Determined Society with Shawn French | Adversity & Mindset - Can Longevity Go Too Far? Regenerative Medicine, Testosterone & the Cost of Living Longer

Episode Date: December 26, 2025

In this episode of The Determined Society, host Shawn French sits down with Dr. David Karli, a renowned physician and entrepreneur in regenerative medicine, to explore the intersection of health, determination, longevity, and the future of medical technology.Dr. Karli opens up about his personal health crisis in his early 40s; including burnout, panic attacks, hormonal imbalance, and the wake-up call that forced him to rethink everything he believed about aging, performance, and medicine. What followed was a complete transformation that reshaped not only his body, but his mindset, career, and mission.Together, they dive into testosterone optimization, mental health in men, the psychology of discipline, and why process, suffering, and systems are unavoidable if you want real change. The conversation expands into cutting-edge regenerative medicine, AI-driven stem cell therapy, and the ethical questions surrounding longevity; including whether living longer actually means living better. Key Takeaways-Hormonal health is foundational to both physical and mental performance-Discipline is doing the work long after motivation fades-True transformation comes from systems, not shortcuts-Longevity without mobility and quality of life is a hollow win-Suffering is not the enemy, it’s part of growth-The future of medicine will be personalized, data-driven, and ethically complex Connect with me :https://link.me/theshawnfrench?fbclid=PAZXh0bgNhZW0CMTEAAaY2s9TipS1cPaEZZ9h692pnV-rlsO-lzvK6LSFGtkKZ53WvtCAYTKY7lmQ_aem_OY08g381oa759QqTr7iPGADavid Karlihttps://www.instagram.com/davidkarli/ Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

I had a panic attack. Ended up seeking out a functional medicine doctor. And she looks at me and says, Dave, you're fat. I'm only 40. Where does this go? That opens up kind of your world again. Those you listening on Apple and Spotify, the dude's absolutely freaking jacked out of his mind. He's fucking constructed, okay? You know, how much shit are you willing to eat to get what you want?

Come on, man. Right. Living the process made me much more effective in helping other people to do it. We have artificial intelligence models now that allow me to actually customize your own stem cells for your problem. It's pretty incredible what our team has done. Say that again for the

honest because that's baffling. We can get people to live to 120 or 150 that will allow people not only to live longer, but to live fuller. Well, we're entering a period of med tech, Sean, where we're about to fuck with nature a lot. If you remember Jurassic Park, you don't mess with nature.

I mean, there were dinosaurs eating people. That's a problem. Bitting the ass, right? What's up, everybody? I got my good friend, David Carly here with me today. He's a renowned physician, regenerative medicine, and just has an overall amazing personal story and entrepreneurial journey that I want to share with you guys today. So super jack to have you on, man.

Welcome to the show. Sean French Podcast Room. Hey, this is it, man. It's like New York. If you can make it here, is that the deal? I may be. I don't know. It's good to be here, man.

Hey, man. I'm blessed to have you. I would have win the right, but I probably would have knocked the mic over. But, dude, it's super, super awesome. to be sitting in front of you again. I was on your show a couple months ago where we got acquainted a little bit. And right off the bat,

we had an amazing conversation and truly enjoyed my conversation with you on your show. It was just very deep and challenging. And I enjoyed it. So I'm just, I'm grateful to have you here today. Well, I would expect a lot of challenge to come back from you today, Sean.

You know, I'm not, I'm not a spiteful little bitch. So I mean, you, get after a mental battle. No, no, no, no. Now, we'll do it a little differently here.

It's all good. It's an honor to be here. Honestly, it's an honor to be here. And appreciate the opportunity to have a chat today. Oh, yeah, man. I think the audience is going to learn a lot from what you have to say. Let's do it. You have a very powerful personal story about your health.

So I guess let's just get into that part first. Yeah. So, you know, I've become known in the regenerative medicine space. And I'll give you the story. But a quick segue, what's happening in the world? right now is this intersection of longevity medicine and personalized medicine and regenerative medicine. Those things are crashing into each other. We talked a little bit about it before we went on. And it's about kind of integrating all those tools together. And kind of my entry into that was a

personal story. So I'm in my early 40s, I think maybe 40, right around 40 actually. How old are you now? Sorry. I am 54, will be 55. Okay, so we're about 15 years ago. Yeah. Roughly. Yeah. Okay. Ways back.

And I'm full-time practice. I had just had a baby at the time running a biotech company, CEO of that. And I'm in business school. And the impetus for business school was I started a biotech company, didn't have any clue what I was doing. So I figured I might as well go learn some business. Anyway, so I just burned out. I fried. And I was functional.

I was keeping up. with life, but man, inside I was just dying. I had no energy. It was hard to focus. It was hard to maintain that arduous, brutal schedule. And I didn't know what's wrong with me. I'm a doctor, right? I'm supposed to know what's wrong with everybody, but self-diagnosing at that point, I think if you looked at me, I looked normal, but I was feeling horrible. And ended up seeking out a friend of mine, a colleague who was a functional medicine doctor. Functional medicine is is what we now know as commonplace, biomarkers, and looking at all your labs and trying to figure out what's wrong,

a little bit more, excuse me, holistically. And I went to her and we did a very comprehensive workup and evaluation. And it was a funny story. So she walks into the room and we had done all this work for several hours leading up to it. And finally, we're about to review everything. And she looks at me, sits down, looks at me very seriously and says, Dave, you're fat. And I wasn't

OPEOB. You're just, you're fat. But I was metabolically unhealthy. And, you know, I was putting on belly and, you know, things that happen to most men as the age.

And we now know back then it wasn't quite as commonplace, but we now know that's often a hormonal issue. Women go through menopause, and we've been correcting that for 50 years. But men have only been, andropause, the equivalent of menopause in men versus women. We've only been addressing,

that in maybe 10, 15 years. Yeah. So we identified, I had low tea. You know, I had all the symptoms and it's amazingly hard to self-diagnose sometimes as a doctor. You're so focused on trying to help everybody else. Sometimes the self-help element of it can fall to the wayside and we can become unhealthy as a result. I want to dive into something really quick. And you're right, but you know, the low tea for the audience, low testosterone.

Yeah. As you guys know, men get older and they lose the production of that hormone. It is very essential in not just maintaining lean muscle mass, but also gaining some more muscle mass. As far as, you know, sleep, right? It affects our sleep. It impacts fat burn. It has such a profound effect on everything we need to be in order to be physically healthy and mentally healthy.

Yeah. And so I had that story too. And to your point, it's like my buddy Jeff Delaney always says, it's like you're running a race with a flat tire. Right. Because you're doing the weightlifting. You're trying to eat pretty decently.

The problem is there's a disconnect in that chain. Yeah. Because until you have the hormone level support, you honestly, like mentally, if I have low tea, I can't distinguish on how to, okay, that's going to be the best thing for me to eat, but leave that alone because of X, Y, Z.

but when I'm optimized hormonally, I now have that intuition and that know-how, but like, okay, I need to double up on this here, and today's an off day, so I don't need this. Like, I don't need all these carbs today because I'm not lifting. You know, and there's a lot of, I'm going off on the tangent,

but I love talking about this shit, man, because everybody's different. Everybody reacts a different way. If you put me on a bunch of rice, and a bunch of even sweet potatoes, I'm not going to look as good as I would, and I'm not going to operate physically and mentally as good as if I kept a really strong protein-rich diet

with fruit as my carbs and a little carblin, you know, for my intra-carb, right? But to your point, man, like all these things kind of work together. Sure. It's all integrated. We've called it integrative medicine for years, but we didn't always have the tools to fully integrate. And now we do.

And it's now accelerating and progressing. But I mean, that's a podcast in and of itself. You know, dietary, you know, recommendations and then personalized medicine and genetically driven nutrigenomics, all kinds of things. But the point is that's a big word. Yeah. The fuck was it? Nutrigenomics.

So that's using your DNA, right? Your personalized genetic footprint to influence what we recommend you eat. Oh, wow. It's something called nutrigenomics. So like, like food intolerances and things like that. Sure. Exactly. So you may respond better to this versus that.

So that's an emerging field that is making progress. AI is driving everything faster now. It's been really, really helpful in that regard. But to get back to the testosterone issue, one of my colleagues, and it is a fascinating topic, I agree, one of my colleagues coined something I always, like one of my mentors, he said, testosterone's the match that lights the fire. Right. So you have a guy who's functional. on the outside looks perfectly fine, functioning, dad, business, you know, life, etc. The problem with that guy is he's feeling lousy and he becomes more and more ineffective with

workouts and training and so forth. And they lose interest because they're not producing a result and it's psychologically discouraging. So if you, if your testosterone's in the toilet and you go to the gym and eat good and train really hard, number one, you're exhausted, it's hard to do. but your body doesn't respond to it. Okay? And eventually that lack of positive reinforcement, you lose interest and you lose health as a result, right? And then you slip and you slip and you slip and you slip before you know it.

You're 40 pounds overweight, unfit, unhealthy, you know, metabolic syndrome, all of the secondary problems that are associated with that. And now we got to play catch up. So one of the interesting things in hormone optimization, and it's astounding to me that this is still a controversial. topic at this point in time. Because the data is clearly, clearly shows that

the upside clearly outweighs the down, unquestionably. Nuances aside. But if you fix that guy, a lot of times what happens is they didn't realize how bad they were feeling until you fix it. They became their new norm because it's not something

that happens overnight. You wake up one day with low T. It just erodes little by little by little. And you adjust and adapt to a new normal, which is I feel like crap. Your baseline is so... That's your baseline. And you settle in and, you know, that's the deal. But it's fixable and correctable.

And in a healthy way that can promote health, not just give you symptom control or fix a symptom problem, but actually promote health. Who doesn't get health problems? Young men with normal testosterone levels. Interesting. Right? They don't get cancers and they don't get heart disease and they don't get all these things. But one of the fascinating things you touched on that I want to hit is we think of testosterone

as, you know, the physical part, which is an important part of it. But there's so much psychological and mental to the testosterone optimization, sleep being the one people often say was unexpected. When I started testosterone, I slept so much better because we think of testosterone as this activating agent. In fact, it can calm you, which is this paradox, right? It doesn't make sense. But we hear that over and over and over again.

And, you know, I'm known for regenerative medicine, but a lot of men ask me to manage their hormones and stuff. And I, you know, I have certifications and training in that. But it's amazing to me that if you don't address that critical piece, everything else doesn't do as well. You know, it's interesting. And you're right, because you're talking about the mental aspect of it, right? And going back to you, you know, when you were 40, you know, 14, 15 years ago where this story began,

you were in there with your doctor. And she's like, hey, here's your issue. You're fat. But that is easy to fix. I mean, as long as you stay on track and you stack habits and you do all that. But the biggest part of it is when you're going through all that, how is your mental state? Because that to me is typically where men really, really struggle when we're in our 40s and overweight, we get really depressed. And we don't know how to fix it.

So talk the audience through your journey from that point on, you know, fixing it. if there was any mental, you know, I don't want to say issues, but any, you know, any lack of confidence, things going on and how you overcame all that. Well, I think there's, there's several, you know, levels that you're managing psychologically.

And one is, I'm only 40. Where does this go? I'm feeling terrible now. What if I'm 60 or 70? Am I gonna be worse? Where's the light at the end of this freaking tunnel? So there's a fear. There's a fear element to it.

I think that was one. But I had another episode that really, it was what prompted me to go to the doctor. I was giving a presentation to peers. an academic presentation. I was on the podium. Excuse me. And I had,

I had a panic attack. Oh shit. I'd never had a panic attack in my life. And I'd done a million presentations. And there was no reason to be nervous or, but I literally, I had like a panic attack. And I had to fight hard to get through that presentation.

And I did. But it was that. And then I had a second episode, actually, I went home for the holidays around the same time. And I remember, you know, you decompressed. You were a family in the holidays, and I went for a run.

And I came back, and I wasn't feeling so good. I thought, man, maybe I'm getting a bug. We went to a Christmas show with my family that night, and we go to dinner. And I had a second episode, two panic attacks over the – I don't know. This was over the course of probably a couple of months. And if you've ever had a panic attack before, you feel like you're dying. You feel like you're having a heart attack. You can't breathe.

You're shaky. And I didn't know what was wrong with me. My family didn't know what was wrong. I ended up in an ER. I ended up in an emergency room. And I had a chest x-ray and EKG and all of the other. And the doctor, everything came in normal. They didn't check blood work at that time.

That's what prompted me to go to the doctor. And I think the whole your fat thing, some people might say, oh, that's insensitive. But no, that doctor, for the reasons you just mentioned, she had to reel me in. My mind is swimming in a million different directions. I don't know what's going on. She needed to capture me. The, hey, your fat, had a little bit of shock value. But then it was followed up with, but we're going to fix you.

right, you're going to feel better. You're going to do better. And it was really effective, albeit somewhat blunt, but it's what I needed. And it was, she was a fantastic, fantastic doctor.

She has since retired. But I credit her for really kind of getting me back on track. And then, you know, I ran with it and did all kinds of fun, you know, body goal things. And we can talk about those if you want to.

But it allowed me to, it allows me to look like this at age 54. Without it, I could not. I don't think so. I mean, if the only people that can see what you look like are the individuals watching on YouTube. So for those you listening on Apple and Spotify, the dude's absolutely freaking jacked out of his mind,

he's fucking constructed, okay? He's constructed. And I push it a little bit. I'm thinking like if I need a bodyguard, I got my boy here and I got my boy Dan behind the camera. I got two big sons bitches protecting me, right? But what I'm really interested in you sharing with the audience is that progression, though, right? Like, so from that day that she reels you in, what did you start doing in small increments that the audience can take home?

If they're struggling with a little bit of a, you know, health journey, first and foremost, go get your blood work done, right? See where you're at? But from that point, where'd you take it? Yeah, you don't fix it if it doesn't need to fix it. You got to name it, man. It needs to be a medical reason, not just for vanity, say. No. But vanity, by the way, can be a very powerful motivator.

And it sure can. And we can use it. But no, so I think it was first psychological. It's a new lease on life, really. And testosterone works pretty quickly. You feel better soon, you know, a couple doses and you're feeling a lot better. That opens up kind of your world again. It allows you to focus is another big one with testosterone.

You're able to focus and stay honed in. And, you know, that drive that you'd had that was getting harder and harder and harder to maintain, and we're driven people. We need that. That's our juice. And it gives you that back. And now you can start to kind of think about what it is you want, what it is you want with business, what it is you want with family and relationships, what it is you want with your body

and your health. it puts you back in the game, takes you out of the stands and puts you back in the game. It's the fire. You have the vote now. You finally have a vote again. Yeah.

So now it's like, oh, man, let's get this. And I'd always been, and I was a college athlete and I'd always been very athletic all my life. And I was the kid who read the bodybuilding magazines back in the 80s and 90s. I always thought that was cool. I was never a professional bodybuilder,

but I always thought it was cool. So I started training and my body responded to the training. And then I got interested in nutrition. Like a lot of doctors were criticized for this, in fact. I wasn't trained in nutrition in medical school. We're taught how to take care of the sick, not the well. Yeah. So that kind of pivoted my journey from sick care into well care.

And I've been involved in researching and developing that ever since. But I use myself as an example. I'm preparing a book manuscript. And we talk a lot about this journey. But living the process made me much. more effective in helping other people to do it. That right there though, right? And I think the audience is probably like, oh, here they go again.

Here Sean goes again on the word process. Yeah. That is everything. The process is everything. You can set a goal. You can set these big mountain of achievements. But if you're staring at those goals and you're really focused every day on getting closer that you're going to feel so overwhelmed, you know, your mental health is going

to struggle. but if you dial in on the process that you set, and you take action on that process, but going deeper, creating standards. Sure. I mean, a standard is so deep rooted in you.

It is who you are is what you do. As long as you hit those standards daily within your process, this, up here, those goals, they start to get closer and closer, but too many people

aren't focused on the process and the standards. They want to fast forward, skip line, ended up on the top of the mouth. It's not the way shit works. So that word process to me means something massive, especially as it pertains to this show. Right.

And by the way, you know, we talk about building bodies, even with testosterone and optimization, that takes a long time. I've been training for years. You don't do this in six months. So if someone comes in and wants me to work with them

to try to, you know, get fit, get more muscular, get lean, et cetera, get healthier. I say, you know, two years minimum. Oh, yeah. Right? Yeah. anything less and you're going to either going to over train and burn yourself out or or you're

not going to hit your goal and you're going to want to quit. I mean, I'm a year in. Yeah. And I'm night and day from where I was last year at this time. Yeah. Well, I know a lot of bodybuilders just because I'm, I'm interested in the field. And what people don't recognize is those guys peak often in their 30s. And they've been training for 10, 12, 15 years.

It takes a long time to build a body you want. But what optimization, whether it's hormone or otherwise, and there are things, nutritional optimization, sleep optimization, all the biohacking stuff that we're seeing and hearing every day, you still have to commit to that process that you're talking about, but stay with it for a very, very long time.

It's not a quick fix, nothing is. But that's the lesson for everything, isn't it? Like, a lot of people start something and they get excited about it. They're super motivated, but then they fall off because they're unwilling to do it. You know, so funny, I always quote,

my boy Dan on this, you know, I used to work for him at paychecks. That's where I started my sales career. And he used to sit people in the room and say, what's the true definition of commitment? And he always said, is doing what you said you were going to do long after the emotion wears off. That's where people stop. But that's where you're built, right? I think that definition is the same thing for determination, discipline. It's like doing those things long after the emotion, wears off. Well, I thought about our previous conversation when you were Miami and, and I knew you'd asked me today, you know, kind of what is your definition of determination and building on your point? I think determination is continuing when everybody else would quit. And so often that's

what it takes. And everything I've done that's good in life. And I've had success in life and failure in life plenty. But it was always harder than I thought, took longer than I thought, and required way more work than I thought when I kind of ventured into it. And I'm a big goal guy. Yeah. And as are you. And I think you hear that from other entrepreneurs. You hear, you know, what's Elon's staring into the abyss and drinking, eating glass or something like that?

Whatever his famous quote is, I don't know that one. That's interesting. Entrepreneurship is staring into the abyss while eating glass or something like that. Makes sense. I mean, you don't get it unless you're an entrepreneur, but that makes sense. It is as hard as a hard. everyone says, depending on your industry. In our case, FDA regulated stem cell therapeutics were a bear, a complete bear to try to

tackle. But, you know, if you have the drive and you have the know-how and you have the optimization in this case as an aging male, then it's a systems problem. We started a new clinic. I was in my 50s. I started a brand new clinic after a previous clinic was acquired. and, you know, we're integrating all these things like I'm talking about. And I harp on my wife works with me and I harp on my staff.

It's systems, systems, systems. We can provide great technology. But if our systems suck, we're going to be a shit show. Systems are everything when it comes to business and building businesses and scaling businesses if you want to try to do that. If you don't have the systems, it's not going to happen. It's a wish, man. Health is the same way.

Health systems, strategy. determination, consistency, habit, all the things that are so cliched and we hear from everyone. But it's actually true. Well, they're cliche for a reason, right? Yeah. You talk about systems, whether it's your entrepreneurial journey, your marriage, your relationship with your kids, there are systems involved. Sure.

And you have to be consistent within those systems. And if you fall off of those things, then progress is stalled. And I like to say you're either getting better or you're dying. Well, personally, when we fall off systems, what? what allows you to rebound habit. If you fall off, habit allows you to rebound. I was part of an entrepreneur group

a number of years ago. Andy Fricela and Ed Milette started. The Artaire thing. Did you like that? I did one year of it in the very first class that they did, and it was fantastic. I couldn't maintain it just because

I just got so, so busy. But anyway, there was lots of great things. But one of the things we did that I loved is everyone had to set a body goal in addition to their entrepreneurial and business goals. And people would say, I want to lose 10 pounds. I want to lose 20 pounds. My goal was I wanted to get to 5% body fat. On a dexa or on dexas?

It had to be dexas. So a true 5% not what I think is 5% or a caliper or anything like that, a true 5%. Dude, and how tall and big you are, bro, that's a freaking massive goal. it was a massive goal. Now, why did I, why did I set such a massive goal? Well, that was part of the exercise of Aratei was to, you know, be, think like a world shaker. But I had to set the goal big because at the time I was, I was struggling a little bit with business and so forth. The medical practice was always fine, but the business part was not, it was part of the reason I joined the group is to network and learn and so forth.

But I had to kind of relearn how to win again as an older person, right? not winning as a 20-year-old or winning in athletics or winning as a doctor or whatever. Winning as an entrepreneur was a different type of winning. It is different. But the principles are the same no matter what the application. So with a really hard body goal, I remember, so I got to 7% really easily. And I'm like, oh, I'm going to breeze through this. This is a cakewalk.

And I was, I think I was living at about 10, 11%. And, but that from 7 to 5 was a nightmare for me. It took a long time. This was timed, by the way. And if you didn't hit it, it was for charity. We did it for charity. So if you didn't hit it, you had to spend more money and do all this. And we ended up giving the money anyway.

So it was fine. But I remember I had to hit it right after Christmas. So at the very end of it was Thanksgiving and Christmas. The very end were two holidays to hit my goal right after Christmas. And I did a couple dexes and I wasn't there and I thought I was there and I still wasn't there. Anyway, my trainer at the time, we were having trouble just getting that last percent or two off. And he goes, just stop eating. I'm like, stop eating.

Stop eating. Altogether. Stop eating. Just stop. I said, for how long? He's like, as long as it takes. Right? Because we're talking about it.

Look, 5% is extreme. Right. That's like, you know, getting on stage. It's not normal. And it's not healthy, by the way. Right. It was. You can't live at five.

It was kind of crazy. Yeah. But it was also a really tough. goal to try to strive towards. So I literally stopped eating. I continue to train. How long did you stop eating for? It was, I think, five, six, seven days, something in that range.

And then went for the Dexa, 5.4%. I hit it. And that was right before Christmas, right before Christmas. That's wild. Let me ask you this, because this is what I find interesting. When you chase hard things like that and you hit it and you're willing to do whatever it takes, I mean, you're talking not eating for a full week, right? maybe water.

I don't know if you did bone broth. Yeah. Hydro did you do bone broth or was there a note? No, you know, it was just kind of electrolytes. And it was a true. It was like a, look, we do it all the time now. We indremently fast, right? But back, you know, back then it was a little bit different.

But yeah, it was just like lights and water. That commitment to that goal and you hitting that. And this is the, this is the what I want to tie in with the audience because I believe that everything is connected. What we do in one area of life and how we handle. that area is how we handle everything else. How did the rest of your life pick up because you were handling that over there? Well, that one took a lot of focus. So I can't say that everything was flourishing as I was hitting that end.

It took serious commitment. I wouldn't say it revolutionized it. But I remember going back to RTA because we had to go back and present to each other. We had ourselves as accountability partners. And I hit it and it was a huge big deal. And I was saying, oh, you look so amazing. blah blah, blah. And they asked to describe your experience with the process. And I said to the group, and I think it was about 40 or 50 of us, all very successful entrepreneurs, I just had to

learn how to win again in a different way. Wow. Had to learn how to win again. Okay. And I wasn't going to hit it until I was able to make that last sacrifice harder than I thought, longer than I thought more difficult than I thought and had to learn how to win again. That I could apply to virtually everything else. Right. So thereafter you're able to apply those principles and that journey. And the reason I want to touch on it, because like I said, like I think everything's connected. You know, for me, it happened real time. Right. You know, I was 31% body fat in November of last year. Right. And 230 pounds. I got down at one point to 186. I'm 195 right now.

A little more healthy for me, but still move into body recomp and all that kind of stuff. But what happened for me is once I took care of that one thing, I started eating better, I started moving my body more, started getting better shape, my mind kicked on, I was more articulate. Yeah.

The show blew up. Like everything. I couldn't get someone to invest in the show. When I took care of that, had two investors come in, built this full freaking team and now we're doing things in 20, you know, the back half of 2025

that I thought was going to take me to 2027 to hit, you know what I mean? So for me, it really, it just, I think it just showed everybody that it was finally living the life of determination and discipline like I talk about on my show, outside of my show.

Yeah, probably your vibe changed too. Oh, way different. You proved to yourself. Yeah, yeah. Right, that you could do something that you wanted to again. Yeah. as we've done many times, and we have to continue to always do.

But it's real quick, sorry, sorry, sorry, sorry. Because I don't want to forget this. Because as we get older, we say, oh, well, I'm older. I can't do this anymore. I can't burn fat like I did when I was 25. Yeah. My metabolism's healthier now than it was when I was 30. Like I'm not with a testosterone of 200, right?

No, no, it's right. Once that's healthy. Yes, of course. and that's part of the issue. But, you know, your energy probably improved. Your outlook improved. You work, your confidence and that's a vibe, right? People feed off of that stuff.

If you're throwing negative energy down, right, you interview people for a living, right? You can probably feel if someone's not got great energy or someone's not there. Yeah, I know what someone's off. Yeah. But what was interesting about it, Sean, is, you know, that was a body goal. And I've since done many body goals. I want to go up. I want to go down.

I want to go left. I want to go right. What I learned is I could change my body. and I had the skill set and tools to do it. Like now I'm bigger and more muscular. And there's pros and cons to all of it. But in business, I was at the, I'm still to some degree at the 7%.

Right? So I was still trying to get to the five. Right. Trying to get to the five. And it was because our biotech company is 15 years old, 16 years old and going on 16. and it's in the process of trying to scale. And that's one of the hardest pieces

is to take a business to scale, right? What does that require, by the way? Systems processes. Yeah, right? So all that stuff. So it was immediately applicable lessons, but I haven't hit 5% on business yet. That's still a work in progress.

And we're still continuing to do that. But having the know-how that you can and having the confidence that you can because the hardest thing I think in business and entrepreneurship, especially in a really difficult biotech business environment, you've been in med tech, is maintaining your confidence that your idea is right and that your idea is ultimately scalable, especially when it's a disruptive idea, which mine was.

And maintaining confidence requires a deep dive in your soul to weather those difficulties. and the determination and grit needed to get there. I like to refer to my entrepreneurial journey as the Rocky Balboa entrepreneurship, right? I get punched in the face for 11 rounds hoping to win in the 12th. And that's what it was kind of like.

Yeah. Right? But I'm not in the 12th round yet. I'm still maybe in the 10th round. You're stuck in the 10th or 11th. I get it. No, I understand exactly your analogy and where you're coming from.

Yeah, absolutely. I love the Rocky movies for reference, dude. Because that's- They're so applicable. That's why America loved Rocky so much because it is literally Americans. They'll have a comeback story. Yeah. You know, everybody's getting the shit kicked out of them right now.

Everybody's getting the shit kicked out of them years ago too. Sure. But it's like you got to hang on. Hang on train systems. Yes. You know, go to Russia like he did. Go to your, you know, proverbial Russia, right? And work your butt off.

Then you come out and then maybe you do get to that 12th round and you do win. Yeah. And then it starts all over. over again. But the beauty of it is no guarantee you're going to get to round 12, right? Yeah. That fear of failure, I want to say fear, that risk of failure is always profound. Even when you scale, it's still profound. So I think the take-home point was something like a body goal, something like this exercise that we did in the entrepreneurial group, and that you have to

set for yourself periodically in life, especially as you get older, maintains that confidence level that you can. It's possible. Eight, nine out of ten in businesses fail. Well, why can't you be the one? That doesn't. I think you talk about the confidence. Like having that internal confidence,

that is done by handling the shit and doing the hard things that you need to handle and do. Yes. It's also partly done by making promises yourself and keeping them. Yeah, you can't lie to yourself. But see, that was my point earlier when I started talking about the show. and asking you, you know, what was your experience? Because once I took care of the one thing

that I couldn't take care of my whole life on a consistent basis, everything started to open up, right? My speech pattern changed. Before, it would be like every seven words would be the F word. Now it slips out every here, you know, every now and again. Like if I'm kicking it with Matt on a show, then of course I'm going to drop an F bomb.

Matt can draw that out. I mean, he's just a fucking horrible person. You know, it's just, you know, but it's like, but for the, most part now it is a it is a is a different energy yeah yeah it's i communicate much better right and i think it's because my lights are on man yeah you know i can say okay that's probably not where i need to go with it yeah but once i fix that for me and did the hard thing and didn't lie to myself and kept my word yeah yeah everything else opened up and that's the that's the

message i want the audience to really take from the first part of this conversation and going to the latter part is like, if you say you're going to do something for yourself, do it, do it. And suffer for it if you have to. So what you always do. So let's talk about that word. Yeah. Like I really love that word suffer or suffering. A lot of people will say, this is miserable.

I am suffering, so therefore I'm not going to do it. Yeah. I truly believe, I truly believe in building a body, building a practice and building a show. building a great classroom for an elementary school teacher. You better suffer a little bit. You have to suffer. Well, if you don't have to suffer, how hard is your goal? That's what I'm saying.

But that's the point, though, man. See, we get that. And I think a lot of people at the very base level do get it. But the moment they have that suffer, that is suffering, like it's 4 a.m. Or damn, I didn't get the gym today. It's 6 p.m. and I'm exhausted. or the level of suffering that's necessary. It's a lot.

Yeah. And I feel as though you don't have to be a masochist to be like, oh, I'm suffering. I love this shit. It feels that way sometimes. But it really does. Like, oh, here I fucking him again doing this thing. And this hurts. This is suffering like mentally and physically.

But you learn something so deep about yourself when you're willing to execute those moments. Yeah. Right? And I just, I feel like more people need to be comfortable with that word. Yeah. It's a fine line between a variant of martyrdom and success, right? So a shout out to my friends. When I lived in Denver, I trained at Armbrust Pro Gym.

So that's where Phil Heath trained, eight-time Mr. Olympia. And Dylan Armbrust, who owns the gym, used to train a lot of professional bodybuilders. And when someone was struggling and go to Dylan, hey, Dylan, you have any vice for me? I'm kind of plateaued. I'm having a hard time. What do you think? Dylan would often say, you need to learn how to suffer more. right? You're not suffering enough. And if you want it, then learn how to suffer more. And I always

remembered that because I think it's very applicable. Maybe this is a good example, Sean. To look like this at 54, I purposefully induce a state of chronic pain every day, pretty much. Right. Now, is that good? Is that healthy? It's healthy here for sure because it's keeping those batteries charged and it's keeping that determination muscle, right, firing. But most people want to live and want to exercise and have fun and feel good. But for me to look like this, I have to suffer every single day pretty much. And I do it partly because I just like it. It's my thing.

I also do it, and I'll use an analogy, when patients come in, I'll often joke with them. If you go to the cardiologist, check your heart. and the cardiologist walked into the room and he was or she was obese, smoking a cigarette and eaten a donut, would you listen to what they had to say? So part of my personal responsibility to patients who were looking to, you know, help their arthritic knee or shoulder or rotator cuff or just help their body in general,

I have to live that process or why would they listen to me? It's like a trainer who's unfit. Would you listen to a trainer who's unfit? Trainers, in my opinion, should be more fit than me, right? or certainly on my level at a minimum. So I take it kind of as a personal responsibility to do this as an example to hopefully encourage or motivate or whatever might be the case. Others to say, hey, if I can do it, I'm just as busy as the next person.

I have, I'm a dad and I'm a husband and I have businesses and I have a busy schedule and I don't always sleep well and always eat perfect. But you know what? I make it a purposeful commitment in my life because it's, what I believe in and I get it done. Yeah. But it is hard. I love what, um, what he's, what, what was his last name again?

Dylan Armbrust. Armrest. Armbrust. Armbrust. A cool name for a gym owner, right? Armbrust. That's pretty good, right? What Mr. Armbrust said, he's like, you need to learn how to suffer more.

Yeah. Yeah. That's that point of failure. And what he's saying is in the gym. If you're getting 10 easy, go up and wait, struggle at eight, nine, and 10. Failed a succeed. Yeah, like really push yourself, like, like suffer. through those reps and those exercises a little bit more.

And that's the same thing with everything. People get to a point. And I, guilty is charged. I don't speak from the top of a mountain. I speak from the scars. Yeah. For sure. There would be moments where I get so close.

But then I would let up because that temperature gauge, that internal temperature gauge, are set like at 70. And I needed it at 100 or a 90. But I get comfortable with the 70. And then I would stop. right? I would literally stop doing what I'm doing. I would stop suffering. And whereas now, I push myself in the gym and I'm like, okay, I'm going to suffer a little bit more. And,

you know, and Dan knows this. I, the same thing with the business. I choose suffering much more than I choose the happy moments. And what I mean by that is I go, okay, what more can I do? What more can I implement. How do we take this to the next level? This is going to be a little bit of suffering. Maybe it's a little more travel. Am I willing to do it? Let's talk to the wife. Hey, there might be some times here. There's this potential tour coming up that I might be a part of. It's going to be two months. I'll be coming home. I'll be back and forth. There's going to be a sacrifice. There's going to be some suffering. But is it worth it? And we get to make those decisions, right? Right. But I choose to stay in that word. Yeah. Yeah. My own internal voice in

my head is, you know, how much shit are you willing to eat to get what you want? Come on, man. Right. Yeah. There's no way around it. You're eating shit. So you need a little bit of shit and get some of what you want or you need a whole lot of shit and win in the 12th. Yeah. Oh, man.

It's true. So, you know, that's, you know, the doubt voice that's in all of our heads, in my opinion, is really just it comes down to determination and how far are you willing to go. I think I'll go back to that. Arate's in my head now that we were talking about. I think Ed, Miley-Elet. at one of the meetings said, part of the reason I'm successful is I don't, other people get tired.

I don't let myself get tired. I keep going. Right. I am tired, but I don't let myself be tired and let that tiredness affect my ability to get what I want. And that is another good definition of determination. Yeah,

it's like doing something you said you're going to do even if you don't emotionally feel like doing it at that time. You've gone to the gym when you feel like crap and you still got to get the work done. And this goes back to why David Goggins has become so successful is he's pushed that to a whole other level of human performance. And then to say that, you know, we think our max is 100 percent. It's probably only about 70 or 80. And there's still more left in the tank, but you have to really eat a lot of shit. You have to tap into it, right?

You have to tap into it. Right. And that's a mental game. Yeah. It's really is. I want to touch on, you know, because we're getting to the back half, I want to touch on regenerative messes, medicine a little bit, you know, stem cells specifically. Yeah. You know, for a long time, it was something that athletes and people had to travel to Mexico. And, and, you know, and, and get the stem cell treatment. Yeah. And now I guess as of July, you know, Florida is one of the, one of two states. I believe Utah's the other one, right?

Correct. We actually get stem cell therapy here in Florida. Walk us through that and what that means, not just for your business, but for people in general. Yeah. It could be, it's a blessing or curse scenario. And so for 15 years, I was limited. You know, I've been researching and developing stem cell therapies for a long time. And we were limited to using the patient's own by the food.

and drug administration. That's what we were allowed legally to do. And there were people breaking the law and doing things they weren't supposed to do. I set up a company that's FDA registered and audited. So we got to play by the rules. In July, Senator Turnbill proposed a bill signed by Governor DeSantis,

which said with informed consent, and it's a very detailed counseling that we have to do with patients. And with a vendor providing the cells that checks a whole bunch of quality balances, checks and balances. We are allowed to, offer to patients,

unapproved cell therapies from a donor, from a different person. And most of them are from birthing tissue cells. So placental dry, medical cord, wartous jelly, amniotic fluid, etc. Which is where the models that are typically used in the ocean.

It's all amni on stuff, right? Correct. So for, look, I fought for years to try to make... Did you like that? Did you like that? I'm very smart, right?

I'm like, you know... Hey, that or you researched it and you're curious like most. Smart. Smart. All right. Then you didn't know that about me. Well, I do now.

Yeah, there you go. I just had to make it. There would be a quiz at the end. So there is a quiz. Next part. It's open book, though, don't worry. Sorry, sorry for the interruption. So, you know, I'd work for all this time to figure.

And we were kind of humming, right? We were figuring out how to make person's own stem cells work fantastic for them. We were getting tremendous results. We have 5,000 patients in our database under study. And just when that happens, I get your stem cells dialed in for you, the law changes to open up this whole new world. So at first it was a little bit like, oh, crap, I just figured out how to do the other thing. Here we go now.

Now I got to start all over again, which is literally the approach we're taking. Because unfortunately, with all of these offshore clinic, there's tons of anecdotal evidence that people are getting better, but there's no publications. There's no podiums at academic conferences. So the lure of a donor cell, someone else's cells, is several full. One, people think, I'm old, I don't have good stem cells. Not totally true. You still have plenty of good stem cells.

Not quite as good as they used to be, but we've shown that they still work great in many applications. There's a lot of celebrity endorsement of use baby cells. They're younger. They're more powerful. In a test tube or in culture conditions, culture conditions, that seems to be the case. But we don't know if that applies to actual human conditions yet. We haven't proven that yet. So what the law will allow me to do, I already have thousands of patients understudy using their own cells.

I will take the same rigorous scientific and academic approach to donor cells and we will match patient populations and directly compare one to the other to see what works better. To finally answer the question once and for all, what works when, where, and why. Making no assumptions that one size fits all. A 75-year-old smoker may require something different from a 23-year-old athlete. A cartilage problem may require something different from a tendon problem. And the confines of the law in the U.S. are that we're allowed to apply to orthopedic, pain condition, painful conditions, or wound care. Okay? So it has to fit under those three indications for us to apply these donor cells.

So the law was extremely controversial, but I think, yeah, If we don't screw it up, we'll be an incredible opportunity for us to learn and advance and progress. Because there may be situations where a donor model makes much more sense. If you're healthy and your cells work great, why don't we use those? I know your cells won't hurt you. We don't know the long-term data yet on donor cells 20, 30, 40 years out. We don't have it. It doesn't exist.

So it created this opportunity and it was a little bit daunting because I had to start over from scratch because it's about our whole biotech approach over the past 16 years has been cells can be thought of like a drug like a pharma type of model there's a particular cellular dose and a measurable predictable response and we have worked tirelessly for years to be able to protect how your cells are going to work for you and we have artificial intelligence models now that allow me to actually customize your own stem cells for your problem it's pretty incredible what our team has done. Say that again for the audience,

because that's baffling. So over time, we developed a model which analyzes you, your medical history, your age, your sex, your body mass index, the medications you're on,

your baseline cell counts. And our model, our AI-driven model, tells me, based on the thousands of patients that we've treated exactly what biologic to make and what cellular doses

to apply to you to give you the best chance for success. Right? That's what we've done over 16 years. Now, that is a model that we continue to validate. We can't just roll that out. Right.

Okay. So that requires, you've been in the space. So you don't just start doing that. So we continue to test that model and refine it. But it exists. And AI was the last piece of the puzzle that allowed me. I thought of this 15 years ago, but I didn't have the tools, the statistical firepower to make it work. Now we did.

And we got some really smart people on our data team to help move that over the presence. Now I got to do it all over again. because the knock on donor cells, which these are culture expansion, expanded cells, meaning we take a placental, we dissect the cells that we want, we culture them to grow more of them, then we freeze them at minus 80 degree temperatures,

then we thaw them out, and then we put them back into the patient. That's a lot of handling. There's a lot that can go wrong. And some of my peers have questioned and actually done some research to question whether these cells, by the time they go back into your body,

are actually still alive. Okay. So part of the law calls for a post-thall viability analysis. Viability means what percentage of the cells are actually alive. Okay. So what we've done is, as usual, take it one step further than that. So when the cells leave the lab, I know how many are in that little vial and how many are alive.

And it's not 100% by the way. Okay. We thaw them to minus, or we freeze them to minus 80. I got to keep them at minus 80 in my clinic. in my lab. And then when we're ready to put them in, we'd thaw them in a water bath under specific protocol

and reintroduce them. But before we reintroduce them, what we're developing now, our protocols to re-measure the dose and the viability again, because it wasn't the viability of percent that were alive when it left the lab. It's the percent that are alive

when I put them into your body. That is our dose. How big of a discrepancy from when you get it and freeze it to when you thawed out in the water bath, the drop in percentage of live? Well, not enough data to say accurately yet because literally this just started in July and we only have, you know, a handful of these done at this time. But we're, I mean, the interest is astronomical for this stuff. So we're getting a lot of inquiries and lots of patients who are interested. Somewhere in the range of 15 to 30 percent die before they get frozen. Okay. Okay. It's in that ballpark. Now the question is when we, when we thaw them out and put them back into the

patient. And I don't want to give data yet because we're still refining that remeasure model in our laboratory. So that's not validated yet. So I don't want to be unfair to the industry. But we would expect to lose probably another double digit percent. So if 100 million came out of the placenta and we lost 20 percent of those and we lose another 20 percent, now we're at 60 percent of the original dose. That is our dose. We think, because here's the kicker. Can dead cells produce a positive therapeutic effect. Seems weird, right? These are living cell therapies. If the cell's dead, could it produce a positive effect?

But remember, the cells release things when they go into the body. And if a cell dies, perhaps it could release growth factors and anti-inflammatory proteins and signals because these are placental or amniotic umbilical cord stem cells to help a developing baby develop. Wow. Perhaps some of those signals are still in that vial, even though the cell is dead. could still potentially get a positive therapeutic effect. And that's some of the exosome.

You've heard the word exosomes. Of course. Exosomes are just the signals that stem cells release to perform their therapeutic function. So if the cell dies, maybe it still releases its exosomes and maybe those exosomes are still in there and maybe those exosomes will still produce a positive effect. That's why we have to measure what came out of the lab and then re-measure what, again, before it goes into the patient. Because if we lose a certain percentage, but we see that therapeutically the patient's

continue to do well, there's something else happening in there that we've got to go back and figure out. Is there a way now to test the growth factors of those dead sales? There is, but it's very complicated and slow and expensive. So some of the research that we do is limited by what the market will bear. Okay. And that market is growing. So we just applied for an NIH grant before the government shut down. So that that wasn't helpful for the grant. But now that we're reopening, we're actively seeking because there's such tremendous opportunity. here, if it's done correctly and responsibly, that we anticipate more and more industry monies will be thrown at this, grant monies will be thrown at this, because as this longevity

push continues, stem cells will be a key part of it. Yeah, and that's what I really want to touch on, too, before we run out of time is longevity, right? This is all very fascinating stuff. I think this is all stuff that people have been in the space of wellness or wanting to get in the space of wellness and wanting to live longer, wanting to feel better, really diving into this kind of stuff. Yep. But, I mean, we're getting to the technology where people are, you know, spouting like, hey, we're going to have the ability to keep someone alive until 100, 120 years old,

or 125 years old, you know, because the heart's still healthy and everything else is healthy, but there's a bigger problem here. Yeah, a huge problem. A huge evolving problem. Yeah, let's talk about that. Orthopedic longevity crisis. So we can make our brains and our hearts and our lungs and our organs and our muscles. live longer, it's realistic to expect that our generation could live to 100 pretty regularly.

The generation behind us, the generation behind us, maybe 100, 20, 150, maybe more. Who knows? But we do not yet have a solution to a deteriorating orthopedic system. And the reason is our orthopedic tissues, cartilage, tendons, they're what we call avascular, so they have no direct blood supply to them. Because they have no direct blood supply, they can't heal. So trauma and mileage and wear and tear is cumulative. It just builds up and builds up and build up with no ability to reverse it yet. So if we can get people to live to 120 or 150, but their orthopedic systems are shit, that's not a very good quality of life.

I'm alive. We talk about lifespan and health span, right? There are two different things. So we need to be thinking more in this longevity movement about an orthopedic solution that will allow people not only to live longer, but to live fuller. longer. Yeah, what's the point of being alive if you're not sure they're living? And then we're a little behind in orthopedics. I'm hoping that, again, resources will be pumped into this, not only us, but many people working on this that will come out with some of those solutions. But early on,

is there anybody in the orthopedic space that understands and has identified this issue and is maybe trying to work ahead a little bit? Yeah. I like to think I'm one of them, but there are others. Sure, of course. It's a really tough nut to crack, though. It's a system that's kind of designed to fail. And, you know, ethically, it makes you wonder if God designed it to fail, should we change that? You know, we're entering... There's that question, right? We're entering a period of med tech, Sean, where we're about to fuck with nature a lot. And I love, there's an old quote from, I love movie quotes. There's an old quote from the movie Jurassic Park where Jeff Goldblum says, I think it was, nature always finds a way. Remember, they made all the dinosaurs women and they've,

found a way to reproduce or something like that. So I always say the more we fuck with nature, the more nature may bite us in the ass. So are we really smart enough, and it really gets into the genetic engineering model, programming cells to perform specific functions? I am very excited about the concept

of taking your stem cells out of you, making them young again, and then reprogramming them to go back and do you regenerate your cartilage in your knee. I love that. That possibility, that potential exists. We don't have the code cracked yet. But again, how, it's about on-off switches.

It's about turning things on and off inside of ourselves. If you turn it on, then, God damn it, you've got to be able to turn it off too. So it's an on-off switch problem that we're slowly figuring out. So for a long time, I was concerned we are not smart enough to outthink millions of years of evolution and nature. the question is, is AI smart enough to do so? And that remains to be seen. But it certainly has given us an intellectual firepower beyond what we were capable of previously. And it's now accelerating. So it'll be interesting to see what that allows us to do safely. And as that capability continues to increase, our ability to manipulate nature will continue to evolve more and more and more. I hope we can. control it. I hope so too. I mean, it's crazy because I can sit here and say, you know, I got three beautiful children. I want to see them grow up. I want to, you know, be able to walk my daughters down the aisle. I want to see my son, you know, raise his family. And so,

hey, if they can keep me alive until, you know, 80 to 100 years old, that's great, man. I would, I would obviously want to do that 100%. But I want to feel good when I'm doing it. Yeah. But I also don't want these other, you know, potential. of really screwing with nature, right? Like, that's a whole other thing. Because, you know, if you remember, Durasic Park, you don't mess with nature. I mean, there were dinosaurs eating people.

I mean, that's a problem. Bit in the ass, right? That's a big freaking problem. So, this has been very interesting, man. And, you know, it's an episode to where I feel that there was so much educational value that was given to the audience that hopefully that they can hold on to. And, you know, if you miss something, you know, rewatch it again, re-listened to it again and share it with somebody you know love and trust but dude thank you so

much man thank you yeah appreciate you uh let me talk to your audience and and congratulations uh on the audience thanks audience for supporting sean he's terrific and and i hope it was useful hope you guys get something out of it keep an eye on us we're going to be working hard with that determination to try to continue to bring you guys some solutions before we let the audience go want you tell them where they can find you you know your website so they can learn about you as a as a physician and and how they can potentially go see you to feel better and then where they can find you on socials. Yeah, so social is just my name, David Carly.

I'm very searchable, Googlable. Carly with a K-A-R-L-I, David Carly, K-A-R-L-I. So if you want to just search me out, you'll find all this stuff. But our clinic is the Carly Health Institute, Carlyhealth.com. And my biotech company is Gray-Ledge, G-R-E-Y-Leg, gray-ledge biotech.com.

That talks about a lot of the, work with patients' own stem cells and the research and development that we're doing in a lot of our data work as well. So between those three things, you'll probably learn more about me than you care to know. To ask some questions for you offline, too. This is really cool. For the audience, thank you guys so much for listening. Again, please, if you haven't subscribed or haven't been following the show, please do that. And if you find yourself loving this episode or the show in general, share it with somebody you know, love and trust.

Until next time, guys, it's David Sermon.