a clear picture of how it's done in nature and how

it's done in modern man. And then what are the ways we can kind of retrace those steps? But let's dive into mitochondrial health because it's such a hot topic right now. And it's funny, people go back and forth on different things in terms of how we go best about mitochondrial biogenesis, how we heal those things, what disease states actually can occur from having messed up mitochondria. But what would you say are some of the most important things we can do for mitochondrial health? Well, this is something I've thought a lot about, and I don't know that I know the answer.

But one of my colleagues, actually a guy who I'm going to be interviewing on the podcast, he's a physiologist at the University of Colorado in Denver, actually. His last name is San Milan, so Dr. San Milan. He's just an incredible physiologist. He made a point to me once, which was, if you want to understand mitochondrial health, why don't we start with the people that have the best mitochondria on the planet, which are endurance athletes. And he works with professional athletes. He himself used to be a professional cyclist or sorry, he's a professional soccer player, very high level cyclist, But now he works exclusively with several of the professional cycling teams as sort of this

physiologist. That's actually how I met him was through our sort of an overlap in that area. And, you know, he proposed this idea, which he's probably not the first to propose it, but I thought it was just such an excellent idea, which was someone who's really, really got switched on mitochondria is going to be able. So if you take two people and one person's average and the other person is superior and you give them the same amount of work to do, and we can measure work in Watts, kilojoules, you know, units of actual work and you have them do the same amount of work, one of them will do so producing less lactic acid. And the one who can have less lactic acid is the one who has more efficient mitochondria. And so that idea really struck with me, which is

we aren't spending enough time really thinking about what peak mitochondrial performance looks like and for me having spent so much time in that world thinking about that i was a little amazed at how i'd sort of forgotten that point because in take a sport like cycling which was sort of you know probably the most recent thing i've done competitively was cycling. We spend so much time training at levels above that, meaning levels where you're producing lots of lactic acid. And your mitochondria are still heavily relied upon there, but it's not really the peak area where you're able to examine their efficiency because by that point,

you're now demanding ATP at a high enough level that you just have to be generating energy anaerobically as well. But what he was saying is, look, let's bring it down to this level where your lactate is 1.6, 1.7, 1.8, maybe up to 1.9, but probably below two and see how much more wattage, because in bikes we use watts as our our metric but you could be doing this on a treadmill and look at you know miles per hour or incline or just look at overall mets you know metabolic equivalents how high can you start to push that number while clamping lactate output there and that becomes your marker of mitochondrial performance so even today that was the workout i did before we did our little set from hell was and i do these i do three hours of this mitochondrial work a week where is that spread between is it done in

one session or no or three it's done usually in three or four so i'll either do 360 minute sessions at what we call zone two or four 45 minute sessions so this week i did four 45s i did like 45 minutes of zone two. And I don't know if you saw, but at the end, I'm actually checking my lactate levels throughout. I'll be checking my lactate. Is that something like a precision extra? It's a point of care device. It's a different device. So there's one called lactate plus, one called lactate pro, and I use them both just to always have two machines doing it. And in case there's a discord inside starts to make me question, does one of them need to be calibrated or something like that? both just to always have two machines doing it. And, you know, in case there's a discord inside

starts to make me question, it does one of them need to be calibrated or something like that. Um, but yeah, so I drive the training by the lactate level, which is overkill. Like if you're a person who wants to do this, but doesn't want to, you know, go and fork over for lactate blood poking things, the poor man's test for this is zone two is sort of the highest level of exertion where you can still carry out a conversation. Now, if we were doing this podcast while I was on my bike at zone two, I wouldn't be talking quite like this. I'd be a little bit more strained, but I could still have this discussion. And once you get past that, once I get to the point where I don't want to talk anymore, then I've gone into zone three.

I think a great place for people as well, something that really helps me have that built-in governor or limiter is to just do nasal breathing. So I'll jump on a Concept 2 rower and hit a 10K row, breathing through my nose the whole time, or a two to three mile jog, breathing through my nose the whole time. And I think that's a great cap. Yep yeah this might be a touch less than that although i'd have to calibrate it um going back to boxing for a moment that was sort of one of my training insights was as you know you know when you're in a fight if your opponent doesn't know you're tired it's a huge advantage and so I sort of figured that out early and realized, why is it I do so much of my training in a manner that doesn't mimic fighting? I should be doing everything with a mouth guard and I should always be breathing through

my nose. If I'm doing squats to failure, I should have a mouth guard and I should be breathing through my nose. When I run, I should have a mouth guard and I should be breathing through my nose. When I run, I should have a mouth guard and I should be breathing through my nose. So that basically changed my training when I was like 15. And I was in a mouth guard six hours a day, always nasal breathing, no matter how much it hurt. And then I started getting to the point where I'd plug one nostril. And it was just like- Alternate nostril breathing? Yeah. Just like stupid stuff. But yeah, no, it's sort of amazing

how you can have those little built-in governors that become great ways to help you understand the physiology. I love it. Well, let's shift gears into how diet affects that as well. One of the things that got me into you was first hearing you right after I retired. I think it was 2014. You were on the Tim Ferriss Show.

And within three months, I had heard you and Dr. Domi Tagostino. I didn't know who was first or second, but I was like, I'm going to give ketosis a shot. Do you know Dom? Yeah, he was actually on the show. Oh, was he? Yeah. Awesome. Great. Absolutely. Great guy. Yeah. Fantastic. Unbelievable dude. Yeah. He's a really great guy. One of the things I love about him and you is your ability to dumb it down a bit for the lay folks. And that's not always said. Obviously, there's some podcasts you have that I got to listen to twice and take notes. But I mean, both of you do a great job at that.

So you were three years deep in the ketosis. Yep. Three years. Yeah, sort of, middle of 11 to middle of 14 was with one night exception, no deviation. Damn. How did you pull off? Did you pull off four to one or were you relying upon the, the, the physical output? I ended up at four to one, but, um, I had a different problem to solve. So this was back when I was still training really hard. Um, and my caloric demand was unbearable. So, uh, part of that was actually during, so from 11 to 14 was a period of time when I went from sort of competitive swimming to competitive cycling, um, by competitive, I just mean like wanker competitive, like, you know, master's swimming, you know, master's

cycling, that kind of stuff. Not like I wasn't like a real dude or anything, but you know masters swimming you know masters cycling that kind of stuff not like i wasn't like a real dude or anything but you know i took my serious i took my training as seriously as any wanker can take their training and i had basically figured out that i outside of days when i was doing really long aerobic stuff so we can park that for a moment as one exception to this rule. But if you just took my standard training, which would have been probably 12 workouts ranging from 60 to 120 minutes per week. So you're doing a two a day, five days a week, I think. But it's generally at a pretty higher, you know, it's at a higher intensity with maybe the exception of a couple of them. So that would have been three lifts, five swims and the remainder on the bike. I still had to keep carbs below 50 grams a day. And that was total carb, not net carb. I just,

I didn't even, I realized it didn't make sense to try to figure, fiddle with net carbs because you couldn't trust nutrition labels anyway. So it was all carbs counted the same and i had to keep them below 50 i also had to keep my protein down below about a buck 10 to a buck 20 which higher than most people it is um and that turned out to be by far the hardest part for me of ketosis that was this constant struggle was protein not carbs and then the rest had to be fat. But I needed about 4,500 calories a day to sort of maintain my weight. And at the time, I was 178 this morning. Back then, I was sort of 164 to 170 was my sort of vacillating weight. So if you do the math on that, you got 50 there, 120 there, it ended up that eight, maybe eight to 10% of my total calories came from carbs and protein combined.

About 90% of my calories were fat. And so that just meant coming up with as many ways that were not miserable to just get pure sources of fat. So I had this whole spreadsheet where I worked everything out. Now, I also had the luxury at the time. I don't think I could do this today, but at the time I was just able to be very repetitive. You know, I could live my food life out of a spreadsheet and I just sort of knew like every food I had, I would put into this spreadsheet and I would, you know, little model would calculate how much of this you could eat. What element became rate limiting here?

Did the carb rate limit you? Did the protein rate limit you? The fat could never rate limit you. And I realized like cream cheese, I could eat as much as I wanted because it was never going to be rate limited by, I mean, you could at some point eat too much cream cheese due to those other things, but generally you weren't. So things like macadamia nuts, olive oils became the real staple of my diet because you're just getting pure fat essentially. Even almonds I had to have gated because at some point you're going to trigger your carb alarm.

Sounds so stupid, but you know what I mean? Yeah. Certainly most forms of protein had to be very gated. This idea of eating like a ribeye the size of your head every night was total bullshit, right? It was like a little piece of salmon or a little piece of this or a little piece of that. But this is why I just get so aggravated by sort of the whole diet world. People have this view that you're eating a ketogenic diet, you're drinking butter full coffee every day. I mean, the reality was I never had a

bulletproof coffee once in my life during that three year period. Um, and instead I probably ate more vegetables than most vegetarians because you just had to, like it became the tool to deliver oil. Yeah. You know, I, I had to have two, like that bowl of salad we had last night, that would have been mine. That would have been mine every single night. Enough salad to feed six adults was mine every night just because it was a vehicle to deliver olive oil. So, um, I'm having two salads a day like that. So, um, I, I know going back and looking at the math, I was at a four to one ratio, but again, I didn't come at it through that lens. I know going back and looking at the math, I was at a four to one ratio. But again, I didn't come at it through that lens. I came at it through, well, if you're going to hit 4,000

calories a day and 3,600 of those calories are going to come from fat or thereabouts, you're going to be eaten like a child with epilepsy. Yeah. That's not, that's no easy feat. And my, my morning ketones I tracked every day, I think my three year average mill, morning millimolar ketone for BHB was 1.73, which is higher than most people. I think as a morning get up out of bed, ketone level. And obviously I'd have days, you know, especially when I, like once a week I was doing a long bike ride, those days would generally be followed by, you know, really high ketone levels in the morning. I could wake up at six millimolar.

Oh, no shit. Yeah. Cause what happened is the body, especially if it's not at a super intense ride, if it's like kind of a modest intensity ride with, you know, maybe if, you know, obviously cycling is always going to have a burst here and there, but if it's a ride where, you know, you're averaging 175 Watts, your normalized power is 200 Watts. Um, your body just gets into a new mode of humming and it just starts generating that fuel, that ketone. And even after you stop, the body takes a while to bring down its production.

So yeah, those days would always be followed by very high levels. I think that max I was between 0.5, 0.7 first thing in the morning for the most part. I wanna dive in here to how that's shifted. Obviously it's, I know you've talked about this before, but it's not a fun diet to stay how if you've in large part eaten carbohydrates at every turn your entire life and you're 30 or 40 years old maybe it's good to create some space for that yeah quarterly now you do one week ketosis one week water fast and

another week of ketosis yep um let's dive into that because i i find this this fascinating it seems on paper to maybe be a bit easier than remaining in ketosis year round, but totally is by the way it is. Oh my God. Cause I've done, I've done two five day water fasts. And the thing I realized after the first one was I cannot be home. I cannot have work. I cannot be cooking food for my little man because when he doesn't finish it, then I'm like, Oh God, I want to eat it. It's too tempting. You are such a busy individual. How do you pull off, not just taking off to the Bahamas for that water fast? Well, I, I always do the water fast in New

York. So it's always a week that, that is definitely makes it easier. I mean, it would be hard to do a water fast for that long here. And sort of the routine there is pretty straightforward. Now that said, look, I'll go out and do dinners and meals and meet with people. And if it calls for us to be doing such a thing in a restaurant, I don't care. So it's not a problem for me to watch people eating.

So you have the discipline. Well, I don't know. I don't think it requires that much discipline to be binary. Discipline, which is something I don't have is, hey, there's a tub of animal crackers. I'll have two. Handfuls. You know what I mean? Like I don't have that discipline. Like I'm pretty good at saying I'm not going to have one, but I'm really bad at having some. And so in that sense, that's why I find fasting to be quite easy. Not always. I've had, I've had one fat, the, the, which fast that I do two fasts ago was one of the most difficult ones I ever did. And I don't know why to this day i've gone I mean, I have some hypotheses that i'll test i'm doing another one in four weeks

And I have some hypothesis that i'll test about what might have gone wrong on that fast, but and I talked about it a few times on instagram because I thought my whole thing on instagram is like Try to try to have an equal ratio of success to failure demonstrated on instagram and I remember posting a video of how much I was just like try to have an equal ratio of success to failure demonstrated on Instagram. And I remember posting a video of how much I was just sucking, like just dying on that fast. I mean, and it wasn't the usual stuff.

It wasn't just, oh, I'm lightheaded because I know how to sort of titrate my way out of those problems. But it was, I'm really dragging. I'm really hungry. My ketones weren't getting up to the levels I would have expected um i really wasn't enjoying it i was really miserable and i couldn't i was it's like you know there's

nothing worse than counting down the minutes until something's over that's it's okay to feel that way once in a while but to your point about flow for me generally a fast is a great experience and part of it's just a conditioning experience it's just to remind myself of how capable I can be when I'm not eating. And that, and you bring that back with you into the world outside of the fast, you know, um, last night or two nights ago when I flew back from New York, uh, you know, it's just every, it's like always those late flights suck because they're always late and you're, you know, so by the time you get home it's like midnight and i know i know that the worst thing i could do is eat even though i'm hungry because i also don't like to eat on the plane so i'm eating you know i have dinner in the airport at 7 p.m new york time so 4 p.m san diego time. And then I get here at midnight San Diego time.

And I'm hungry because I've been up on a computer. And that was a moment. And I remember I walked in the door and I opened the fridge. And it was just a ton of stuff I could have inhaled. Big bowl of rice, ton of berries. It's not like I wanted to go and eat potato chips and cookies. I just wanted to eat all the potato chips and cookies. I just wanted to eat all the stuff that was in the fridge. But I knew, I know what that's going to do to my sleep.

It's going to destroy my sleep. And I knew that like my sleep is just my baby. Like I want it. I want my heart rate variability. You know, I want my heart. I want all those metrics to be dialed in. So I said, dude, just close the fridge. You can do it. You've been here before. You've been hungry before. You've gone to bed hungry many a time. You can do it. So that was a great example of like a little victory that I think fasting can help you with outside of the fasted state. Being in the office when, you know, the cake is brought in and I'm like, all right, you can do this. You can walk away from the cake, even though you're hungry right now. And that cake looks damn good. And by the way, at least half the time I give in and I have that stupid cake, but, but you know, I'll take 50% victories over none. Yeah. And on top of that,

like at that point, you could, you could honestly say that you have earned that you do have some, some flexibility. You're probably going to utilize carbohydrates a lot better than if you hadn't spent time fasting in the past or in ketosis. Well, the CGM also really helps me. This has become a total game changer for the way I function. I don't have to guess anymore when I'm hitting my limits of carbohydrate intake. You had the guy on who created that. That's right. Well, he didn't create it, but Kevin Sayre is the CEO of Dexcom, which is one of three companies that make it. But they're also, they make like the other two companies don't make a very good one. So they make the best one by far.

They're the only company that's sort of dedicated exclusively to making this. They run about a thousand dollars. Is that right? Well, um. You need a prescription. Yes, you need a prescription. And I think for the, you typically buy a 90-day kit so the 90-day kit has the transmitter um and then you buy like the scent you have a sensor last 10 days so you'll buy nine sensors so the nine sensors plus the transmitter is a little under a grand um Um, so yeah, it's, it's, it's, it's crazy expensive, you know, call it $10 a day is basically what you're paying. It's a little less than, yeah, it's probably like 900 bucks and it might be less by the way. I think Costco gives a great deal on

the transmitters. Okay. Um, but anyway, so whatever, call it five to 10 bucks a day. Okay. That's a ton of money. I get that. But for me, that's just a totally worthwhile investment because of two things. One, you've got a whole set of insights that come from this. And, you know, I'm coming up to four years wearing CGM. I still learn little things. I am still blown away at the things that I eat that will impair my glucose metabolism. And at the other end of that spectrum, the times when I am metabolically in such a good place

that my tolerance for carbohydrates in general and even junky carbohydrates is much higher. So that's the kind of insight piece of it. The second piece of it is the behavioral piece. It's, you know, with our patients, we talk about, all right, you know, first thing we want to do is get a baseline on you. And we explain to them, look, by evaluating your baseline, we're changing your behavior. That's called the Hawthorne effect. And we try to get them to fight against the Hawthorne effect so we can truly see a baseline. But sometimes you can use the Hawthorne effect to your advantage, which is effectively what a CGM is.

CGM is a little plastic Hawthorne effect that comes everywhere with me. And I gamify it. It's how I decide sometimes I'm not going to eat that cookie. Because if I eat that cookie, I'm going to have to look at this number go higher than, and I have very dialed metrics on exactly what I want to see. And it's going to screw up my metrics. And it's sort of like what the ring has done for me. The aura ring has done on sleep. It's like, I've always appreciated the value of sleep. You know, not always, but you know, once I realized it, I dialed in, but the ring allows me to take it to another level. It's

gamified it a bit. So now every night I'm thinking, all right, is it cold enough? Is it dark enough? Have you dialed yourself back? Are you making sure you're taking blue light away? Are you not eating? You're not drinking? All of those things, because now I see how negatively they impact my sleep. So for me, the CGM and the ring just become a great tool to improve my behavior, even when i'm not learning something new just because of the game i play with myself yeah it's really important to have that i mean that really is the beauty behind the self-quantification movement right we have access i have a whoop watch on both of those are incredible tools that was something for me because i love dry farm wines i'm not a big drinker but if i you know if there's a fight on tv and i'm partying with friends and i have a bottle like that's gonna fuck up my sleep score yeah i might

have zero minutes of deep sleep yep uh if i'm able to scale that back and just have a glass or two with dinner totally different ball game and i'm even more sensitive i i mean like last night when you guys when when when the guys had the beer like i love that beer like that's like that's i don't like beer but i like that beer a lot but you know know, when I was pouring them, I was like, I'm not even gonna pour myself one. I'll, I'll pour my wife one and I'll have two sips and that's it because of that exact reason. If I had had a full, um, glass of that, that would have impacted my sleep. Well, let's talk about a bit about what disease states benefit most from ketosis fasting and obviously fasting covers a lot and i'll link to um the complete guide to fasting by dr jason

fung and jimmy moore which i think is a great place for people to start because it kind of gives a broad view of all the different forms of fasting so if you're not willing to pony up for a seven-day water fast you can get away with some intermittent fasting and i don't know if you know this but i'm working really closely with a company called Zero, which is an app for fasting. Oh, yeah. No, I did. I'll put in my shameless plug for Zero is just a great place for people to get started with fasting because you can start with the simplest thing imaginable, which is just time-restricted feeding. Just use a timer, figure out when you're eating and not eating. The way I always explain to people is the first

thing you want to do before you change your behavior is understand your current behavior. How often are you going without food? And I think most people are kind of amazed that we live in this world of an incessant IV drip of food. And it's like there's nothing evolutionary about that. So, I mean, it's very hard to make the case, despite the fact that the breakfast cereal companies will tell you that breakfast is the most important meal and you should be eating six meals a day or whatever other nonsense is spewed out there. But for most people just to observe what is the largest gap they take in not eating, which is almost without exception from when they eat their last thing

before bed till their first thing in the morning. But see, how much can you start to stretch that out? We could talk for hours about the actual data on time-restricted feeding. So what is the actual efficacy of this in, for example, treating type 2 diabetes? But I would argue that even if time-restricted feeding brings with it no medical benefit, and I think it does bring some, by the way, but if it didn't, I still think it's a valuable tool because it really is the thin end of the wedge to bring you over to intermittent fasting. Intermittent fasting being, I define it as a fast that's a couple days or longer, periodically done. I love the Xero app. I saw right when they put the content with you up on it and text. I was like, Oh shit, we're going to be making a ton

this summer. Actually. Um, we're going to do is basically take a lot of the content that, you know, I, I sort of provide my patients and sort of figure out a way to now kind of scale that to sort of get you basically allow everybody to sort of figure out like, how can you navigate this? Cause it's super intimidating. I think for people to hear even a discussion like ours and be like, what are those two idiots talking about? Like, what do you mean fast? What do you mean not eating for seven days? And of course, you would never, I mean, actually, I shouldn't say that. There are some physicians, Jason Fung, who's an amazing doctor. Jason actually does this sometimes. He'll just take a patient that shows up with raging diabetes and he'll be like, all right, dude, you're not eating for 10 days. See you in 10 days.

By his own admission, half the time that doesn't work. 80% of the time they just don't do it. And when they do it, the results are mind-boggling. They can be off insulin in 10 days. But I think for most people to start through this pathway of time-restricted feeding to hypocaloric intermittent fasting to water-only intermittent fasting, even if you took a year to do that, which is actually the timetable we would give most of our patients, one, you're blown away by how much you adapt to it. And two, you're just blown away by the benefits. Yeah, it's incredible. And the benefits range far more than what you see on blood work. Some of the first things that I started to notice were my brain worked better,

cognitive function, I was sharper. I had more energy throughout the day, like infinite energy. And I mean that cognitively, not just like physical energy where I could do better in my workouts, that came too. But just the ability to think, to not bonk, to not crash in the mid afternoon, like that's huge. Also, I think just some of the aches and pains that tend to go away yeah when that lowered systemic inflammation yeah yeah and without the need for non-steroidal anti-inflammatories like you and i think going back to mitochondria i mean i think there's a real mitophagy component here um i can't i talked about this on a podcast although so i apologize that i'm repeating it it might have even been my own podcast so i i can't for the life of me remember when or where, but I talked a

little bit about a paper that came out a year ago that was very interesting. One of the big differences we see between the muscles of someone who's 30 and someone who's 60, and let's assume that they're both doing all the right things. So we're not, we're trying to make it as apples to apples as we can with the exception being age is if you biopsy their muscles, you will see more inflammation in the muscles of the 60 year old than in the 30 year old. And we just know as we age inflammation increases and that's led, you know, some people to use sort of the cheeky phrase, inflamaging. So a paper did an interesting experiment with, I believe it was in mice, where they gave a molecule that blocks the ability to sense mitochondrial DNA. So this molecule is called sting.

And by doing that, they were able to reduce inflammation. So what does that tell us? If you unpack it, what it suggests is that mitochondrial damage is uniquely inflammatory. So why that is, one explanation would be that, as you know, the mitochondria have their own DNA. They come with their own genes and it's a sliver of our genome, right? We have in the neighborhood of, you know, 24,000 genes in our nucleus. So we would call nuclear DNA. And you've got, God, I'm blanking on it now. I want to say like maybe 20 genes in the mitochondria, that's it. But those come from bacteria. And when the mitochondria are damaged and when they're breaking down, that mitochondrial DNA is getting into the cytoplasm and it's eliciting an immune response because it looks foreign. So when your DNA, your nuclear DNA

breaks down, your body ignores it because it knows that it's you. But when the mitochondrial DNA break down, even though they're you, they don't look like you. They look like a foreign pathogen. They look like a bacteria. And therefore you get this enhanced immunity. And what this experiment did was it demonstrated that if you gave something that blocked the ability to sense that, even though you were breaking apart mitochondria, you stopped the inflammatory piece. And so just as we see autophagy where the body self-recycles whole cells,

you can self-recycle these mitochondria. And I think that fasting is, at least to my understanding and my knowledge, I don't think there's a better way to accelerate that process. So that's why I think these periodic periods of fasting can be quite powerful. No, yeah, absolutely. No doubt. Let's talk NAD. I forget the guy you had on.

I had a couple. I mean, well, I talked to David Sinclair about it in detail. And then again, Chris Masterjohn. Yes, that's what I'm thinking of. So you guys, you guys touched on quite a few things. I think the perils of the supplement game with, with products like Elysium and things like that and where they fall short. First, let's just get abroad. What is NAD? Why electron proton acceptor. So NAD exists sort of in a equilibrium with something called NADH. And they're useful for several things, but one of the things that they're very useful for

is helping us to transfer electrons. So the mitochondria, which we've been talking about, they have these different complexes or subunits that span their inner and outer membranes. And if you think about what metabolism is, metabolism is in part just an energy transfer problem. It's basically taking food, which is chemical energy, so the energy of chemical bonds, particularly the carbon-carbon and the carbon-hydrogen bond. And by breaking those bonds apart through this metabolic process, you liberate energy. And we use that to then create electrical energy, which is this electron transport chain that eventually we kick back into chemical energy to make ATP. So in a

nutshell, that's kind of what's going on. And there are these things that transfer it. So NAD and NADH exist to do that, among other reagents in that system. But there's this other thing, these other sort of class of molecules called sirtuins that also play a role in preventing aging. And David Sinclair, who I did interview, I think David and I talk about this. And David gave, I think, about as good a treatise as you could have on this topic, given his expertise in it and his sort of affinity for being able to talk about complicated things easily. Sirtuins play this amazing role in basically doing all the right stuff, right? So rather than go into

all of the molecular details of what they do, pause it for a moment that sirtuins are good. I don't think anybody will dispute that. Sirtuins require NAD to do their job. So think of NAD as the fuel that sirtuins need to reduce inflammation, enhance homeostasis, and all of these things. There is no denying that as we age, our NAD levels go down. Now, it begs a question. Do our NAD levels go down because of some reason we can't think of? Do they go down because we make less? Do they go down because we use more, because we need more? Because as we talked about a second ago, the older you get, the more you need the repair benefit of the sirtuins. I think a number of people believe that the latter is the primary

issue. It's not that we're making less NAD. And even if we are, that doesn't change the argument, by the way, but we're certainly using more NAD because we're relying on these sirtuins more. And so the, and again, I think up until what I just said now, I think there is broad consensus in the scientific community on what I just said. Where I think it gets a little complicated is what would you do about that? And so the first order answer to that question is, okay, you need more NAD. Okay. Makes sense. How do you do that? Because I can't just give you a pill of NAD. It turns out, despite the fact that this happens all over the place, I can't really give you intravenous NAD because that's not really getting into your cell. And why is that? That's where I was heading next.

Not to take you off topic, but obviously there's some, I think a big clinic in San Diego that does this for opiate addiction and they'll do day long NAD IV treatments. I've had them done before. That's actually how I met Tim Ferriss and Lance Armstrong, fucking name drop, name drop. But that's where I met those guys and we were doing that. And I can't speak upon their experience. Maybe it was placebo for me, but I worked out like an animal. I wasn't sleeping well and I never got run down. I mean, my intuition is it's probably a placebo effect because there's just no evidence that the nad in your bloodstream which is where they're delivering it is making it into your cell okay um now remember i could give you a mega dose of niacin and you will feel i could make you feel like an enormous flush and

in fact as you probably know they've even used niacin sometimes as placebos in psychedelic studies because it has such a profound impact that you feel, but no known sort of cognitive or neuropsychiatric or psychoactive properties. So my point of view on this is that intravenous niacin is, sorry, intravenous NAD is not actually getting into the cell and it's not at all addressing the problem we have but you absolutely feel it um it's funny i remember talking to lance after he did that because he called me and we were talking about it and he was like dude that was like the worst feeling in my life it sucks yeah yeah um so yeah and i haven't had it done but i've talked to and i've talked to tim i've talked to a bunch of people who have done it. And yeah, the general consensus is it doesn't feel good at all.

But of course, so in other words, and that's a real feeling that doesn't strike me as placebo. It's so uniform and so ubiquitous that people experience that. I think the benefits are probably placebo. And I think that, you know, you mentioned a company Elysium, there's another company called Chromadex, which are really the two big companies in this space. And, and also two companies that have really legitimate scientific people in them. I mean, I think the supplement space is highly unregulated and it's sort of buyer beware across the board, but these two companies are actually created by scientists. They have real scientists involved and they do real science. And even though I don't necessarily agree with their conclusions all the time, I would disagree with them in the way that I would disagree with a legitimate person doing science.

Their view is, yeah, you can't just give people NAD. So what you have to do is give the precursor to NAD. And that would be nicotinamide riboside, abbreviated NR. And again, here there's different ways to sort of do this. What Elysium is doing is taking NR and pairing it with something called terastilbene, which is abbreviated PT. So it's NR plus PT is this compound that they made called Basis. I think Chromadex, well, they have a product called TruNiagen, and I can't recall if they're using terastilbene or just NR. But notwithstanding the legal battles and hatred between these two companies,

in my mind, they're basically equivalent. People at both those companies might hear me right now and go, no, we're not. Oh my God, what is that idiot saying? I apologize if I'm out to lunch on that, and maybe things have changed a little bit, but they're effectively both putting out what I would consider a that are a pharmaceutical grade NR plus or minus this or two an activator. This is one where I am still trying to understand this space, but a medical school colleague of mine named Josh Rabinowitz at Princeton, his lab published a study, I believe last August, maybe it was in July, we're coming up to about a year ago, that at least in a mouse was able to use an NR tracer and an NAD tracer and basically suggested that that NR

that you were giving orally was all going via the liver. So we have something called the first pass effect, right? When you eat, like like, pharmacology is an interesting study, and that applies to supplements. I don't consider drugs or supplements different. It's just a regulatory distinction, but these are external molecules you put in your mouth. If you're designing a drug, you always have to ask yourself, what does the liver metabolism do to this? What is the first pass effect doing? So some drugs are actually designed where you eat a pro drug in anticipation of the liver turning it into the drug you want. Other drugs are designed such that there is no first pass effect, if you can make that happen. liver made a ton of NAD, which now puts us back in the same question of, well, is that beneficial

to the cells outside of the liver where presumably you want it, like your muscles? And again, I think the folks at Chromadex and Elysium will tell you, yes, it's getting in. And they'll probably also argue that the NR is directly getting in. I just haven't seen enough data. Some of them have said to me they've got unpublished data. I don't have a dog in this fight. I mean, I have absolutely nothing to gain or lose by this. I'm just purely interested. And frankly, if there is evidence that you can take oral NR or NMN, by the way, which is a, it's not even worth getting into the distinction. They're almost identical. One might be more stable than the other, but if you could take oral NR or NMN and have it get into cells that matter and become NAD, dude, I'm the first guy in line to be doing

it. You think that it would take something like Dr. Andy Galpin or anybody else that's doing muscle biopsies to study that with the idea? I don't know because it really, I mean, look, I don't think this is that hard to study. I mean, I shouldn't say that. What you really want to know is, is it not just getting in the muscle? Is it getting in the mitochondria? I mean, to me, that's sort of where I want to know it's happening. But it might not have to get into the mitochondria. Maybe it just has to get into the cytoplasm of any cell that matters, any myocyte. I'm going to be having David Sinclair back on my podcast actually at the end of the summer. And this is definitely going to be a topic we're going to get into because I just think David's one of the most knowledgeable people on it. You know, he trained with Lenny,

who's Lenny is the scientific founder of Elysium. So, you know, these guys are these guys are smart dudes and I'm all for it. You know, I did I took the Chromadex product, which is Trinigen for 90 days, like two or three years ago, just as an experiment to say, will I feel any different? I didn't feel worse? I didn't feel worse and I didn't feel better. And there's nothing you can really measure in my blood that's going to help me think about it. So I just, I'm somewhat of a minimalist when it comes to everything I take. That sounds odd for people who know me because they think I take a lot of stuff, but I can actually point to either a biomarker that's changing or something that's changing in my experience, although it could

be subjective and therefore placebo. But with that, I just couldn't make the case. Conversely, I've had patients who swear up and down that their sleep is infinitely better as a result of it and that they have more energy to which I say, great, keep taking it because one, I don't think it's harmful. I really think it's a safe product. And even if it's the placebo, I will take it all day long because if it's making you feel better and sleep better, then more power to you. Hell yeah. All right. Two more before we get into the topic of conversation I really want to chat about. I definitely want to chat about all this stuff because I'm learning so much. But you had ronda on and you were talking about igf1 and kind of this you know i remember uh in college taking igf1 and i remember people right when the deer and taking igf or taking oh you're taking a spray

okay not growth hormone no no i was taking igf1 lr3 yep and i had tried tried growth hormone in college playing football and both worked then they came out with the deer antler spray and a lot of people sat on both sides of the fence. I think you can still find that somewhere. That's the stuff Ray Lewis took when he tore his tricep. Yeah. I don't know that that shit works, but point is for a while that was like, hey, this is going to help you perform better. And then for a while, the longevity community said this will make you die quicker. And this is what accelerates cancer growth and all that. And then what I found curious on your podcast with her was that it is sort of, as with many

things, this bell curve. And you don't want to have the extreme low end and you don't want to have the extreme high end, but somewhere in between. So with that, if that's correct, with that said, what are the ways we can raise that naturally? So I think raising IGF is really easy. Um, IGF is highly responsive to protein. Uh, highly responsive to particularly methionine, um, which fortunately is pretty ubiquitous. So you don't, no one needs to go out of their way getting my methionine supplements, right? Just eat some meat, you'll get some methionine. Um, so I've actually only once

ever sort of quote unquote signed off on a patient taking growth hormone. And he was a patient who came to me having been on growth hormone for many years at a very low dose. I mean, he was taking two IUs, one IU. He was taking one actually. Okay. And he had, he had a very low IGF and he was, he, he argued that he'd, he'd never been clinically tested for growth hormone deficiency, but he was a pretty small stature. And, you know, he just said, look, I've always had a low IGF. And, and so I, you know, sort of take GH and we boost it. And we did an experiment. So that was all happening before, you know, he was under my care.

We did an experiment, took him off it. And sure enough, he never really bounced back. So either he had become sort of resistant to it or, you know, that was his baseline. So, you know, he's back on that dose now. But other than that, I've never looked at a patient and said, God, your IGF is too low. We can't raise it. That's an easy thing to do. If someone's at the 10th percentile and you want to get them up. The bigger issue clinically to me is what do you do for someone who's persistently elevated? What do you do for somebody who is persistently at the

90th percentile? They're persistently two standard deviations above their age appropriate level. Should we do anything about it? That's the first question. I mean, I really don't know the answer. I find these data to be far more complicated than they're made out to be. And I think that's sort of what Rhonda and I talked about. And I'm going to have Rhonda back on in the fall. And I think we just have to revisit this topic because I think IGF is very beneficial in the brain. I haven't seen any evidence to suggest that IGF is anything but positive in the brain.

It's very neurogenic. So if you could bathe your brain in IGF, I think your probability of getting Alzheimer's disease goes down. IGF also tends to have real benefit around the heart, but it seems to, at high enough levels, have a detriment with respect to cancer. So I don't think we like answers to questions in biology that are sort of contingent, gray, if this, then that, over here is fine. But I do think that's a little bit about what's happening with IGF. And by the way, I think that's why the story isn't so clear.

I think that's why we don't know the answer. The other thing is, you know, the dose probably makes the poison. You know, I think IGF is, at least my view is it's probably the single most used PED, uh, in all of sports because it's largely undetectable. Um, so, and, and talking to many athletes, like, I think there's a real benefit to it. I don't think it's as beneficial as testosterone, frankly, but I, I think if you're, you know, using testosterone as a PED is pretty hard. You have to really know what you're doing and how and when to take it, but you can sort of take growth hormone with impunity. And so I think you can, you'll definitely get a benefit from it. I think especially on the sort of regenerative side and just the healing side, but it's sort of, it's always been interesting to me that we don't see more cancer in people who are clearly using GH. And you could argue, well, maybe it's got a long tail to it.

But again, that's sort of counterintuitive with the principles of how a growth factor works. Growth factors work locally, right? So if you played in the NFL, if we just argue, which I think I could argue pretty convincingly that probably half the NFL is on growth hormone. So you take a bunch of people who are on, half of them who are on growth hormone, which is whatever, let's say that's 10x the general population, and they'll do it for 10 years. Well, we have enough longitudinal data on these people to say, why is it that 20 years post-NFL careers, the rates of cancer aren't alarmingly higher in

retired NFL guys than in the general population? And although I've never looked for that particular study, I have to think somebody has, and then we'd know that answer. And if it's not there, and the answer is, oh, but wait till they're 80, I'm like, well, wait, are they still taking GH when they're 80? Or are you assuming that something that happened in their 20s and 30s? So the whole story just doesn't sit well with me. I don't know what's going on. And therefore, I default back into less messing with the system, which is there's no easier way to reduce IGF than to fast.

I mean, every time I do those fasts that we talked about, the sort of keto, fasting keto thing, I'm always checking labs around them. And just seven days, well, keto usually drops your IGF alone just because you're protein restricted. But the seven-day fast will cut my IGF in half. So if I enter a fast with an IGF of 200, seven days later, it's 100. It's 90.

Do you see that bounce back pretty good after the refeeding? No, it's actually later, it's 100. It's 90. Do you see that bounce back pretty good after the refeeding? No. It's actually, and it's funny. If I could time course one blood test, actually, and I should do this, I should do, I don't know, every two weeks, just do an IGF level to follow that. Maybe even every one week if I really want to be rigorous. I'd love to have one year of IGF data as it pertains to when I fast. I should actually do this. That's a ridiculous pain in the ass to do, but I should probably do it because my intuition is it takes two thirds of the time to my next fast to bounce back. Does that make sense? Yeah. Okay. So let's say you start at 200, you end at a hundred. It takes two months to get back to 200 before you hit it again.

I think that's what's happening. So, so if I, if I'm, if I could discipline myself to do weekly IGF levels and pair it, you know, with my fast, that would actually be an awesome graph. And we could calculate the AUC area under the curve of that. And I think that to me is probably the metric that matters most. Hell yeah. I'd geek out on that. All right. What is rapamycin? It is just my favorite drug on the planet. Did we talk about Rapa in Hawaii? We did talk about it in Hawaii. Yeah. I remember listening. I forget where it was. It was before you guys went to Easter Island, but of course I listened to that with you and Tim and the other guy. So rapamycin is a drug that was discovered sort of by accident in the 1970s. So in the 1960s,

an expedition from Canada went to this really remote island called Easter Island, which is the actual most remote place in the world inhabited by humans, meaning there is no place in the world inhabited by humans that is further from other humans than Easter Island. And they went there to do lots of things, but among them, bioprospecting. It's always interesting to go to a place that is so isolated and ask the question, are there bits of biology that are unique to this place? And in one of the volcanoes there, where as legend had it, the inhabitants of this island who are known as the Rapa Nui would go when they were sick and a night of sleeping at the base of this volcano could heal all their

ales. That's the local myth that they told us. I have no idea if that's true. But they drug up a bunch of soil from there and they brought it back to Montreal. I think this expedition was out of McGill University. And it kind of sat there untouched until the early 1970s when this guy named Siren Segal, a really, really smart chemist, started putzing around and he isolated this thing. So there was a bacteria that they found inside that soil that also they'd never seen before. The bacteria was called Streptomyces hydroscopicus. And the Streptomyces family is a super common family. We're covered in it as we sit here, but this hydroscopicus variant of the family had never been seen before. And he noticed that this bacteria secreted something,

a discreet chemical that he was able to purify, and it had potent properties. The first thing he noticed is it was absolutely lethal to fungus, so much so that, according to his son, Ajay, he thought he'd found the cure for athlete's foot. This was going to change the nature of athlete's foot. And so you got to come up with a name for these things. So he called it rapamycin because the Rapa Nui, being the people of Easter Island, he wanted to sort of pay homage

to the people of this island. And there's a very interesting story about it, which I won't go into great detail on, although it is one of my favorite stories in biology and how close we came to never knowing about this drug. So it's sort of mid seventies. He's, he's tinkering this. I actually have all of his original papers, not the actual papers, but I've done, like I've gone back to archive libraries and I have the very, very first paper where he describes it. And, you know, these are just in boring, unsexy chemical engineering journal, you know, or chemistry journals where you sort of say, figure out a new molecule, right? And he's got like a stock of it. And he's even like giving it to one of his neighbors, apparently who had athlete's foot and it cures it miraculously.

And it's very anti-proliferative. So the pharma company that he was working for at the time basically goes through a round of downsizing and the Montreal branch of this gets shut down. His job is spared, but he has to move to New Jersey. So they order all non-viable compounds to be destroyed. And rapamycin at this time would be considered non-viable It wasn't they hadn't filed what's called an IND an investigational new drug They hadn't gone down a regulatory pathway with the FDA to do anything about it so this was something that he was supposed to dismantle and Again, I've become friends with his son and to hear it from his son. He was sort of like yeah

There's no way I'm getting rid of this. So he and his son brought a whole bunch of it in freezers and personally moved it to their new home in New Jersey. And it sat in their freezer for almost a decade. And then that company, that small company that he was at gets bought by a larger company called Wyeth in the mid 80s. And Wyeth says, okay, new sheriff's in town. And so Saren goes to his bosses and says, hey, tells them the story and says, do you mind if I get back to work on this? And they said, sure, knock yourself out. They're delighted, right? So sure enough, he gets back in the lab, starts working on this stuff and figures out that, yo, this stuff's got some magical properties. And in particular, it was highly destructive to a special type of immune cell called a T cell. And to make a very long story

short, by the late 90s, 99, this drug gets approval by the FDA as an immune suppressant because it impairs this particular type of immune cell that's so important in fighting off organs. So if you get a kidney from Ryan, your body's going to quickly figure out that that's not your kidney. The immune system is just awesome at recognizing non-self. That's what makes the immune system so beautiful. So it doesn't have to know that that's good or bad. It's just not you, and therefore I'm going to destroy it. And so drugs that can turn that down are imperative for people getting organ transplants. And so rapamycin is approved without much fanfare for that purpose. And it would stay in that largely niche role as an immune suppressant for transplant patients

for a decade until 2009. Although I will say this, I've gone back and seen other reports of people in the early 2000s, 2003, 2004, 2006, where people started speculating that rapamycin might have superpowers, that it might actually be much more important than an immune suppressant

but i would say this didn't make front page of science tough until 2009 when a study came out that gave rapamycin to a series of mice that were 600 days old both male and female 600 days for a mouse by the way is like 60 for a human So that would be considered like late middle age mice. And it should be worth noting that very few interventions tend to work when mice get that old. So we all know that, we all know, I say like, it is well known that calorically restricting mice at least under the right conditions can make them live longer. But it turns out that's not true if you wait until they're 600 days old. You can't fix the system once they're that far in. But rapamycin did a couple of things that blew everybody's mind. The first is, starting at this late in life, it extended life. The second thing is it did so both for male and female. That's a very big deal. This study was repeated several times, NIH funded, and it kept coming to the same conclusion. In fact, it has

since been demonstrated either directly or indirectly, meaning directly with rapamycin or indirectly where you do genetic manipulation to produce the same effect, that rapamycin extends the life across all lines of biology, basically spanning yeast to worms, flies, bacteria, mammals, et cetera. So that's kind of remarkable because again, to my knowledge, there's no compound that has ever demonstrated that. And they're working with like middle-aged dogs now, is that correct? Yeah. So a guy named Matt Caberlin, who I also had on my podcast last year is, and it's really funny just as a little footnote. Remember how I was talking about that guy, Lenny at MIT, that was the big Sirtuan guy, that's the scientific founder of Elysium. Well, Lenny, one of the, I guess, sort of impressive things that you always

want to consider in a scientist is what is their pedigree, but more importantly, what is their lineage? Who have they spawned from their labs? And when you look at the people that came out of Lenny's lab in the 80s and 90s, it's sort of remarkable. So Matt Caberlin being one, Brian Kennedy being one, David Sinclair being one. All of these people are absolute giants in the field of longevity. And to think they were all postdocs under this guy is pretty remarkable. So yeah, Matt is working on this with dogs and which is actually a brilliant model to do this in because companion dogs are not, they don't suffer the same limitations that sort of bred, you know, highly, highly, highly inbred mice are. Inbred, you know, laboratory mice can be

basically homozygous at every loci, meaning they are like, you'd have a hundred mice, they're all genetically identical, which is advantageous for some things, but it also speaks to just how genetically messed up they are, how pre-programmed they are to get cancer. With the companion dogs, they're in our environment and they're a pretty good model. And so Matt is seeing really amazing stuff, especially with respect to cardiomyopathy, which is basically when their heart muscles get really weak. This accounts for, this is one of the three leading causes of death for a dog, uh, cancer being another one, and then, um, accidents and euthanasia being the others. So, um, that, you know, and I don't remember the exact details we talk about on the podcast. I think within 12 weeks, they were

seeing an increase in ejection fraction in these dogs by 10%, not relative 10%, absolute 10%, which is, I mean, that's the difference between a dog that can barely do anything and a dog that can get up and walk around. So I think for this reason, a lot of people, myself included, believe rapamycin is probably the most interesting drug that we have today in our toolkit for longevity. And then of course it begs the question, well, how would you take it? Because we see the way patients take it who get transplants, because it's still used very widely in the field of transplant medicine. And I think we pretty much know that's not how you want to take it if you're trying to get a longevity phenotype. So there've been a number of studies

that have indirectly looked at other ways that you could take it, for example, taking it sporadically. And so the question with all drugs is what's the frequency, what's the dose? Those two variables will give an infinite number of combinations, but you know, I think we have a Loose sense of probably what's in the ballpark of how to take it in terms of how often you should take it and how much You should take when you take it and it's not without its side effects Is your audience squeamish? No, go for it 80% dudes look at that. Oh Yeah, yeah, those mouth sores are from rapamycin is that

because you do it bucally no it just it so i bit my lip the other day and normally if you bite your lip like you wouldn't feel anything like it heals in a day but because it's got some anti-proliferative properties it's just taking a long time for that to heal. So these apathos ulcers are one of the side effects of rapamycin. Now, the good news is you don't get them that often. You usually have to, for me at least, I have to traumatize the tissue and doing something as stupid as biting my lip was enough to do it. But this thing has taken like, I mean, it's five days. So if I cut my shin on something, would it take longer to heal? That's a good question.

I don't know. And I haven't appreciated that. But it wouldn't surprise me, actually, if that were the case. Because again, it is anti-proliferative. And that would, of course, explain why, at least in an adult, it could be a beneficial anti-aging platform. You don't have to question it. I mean, you know, I just, I'd have a very hard time making the case that a kid should be taking this for any reason, just as I have a very hard time making a case that kids should be fasting or something like that. Yeah. Yeah. That'd be very small percentage of people. Well, let's shift gears to something that I, that, I mean, it's, it's no secret. Anytime I have somebody on the show who has some experience in this genre of, uh, of life, I like to take a deeper dive here and feel free to go as, as deeper as shallow as you want with, but how,

how have psychedelics and MDMA impacted you personally? Um, I mean, I think profoundly I would place them in the category of things that, I don't know, it sounds a bit cliche, but I sort of feel like you, it's impossible to say I owe my life to X, except for extreme circumstances. You know, you were stuck on a railroad track and a train was coming and someone came and physically grabbed you and picked you up off the track and you're about to be run over. You owe your life to that. But, you know, if I were to sort of list out all of the things that have had an impact in my life from people to insights to this, the other thing, I mean, I just have to place these, these agents, especially MDMA, but also psilocybin, um, as, as, you know, just, I mean, it's hard to describe what these things can do,

especially when you're doing them in a way that I think you get the most out of them. I mean, I think many people listening to this will have taken MDMA in a sort of, what's the word, like a recreational way or at a party or something like that. And unlike psilocybin, it's always a pleasurable experience. I've never really heard of somebody take MDMA and have a negative experience from it. But I also don't think there's anything that's particularly lasting that comes from it if you're taking it at a concert or something like that. So what I'm talking about, and I know what you're talking about is, what are these clinical scenarios under which people take it with an intention and some form of guidance and therapy that basically allows you to be opened up

in a way that you can have sort of a therapeutic or healing relationship with either the person you're with or yourself. And in that sense, I think when I was talking to Rick Doblin about this, I said, you could make the case, this is the single most important synthetic creation of humans, MDMA in particular. Of course, psilocybin occurs in nature. And it also, although less predictable. I think it's, if done correctly, I mean, just, again, it comes back to sort of, that's why they get a special category in my, you know, we talked about how drugs and supplements and hormones, whether you're talking growth hormone,

testosterone, statins, rapamycin, they're all lumped into one sort of bucket of my tactics of how I think about it. But these molecules actually go in a different bucket. They go in this emotional health bucket because that's really how I think of them as tools to heal. For me, first and foremost, to heal because I think most of us sort of get here with a bunch of scars on our back. And most people are generally getting some benefit out of those scars. But what I'm interested in understanding is, can you preserve the benefits that those scars gave you, but actually minimize some of the negatives

that come along with it? Because very few lumps or scars are all upside and no downside. And I think there's, the pendulum tends to swing on this stuff a lot. And I think a lot of people today have this view that all adversity is good. And, you know, we've coddled kids too much. And I think there's absolutely truth to all of that, but that, that's also a very un-nuanced way to approach this. There is genuine trauma that occurs in people's lives. There are generally things that

occur in people's lives for which they begin to adapt. And those adaptations, which serve a protective role, become maladaptive as they get older. And so to me, these drugs become, and I don't even like to use the word drugs because it has such a negative connotation. These molecules, they just become a way to start to untangle that and say, look, a lot of good came from that experience, but I'm behaving in ways or experiencing things in ways that are not, they're not in my best interest and they're not in the best interest of the people I care about. So how can I sort of go after those things? And these things just allow a portal into that world.

Yeah, those protective mechanisms that we carry with us for so long, they serve us probably pretty well when it's early on in life and we don't have our feet underneath ourselves, you know, teenage years, 20s, those kinds of things. But at some point they stop being effective models for how to live. And it is, I mean, they are some of the best tools on the planet for that, when done properly. We spoke in Hawaii about

what's happening in the research right now. And I'd like you to talk a bit about where you'd like to see it go versus how it's going now for psychedelics yeah when it comes to studying this stuff well you know the the the organization that uh that rick doblan founded maps the multidisciplinary association for psychedelic studies they're just doing such amazing work you know rick actually spoke at ted this year that's a big deal i mean that's it's hard to overstate what a big deal that is. This is not like your local TEDx. This is the TED stage, which is the biggest stage. And TED was very reluctant to have somebody stand up there and do that. That's how uppity TED still

is. So it was a really big deal for Rick Doblin to be able to get up there and talk about psychedelics. And I think it's just a testament to who he is and to the sort of steadfast nature with which he and his supporters, his board have sort of methodically gone down this path of going right to the United States government to say, look, we don't want to do this behind closed doors. We don't want to have to send people to other places to do this. We believe we are dealing with a molecule here that can change the lives of anyone who's been traumatized. That's the indication they're going after is PTSD. And after spending a lot of time with Rick, I've come to realize just how sensible the

government is trying to be on this. I think there was a lot of really bad stuff that happened in the mid 80s. And I think there were a bunch of really bad actors that had a completely irrational, idiotic response to MDMA. And that's when it basically became scheduled as a schedule one agent in 85 or 86. But I think within five to 10 years of that, most people in the government realized that was a mistake. And now it's a question of how do we create a template that says, how do we walk back those mistakes? Similarly, let's look at what the definition of schedule one means. Schedule one implies some combination of the following. This has no medical benefit and this has a high potential for abuse.

Have you ever once finished taking psilocybin and thought to yourself, I can't wait to take that again? Never. And I've never taken it back to back days. not a single time in my life. I mean, it's the opposite of addictive. It is such a powerful experience that you need staggering amounts of distance between administrations of that, years in some cases. So there's nothing addictive about these things. And furthermore, to suggest that they don't have medical benefit, well, in as much as you consider prevention of suicide, depression, improvement of quality of life and relationships with others, if those aren't medical benefits, then I think we have to revisit the entire field of medicine.

So just on first principles, these things do not deserve to be in the Schedule I bucket. Even cocaine is not a Schedule one drug. Cocaine is a schedule two drug, which means we all acknowledge it's highly addictive, but we at least acknowledge there's one medical benefit to cocaine, which is in anesthesia, nasal anesthesia. So the only drawback of MAPS is it's a nonprofit and therefore it hasn't had the resources to pursue this the way you could pursue it if Pfizer wanted to throw its muscle at it. But that said, the phase three, so in pharma, you file what's called an IND and then you do phase one testing, which is to determine the safety. So that's been long done. So we now know MDMA is completely safe. And when I interviewed Rick for my podcast,

which isn't out yet, so I don't know when this will air, but that'll be out sometime this summer. I mean, he goes into great detail about the total chicanery and bullshit that went into all of the mythology around the toxicity of MDMA causing Parkinson's disease and all this stuff. I mean, those papers were actually retracted. It's not just that they were oh we think they're right but maybe more evidence is against it no no they were demonstrated to be patently false and forcibly retracted out of the medical literature that's how wrong they were so you know again the dose makes the poison i'm not suggesting that you could take all the mdma in the world and be fine just as i'm not suggesting you could take all the tylenol in the world or all the alcohol in the world or all of MDMA in the world and be fine, just as I'm not suggesting you could take all the Tylenol in the world or all the alcohol in the world or all of the everything in the world

and be fine, rapamycin included, right? But when this drug is taken in the way that it's being used in the therapeutic setting, I mean, it's profoundly safe. The phase two trials then demonstrated how efficacious it was, meaning how much benefit it provided and now the phase three trials are expanding that that's the way drugs have to be tested so phase three you test efficacy but in a more rigorous manner in a larger manner so if i could change one thing i would just make it faster but i believe that we're very close probably a year away from compassionate exemption use and probably, I don't want to misspeak, but maybe three years away from basically a descheduling of this. And psilocybin is sort of right on its heels. And again, the question with all these molecules is

what's the indication? I mean, the people who are supporting this research have to make complicated decisions, which is you want to pursue the right indication. That's the name of the game in the pharmaceutical FDA landscape. So if you pick the wrong indication, you're hosed. So if you decide psilocybin is a great drug for erectile function and it's not. Well, you just spent a ton of money and a ton of time to demonstrate something that's wrong and you're not going to get FDA approved and you're right back to the beginning of the line. I mean, that's not entirely true, but that's sort of directionally the case. So I think with MDMA, it's pretty clear that PTSD is the indication. And then of course, the question is, what's the best indication for psilocybin? Is it smoking cessation, alcohol cessation where it has profound efficacy? Is it recalcitrant

depression? So drug resistant depression. So people who have depression to many, many drugs. Is it end of life issues? I think they have decided it is not going to be the end of life indication though those data are, I mean, staggering. Yeah. They're it's, it's, it's, it's, it's hard to believe. So I think it's exciting. I mean, like I, I don't know. I mean, I think about this stuff through the lens of my own kids actually.

And I think like, I love the fact that by the time my kids are into their twenties, we'll have a totally different way that we interact with these molecules and they won't have to do things behind closed doors or something like that. There'll be a, there'll be a way to, you know, do this sort of white glove. Um, and that just means that at least for my hope is there'll be less suffering. Yeah. Yeah. That's, that's a beautiful hope to have. And we see a lot changing now.

And I think it's, you know, in comparison and contrast to the 60s which i wasn't around for it looks like we have a degree of care behind that so the same mistakes aren't made twice yeah um well i know you got to run but let's let's i want to leave the listeners with something that has had a huge impact on your life and something that's had a huge impact on my life but i want to talk a little bit about before when we'll leave. I'm going to play this for people at the end of this podcast. This is Water by David Foster Wallace. How has that resonated with you? What is listening to that? Why do you continue to listen to that? Yeah, I listen to it all the time and I love opportunities to share it with people, which is probably how it came up when we were in hawaii i think kyle hadn't heard it right turman yeah yeah i think something yeah and so i think it was like anytime i'm around someone and it comes up and they strike me as

someone who's thoughtful and introspective and receptive which of course anyone who knows kyle knows of course he is um it's like a perfect excuse to spend 24 minutes listening to what i consider one of the most important, well, what I would argue is the greatest commencement speech ever given, but arguably one of the most important speeches period ever given, which was an obscure little commencement speech given in 2005 at Kenyon College by the writer, David Foster Wallace. It's hard for me to talk about it only because I don't know what to say without the, it's hard to say much more than what he says, right? He just says it so well for me. It's, it's something where the first half dozen times I heard it because I was not in a mindful practice of meditation yet.

I understood what he said, but I wasn't equipped with a tool to practice it. And I think the difference is now I at least have a tool to practice what he's talking about. And so there's, you know, when I think about how emotional health matters and I think about all the different pieces of the puzzle, this is water is in and of itself kind of a piece of the puzzle. It's actually examining that talk over and over again, both for the claims that he makes about us as individuals, which I think it's very important to always remember. He talks about how none of us are atheists. We all have gods. And I think about that all the time, which is who are my gods? What are my gods? Because I don't go to a church to worship a god, but I do worship a lot of gods. I worship intellect. I worship my body. I worship

material things. And it would be wonderful to say that none of the above are true, but I'm not able to say that. So by knowing that I allow myself to keep those things in check. I mean, it's a silly thing, but it's like, I've really, I've almost embraced sort of the, the loss of part of my physique. You know, I don't train as hard as I used to, you know, I, like the, the, I work with, you know, the girls I work with, they all, they get a kick out of like how obsessed I used to be about always being able to see the veins on my abs, right? And it was like, it became like a running joke

at the office, right? It was like, dude, if you eat that, you're not gonna be able to see your ab veins tomorrow. And it's like, you know, I haven't seen the veins on my abs in years now. And not only does it not bug me, but I actually think it's a good thing. I think it's a good thing for me to stop being so attached to this image of myself,

which I know what it's about. I understand what demons are being fed, and I can trace them all the way back through my life. So that's one part of the talk that I find incredible. Also, I think just this idea that he is so powerful and makes such a great case for stating the obvious, which is every experience we have is living the world through our own eyes. Right now, I'm sitting in this room. Everything I've experienced in the last two hours is looking at you from where I am and seeing everything from my point of view, how I'm perceiving the temperature, how I'm perceiving, you know, what we're talking about, all of these other things. And when you extrapolate that to

just your interaction with the world and you stop and you remind yourself that no one else is experiencing this moment or any other moment the way you are because no one else is inside you. And that has to bring a little bit of humility. It's what allows me to at least 10% of the time pause when I'm being a dick and realize, oh, there might be another way to think about this. There might be another way to view this. That other person could have a totally different point of view that I'm not able to appreciate because I'm not in them. And that kind of humility, I think, is a big part of not being miserable, which I just think, for lack of a better word, or lack of a better term, it's a laudable goal,

is just to not be miserable. And so we suffered i mean he describes it he describes it effectively the same mantra as as what you know any any meditation student will will will talk about which is you know we just suffer so much more in our minds than in reality okay brother thank you so much i really appreciate you coming on yeah man and uh getting to come out here and hang with you and shoot shoot the bow and just everything that's going on uh you're somebody when i first got in a podcast i wanted you to have on it means a lot to me awesome man thank you so much we have to drive with peter attia that's your podcast obviously this show notes going to be littered with links to different episodes of that uh where can people

find you online um most of it is just through the through the with links to different episodes of that. Where can people find you online? Most of it is just through the website, peteratiamd.com. And that'll link to whatever social and podcast and all that stuff. Yeah. Awesome, brother. Thank you so much. Thanks, man. Thank you guys for listening to the show. Today was sick.

I've been waiting since the day I recorded this to release it. And that's one of the reasons I've gone to two episodes a week was simply because I did not want to be done at the end of this year, all the way through the first half of 2020. I don't want people to have to wait six months for their episode to air. Peter Attia is just a phenomenal,

phenomenal human being who is constantly learning. He is a teacher and truly still embodies a student's mind. And that's something that resonates with me very deeply. I hope you guys enjoyed the show as much as I did. Make sure you check out Peter Atiyah online. We've linked to his social media in the show notes. And if you haven't started listening to The Drive, please do so. It will change your fucking life. It is one of my favorite podcasts that I listen to personally, The Drive with Peter Atiyah. Thank you all for tuning in. And as always, 10% off all supplements and food products at onnit.com slash Kyle.