Welcome to the VP Life Podcast, the show
where we bring you actionable health
advice from leading minds.
I'm your host Rob.
My guest today is Adil Khan, a Canadian
board certified physician and founder of
Eterna Health, working at the forefront
of regenerative medicine using stem
cells, peptides and gene therapies to
repair tissue, reduce inflammation and
optimise human
performance at a cellular level.
Expect to learn how regenerative medicine
is shifting healthcare from symptom
management to true biological repair,
what stem cells, peptides and emerging
therapies are actually doing at a
cellular level and how these therapies
are being used to treat injury, chronic
disease and even influence
the aging process itself.
Now, under the conversations, Dr.
Adil Khan.
Good morning, Dr.
Khan and thank you so much for joining me
on the podcast today.
It's an honour to have you on to discuss
all things longevity
and regenerative medicine.
Now, I can't imagine there are too many
in this space who aren't familiar with
you and your work, but for those who have
been living under a rock, would you mind
introducing yourself and
how you got into this space?
I know you've got quite the story there,
everything from sort of sports medicine
all the way to Tesla.
We've got time, so yeah, if you could
just run us through that.
Yeah, the Tesla thing is I guess
interesting, but because I was a regular
doctor with like a GP, just doing family
medicine and then I started doing sports
medicine and in sports medicine, we are
dealing with chronic injuries, people
with shoulder and shoes, knee, elbow,
whatever, the gamut.
And so people typically do physiotherapy,
they do cortisone injections, which are
just steroid injections to
help with pain and inflammation.
And if that doesn't work, you're usually
sent off to a surgeon or, you know, or
tell or or to take some pain
meds and just live with it.
So I was obviously not
satisfied with that approach.
And so I was kind of like, okay, there
has to be other
options to help these people.
And that's what led me to PRP, which is
platelet rich plasma.
And that's essentially where we just take
your blood, we concentrate the platelets,
which act like little molecules and
signals to help with healing.
And I worked with the guy
who actually pioneered PRP, Dr.
Gallia, he was kind of the first in the
world to do it for like Tiger Woods, a
bunch of other people.
So I was very fortunate to have him as a
mentor, and really learn, let's say the
foundation of regenerative medicine,
which is just the principles of how your
body can heal and cell
biology and all that stuff.
And, then that kind of
led me down this whole road.
Eventually, I got involved in a clinical
trial, using stem cells in
osteoarthritis, and for using body
people's own stem cells.
And we'll obviously go into, you know,
about what stem cells really are.
But, but the point was, this was a
clinical trial, and I was involved in
research, and I kind of just went down
the whole rabbit hole, of trying to find
what's the best for my patient.
And again, this was a lot of this was
driven by curiosity.
And, you know, just because you mentioned
the Tesla thing, I guess I had a little
bit of good fortune, and I
was an early investor in Tesla.
And so because of that, I had a little
bit more, let's say,
leeway and taking risk.
You know, unfortunately, most doctors
can't take much risk, because if they
have to follow, they have to follow their
college guidelines, they
have to stay within the box.
And you know, because
they're scared, right?
They're scared of their license, they're
scared of getting medical legal stuff.
And so I was kind of like, well, you
know, I have some, I have a decent,
decent foundation to kind of go lean back
on if I can't practice
medicine or whatever.
But, but it all it worked out pretty
well, obviously, in the sense that I was
able to build something outside of Canada
and get people coming to me from all over
the world, because I was just very
curious and trying to figure out what's
the best for my patient.
And that I think that's the kind of the
take home message is when you're driven
by curiosity and problem solving, then
you're going to eventually come and do
something that's meaningful, hopefully
for a lot of people.
And that's, that's what led me to the new
cells, which ultimately is what I think
got me a bit more well known in the last
last year or two, because I was the first
doctor in the world outside of Japan to
really start using those cells and
helping a lot of patients with that.
Yeah, that's incredible.
I just like to sort of dive into the sort
of this idea of regenerative medicine a
bit more, it sort of, it tends to fall
under this whole sort of functional sort
of integrated medicine sphere.
And I sort of found that within this
community of physicians, you have doctors
who are who are functional integrated,
but then they sort of tend to sort of
appear one way or the other.
Some of them tend to end up in this sort
of the regenerative space where some of
them tend to end up
in the gut based space.
Obviously, ultimately, of course, it all
ultimately comes down to the same thing
when you're dealing with something
systemically or chronically.
But how would you define regenerative
medicine and sort of maybe differentiated
from the rest of the sort of the
integrated space
because there is definitely,
well, there's a lot of similarity,
there's definitely a lot of differences
there that I think a lot of people tend
to get maybe just a bit confused over.
So yeah, how would you
define that space particular?
Yeah, I mean, look, regenerative medicine
is really about getting
the body to heal itself.
I know that it's a simple definition, but
that's at the core, that's what it is.
It's like, how do we give it the right
signals, the right cells, the right
scaffolds, and in this in the case, and
then so signal cell scaffolds, that's the
easy way to remember it.
Those are the three kind of recipe
ingredients that you need to help your
body to heal itself.
And it's really the biggest difference
though, it's I don't really like the word
functional medicine.
I know some people may not like that.
But I like I like systems biology.
Systems biology is a medical framework in
which we look at the body as a uniform
system, which if one component breaks
down, then it can
affect another component.
So for example, in Alzheimer's, we know
now that there's gut dysbiosis can affect
the brain from a new
inflammatory component.
That's just one example, but there's
millions of examples.
So the point is, the body is
interconnected and treating it as a
fragmented system as a fragmented
specialty based, which is what we set up
in modern medicine, doesn't work.
So yeah, that solid approach.
I suppose we're just going in on a rabbit
hole here off the cuff.
But why do you think I mean, you've been
through the traditional medical training
system, you didn't start off as a
naturopath or anything like that?
Why is medicine still so
siloed in its approach?
I mean, your systems
biology approach just makes sense.
Why do you feel the establishment such
that it is, it's still sort of driving
forward this idea that doctors should be
educated under this sort of in this sort
of very monocular,
especially the one to the better word
state where they just focus on one?
I mean, medicine is slow moving in
general, I think we're the only
profession that probably
still uses fax machines.
So like, that just that just shows you
how sad our profession is sometimes.
And the, but what's happening is, you
know, as an aside, just, you know,
because of all this tech, people, let's
call them tech bros going into the house
space and longevity space, it's it's
forcing doctors to help to either they're
either just going to become outdated, you
know what I mean, and AI and precision
medicine and all this is going to happen.
And then doctors all of a sudden realize
that they don't have a place that
ecosystem, if they don't keep up with
what's happening, right.
And so I think they're gonna a lot of
doctors are gonna be forced to keep up.
But the reason a lot of them are slow to
change is because they can just get away
with doing what
they've always been doing.
And there's no
pressure on them to change.
It's just like a guy is this is like
having a giant government body, right?
Why are governments so slow to get things
done, at least in you know, at least in
like Canada and UK, I think, and a lot of
times it's just because it's like it's
like turning a ship around like a giant
ship, you know, they're not agile and
flexible, they're just,
they're set up inefficiently.
And so even though the approach makes
sense, and it's logical, they want to
probably have like, you know, they
probably want to have decades of clinical
trials before they'll be like, okay, now
we can put this into guidelines, even
though if from a first principles, and
real world evidence
approach, it makes so much sense.
And clearly, the modern
system isn't working either.
So it's like, why not try something else?
But you know, and that's where I guess
the part of the problem with the system
is the way set up is, you know, to go
through this long regulatory framework,
you know, with phase one to phase two
phase three trials and all that costs
like $100 million in North America.
And it just like, who's who which
tactician, there's no one who can afford
to do that with like systems biology, you
know, I mean, because this is biology
isn't like, it's not like a drug, you
know, it's not like,
it's, you can't pat it in it.
And you can't, you can't make millions of
billions of dollars off of it.
So just, it doesn't it
doesn't work with the system.
And so the only other solution is this
kind of grassroots movements, which is
now what's happening, I think, with
people just taking
healthcare into their own hands.
Yeah, no, it is it is
definitely the way forwards.
And I think there's definite, I mean, a
little knowledge for the average person
and little knowledge can definitely be a
dangerous thing, that's sort of the whole
idea of the Dunning Kruger effect.
But yeah, I do think that it yeah, as you
said, it is ultimately the way forwards
and getting people to take ultimately
responsibility for their own health and
then to be to be more educated when
speaking to someone such as yourself
probably is at least
establishes sort of a baseline.
In any case,
before we go on a complete tangent, I
suppose you might as well get back to the
longevity and
regenerative side of things.
But anyway, so obviously,
longevity is a major is a
major thing at the moment.
Everybody's talking about longevity,
everyone's talking about
increasing their health span, etc.
And I'm of course, it's something I'm
interested in, but more so from the
perspective of say, modulating the immune
system in the inflammatory response and
improving cell energetics.
And then definitely restoring and
maintaining hormonal function.
Maybe more so than I am looking at a
single mechanism, or a single sort of
molecular target that
would extend lifespan.
Maybe it's because I'm not a geneticist
or speak, I will speak some very bright,
but I tend to try and focus on the big
picture rather than the minutia.
Now you're obviously in the trenches with
work you do with regards to sort of
helping the patients that you have who
are looking to sort of
improve their longevity.
How do you define longevity?
And then what do you find the biggest
needle movers are in that respect?
Yeah, I mean, I think
you kind of hit on them.
But my definition of longevity really is
just being able to live your highest
quality of life for as long as possible,
which is very simple.
But at the end of the day, what happens,
and this is a real statistic over 90% of
people over age 60 in
America have a chronic disease.
So meaning their quality of life gets
affected, and they can't do the things
that they want to because of their
illnesses or diseases or pain or fatigue
or whatever, maybe mood, depression,
there's so many things
that happen as you get older.
And if you can maintain a high quality of
life for that, as you get in, especially
as you get older, that's really what
longevity is, right?
Being able to live to
your fullest, so to speak.
And that's, that's, that was the whole
thing with my original kind of, let's
say, profession, which was giving getting
people out of chronic pain, because pain
affects people's life a lot, not just
from a purely mental health perspective,
but it can affect their ability to stay
active, which ultimately then affects
their whole health, right?
So because if you're in too much pain,
and you can't stay active, then your
whole body becomes the condition, right?
So that's, that was one of the big things
I realized is that
it's all interconnected.
So you can't just, and that's why you
have to look at the body as a whole.
And so when you're coming to the point of
what moves the needle the most, you kind
of hit them both, which is hormones and
immune, immune system, and the immune
system, the reason immune system is so, I
mean, immunology is
such an interesting topic.
And there's so much, there's so much
stuff going on in right now.
And I'm, I spend most of my extra spare
time reading about immunology these days,
because it's just, that's the hot topic
right now in medicine, I think.
And the reason is because it turns out
the immune system modulates or controls
all these other cells, meaning they
dictate, if the, if your immune cells
send the right signal, you're going to
have good regeneration and good healing,
for example, versus if they send the
wrong signals, and you're going to have
scarring and fibrosis.
So your immune cells, that's just one
example of, but it turns out even with
even cardiovascular disease, there's an
inflammatory component with
plaques and heart disease.
And, and like we talked about
Alzheimer's, neuroinflammation, and so
many different things come
back to the immune system.
So if we can keep your immune health
better in terms of slowing down the aging
process, and that's going to have a huge
impact on your aging.
And that's not just me saying it again,
there's, there's data to back this up.
There's a study in Stanford, which is
really interesting, is
a 17 year long study.
So they looked at seven, like, so almost
two decades, and they track people's
immune system health.
And they found that the immune system
metric that they were using out predicted
their out predicted epigenetic clocks for
predicting mortality or death.
So by up to seven years, so they could
predict more accurately by seven years
more than those epigenetic clocks on, you
know, how long someone's going to live,
which is super interesting.
So what that comes back to is if we can
slow down your immune system aging, we
can likely help you live a healthier,
longer life and, and also
prevent chronic diseases.
And that's, and that's why people have
heard of this whole inflammation concept,
right, chronic inflammation being one of
the biggest drivers.
But so let's come back to why does your
immune system get
older in the first place.
And a lot of this has to do with your
bone marrow micro environment, because
that's where the cells are made, right,
the bone marrow micro environment is
where the stem cells get made, and rest
where your immune cells get made, too.
And so what happens is there's something
called a hematopoietic shift, which means
that more of the, let's say, bad immune
cells are being made, and less of the
good immune cells are
being made as you get older.
And so there's a, there's a
shift that happens with aging.
And so, and then the other thing is your
thymus gland, which is starts to shrink.
Yeah, exactly.
It starts to shrink, and
that trains your T cells.
And that that also doesn't
work as well as you get older.
So the bone marrow and the thymus gland
are two hot areas of research right now,
because if we can do thymus regeneration,
and then if we can keep the bone marrow
micro environment healthy, so that you
can continue to produce a good immune
cells, you can significantly slow down
the aging process, and potentially even
reverse aging, I think.
So that's why there's because there's a
research study that was done in mice, but
it's super interesting, where they were
able to use these engineered stem cells
are called IPSC HSCs.
So they're basically, you know, the
Yamanaka stem cells with hematopoietic
stem cells that were able to reprogram
the bone marrow micro environment, and
significantly slow down
the aging process in mice.
So that just that's just
a very interesting study.
But I think the real world application at
the moment is we do have therapies that
can slow down the immune system aging
process, such as immune cells.
But obviously, I think the I think, you
know, the, the regeneration or repair of
those micro environments and that tissue
in the thymus is going to be a really
interesting area for longevity.
Yeah, no, it's fascinating, especially
when you start looking at some of these,
I don't know what you think of
bioregulators that are supposedly have
been shown to help regenerate the thymus.
Specifically on the immune system,
though, what do you feel about this idea
of the fact that the immune system is
going to for the most part is going to be
triggered by a huge number of
environmental factors, anything from
mold, microplastics, etc, that are then
sort of going to drive up this
inflammatory response that was then going
to result in the development of the
inflammation specifically.
Do you think that I suppose part of the
picture here is looking at ways to sort
of reduce that that load on the body so
as to reduce the 100%
in fact, there was a study the research
on if you look at the research on
multiple sclerosis, which is an
autoimmune condition, it's almost it's
every like they found like something like
I can't remember the exact number, but
it's really high, like 95% or something
was linked to EBP, like so almost
everyone who has MS has EBP, which what
does that show you that shows you that's
probably the actual cause of MS, you
know, that's like like like likely the
causative or most important risk factor.
And so chronic infections and chronic
toxins in the body, microplastics,
pesticides, all these things play a role
in kind of hijacking our immune system
and making it in balance or dysregulated.
So that's why we know this.
I mean, the medicines know this for a
while too, as they
call it molecular mimicry.
That's kind of like
the medical term, right?
And so essentially, just meaning like
these toxins are kind of making your body
think that the tissue that's healthy is
actually unhealthy, and
then they start attacking it.
And so why is that tissue presenting as
an unhealthy tissue in the first place is
because there's intracellular pathogens
inside of that tissue, or there's
microplastics, or there's all this
garbage that's
building up inside the cell.
And then your immune
system's like, hey, what the heck?
What's wrong with you?
And then it starts attacking it.
And so then the doctors are just
suppressing the immune system.
They're not going- Biologics.
Yeah, which is biologics or
immunosuppressants or f-prednisone or
monoclonal antibodies.
They're not really
fixing the problem, right?
Which is fine.
We didn't really understand all the
science before, but I think now it's
becoming much more clearer.
And so what we do is we
try to remove the bad.
And there's all these technologies out
there that can do that pretty effectively
now with, there's something called in-use
phoresis, which is in Europe.
It's been around for a while and they've
had, they have data showing, they've
helped autoimmune patients and they can
remove microplastics
and all these things.
And you can combine that with other
therapies to kind of
reset the immune system.
So that's the whole idea.
Yeah.
And where do stem cells
start to fit in this picture?
I suppose you might, it's a good sort of
juncture to start talking about stem
cells in particular with
regards to immune system.
Of course, I think most people view stem
cells purely from the sort of tissue
regenerative standpoint.
I think that is what comes across in
social media the most in any case.
You take stem cells, whether it's, yeah,
whatever form it is, whether it's an
autologous stem cell, such as, I believe
that's PRP, something like that, if I've
got that right, or some sorts of
harvested stem cell.
And most people sort of associate that
again, whether you've got some sort of
cartilage degeneration on your knee or
some sort of aesthetic procedure.
But how are you utilizing these therapies
in these cells to then sort of modulate
the immune response in particular?
Yeah.
So the first problem is, I always have to
get a little bit of a history lesson,
unfortunately, because the first problem
is the word stem cells,
mesenchymal stem cells.
And mesenchymal is kind of like an
embryological term that all these stem
cell clinics that are out there, they're
using what are called mesenchymal stem
cells, which are either derived from fat,
bone marrow, or umbilical
cord tissue or placenta tissue.
Those are perinatal tissue, those are
typically the three most common sources.
And so the problem is the guy who coined
that term in 1992 wrote a paper in 2017
saying that we need to rename it to
medicinal signaling cells.
His name is Dr.
Arnold Kaplan.
And so essentially he was saying that he
named them wrongly because
they are not true stem cells.
They're just not able to regenerate
tissue, like you were saying.
What they do is they do something called
paracrine signaling, which is a signal
and they modulate their environment,
which can still reduce inflammation and
still be helpful, but it's not true
regenerative, which is what people are
looking for and what people are hoping
for with these treatments.
And that was a problem with all these
stem cell clinics and why most of these
stem cell clinics, to be
honest, are scam in a sense.
And a lot of them are
just marketing and hype.
And there's just a lot of
misinformation out there.
And that's also why a lot of mainstream
doctors don't like it because it's like
these clinics are offering these things
which aren't true stem cells.
And that's still a problem because all
these clinics are saying we do stem cell
injections, but they're not
doing stem cell injections.
They're doing signaling molecule
injections or what are, or the other,
other technical name is what's called a
committed progenitor cell, which means
it's already committed
to a certain cell lineage.
It's not able to differentiate into all
the different types of cell types.
So what is a true stem cell?
A true stem cell, it can
turn into any cell in the body.
What's called a pluripotent stem cell.
And so that's, that's, but the issue with
pluripotent stem cells has historically
has been the risk of tumors or cancer
because they could not
turn into tumors as well.
Right.
And that, that's the kind of the big
breakthrough with these new cells, which
is what we're using because they're
pluripotent, meaning they can turn into
any cell in the body, but
they're non-tumorogenic.
So they have the best of both worlds.
So they can not only differentiate into
cartilage or heart or liver.
They've been shown to generate into new
bone, like new brain
tissue to like neural neurons.
So they can turn into anything you need
them to, but there's no risk of cancer.
And in fact, there's research suggests
that they may even
suppress cancer growth.
So it's really, really promising in terms
of their future of, for so
many different applications.
But to come back to your question, what
the immune cells do more than anything is
they help modulate your immune system.
And this has been shown in, in clinical
clinical research, but also with some of
the evidence that we published, we just
published some, we
just published a paper.
I mean, it's just a few cases, but we
used, you know, we use this generation
lab, which is like systems biology aging
test, and essentially measures 19
different organ systems.
And we're able to show like, with just
one or two infusions of the immune cells,
you can see like 10, up to 10 years of
reversal of biological
age in the immune system.
And then you can see
significant slowing down of that.
And then you see the inflammatory
response completely become blunted.
So there's a shift that happens after the
immune cells, which
is really interesting.
And the whole idea is that we combine it
with that blood cleaning technology.
So for, let's say someone who has an
autoimmune condition or dealing with
chronic infections, you know, whether
that's mold or lime or whatever, then one
of the things you can do is you can
remove all the bad stuff using that
technology, like the endocerases, and
then you can put in the new cells.
So it's like you're, you're preparing the
soil before you plant the seeds.
And then you can also you can, of course,
we touch on hormones a little bit, you
can also optimize our hormones using, you
know, functional genomics and blood work
and all that stuff to really look at
their hormone metabolism, and then figure
out and make an
individualized plan for them.
So that way, you're kind of like
optimizing the hormones, you're
optimizing their body
before you put in these cells.
And that's really what
leads to good results.
Yeah, definitely.
And I'd love to come
back to homes in a moment.
Mechanistically, what is going on, I
suppose, at this, at the level of the
immune system, when you're introducing
these stem cells, is there sort of an
increase in natural killer cell activity?
No, it's actually a Treg and TH17.
It's increasing the balance of that.
And then so basically
more T regulatory cells.
And then the other thing is it's
increasing macro, what's called
macrophage polarization.
So shifting the macrophage.
And one to two.
Yeah, exactly.
Yeah.
So those are two of the biggest ones.
But then there's also the other thing is,
is helping with what's called SASP,
senescence associated
secretinative phenotype.
So which is essentially one of the
hallmarks of aging, and it helps to
reprogram those cells to have a different
gene expression profile that's more anti
inflammatory, as opposed to the pro
inflammatory senescent profile.
And it actually clears out this is the
coolest thing about new cells.
New cells have what's
called phagocytosis.
So they actually eat the day so let's say
they go to your heart, and there's a
damage, there's damaged heart cells in
there that are senescent that are old and
your body can't clear them out, the new
cells will actually eat them.
And then they'll use a cellular machinery
to turn to a new heart cell that's
functionally better and works better.
Yeah.
And for the audience, that whole process
of phagocytosis forms into this what's
been sort of popularized as this idea of
autophagy upregulating the sort of the
cell recycling process
within a specific target tissue.
That's fascinating, especially the
ability for it to sort of help balance
out that TH17 response as well.
I mean, I know that's also mediated by
Holman specifically, which we can talk
about in a minute things
like excess of estrogen, etc.
Wow.
And then, yeah, I apologize to everyone
who's listening, I might get we might get
a little technical here.
What do you how are you then regulating
the SASP on the back end of that with
regards to looking at compounds like your
your senolytics, everything from your
natural phi-setins to your pharmaceutical
candidates like dastinib.
Are you utilizing any of those compounds
to then sort of clean up the sort of the
leftovers senescent cells?
We use there's a couple there's a company
called qualia, which
makes a senolytic supplement.
So we've been using that one.
And I don't know if there's anything, you
know, I'm not I'm not a super expert as
you are on supplements.
So there might be
something better out there.
But that's the one I've been using.
And then the other other interesting
intervention from a cellular therapy
perspective are NK cells.
So allogeneic natural natural killer
cells act like a
sponge for senescent cells.
So that's another if you you know, for
for older people, especially, excuse me,
for older people, especially, you can do
NK cells prior to the mucal infusion,
because the NK cells help to reduce that
SASP microenvironment and help to clear
out some of the senescent cells before
you put in the mucal.
I did not know that.
I believe that IP6 phosphate just doesn't
offer you probably aware of this is also
going to increase in activity within this
within well within the
immune system as well.
That's anositol 6 phosphate.
So that's also an interesting one that's
been shown to increase.
I assume it do you mean natural killer
cell activity there?
Yeah, okay.
No, that's an that's one that's also got
shown to be quite
effective at helping to increase.
Yeah, NK cell activity.
In any case, I think we're getting a
listen to the weeds here.
Dr.
Kahn, I'd love to maybe pivot and to talk
about hormones a little
bit now if that's okay.
Specifically, as they again, as they
pertain to these longevity outcomes.
Now, like you,
I follow bodybuilding quite closely.
And, and to be honest, I think maybe
outside of individual societies yourself,
and a lot of these sort of
institutionalized academics, their cohort
of individuals that definitely I find
fascinating because,
for the most part, I think they
understand human biology better than
better than most, especially your sorts
of your newer guys,
like, like your Dean St.
Marty, your vigorous Steve's, etc.
I mean, they, it's in their best interest
to understand the human biology because
ultimately, that's the way
you get the body thereafter.
Now, I'm not saying that what these guys
do is necessarily the
best for longevity outcomes.
I mean, yeah, yes, your tremolones, your
methylated testosterone are great for
throwing on slabs of tissue.
But from a systemic standpoint, they're
just going to
increase oxidative stress and
drive up androgenicity and create all
manner of health
issues related on the line.
The proper use of HRT, however, I think
does interest me as longevity aid,
especially in the society we have today,
where people's levels of hormones for a
lot of the reasons we've already
discussed are just lower than ever.
Now, of course,
yeah, endocrine disruptors
lack of sleep, the list goes on.
And again, as you said earlier, these
environmental toxins, yeah,
two times, so your molds, etc.
Now, I'd love to discuss maybe some of
the nuances of HRT and both men and women
from a longevity perspective.
But why do you think, but before we get
there, why do you think it's often
overlooked as a longevity
candidate or a longevity aid?
I mean, especially when you start looking
at the ITP, most people are just again,
looking at these single molecules to try
and sort of, yeah, improve longevity
outcomes, improve health span, whether
it's astaxanthin, or the latest senolytic
or whatever, but very few people are
seemingly, again, we've discussed this
already, the immune system, but focusing
on the endocrine
system, the hormone system.
Do you have a feeling as
to why that is specifically?
Well, I think part of the problem is
there wasn't personalization and
understanding how to
restore the whole access.
Like, for example, it's kind of, it was
very primitive, and it still is for a lot
of people, which is basically like, oh,
you have low testosterone, so take some
testosterone, you have low estrogen, so
take some estrogen, but there, but again,
it's, it's kind of looking at the whole
body and asking yourself, okay, does this
make sense for this picture?
Or why is it low in the first place?
Or is there something we can do from a
systems biology approach to get your own
body to produce more of it?
And especially for a young, like you
said, younger and younger people are
presenting with low testosterone.
That's not normal, you know, and there's
people in their 20s and 30s going on TRT.
And that, that, that to me is a bit of a
problem, because then you're not, you're
not going to the root cause necessarily,
which could be the adrenal access, and it
could be because of microplastics and the
endocrine, it could be so many different
things that you want to look at and see
if you can kind of restart or re jump the
system, so to speak.
And there's, and I think that's where
kind of functional
genomics was really interesting.
We have a doctor, Dr.
Mansoor Muhammad.
He's a, he's kind of like the guy who
pioneered, I would say he has, he's the
only one I know, as far as I know, that
has this insight into looking at your
specific genes that
affect hormone metabolism.
Because obviously when you do these
genetic tests, like, you know, from these
DNA companies, they look at there's
thousands of genes and it's not very, it
just gives you a big report and it
doesn't really give you
a lot of good insight.
You know what I mean?
It's very generic.
Whereas Dr.
Mansoor, what he does is he says, no, I
figured out which genes to look at
specifically to optimize your health and
longevity and not just hormonal ones, but
then there's other important ones too,
obviously like methylation
and other things like that.
But so he does a very tailored approach.
And that's what we use personally to
optimize people's hormones.
Because then he can say, okay, look, your
estrogen metabolism or your progesterone
metabolism is faster than it should be.
And therefore, this is like a deficiency
that you're going to or you're going to
have, you know, because of that you have
this X deficiency and this
is what you need to take.
So he can give you a much more
personalized and specific plan than just
kind of being like looking at your blood
work and telling you based off your
genetics, maybe why your hormones, you
know, are presenting the way they are.
Yeah, definitely.
Is his company the DNA company?
Have I got that right?
He was, long story, he
was part of the DNA company.
He was the founder, he was actually the
founder of that company.
He was his chief scientific.
He was the one who
created all their products.
But then he ended up leaving
and started his own company.
And now his company is
called the PhD clinic.
Okay, no, I have to check that out.
No, it's another rabbit hole.
But yeah, no, I love the
fact that you brought that up.
I think, and in a minute, we will have to
talk about the importance
of hormones and longevity.
But yeah, I think people especially women
who put on to HRT, genes
aren't taken into account.
And I think another great test is, as
you're probably well aware of, is the
Dutch test in that respect.
And just being able to identify how
effectively someone is going to
metabolize a certain hormone before it's
introduced to their body, I think is very
important, especially for women sort of
transitioning or going into menopause,
where maybe they've not actually ever
done any sort of hormonal testing as a
baseline previously.
So you don't have an idea of how
effective of where that sort of estrogen
baseline necessarily is.
Now, of course, you can
give someone testosterone.
And for the most part, that's relatively
easy to control in terms of systemic
outcomes, but in terms
of a side effect, sorry.
But when you start looking at estrogen,
and giving it to someone specifically,
and you're not aware of how well they're
going to methylate or break it down,
you're not aware of sort of first and
second phase detoxification, in that
respect, I think it
starts to get quite messy.
And you can potentially start to trigger
the development of certain cancers,
especially where there's just a buildup
of estrogen in the body over time.
Obviously, your estrogen sensitive
cancers specifically.
So yeah, that's amazing.
I love the fact that you take that
approach and you're looking at it from
more than just a serum
blood work standpoint.
In any case,
off track again, this is...
That's interesting.
Yeah, because most people, I mean, that's
what's offered to 99%
of people still, right?
So people need to know that there's
something more sophisticated out there.
It's just educating the public.
Yeah, no, definitely.
And I think it just goes to the sort of
whole cookie cutter approach with hormone
therapy, and why it
fails to so many people.
Obviously, in the UK, I'm sure familiar
with the system we have here, everybody
just gets the overall patch, obviously,
women in this respect, and then all of a
sudden, they're bloated, depressed, and
they have no clue why, but they're on
HRT, why is it not working well?
You are now estrogen dominant, have no
progesterone or testosterone, and you
wonder why you feel miserable as hell.
In any case,
again, apologies to everyone listening,
we've got straight into the weeds.
But Dr.
Kahn, I think it would be great if we
could maybe just take a quick step back
and talk about some of the importance of
the importance of hormones in longevity.
Now, I think when people think of, again,
think of hormones, it's just the sex
hormones that they think about.
Of course, there are dozens of hormones.
But specifically,
your testosterone, your estrogen, your
progesterone, your sex hormones, why is
it important to maintain
levels of those hormones as we age?
What are their sort of fundamental roles
in helping someone to age,
quote unquote, gracefully?
Well, I think we know with obviously with
testosterone, but also estrogen and
progesterone having the right balance,
they all they relate to muscle mass, bone
density, heart health, brain health.
So meaning if you have low testosterone,
you're at increased risk of depression.
In fact, there was a talk I attended
once, where they said the most common
reason for a Prozac prescription in men
is low testosterone.
And because a lot of doctors, I mean, now
there's obviously
more awareness about it.
But 10 years ago, there wasn't that
awareness to check
testosterone routinely.
I mean, I don't think
it's still done routinely.
But you know, at least there's more
awareness to understand that, hey, maybe
you have low mood, and maybe you're not
feeling very good
because of your hormones.
So more people are at
least thinking about that.
And then I think, you know, with estrogen
and progesterone is kind of the same
thing, we know how
protected they are for the body.
And finding the right balance is the key.
It's not about like you said, it's not
about having high levels necessarily,
it's about achieving
balance of those hormones.
And that balance can be a little bit
different for everyone too, I think.
So that's really where, you know, I think
for musculoskeletal health, especially,
that's really, I think the important
thing when it comes to longevity because
sarcopenia and low bone density become,
which is osteoporosis, become a big
problem for women, especially as they get
into their 50s and 60s.
And it only accelerates and then becomes
a big problem for men too, as they get
into their 60s, and they
can't put on muscle mass.
So if there's something, you know, we can
do to combat that from a hormonal
environment, then that's going to be, you
know, obviously ideal.
And I think, I think, you know,
obviously, the thyroid, the thyroid
hormones are also important, those are
just the sex hormones, but thyroid, I'm
sure people know that's
related to metabolism.
And, you know, it can, if you have a
thyroid, it can make you sluggish and
weight gain and all this other stuff.
But it can also affect importantly for
us, it can, there's studies showing that
if the thyroid levels are low, it can
affect the micro environment of the stem
cells to do their job effectively.
So that's one of the
reasons we look at hormones too.
And we want them optimized because it can
affect the stem cells
ability to do their job.
Yeah, no, I'd love to get into the
thyroid the minute because again,
something that I think a lot of people
sort of overlook is that if you've got
poor circulating levels of T3, the active
thyroid hormone, it's going to alter, I
believe, its star expression within the
mitochondria and the ability for the
mitochondria to actually
produce energy as well.
In any case, how do you, as a physician,
of course, start to look to help people
optimize thyroid, not excuse me, this
hormone function off the bat, obviously,
you're taking a functional
sort of genomic view of it.
And you're obviously including a lot of
blood work and, and
other metrics in this regard.
But are you sort of starting off with
sort of prohormones, things like
Pringnelen and DHE to start off with just
to see if you can increase
someone's natural sort of
Yeah, that's my approach.
Obviously, everyone's
different with this stuff.
But I'm always of the
logic that if we can get your system to
work better on its own,
why don't we try that first.
And that's where peptides and you know,
you mentioned bioregulators, you know, my
regulators, I don't know how great the
evidence is on that, to be honest, and I,
you know, and I've heard mixed things,
but I have seen, I've seen it helpful in
certain cases, very, bioregulators are
very hit or miss in my experience.
But you know, peptides tend to be a bit
more consistent, for example, something
called kisspeptin, an ACG, which is, you
know, basically can stimulate your LH and
your own body to produce more
testosterone on its own.
And that you can, like you said, you can
combine that with precursors like
pregnant alone and DHEA.
And then, you know, you can really get
your own access going again and get your
own body to produce more testosterone.
But I think so to me,
that's always my first approach.
Same thing with, you know, even with
estrogen, estrogen metabolism, for
example, there's research showing that,
you know, the vaginal microbiome and the
gut microbiome can
affect estrogen metabolism.
So meaning your estrogen, you can become
estrogen dominant because of gut
dysbiosis and because
of vaginal dysbiosis.
And so there's these next generation
supplements now, probiotic supplements,
basically, which help to restore the
flora, which have been shown to help to
restore the balance in
the hormones as well.
Yeah, that's fascinating.
I'll have to do a bit of a deeper dive
into that, especially sort
of the vaginal microbiome.
Yeah, check it.
There's a supplement called Get Happy,
it's from Germany, you know, how to name
Get Happy, but it's from Germany.
And it's a vaginal microbiome supplement,
but it's been, that's
basically what it does.
And they have the research to kind of,
they have like, a lot of research to kind
of back up what they're saying.
Yeah, I'll definitely dig into that.
Thank you.
And then just to sort of, I suppose,
touch on the thyroid piece specifically.
Now, obviously, in aging populations, the
thyroid is naturally going to decline,
you sort of see that that transient rise
in TSH as an individual gets older, and
then I suppose, naturally, sort of lower
levels of the circulating thyroid
hormones, T3, T4, T3, T3, T4, etc.
Maybe, that might be a bit of a technical
question, I suppose, but where do you
sort of, how do you start to deal with
some of these hormones, again, from a
long, well, thyroid hormones from a
longevity perspective, especially taking
into account that as one ages, there's
going to be a sort of a decrease in these
three levels of
circulating thyroid, of course.
And I only mention that because I assume
when you look at it from a sort of a
physiology standpoint, there has to be a
reason for thyroid declining as one ages.
Now, obviously, if you ramp up thyroid
activity too much, you're going to
actually end up sort of burning through
that stem cell pull, I think
I'm correct in saying that.
So how do you find that sort of that
happy balance between helping somebody
sort of maintain optimal thyroid function
so that they aren't brain fog depressed,
overweight, and moody versus not in this
sort of hypercatabolic state where
they're burning through the excess
cortisol stem cells, etc.
Do you find that people generally need
replacement as they sort of get older?
Or is that sort of very individual?
Well, yeah, I mean, you're coming back to
the whole idea, right?
The thyroid is kind of like the metabolic
engine of the cells.
And if it's not functioning properly,
then your whole metabolic activity and
how your mitochondria work and everything
in the cells will be affected.
And so that's why it's such a crucial
hormone to have optimized.
But the way I look at it is there's, for
example, there's a lot of co factors such
as selenium, which is such an easy thing
to supplement with or eat Brazil nuts,
which can be an important factor to help
with increasing your own body's
production of thyroid and
making it work more efficiently.
And then there's something called reverse
T3, which is another way to kind of look
at and interpret that, hey, maybe your
body's under a lot of stress and then get
cortisol and adrenal dysregulation.
I don't really like
the word adrenal fatigue.
But dysregulation is the more appropriate
word, I think, which is, you know, when
your cortisol is low, it's high, and when
it's high, it's low.
And that's what
happens to a lot of people.
So they don't have that spike in cortisol
in the am and then they have that they
actually have high cortisol in the pm and
they can't do wired retired.
And that's that's that kind of
dysregulated rhythm, it can play a big
role in affecting
thyroid function as well.
So I think that's why you have to look at
the whole picture from that perspective.
But to answer your question, it's very
important for us because if at the end of
the day, if you're if you're thyroid
hormone, it's kind of like the one of the
lowest hanging fruit, you know, and if
that's not optimized, then it's going to
affect your whole body's health and
longevity and your metabolic health,
metabolic health is the foundation of how
longevity really that's why that's why
GLP ones, you know, as much as I don't as
much as they have side effects and other
things with them, they're probably net
positive for society, you know, because
at the end of the day, they're proving
people's metabolic health.
And I think if anything, that's going to
help your metabolic health as just from
like a first principles perspective for
health, I think that's going to be a good
thing for your for everyone really.
Yeah, no, I do appreciate that because I
think, I mean, again, I, I, I don't think
we need we should we should need GLP ones
and everybody's very quick to sort of
throw them under the bus.
But as a society, I think they're an
incredibly useful intervention.
And of course, just from the their
ability to, as you say, modulate
metabolic health by way of obviously
improving blood sugar, but the obvious,
of course, they are starting to show
quite a lot of efficacy for off off label
as well for helping to control
individuals with issues
with MCAS and histamine, etc.
So I do think that they're an incredibly
useful class of molecules.
Dr.
Kahn, I know we're sort of slowly
starting to run up in time, but I'd love
to ask you about mini circle and its
inability and its ability to help
regulate testosterone levels.
Now, the way I understand it, mini
circle, it's, it's, I suppose,
fundamentally, it's a
gene editing system.
And yeah, you're not directly editing the
genes, of course, but you're all
introducing a viral vector or you're
utilizing CRISPR or anything like that.
But from what I understand, you're
utilizing a sort of a plasma vector, a
plasmid vector, I think, to then alter
the expression of various genes.
I've bring this full circle, of course,
could you sort of explain that process to
us and how you're utilizing it to help
optimize testosterone
levels in individuals?
Yeah, so it's what's
called an additive gene therapy.
So we're adding a gene to your body,
we're not editing your genes.
So it's, it's obviously safer in that
sense, because it's not as complicated.
But and traditionally, the problem with
gene therapy, additive gene therapy was,
you know, finding the right vector that
could be both safe and effective.
Mini circle plasmids are definitely very
safe, because they're very inert.
So they're basically derived from
bacteria from E. coli is kind of just
imagine it just like the name says, it's
a mini circle, it's like
a little circle of DNA.
And then you can you can use it to what's
called transfect a cell.
So that cell becomes like a little
factory to produce more
of the gene of interest.
So that gene of interest could be could
be like something for helping with
muscle, it could be something to help
with brain could be there's so many
different genes, obviously.
And the one that became that we've been
doing is something called follow statin,
which is more to help
with muscle strength.
And interestingly,
just to share my experience with people,
the mini circle plasmid has kind of been
like hit or miss, you know, it works for
some people, it doesn't work for others.
So it's not consistent.
But there is something called, there's a
company called triple helix, which has
what's called a viral gene
therapy, a AV, adeno, socio virus.
And that one has, you know, a V's have
been studied for decades.
And the issue historically with viral
vectors was triggering some sort of
immune response, right?
Like you don't want your
immune system to attack the virus.
But now they can engineer the viruses, so
they're hypo immune, and they don't have
that risk with them.
So essentially, you can transfect the
cells with this viral vector.
And it does work more
effectively than the mini circle.
I you know, in terms of safety, it's also
it based off their data, it seems to
equally as safe too.
And it can last.
The interesting thing about the viral
vector is it can last for up to 10 years.
Whereas you know, the mini
circle only lasts for a year.
So there's some
interesting pros and cons of each.
But the point is, these vectors, whether
it's a viral vector or a mini circle
vector, they can eventually be used to
transfect your G your cells to perhaps
produce more kisspeptin or luteinizing
hormone or gene or H.
Yeah, yeah, something to help your body
produce more
testosterone for as an example.
So I think there's definitely going to be
interesting applications.
I know, I know mini circle, they were
trying to produce an LH gene therapy.
That was one of the things but they
couldn't get the levels high enough to
the test for the testosterone to actually
go high enough for it to be meaningful.
So it might not be a thing with mini
circle, maybe it'll be something with the
viral vector company.
But there's you know, this is obviously a
hot area and there's so
many companies in this space.
But I do think it's not that far distant
in the future, well, we'll have a gene
therapy product for hormone replacement
therapy as opposed to having to go on
like TRT or something.
Yeah, I suppose that is dependent on how
effectively the testicles or potentially
the theca cells and women, I think that's
where testosterone is produced in the
ovaries, are functioning as well.
I assume if somebody has
a secondary hypogonadism, something like
this would be effective if it's helping
to stimulate the HPT-8 to
then produce more testosterone.
But if there's a primary defect in the
tissue within the body, whether it's the
theca cells and women or I suppose
potentially the adrenal cells and women,
which obviously produces a certain amount
of androgens as well, or the testes and
men, that treatment like this is
assumedly not going to be as effective.
Would I be correct in my thinking there?
No, yeah, exactly.
It definitely will depend on the person
and their bodies, like let's say receptor
sensitivity and ability to kind of have
the signal because at the end of the day,
this is just introducing an additional
signal to your body,
which is this peptide, right?
And how receptive your body is to that
signal is going to really dictate whether
or not it functions well.
Yeah, no, definitely.
Again, Dr.
Kahn, I want to be
respectful of your time.
So I'd love to sort of end off with a few
rapid fire questions,
rapidish fire questions.
They're never rapid fire, but we can try.
We can try.
In any case, okay, so yeah, and these are
going to be a bit all over the place.
Obviously, definitely with the focus on
the regenerative side of things.
But okay, so money, no object, and
someone comes to you and they're sort of
growth hormone deficient.
Are you sort of a fan of sort of Incrolex
or sort of HGH as sort of as a primary
replacement therapy there?
I guess it depends
how deficient they are.
But if they're on just like, let's say,
the low side of normal, which is like, I
would say, typical people as they get
older, then I'm
potentially a bit I'm a bigger fan.
I mean, maybe I'm a little bit biased of
growth hormone peptides.
So for example, like I from relevant and
test from rally and then, you know, the
growth hormone releasing hormones and
trying to get your own body to produce
more of the peptide of
the hormone on its own.
So that's that's personally my approach.
But I know there are very good
endocrinologists and very some very good
doctors who know how to cycle, you know,
who know how to dose the GH properly and
pulse it and everything so that it
doesn't cause your own body to shut down
or anything like that.
Yeah, no, I think that's
definitely the smart way forward.
And sadly, I think for a lot of people,
again, as the age, you're going to
struggle with the production, you're
going to struggle to get the maturity to
reduce enough GH, obviously,
which I think is maybe where those
peptides start to lose the efficacy.
As one gets older, would I
be correct my thinking there?
The your body's own the secret to dogs?
Yeah, you're yes.
Yeah, because you mean that because the
pituitary signal wouldn't be as good as
it was when you're younger?
Yeah, essentially.
Yeah, so so that yeah, so
they may not be as effective.
But then I mean, I've been able to use
those peptides and people in their 60s,
even, you know, to help them with their
growth hormone and fat loss
and recovery and all that stuff.
Okay, that's amazing.
Okay, next one, cloth or follow statin
just from a sort of a longevity
regenerate standpoint,
which sort of big stats you both
know is kind of the brain, let's say the
brain one, right helps it can help with
brain focus, like may help with IQ even
and has all these interesting benefits
for protect your body against dementia,
especially even if you have the apo E4
gene, it can protect your body.
So clotho is a really
interesting peptide.
And false data is kind of the physical
version of that, which it can help with
strength and muscle.
So I'm a little bit biased, I guess,
because I'm a bit of a gym guy.
And I think I think follow statin
probably has more applicability for the
wide, let's say the wider population
based intervention, because most people
don't have enough muscle, and most people
lose a lot of muscle as they get older.
So if you can do something to combat that
process, I think that's going to be a
more important public
health intervention.
Fair enough.
Okay, if you were to speculate, when do
you think gene therapy generally speaking
is going to go mainstream?
Do you think it's going to
be the next five 10 years?
Mainstream gene therapy is kind of I
think gene therapy is where like, you
know, stem cells were like 10 years ago,
maybe so like, yeah, 10 years probably
like stem cells, I mean, aren't
mainstream mainstream, but they kind of
are getting mainstream, you know, like,
obviously, like now with the big
celebrities and all these other people
doing it, there's a lot
of people interested in it.
And most people have heard about stem
cells, but most people have not heard
about gene therapy or like just have very
vague understanding of it.
Fair enough.
And last one, what is your longevity and
health optimization
routine currently look like?
Well, aside from just the basics of
weight training and cardiovascular, you
know, keeping the biggest thing I think
for that stuff is high intensity short
bursts of exercise, you don't have to
spend hours in the gym, you can even do
15 minutes of high intensity, like a full
body a few times a week, same thing with
high intensity interval training.
So I think being efficient and having
intelligent protocols is
kind of the way to do it.
And I think supplementation is also one
of those interesting areas, which we
could probably spend a
lot of time talking about.
But we were but I definitely like there's
certain supplements I definitely like
such as creatine, such as the collagen
peptide that you guys make, I really like
that one that we're talking about,
because that's, you know, something
that's hard to get through diet.
There's a really
interesting supplement called glitine.
Glitine is the only supplement I know
that can improve
intracellular glutathione.
So I like so that's a really interesting
supplement because glutathione is like
the master antioxidant in your body and
glitine can is
basically a precursor to that.
So those are some of like my favorite,
let's say, longevity supplements that I
take on a regular basis and then and then
just kind of doing the foundational stuff
with minimally processed foods and sleep
and mindfulness and all that good stuff.
That's amazing.
Dr.
Khan, you've been amazing.
Honestly, that was an
incredible conversation.
Thank you.
Where can we point people to find you
should they wish to sort of reach out
learn more about it and
what it is you do, etc.
Yeah, I mean, I think I'm most active on
Instagram at dr.acon aka jn.
And then we are web our company is called
Eterna, like eternal without L and our
website is Eterna.health if they want to
check it out for more information.
Perfect.
Thank you so much for your time.
I'm definitely going to have to sort of
try and get back into Mel's good books
and see if I can book
you again in the future.
But this has been amazing.
Thank you so much.