The Checkup with Doctor Mike - My Doubts About Bryan Johnson’s “Never Die” Protocol

Episode Date: April 3, 2024

Bryan Johnson began his life as an entrepreneur, buying, selling, and growing companies like Venmo to build a healthy living for himself. Several years ago, he became fascinated with the idea of maximizing human technology to extend the length and quality of one's life as far as possible. Today, he lives as the most tested man in the world at the center of "Project Blueprint", where drawing on his access to wealth and resources, he pushes the boundaries of human existence to see if he can become the oldest person of all time. As someone who has pushed back quite strongly against biohacking and "optimizing" one's health beyond homeostasis, I was fascinated to ask Bryan about his approach to life and fact-check him on a few of his theories. 00:00 Intro 01:42 Baby Steps From Superintelligence 14:33 Tracking Your Life 21:28 Overpopulation 24:55 Colonoscopy / Testing 30:08 Lessons For Normal People 36:32 Plasma Transfusions From His Son 42:11 HGH Harms 44:50 Sleep Tracking / Sleep Score 50:30 Harms Of "Don't Die" Executive Producer and Host: Doctor Mike Varsahvski Produced by Dan Owens and Sam Bowers Art by Caroline Weigum

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maximization. It's species maximization. It's trying to get life in this part of the galaxy to flourish. When you know something is going to be shorter versus longer, is it fair to say we more are likely to Are you essentially making your life less valuable by living longer years? Brian Johnson is the most heavily tested human in history. After flipping Venmo for a cool $800 million, Brian became obsessed with Project Blueprint, his self-funded scientific endeavor to, for lack of a better term, live forever. He has adopted an extreme lifestyle where he is aggressively exploring highly experimental treatments treatments and research, all aimed at extending his lifespan into infinity.

And while longevity is admirable, quality is just as important. So I invited Brian to New York City to not only learn the ins and outs of his extreme approach to life, but also break apart the philosophy of a man who's not only desperate to live to tomorrow, but to establish a legacy 500 years from now. Given the lack of quality of evidence behind most anti-aging therapies, I wanted to focus less on the individual protocols, but instead discuss this unique philosophy of exhibiting complete control in a field where perfect is often the enemy of good. This is an episode unlike any other that I've done. So please help me in welcoming Brian Johnson to the Checkup podcast. Where do you gain

your inspiration for going on this journey and how do you stay motivated? Because I know it's not easy to make sure that you're following all the rules to the T. Yeah, it's very hard to be human. Yes, understated. Yeah. I mean, really what I'm trying to do is to back up in a thought experiment. So imagine if we were speaking, if we could whisper in the ear of those that lived in 1870, we might say something like, hey, there are these new ideas about microscopic objects that cause infection. They're called germs.

Now, most people would hear that idea and say, that's crazy. You're telling me beyond the resolution of my eyes, and that's the thing that's doing this. death thing no but it's always the case that the future is always present it's here right now and the question is what is it and so if we imagine the same thought experiment from the year 2500 the 21st century and they whisper into our ear what do they say that's what i'm trying to do i'm suggesting that they say don't die is the only thing that we as a species figure out and that is because we're babysits away from superintelligence and when you're have intelligence that's a million times or a billion times smarter than you are, you have to

figure out what to do. And so people think that Blueprint is about health and wellness or about vegetables, and it's really not. It's what to do on the eve of superintelligence. And that task is to live the healthiest life possible? For what goal? it is an observation that our intelligence relative to an insect we're orders of magnitude more intelligent than insects

and we can do things that insects can't do AI is going to be orders of magnitude more intelligent than we are it will do things we can't do and one of those things could be solving aging we don't know but it's reasonable to contemplate that that could be a situation now if that's the case and we're this close to these tools being available, then we may shift as a species from carrying about wealth accumulation and status and power to simply don't die. And so the observation is that don't die is the most played game by everyone all over the world every day. You and I breathe

every few seconds. We look both ways before we cross the street. We all play don't die. So it's played more than capitalism. It's played more than any religion. It's the most played game in the world and if we take this thought experiment further once we get to the point of don't die and we've extended life so indefinitely that we're not dying is it then survive and push out the people who are coming on to the earth like what what changes then in this hypothetical or at least future thought-provoking experiment in doing that i try to put myself in the in the position of homo erectus a million years ago so imagine we travel back in time we're there they have the axe in hand and we pose a few questions.

We say, where's food, where's danger, where is shelter? We listen to those three answers. But then we say, what is the future of the species? We primarily listen for entertainment purposes. They're not going to be able to riff on quantum mechanics, right? Or string theory or computers or all the things we have today. We may be homorectus right now. So our ability to imagine what may exist and what problems may arise.

and so it's the first time in homo sapient history where we cannot predict even three months out we just no longer know and we're up against a wall of fog and so when we're in this situation I come back to the simple question is what is the one thing I do know is I don't want to die

and by doing that then I've taken a systematic approach to say okay if you're going to go about that process how would you do it you would go about measuring everything you could in the body trying to assess scientific literature measure again and just go through this process trying to figure your way out. What can we do today? Yeah, like the idea of surviving is innately

written in our code to some degree, right? That's why we have anxieties when, as a form of problem of progress. When things get safe, we become anxious for no reason at all because our brains were attuned to survive. And then at some point, we get to the age where we no longer can sustain life and life ends. And there's people who claim there's beauty in that, the fact that life ends. Do you disagree with that notion? Humans are very clever, and we create clever stories to justify anything

we feel uncomfortable with or anything we want to be excited about. And so if you look at the number of things humanity has done to try to reconcile with death, I mean, every religion is an attempt at reconciling with death. And we have cultural norms like live fast and die

young. And so we have all these all these tools for us to say that death is not only okay but it's desirable now you know would we have invented those stories if death never was you know or is it a reaction to this inevitability that everyone feels pained about and so in even if you said two two decades ago that death is a maybe or that don't die you would be ridiculous it's not it was never possible until right now to even pose the question that is that real or are you just like off in la la land. The notion of humans creating stories after the fact

and being like the Monday morning quarterback, if you will, is so commonplace and happens all the time in our logical reasoning as a form of fallacy. But isn't the thought of don't die just another version of that story from the other side of the perspective, also kind of without data knowing to whether or not this is just a story

we're telling ourselves? Certainly could be. Yeah, and that's why I try to go through the thought experiment of if I try to be as self-aware as possible and strip myself from all things, literally the only thing I can say about my existence is that I want to continue to exist in the next second and the next second. That's all I know. And so for me, that I'm trying to create clarity of thought. This is again, it's like, when we look back at previous centuries, the 15th century, we compress the entire century into 20 things that

were accomplished. Everything else is gone. You know, you may have an ancestor's biography, but that's your ancestor, but we as a species compress. That same thing is going to be true for the 21st century. They're going to look back at us, and so much of what we care about and we think is the end of the world of something doesn't happen is going to be lost to history. No one's going to care. And so I've tried to, in my own thought experiments, say, what is the 0.01% stuff that does survive in this time compression? And what is that in your mind? that the 25th century, if we could listen into that conversation, they would say, it's amazing that Homo sapiens with their primitive brains

and primitive tendencies were precocious enough to figure out the only priority they had was don't die. Now, don't die individually, don't kill each other, don't kill the planet, and align superintelligence with don't die. that it was a fabric of all intelligent beings on a single philosophical substrate of don't die. It's very Darwin in its perspective, right? Survival of the fittest, survival of the longest, right?

Yeah. Which is changing the adjective here, or the adverb. We talk about in medicine frequently measuring not just length of life, but quality of life. If we get too focused on the length of life, isn't it true that the quality of life can then suffer as well? well in your eyes or you disagree with that? I think it's possibly, that is a valid observation in the 20th century.

I think it's something that should be questioned in the early 24th century on the eve of super intelligence. And this is, I come back to this again and again, I don't think we can say anything about the future. It's like asking homo erectus, posing the same question and then saying, what do you think about blank, there's just no intelligence there to even comprehend the reality. And so when you're talking about the change of intelligence, as dramatic as we're contemplating, it's hard for me to imagine that our priors would map to that. Well, I'm sort of speaking more about the present in the situation

of, let's say we have a person who their quality of life is suffering because they're on a ventilator. They have no longer any brain activity, but their heart lungs are working because of the machine, this person is technically alive and we can get a lot of years of life out of them. Yeah. But is that without the quality that that person would have wanted for themselves? Where do you fall on the spectrum of that line of thought? Yeah. I mean, I actually went through this as well in signing my will documents.

I had to go through this thought experiment of how long would I stay on life support and under what conditions? I agree. It's nuanced and challenging. It's very hard. I think you probably aware of the literature where people who, people say who work for example, with ALS patients. They'll say, if I ever become an ALS patient,

and if I ever get to the stage of deterioration, please just pull the plug. And then they arrive at that state and they don't want someone to pull the plug. And so I've just seen again and again that a person's imagination what they may want is almost always wrong when they arrive at that place.

And so for me, I'm always very careful imagining what I think I want, when right now I could say, like, oh, of course, that's a valid point, that just pull the plug, we don't want that. But there's very few things as strong as wanting to continue to exist. Aren't you thinking about that future perspective that you say we're so inaccurately judging? Every time you make your daily decision to eat the exact number of calories, sleep the same

number of hours, do the protocols as you're doing them, because you're thinking you'd want to live as long as possible, is there a world where you do live much longer than you would have if you had not done those things and then wish you lived a shorter life? I think that's possible in a previous era. Now I don't think so. If you look at the differential between intelligence of what AI can do versus ourselves and the speed of which it's moving,

I'm open to this idea that everything I care about, everything I perceive to be valuable to me may be completely replaced with some other framework. That if you look throughout humanity, I mean, there's been thousands of human civilizations rise up. Each have their own cultural and social norms. No one's exactly alike. So we've seen that human intelligence can structure itself

in a very wide variety of ways. And you walk into now with that kind of new intelligence, and you look at how AI agents play in games and what they, it is so unintuitive to us what they do that this is why I'm open to this idea that it's a reality that may be incomprehensible to us. Yeah, I definitely think it's incomprehensible. And I think part of it is what, quote unquote, makes us human, for lack of a better term. And again, that could be something we say to pacify ourselves surrounding the unknown. When you know something is going to be shorter versus longer,

is it fair to say we more are likely to enjoy that? If I tell you that there's less of a certain baseball card, the rarity of it is higher, which is essentially a shorter life, rare years. Don't we put higher value on that? So are you essentially making your life less valuable by living longer years? During the Volvo Fall Experience event,

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and you look great for your age thank you yeah if i were to live to live to 50 you know that's a very it's a finite time frame that I have to live and let's say an alternate universe I live to be 90 you know I'm not sure how I would mentally reconcile with that and say like those those four years were the best years of my life because I was all in on living versus you know for the remaining 40 years I got to live I got to see the following things or do the following things I don't know it to me that seems like a very hard question to answer yeah That's a very reasonable answer. If, you know, you follow all these tools that give you ages of certain organs

or your performance on certain tasks. And I'm going to be very open about my bias and skepticism about those things because I've seen non-validated technologies come and go throughout my young career as a physician. And I've been hesitant to recommend them widely to people outside of maybe entertainment or gamifying certain things like exercise. And I've also seen it not be widely applicable to the general population. Like even something if we really simplify it to step counters.

Before we used to recommend in our family medicine clinic, everyone, give them a step counter, that will gamify, make them excited to walk, and it did. But once we tracked them for a longer period of time, we saw like everyone fell out of love with them. It was the novelty of the situation that caused them to use it and then they stopped. So when I hear things like there's the A,

that your body currently is, or the age you're gonna live until, like there's the 10x health that the insurance predictor would tell you how long you technically will live if you continue living your current lifestyle. I find those to be widely inaccurate because I don't find them very well validated.

But what is interesting to me is, if I could tell you with certainty that you're 46 now at 50, guaranteed death from my new technology, Would that make the next four years more or less enjoyable? Than if I lived past it? If you didn't know. Because you're seeking knowledge, right?

And I'm always like, okay, knowledge, but with knowledge that you can actually change something, right? Because otherwise, knowledge with more knowledge is somewhat scary in some scenario. So if you could know age 50 is the end. end or not know. Like, I have a helmet here that I could put on and give you exact estimate. Do you want to know? I would definitely want to know.

Yeah. My relationship towards data is I want to know all of it. I mean, I think that your thought experiment, yeah, if you put a clear line on death, then you definitely are self-generating a mental state that is an aroused state that probably isn't sustainable over some duration of time. You're going to live differently, yes. So I think it's a fair, that that definitely plays into human psychology, that I would live probably, well, I live pretty ferociously right now.

But like, yes, I would definitely have probably higher intensity of living, I would imagine. When you say higher intensity, does that mean you stop your protocol? I don't think so. So you get incredible enjoyment of doing and living this regiment their lifestyle yeah i mean my my meaning making game how i understand my value i want to be admired by the 25th century i want them to point and say in the early 24th century and now i built this model based upon my reading of a lot of biographies of previous centuries i admire them for having done seemingly impossible things so yes i would do it because my objective is to point the

species in a direction of don't die. I think we really are at this stage of potentially the most extraordinary existence in the galaxy. And that's what I want to be known for. That's what I want to try to accomplish. So my objective is not life maximization. It's species maximization. It's trying to get life in this part of the galaxy to flourish. So you're hoping with the results and knowledge and data that you gather about yourself, someone else could look at that and say, oh, I've learned from that and I too can help myself, my family, etc. I'm trying to turn the zeit. I mean, there's so many examples throughout history where individuals or small groups of individuals did something that changed the course of humanity, and that's the objective here.

When you make some of these things that could be tangible takeaways for others, isn't it somewhat problematic in that you're the most measured man in the world, right? Is that correct? I think it is. I think it is. Okay. But you're tailoring your approach very individually, right, based on data markers, things you're gathering about your hormonal profile, your growth, your physiologic state. Isn't it then difficult to generalize that for people of different genders, different activity levels, races, medical conditions, or do you feel like it's universally applicable? Yeah, I think it's more universally applicable than it is personalized.

If you look at the core tenets of blueprint of prioritizing sleep, getting exercise, eating well, and not doing bad things, most people, that's on point four. And there are nuanced things that are particular to me. I take rapamycin, I do metformin, I do a carbonyl. So those things are on the outlier blueprint, but the primary is really the basics we all learned our entire lives, which are just the hard things to do.

So do you think then that takes away from the revolutionary aspect of blueprint in that this is what's been said to us for, you know, 100 years? so it's not that the science is revolutionary it's that the philosophy behind it death has always been inevitable and if we contemplate that it may not be inevitable or that there's like even though maybe it changes everything so the don't die if we just pose if we try to isolate and say what things threaten the continued existence of the human race i would say there's three things one is human annihilation, either through weapons of mass destruction. Two, is the Earth becoming unsustainable, the biosphere. And three, is something with artificial intelligence, that we

don't build it correctly, and there's some undesirable outcome. I tried to become all, I could try to become each one of those problems. So what I'm trying to do, I'm trying to solve climate change through health and wellness, that we treat planet Earth the same way we treat our bodies. It's an identical relationship. Now, if you replace my body to planet Earth, you do the same protocol. You'd get a whole bunch of data, look at evidence, you'd create a protocol, you'd go through the process of doing it again and again, the scientific method. So what I'm trying to say as a species is it's the philosophy and the way we approach our existence, which is what's important. Not that going to bed on time is revolutionary. It's saying that we're in this

special moment in time, and the way we solve our existential threats, is through individual decision-making. It's not blaming someone, it's not pointing fingers, it's not asking someone else to come in and save us, is through individual powers. Does the fact that as we multiply, if we don't die,

the effect on the earth is disastrous? So is that a tenant that kind of doesn't vibe with the original mantra of don't die? Yeah, it certainly could be. It reminds me, however, of the problem in early 19th century, New York, where horses were the primary mode of transport, and there was so much manure all over New York, where it was disastrous. The Hudson had all this manure, people were getting sick,

the drinking water was polluted, and everyone thought the world's coming to an end. And then Henry Ford made the Model T, and that solved horse manure. Now, of course, the car caused all kinds of other problems, but still, the horse manure problem went away. And so I know overpopulation is the imagination, but there's also possibility that overpopulation is a horse manure problem that is not really a problem. There's something else the problem. Now, it could be, but I just call attention to this that a lot of people hear the argument and they jump to overpopulation and they foreclose this other thing so fast without giving the other side of the contemplation any air to breathe. And so what I'm saying is we, if we're cautious and wise, will realize that

no previous generation has correctly mapped the future as it's unfolded. Most of it has gotten wrong. So we're probably the same. The majority of our imaginations are likely wrong. Yeah, I mean, that's very fair. If you ask anyone in November 2019, what they envision the next few years would be like everyone's guess would be wrong. That's right.

So that's true. When you say people foreclose on the notion of, you know, overpopulation, maybe perhaps being a good thing, or living forever could be a good thing. who are those people that you're referencing oh so if you even say the idea living forever it breaks the human brain you can't say those words like no one can comprehend it so it just provokes this knee-jerk reaction which just squashes it squashes it so i like to talk about living tomorrow because living tomorrow and living forever they're identical you know i in my current state as a 46-year-old i in my mind assume i'm going to live forever like death does not seem real to me

because I'm not yet in that state. Now, when it does creep up, that's a different reality. But I don't live life with the expectation that's going to end anytime soon. I think I have all the time in the world. It's like this trick our minds play on us. And so I really focus on don't die and don't die for tomorrow because that's what we understand, it's what we care about, and that's how we build habits for this moment.

So you focus your mindfulness towards the don't die mentality. And you're saying that you can plan for it once you get to that state. But in reality, most people don't plan their deaths. I mean, they're obviously unique exceptions, but most people, something happens and they're no longer living. So how can we guarantee tomorrow? And that's why I feel like it's hard for folks to comprehend because it doesn't seem feasible right now,

the same way that the airplanes were not feasible back then. So the reason why it's puzzling to me as a physician is because I see how flawed science, currently, and how a lot of data confuses us at times. Like a prime example of false flags on tests that then require follow-up or interventions that are problematic. Like I've read about you receiving colonoscopies earlier than the traditional recommended screening period of age 45.

I didn't. Oh, you didn't? I didn't know. I did a pill cam. Oh, you did anidoscopy of colonoscopy. Yeah, okay. So you don't do colonoscopies? No.

And is there a reason why you chose the pill endoscopy versus a traditional colonoscopy? Yeah, because the polyp detection was high enough that we thought it was a decent coverage. And the risk of death, I think it was like 1 and 10,000 on the colonoscopy. So we felt like the risk tradeoff of the detection was better for the pill cam. And then you discount the part of potential intervention and prevention aspect of colonoscopy. Like if there is a polyp, you can remove it versus on the pilloscopy, you can't do that? Yeah, the pill was such a benign thing. I took, I fasted, I took some laxatives, I did the pill and then I drank laxatives for six hours

and then I got the 40 or 35,000 images or whatever it was just to get a baseline of what do we think we can find here. And it was a pretty good technology. Yeah. And was there anything interesting that you took away? Nothing. Perfect clean. Yeah, perfectly clean. Yeah. But an interesting video. But I mean, to your point, like I agree with you. For me, the science doesn't need to be, true eternally for this to make sense in my mind. Like we all know the science is going to move. Some things I do today are not going to be good ideas and it'll transform to something else. Totally agree with you.

Like that's what has always happened to be naive to think otherwise. What I'm really trying to say is it's that we're vigorously engaged in this process because we have this practical question. So as you can tell, I think a lot about AI. So we build these super intelligent tools. Then we have this question, what do we do with them? Do we use them for war? Do we use them to get more social media followers?

Do we use them to kill each other? What do we do? And so we're bringing AI into all the games we humans play. That's potentially the most dangerous thing we can do as a species. The new BMO, V.I. Porter, MasterCard, is your ticket to more. More perks. More points. More flights.

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Does it create videos better than any movie maker? It replaces us in many ways. Does it do government? Like, who are, do we elect leaders anymore? Like, we have to basically revisit every facet of society because this new thing is here. Now, that's pretty traumatic for us as a species. That's a lot of change. Like, we look at a little virus, like it shuts society down.

And now we have a new form of intelligence. coming on the scene that's going to shake every pillar of our existence. So what I'm trying to say is the process I'm going through is just simply a process of trying not to die. We're doing our very best with the science we have today. We're making mistakes. We're improving. We're open to all this stuff.

But it's just the process. And it really is meant to say, what do you do when you have really powerful technology? You apply it to improve the condition of all humans. Yeah, like the idea of the notion that you point out of folks, like, The things we do in science today will evolve and we'll look back 100 years from now and say, oh my God, I can't believe we used to do colonoscopies. We can just with this thing see internally without even going inside the body, right? There's going to be plenty of that.

Well, those things will come up and will be tested on a wide population. When you're using yourself as the benchmark for tests, especially when you're very excited about the technology and the testing, do you see how bias can impact the outcomes of those results? Sure. so how do you safeguard against that or you don't yeah so we do our best yeah but this is i think of myself more like magellan or ernest shackleton or lewis and clark or any other explorer before me i'm trying to demonstrate something that has never been done before which is a bravery to try to tackle death now this of course is a story as old as mankind for the first time i think this is this is the

first time in history it could be taken with a serious face and that's what i'm trying to to do. And so, yes, I'm going to make mistakes. Yes, you know, it's an end of one that has all these kind of limitations, totally aware of all this. And I'm not going to try to make the argument otherwise. What I'm trying to say is it's a worthwhile endeavor. Yeah, I could see pushing towards that endeavor to some degree brings tremendous value. The concern I have is there are people that look to you as a figure who's very influential, who is looking great for your age and even for younger than your age and say, I want to do that too.

And they don't have the means of doing certain things outside of the pillars that you mention of sleep and exercise. And they start spending their limited time, budgets, et cetera, to try and chase that dream. And my thought is, anytime you're prioritizing something, it's at what cost, right? So when someone asks me, like, is diet soda bad?

And it's like, for whom, for what condition? Is it replacing what? Like, all these questions pop into mind. So it's, is this a worthwhile endeavor for the general public? Because for you, who am I to say what's right for you? That's completely your world, right? You have bodily autonomy. But the question is, what should the general public be taking away from your journey?

Yeah. I mean, let's imagine we pose a question. Someone sees someone else get wealthy through this thing called capitalism. And they want to start doing it too. And they start doing it at the cost of all other things. Is capitalism a good thing? is capitalism a good thing for whom in what condition i mean like i would ask all those same scenarios yeah i mean it's like any pursuit for humans they lock in on a given game they want

to play whether it's their own wellness or whether it's trying to make money or whether it's trying to get social media followers i mean there are these pathways any human can take for any system they want in those pathways a lot of times what ends up entering into the space is survivorship bias of someone who has been lucky, taking the right path at the right time, et cetera, et cetera, and then people try and follow that route one to one, and oftentimes it doesn't happen because, you know,

and of one, as you precisely put it. So I'm just trying to find, what can I take away from your journey to bring to my viewers to my patients that's going to actually make an impact that is valuable to them in the long run besides the philosophical thought experiment of what,

if we don't die. Because I think that is a valuable thought experiment. I think there's so much value into thinking beyond death. And I think you said that a lot of the cultures in the past, they lived very differently and they evolved very differently. And that's true to some degree, but there's some unique through lines, like the thoughts, what happens after death,

the fact that almost every culture had some sort of substance that allowed them to escape reality, whether it was alcohol, opium. You know, there is these human flaws in us, And that's always been largely celebrated, but now we're taking the other approach and celebrating potentially getting rid of human flaws, right? Is that the correct way to think about it? Yeah.

I mean, what I suggest for your patients is that I'm making the observation that we humans have largely seen ourselves as martyrs for certain causes. So people take better care of their pets than they do themselves, better care of their kids than they do themselves. They take better care of their professional events, their wealth accumulation. So people prioritize a very long list of things higher than their personal wellness because they think they're achieving this immortality of legacy and contribution to these other vectors. And what I'm saying is the age of martyrdom may be coming to an end where it may make sense to put your mask on first. That means going to bed on time.

It means exercising. It means trying not to engage in bad vices. And so it's really a fundamental shift of how we understand ourselves. That's why I don't die. It is a philosophical argument, but it also informs what you eat for breakfast and what time you go to bed and whether or not you drink alcohol and whether or not you smoke the cigarette. So it's extremely practical on a day-to-day basis. Well, practical is tough because, you know, the human psyche takes so many different forms.

Like I've treated tens of thousands of patients and not all successfully, might I add. And some of it may be, you know, optimal treatment wasn't there. the presentation of the condition wasn't very clear, but also because patients don't oftentimes take care of themselves as well as they should, and the human psyche is so imperfect. So is it practical to say that, you know, like how long of your day of waking hours do you spend not dying? Yeah, a lot for me.

Like, is that practical? Well, so the people doing Blueprint are able to play the power laws. So what we did at Blueprint that was unique is we went through all the scientific literature, all health span, all lifespan studies, we graded the effect, we scored the effect size, and then we graded the evidence. And we said, can we define power laws in health span, lifespan, lifespan? And we put all those into me, and we measured everything, and we made it all public. So basically we're just trying to say, as a scientific project, where are we with the fountain of youth? Like, if you look at it from an organ by organ perspective and every measurement we have, whatever you think of those measurement

modalities, whether it's goal standard, silver standard, like whatever the case may be, here's a rough assessment on where things are at. And then we can distill it and say, all right, mom and dad, here are five things you want to do in life, and you can allocate, you know, 30 minutes a day to do these five things. So I've tried to make it very easy, approachable, low cost. It's why I've made the whole thing for free. It's like my parents, my father, 71, you know, like they're pushing the ages where they're really starting to deal with their averages of aging.

And they've been able to implement these power laws and dramatically change their health. What are the power laws? So the five big ones are not smoking. A exercise six hours a week, a blueprint or a meta-training-like diet, a BMI of 18.5, 22.5, and then moderate to no alcohol. And then sleep, you would add there as well as the... Sure. And that's the part that you get for free with the Blueprint Protocol? That's the influence.

So I mean, so I spend a lot of time doing all these measurements and testing all these therapies. but the takeaway for someone else is, you know, do those five things. And so if you don't smoke, not a big deal. If you don't drink, not a big deal. Here's the rough dietary protocol to follow. Maintain a proper weight, get some exercise, and like you're there for a power law. Now, that also means try to eliminate vices, you know, which is probably the hardest thing. Sure.

And so, yeah, but it's like these really basic things that most people know, but they're implementing. Now, if you want to go to a more gradual level, then I've got those things for you, too. But I've tried to just meet people where they're at and say, here's, some things you can do with baby steps to be in a better spot. If you went on social media and you talked about those pillars exclusively, or sorry, power loss? Yeah.

Power loss. You would probably not build much of an audience. Not because anything against you, but just because there has to be something sexy and fun and unique. And that's why folks are paying attention, right? So as much as you're saying, like, these are the five healthy habits that everyone should follow, they're more interested in what you're doing to the extremes. Am I right in thinking that, or you think I'm disconnected?

It's the entryway, yeah. But when they have to, they can observe it, but when they pull it back to their life and say, now what do I do, it comes back to those things. And those things that you do, like some of it, you know, seems really out there for me. At one point, were you doing plasma transfusions from one of your younger children? Yeah. Yeah, take me through, like, the logic of that and why you decided to do that. Yeah, so we were exploring various therapies we could do, and plasma came up as one.

The effects in animal studies are pretty convincing. and not convincing. The effect size is good. So he thought, we'll try it. So what happened I was talking to my father, he called me a day and he said, he's in the legal profession. He said, I just wrote a brief. I walked away, I came back, and it was a scrambled bunch of words. And it's like, I couldn't believe it because I didn't see it when I was riding it. So he realized that he was experiencing a lapse and he wasn't aware of it, which terrified him. And so he said, I will do anything from my cognition. And in our research in doing this, we had seen that a lot of trials were being done for Alzheimer's and Parkinson's.

As we said, interesting, I said, dad, I would be more than willing to give you a leader of my plasma as his experimental therapy. And he said, I would do anything to try to combat this. My son overheard the conversation. He's like, hey, I'm in too. So we're like, great, this is like a multi-generational plasma thing, how fun. Okay. Some people go to the beach, some people are plasma.

Okay, very interesting. So he went there. And it was actually really fun because my father was most, you know, missing from my childhood because he was engaged in hard drug use. And I always wanted him to be around and he never was. And it was very hard on me. We've always worked very hard at our relationship, but he just has had a lot of challenges. And then my son, I was married and I had three kids. I got a divorce and my three children were split between dad who had left their religion and mom who had been in the religion. And so for 10 years, I was the other. You know, I couldn't be trusted because

they were part of this religious group that said, this is how we understand reality. Dad is not part of that. Therefore, we can't trust him. And so weirdly, I was without father. And now I was this super engaged father trying to raise my children. And they were like, thanks, dad, but we got this. And it was this form of torture. And I had one of my three children come decided to live with me. and he and I have become best friends. And so it was this moment where, yes, it was about plasma because we thought it was safe, but it was also about my dad, myself, and my son, and the three of us getting together. And so I know from the outside looking in, it seems crazy, it's eccentric, it's everything that triggers people in so many ways.

It was also one of the most special moments in my entire life. Now, when I measured my biomarkers, there were no change in my biomarkers. We didn't see any effect. When we looked at my dad's biomarkers, we looked at his DNA methylation using the Danudin Pace algorithm. His speed of aging lowered by the equivalent of 25 years. Now, speed of aging, the DNA methylation is still a silver standard, right? It's not, it doesn't have all-cause mortality, so it's not gold standard.

We still don't know what it means and why. Still, it's a legitimate technology with a lot of scientific publication on it. and his speed of aging stayed down to 25 age equivalent for six months had a meaningful impact on his biology and he would say in his subjective experience as well so from my father's perspective it was one of the most substantial interventions he's had in his entire life and so I know that from the media's perspective looking in it's absurd from my personal experience is one of the best experience in my life and meaningfully impacted my father yeah that's awesome that it brought you guys closer together as a family and I think

the reality of all of these things is everyone has their own risk tolerance. And some people can look at a rock climber and say, you're ridiculous for risking your life, you're ridiculous for jumping out of a plane. I became a professional boxer and they're like, you're a doctor, are you getting head injuries? Yeah, and I agree that it's not healthy and I don't recommend it. The issue comes in when we say lines like, the test has a lot of scientific research behind it. That statement, to some years, well, sounds like it has validity to what we're doing. And we have to be really careful on how messages land to the general public, where the validity of the weight of evidence is unclear. Yeah. And I don't want folks thinking that that is the answer

to their longevity or that this is mandatory and they can skip out on certain health habits or they can't be healthy unless they have plasma of someone younger. So my goal of educating on science is really just getting people to think about the scientific process of what evidence means because you're a brilliant person in terms of your knowledge, right? You can think much deeper than the average person. You way smarter than I am in your knowledge of understanding evidence levels even. And I think about the general public not having the depth of understanding of

what a DNA methylation test is and hearing it and sounding like sci-fi and them craving it as if that's the answer. I'm like, man, I wish they would just listen to your five power laws because that's what I want them to listen to. And that's where probably the biggest criticism would occur from the medical community.

But the fact that you and your family bonded over this and someone finds it weird, humans do all sorts of weird stuff. I mean, like, that should be without judgment what you and your family do. so I don't think that's valuable. Is there anything that you've done in this journey that has ended up harming your health? Don't miss Swiped,

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For Esselor Stellis Lenses at your child's next visit. I'd say the worst outcome was using human growth hormone. We were repeating a study that was done for thymus rejuvenation, so the gland responsible for the immune system. So we did 100 days of human growth hormone, 0.6, 1.8 IU was the dose. And we successfully changed my thymus fat fraction by seven years equivalent. So I, according to three MRIs, we regenerated my thymus by seven years. That was positive.

But it came at a pretty extreme cost. I had intracranial pressure increase. I had my blood glucose were messed up. It was pretty disastrous for my body. And so I don't think we would do HGH again. I think we'd probably take a different approach, maybe look at some peptides or something. But we were trying to go after. No one had, not no one, only one group had tried to do thymus rejuvenation.

It's a really hard one to get at. And we wanted to take a stab at doing something hard. And why was the thymus the primary organ you were focusing on with human growth hormone? Because, well, I guess we've been trying to rejuvenate all my organs. So we take each one in the heart and liver lungs and then we say, how do we do that? And then what therapies are available? And the thymus just has such a huge yield because it's the immune system. You know, very few things have such a power law in the body.

So we wanted to put our targets on that. And we found there was a therapy that had been through a study. So we had some data on some number of participants. And when you undergo one of these trials, you take a lot of measurements in order to see how one therapy impacts the others. Because you're doing many therapies at once, is there ever a fear that they're clouding the judgment of what's actually happening when you're trying to perform a measurement? Yeah, we've borrowed from pharma. So pharma has the same problem when you introduce a drug into the body. They have a statistical process where you go through a questionnaire and you try to isolate and they use probabilities to determine whether given therapy.

therapy has a given effect. So we've tried to use stats too. But it doesn't, it doesn't create a crystal ball. You're still dealing with probabilities and you're still dealing with potential confounds. Yeah. And I mean, a lot of that statistical power comes from the number of people involved and the randomization of it. So that is also tricky. I'm just thinking of the, that's absolutely fair. The guidance that, again, we can issue from some of these things. Yeah. And I mean, knowing all these things, we do our best, knowing full well, We just, because it's end of one, we're limited, but we do genuinely try to be intellectually honest.

That's great. I, um, I have a theory about like fitness trackers and it's going to be widely different than your viewpoint. So I'd love for you to critique me on my viewpoint and what you think, but give me a genuine, like, reaction to what I'm saying. When folks come in and they say, should I monitor my sleep score? Should I monitor my fitness tracker? Should I do these things?

my usual answer is no. And I'll explain to you why and you tell me if you think you agree, disagree, and why. My thought is when you have a sleep tracker on, a fitness tracker on, it potentially makes it more difficult for you to understand and listen to your own body. And one of the most important things

when I see a patient, let's say they come in for the symptom of pain, knowing is that symptom of pain urgent? Is it scary? Is it an ache from a hard workout that they can push through? That sort of knowledge comes from trial and error without outside measurement.

It comes from intuition of your own body's functioning. So for example, when someone sleeps well, but then we tell them as scientists, hey, you actually got a bad night's sleep, we lie to them. They perform worse on tasks because we've led them to believe that off of their device, even though we were tricking. Yeah, yeah.

And then people will say, but Dr. Mike, when I have a drink of alcohol, my sleep score goes down, that incentivizes me to not, and I think that's wonderful. But the question I would ask them is if you had the glass of alcohol and you didn't sleep well and you wake up and you feel like shit,

did you need the watch to tell you that? So it's like I could see the instances where it helps, it would have helped anyway and you would have known. I could also see the instance where it tells you something that could potentially even be harmful because it leads you to believe

something negative about your body. And because there's so many confounding variables happening in life at the same time, it creates a notion of control that I believe we don't have and we don't have yet. What do you think about my stance? Yeah, I, this year, I achieved eight months of a perfect sleep score using my wearable. I don't think anyone in the world has ever done that before.

And it was my personal experiment to see, could I achieve high quality sleep every single night? And to do that, I needed to create quite a few intuitions. I needed to understand what happens when I eat pasta at 5 p.m. What happens when I watch a movie on a big screen an hour before? What happens in like hundreds of questions? I basically was trying to build intuitions, what happens when? And when I go to bed, can I deduce my heart rate?

And my resting heart rate is my biggest predictor of my night's sleep. And so I would say I would never have been successful at doing the eight months of perfect sleep, how to not have a wearable. I just would not have known how to connect these variables. And because I was doing this in a systematic way, I could isolate these effects more.

I could isolate a given day, a certain dietary thing or what do the case may be? And so, yeah, I think that for me, it was the only way for me to figure out sleep. Do you think eight months of perfect sleep is necessary for a healthy lifestyle?

Like if you had every seventh day, you had a shitty night's sleep, do you think that would derail your ability to live a healthy lifestyle i was so i don't know about that i was doing it because i i come from the entrepreneurial community and that culture is very much grind culture as you're a martyr i mean i'm sure as a doctor yeah they abuse them so all the time with our 24 36 hours shift exactly so it's you you come from a culture where people will tell stories about your bravery and courage if you stay up for multiple nights working on a project,

or if you're so tough, you don't need sleep, or you only need two hours to sleep. And so there's all this lore and mythology and status that comes along with not prioritizing sleep. And so I was trying to change that Zichyc has to say, I'm from this tribe, and I'm going to show you that I can be equally as productive in life and do so on high-quality sleep

and even improve my productivity. So I was trying to prove something to my community that it really is important to prioritize your sleep. If you think about it from, so you take a leader of a company, let's say it's 100 employees or 500 employees, when that person is self-deprived, they're inebriated.

It's as though they're actually drunk. So you have a drunk person leading the company you work for. I don't want that. I don't want to tell stories of how bold and courageous they are by missing sleep. It's really stupid. And so I was trying to make that point. Now, I was trying to say you too can do this and achieve the best performance of your life.

And so I had a number of objectives. Whether you can miss one night, that's kind of like a cheat day to me where that's one of the most common questions I get. I don't want a cheat day. I've now got to a point where I can imagine doing a given thing, eating a donut or ice cream or whatever or a pizza. It makes me sick because I know how I'm going to feel. I know it's going to ruin my sleep. I know I'm going to be groggy. I'm going to hate life the next day.

The pain is so intense and it's so long for that. that teeny moment of maybe pleasure, but no, I'm past it. And so the cheat day thing, I think, is a bad idea. It's a bad cultural moment, and I wouldn't want to, because then we're so, we're such an uncontrolled form of intelligence, right? Like, we're just totally out of control. And if you give anybody a vector to be like, and today, you get to do anything you want, it just becomes disastrous.

Because then, like, tomorrow's like, well, one more day, I'll spend next week's day tomorrow. Yeah. Runs away. I could see how, I mean, we're talking about extremes of situations. you know, giving someone unlimited runway or giving them extremely limited runway where they have none,

neither of those are going to be ideal just on the way that the human body works through homeostasis. It's trying to keep a balance. And there's frequently a statement in healthcare that I've referenced where the enemy of good in medicine is perfect. And I've seen that time and time again,

either from a procedural standpoint where we're suturing and we're trying to make something perfect and when we do and we try to make it perfect, it actually gets way worse. whereas we had it good, or we try and normalize someone's hormones, and when we try to make perfect or higher and achieve hyper optimal performance, it backfires and creates a negative effect.

So I worry that chasing to the extremes, chasing perfect, chasing don't die, can create negative impacts on people. Do you think there is potential negative impact from chasing don't die? Yeah, I think I could definitely respond to this comment and use words that would makes sense in the year 2024 of like, yes, like, I agree. And like, here's all. But I'm really going to comment on this from the 25th century perspective, because that's the one that I think that is not included in the conversation. And so I know when I built my software, my payments company, Braintree Venmo, we weren't like, if the transaction is $97 and $28, we're like,

it's okay if it's a penny off. Like, you need absolute precision for that transaction. And if the servers are down, you can't process a transaction. If it's down three hour, or three minutes a day, that's okay, like absolute precision. So we build technology with absolute precision because that's what we can do and it demands. We tolerate this idea in any part of our lives where we don't have control of the circumstances. We say, well, here's a way to think about it

and here are the pros and cons, like given thing. But I think that's the framework we have because that's the possibility of the technology. We humans are, we're not built to be perfect. We're kind of messy creatures. Now, that may not be true, for the future. We may be able to build ourselves

with precision that is unimaginable to us right now. So right now that I would say, yep, reasonable opinion, totally agree. Also, we're going into this new future. And so I'm building myself, I want to be the example

of what we can build. And so I go to these lengths to say, yes, you can achieve perfection, and it's great. And so we'll have all this help from all these tools of biological engineering, molecular engineering,

intelligence, like they're going to converge on us. So we're becoming a new species and new possibilities are there, and I'm trying to bridge to this new reality. So you're thinking about it from like a philosophical standpoint of the future. It's so interesting that this conversation, we're talking about, you know, answering questions from the future, right, of the 25th century. But at the same time, you're very wise in predicting that we don't have the power to predict. We suck at predicting. So how can we, how can you be answering me from the 25th century, if we're so bad at predicting. I look

at the systems that can be predicted. So if, for example, if you say intelligence is currently increasing, that is like, you say a general trend, like whether you know, whether you think it's an exponential increase or linear increase or

some other curve, it's generally increasing. So more intelligence to the world. We're getting better at harvesting. energy from the sun, from all sources. So that's improving. We're getting better at storing energy and batteries. We're getting, so you can take these macro trends and say what's happening at a civilization scale and then map towards humans. We're getting better at augmenting humans. So in my car, my car is going to drive itself or it's going to give me little vibrations

that I'm on the side of the lane. Or like all these things. So you look at the apparatus. Those are the things I model out with accuracy, and to say, if we're on this general trend line, I can follow those. But as to the specifics, you know, like, I don't know. So that's how I try to map my personal life is system, structures on the inevitabilities of what appears to be society absent some kind of catastrophic event. Yeah. I struggle around that concept of prediction with trends, because I just, the humans are so imperfect from just their ability to predict things that aren't available to us, like the idea of a virus coming in and destroying us. Because before that, our idea of a terrible virus was the original SARS virus, which was incredibly

lethal. So when SARS-Co2, the virus that causes COVID-19 came about, people said, oh, well, it's not as lethal. This is going to be great. And actually, because it was less lethal and more people walked around asymptomatically and spread it, it killed exponentially more people. So, like, the idea that something is even less worse could be worse. And that's where I feel like the human flaw and why when you say, like, you're trying to put your spreadsheet together without any inaccuracies is because that is a measurable thing. You can define it. You can count it.

It's there. And with humans, when I look at a blood test result, I have ranges. Sure. And those ranges suck. Yeah. Our temperature that we use to gauge non-fever versus fever. is horribly inaccurate. When I try and lower someone's blood pressure

to what we call the ideal standard to reduce rates of heart attack and stroke, the idea that it's going to work for the person sitting in front of me that I'm actually treating this with, even though I have good research to say that it is, it's not going to work 99% of people that I'm giving the medicine to,

and yet it's still valuable. And that's coming after trials that have failed 99.99% of the time with biomechanical mechanisms that rationally made sense or were proven right in animal models or petri dishes or lab models. And I'm like, oh man, there was so much failure

leading up to this point. And yet, I still have such a lack of control of my patient's well-being. I struggle to know how I can compare someone's health to their spreadsheet, which is counting digital dollars or physical dollars. That's what is hard for me to wrap my head around.

Yeah, I mean, I'm sympathetic to what you said. I mean, there are some things that on the power laws of evidence, like, you know, is smoking going to shorten lifespan and increase the probability of cancer? Pretty reasonable. You know, is exercise helpful to increase lifespan? Pretty reasonable based on the data. So I think if you score the data and you try to isolate those, you can step away from a total chaotic world into more predictability.

but the things I'm talking about for predictability is not whether a virus is going to show up, not the lethality of it. Those things are out of control. I'm trying to say, you know, what is the total compute power on planet Earth? What is our ability to engineer biology to perform the functions that we design it for?

I'm trying to say system laws as a species because within humans and human systems, we have the element of chaos that is just very hard. Yeah, there's a lot of chaos. And, you know, I think what your message, I hope, resonates with my audience is that you've spent a lot of time researching and measuring things and still the pillars and the power levels that you find most valuable are the things that are the most simple and available to everybody. And I hope that's what folks take away from this message of, you know, putting on sunblock and, you know, protecting themselves from excess sun exposure, UV exposure, not drinking, not having bad habits, or limiting those habits, making progress along the way. So I think that message is so invaluable. And the fact that you've developed a passion for it is truly admirable.

It's like really cool to see someone who's genuinely passionate about it. And it also recognizes the weaknesses of it. And at the same time, there's some critiques, you know, I have as a skeptic of looking at it, whole picture and saying, you know, I love that you're thinking about it from the 25th century, but are we going to get to the 25th century? What are humans a thing in the 25th century? is the way the exponential growth

can continue. I just, I'm such a strong proponent of saying I don't know that it's hard for me to be able to give definitive answers in such an uncertain place that the world is.

Yeah, my protocol does not need to be right for my message to be correct. That's powerful. Yeah. Because I think it's more of a philosophical message of, hey, don't let thought limitations. limit how you think about what potentially can happen.

We have built a society around die. If you look at the die economy, so fast food, junk food, cigarettes, environmental toxins, grind culture, your lack of sleep, there's a huge amount of money spent in die. If you look at the don't die economy, seatbelts, medical care, smoke alarms,

it's equally as big. And my prediction is the amount of money we're going to spend on dough die is an exponential, it's a right up to the right. And the amount that we spend on die is going to go down. The we as a species are going to mature past our primitive ways of the death culture we have right now and walk into a new era. And so it's the gist that matters. It's that I am going to take care of my, it's like the way you take care of a car. Like you want the car to last a long time. You're doing the same maintenance for yourself. Like you want your body and yourself to be able to go on this journey.

what I'm trying to do is I'm trying to say, get us in the right spot in this moment after 4.5 billion years, and we could have the most spectacular existence ever. Well, thank you so much. Thanks, friend. Awesome having you on the podcast. Thanks for having me.