Live Longer and Healthier with Dr. Alexander Paziotopoulos, MD

Today I'm speaking with Dr. Paziotopoulos on the Longevity Optimization Podcast. In this episode, we explore his unique journey into the field of medicine and longevity, focusing on the integration of AI in health monitoring and the innovative concept of medical maintenance engineering. The conversation delves into the importance of imaging, the role of supplements, and the critical significance of compliance in health programs. Dr. Paziotopoulos highlights key compounds for longevity, emphasizing the essential role of vitamin D in overall health and its importance in cancer prevention.

Dr. Paziotopoulos is a distinguished physician and researcher with a deep commitment to advancing the field of longevity and personalized medicine. With a background in both traditional medicine and cutting-edge technology, he has become a thought leader in the integration of artificial intelligence into health monitoring systems. His expertise encompasses a wide range of health topics, including the development of innovative health protocols and the exploration of novel compounds that promote longevity. Dr. Paziotopoulos is particularly passionate about the role of vitamin D in health, as well as the importance of water filtration and gut health. His forward-thinking approach emphasizes the need for data-driven solutions in healthcare, making him a pivotal figure in the future of age-reversal medicine and functional health.

Follow him on Instagram : https://www.instagram.com/alexpazio/

Timestamps

02:57 The Journey to Medicine and Longevity

06:11 Medical Maintenance Engineering: A New Approach

09:05 Imaging and AI in Health Monitoring

11:59 The Role of Supplements in Longevity

18:03 The Importance of Compliance in Health Programs

21:01 Exploring Key Compounds for Longevity

23:59 The Benefits of Natural Foods vs. Supplements

26:57 Vitamin D: The Essential Hormone for Health

31:04 Vitamin D and Cancer Prevention

32:41 Exploring Methylene Blue

34:32 The Importance of Water Filtration

40:53 Patient Management and Protocol Development

52:33 Age-Reversal Medicine and Future Therapies

01:01:04 The Future of Medical Maintenance Engineering

01:03:43 The Future of Data-Driven Medicine

01:12:27 Understanding Omics and Personalized Health

01:19:24 AI's Role in Longevity and Health Optimization

01:26:40 Innovations in Cancer Detection and Treatment

Transcript

[00:00:00.280] - KAYLA BARNES-LENTZ

Welcome to the Longevity Optimization podcast, where we discuss longevity, optimal health, nutrition, peak performance, cognitive excellence, and so much more. All right, Dr. Paziotopoulos. It's a pleasure to have you here with me today.

[00:00:14.600] - ALEXANDER PAZIOTOPOULOS, MD

It's a pleasure to be here. It's a beautiful place.

[00:00:16.720] - KAYLA BARNES-LENTZ

Thank you so much. Today, we're going to be talking about AI and longevity. You're a medical doctor. Tell us a little bit first, how did you get your start? How did you get interested in longevity?

[00:00:30.400] - ALEXANDER PAZIOTOPOULOS, MD

Yeah. I mean, a long story, but I went around the long way.

[00:00:35.130] - KAYLA BARNES-LENTZ

Okay. Well, tell me about it.

[00:00:36.960] - ALEXANDER PAZIOTOPOULOS, MD

Instead of standard undergrad medical school gone, I did undergrad, and I did it in physical methodology and ecology, ethology, and evolution. Then I didn't do much with it and became a builder, and I built for about eight years in Chicago, houses and projects things like that. Interesting. But that was really cool because I got to learn a lot about project management, and that is really being useful now. Then I got into yoga, and one of my girlfriends got me into yoga, and I dove headfirst and did this super long teacher training right out of the gate. I fell in love with Ashtanga and sold my business and moved to Boulder.

[00:01:26.580] - KAYLA BARNES-LENTZ

Big life change.

[00:01:28.550] - ALEXANDER PAZIOTOPOULOS, MD

Lived in a cooperative house where you had to be a vegan and you had to do Vipashana meditation. You had to be an activist, and you had to have a spiritual practice. That was called the Chrislist Cooperative. I lived there for a few years and studied with Richard Freeman doing a shodanga, and then I started doing Shaolin Kong fu. Okay. And fell in love with that and went all the way up to about third-degree black belt. Oh, wow. That's great. I was feeling amazing. It was probably like some of the most vibrant I've ever been in my life, but I didn't have any stressors. I just decided I want to do something with all this. So went back, took some more classes, did some neuroscience this time in more biochemistry. I was going to go down the PhD route of neuroscience. One of my best friends tucked me out of it. He's like, That's not going to work. What was his reasoning? I'm like, Why is that not going to work? He's just like, think about it. He's like, you're going to write a dissertation. They're going to tell you, rewrite it. You're going to tell them you don't need to rewrite it.

[00:02:37.410] - ALEXANDER PAZIOTOPOULOS, MD

They're right. They're never going to get you a degree. He's like, and then if some wonderful thing happens and you can get through all of that, then you have to write for grant money. Yeah. And who are you going to get your money from? Yeah. And I'm like, why don't you just write the grants for the money? He's like, they're all going to be dirty companies, according to you.

[00:02:57.960] - KAYLA BARNES-LENTZ

Yeah.

[00:02:58.510] - ALEXANDER PAZIOTOPOULOS, MD

And it'll be dirty money and you won't take it, so you'll perish. He's like, Why don't you just go be a doctor and then you could do research or you could see people or you could do whatever you want.

[00:03:08.080] - KAYLA BARNES-LENTZ

Yeah, that's true.

[00:03:09.320] - ALEXANDER PAZIOTOPOULOS, MD

I was like, Oh, yeah, all right, I'll do that. I went to med school, and then In med school, I was like, Well, I don't know if I really want to do this stuff. I found a functional medicine program out of A4M. I started doing that while I was still in med school.

[00:03:28.190] - KAYLA BARNES-LENTZ

Oh, wow.

[00:03:28.730] - ALEXANDER PAZIOTOPOULOS, MD

That sounds much. Which They let me start it. Of course, I wouldn't be able to get my fellowship until you have a certain amount of years of practice. But it was a double-edged sword because while you're going through residency and you know functional medicine, Oh, yeah.

[00:03:45.550] - KAYLA BARNES-LENTZ

I'm sure that has to be.

[00:03:46.490] - ALEXANDER PAZIOTOPOULOS, MD

They really butt heads really hard.

[00:03:48.730] - KAYLA BARNES-LENTZ

I storm you about it.

[00:03:51.010] - ALEXANDER PAZIOTOPOULOS, MD

It got me in trouble a lot. I did. So I'd be like, Well, I don't want to do that.

[00:03:54.930] - KAYLA BARNES-LENTZ

Yeah, we could do this, right?

[00:03:58.130] - ALEXANDER PAZIOTOPOULOS, MD

Anyway, and then the residency I went to was really awesome because it had integrative medicine and residency from Arizona, Dr. Wiles program. Oh, nice. I got that. Then I did functional medicine, I did the advanced metabolics, and then I did a stem cell fellowship, and I threw some esthetics in there. Then I did peptide workshops. Nice. I just keep trying to stay on top of everything. Then lately, I've been in age reversal conferences. Fun. I created this thing called the Medical Maintenance Engineering.

[00:04:30.020] - KAYLA BARNES-LENTZ

I love that. We talked a little bit about it.

[00:04:32.450] - ALEXANDER PAZIOTOPOULOS, MD

That's what I speak, and that's what I'm asked to speak about at conferences.

[00:04:37.120] - KAYLA BARNES-LENTZ

Okay, so let's first of all, love the story. You've lived a couple of our lives, it sounds like, but I love where you ended up. The industry, it's so fun. Actually, are you going to A4M this year? Yeah, I'll be there. Okay, great. Me too. We're doing this red carpet thing on the 15th. Are you familiar with that? I don't know what that is. It was like a documentary called Biohack Yourself. Oh, I'll also do some details about it. They're about to do one on female health, too, that I'm in. That's cool. It's a lot of fun. That'll be good. But love A4M, great resource. Yes, talk to me about this new platform that you've built.

[00:05:13.670] - ALEXANDER PAZIOTOPOULOS, MD

Yeah. Think about it like this. Think about something that's really complex that needs to be maintained at the utmost level of optimization or people die.

[00:05:28.680] - KAYLA BARNES-LENTZ

The so the body?

[00:05:29.670] - ALEXANDER PAZIOTOPOULOS, MD

No, just in general. So think about the airline industry or bridges or rockets, NASA projects, things like that. If you go back in time over 100, some years ago, they created maintenance engineering, because what the engineers found out back then was that their machines were not the sum of their parts. When you start making really complex machines, they act differently, and you also have to make sure that they're maintained at the right level. This part might last for this many hours, or this part might go under a certain amount of stress and needs to be replaced at a certain time, or this hydraulic system might need maintenance at this scheduling. Then they figure out, okay, it might fail here, so that means that we have to maintain it here. Otherwise, people die. The airline industry is a great example of this because there's very few crashes. I mean, there are, but they're extremely few. Then you compare that to the system of medicine that we have today. If you listen to NASA, they always talk about single points of failure. They might have, say, the James Webb Space Telescope, right? It had, I don't know, 250 or something more single points of failure.

[00:06:56.360] - ALEXANDER PAZIOTOPOULOS, MD

If any one of these failures happened, the whole thing was scrapped. They would have a useless piece of garbage in space, billions and billions of dollars. They had to make sure that everything worked really well. And those single points of failure, they worked it out really well, so they didn't happen. We have single points of failures as human beings. This is one of the things that drives me crazy about longevity is because people don't talk about this first. Somewhere between every 40 seconds and every minute in this country, there's a cardiovascular event, an MI, a heart attack. That's ridiculous because we have the clearly heart exam, or you could just get a CTA. There's all there are kinds of measures that you can do with Pervatory-wise. So this is a completely preventable thing, 100%. Nothing's 100% preventable, right? But we could drastically reduce how many cardiovascular events there are. Same thing with strokes. We can image the brain with contrast, and we can see all the blood vessels in the brain, and if there's going to be an aneurysm or they're not going to be an aneurysm. You can do that at regular intervals so you can track and you can measure.

[00:08:11.820] - ALEXANDER PAZIOTOPOULOS, MD

So you're like, Okay, this blood vessel was this diameter at this point in I mean, now it's this diameter at this point in time. Then you can graph that out like, oh, this is going to rupture, and it's going to be an aneurysm. It's just like that same thing with the hose when it starts to open up. Poosal's law says that the pressure times radius to the fourth, it's going to go. We need to keep track of all the main vessels, the aorta, all the main vessels of the brain. Nobody does that, or there's very few people that do that.

[00:08:41.060] - KAYLA BARNES-LENTZ

Yeah, it's actually funny. I did this, the German company called Perceiven, I think, came, flew out. They flew out yesterday, and they filmed. They came over at 5: 00 AM. As I was rolling out of bed, they filmed my entire routine. But one of the questions that they asked, because my husband and I have gotten a lot of press about living to 150 and stuff, and they asked me, Are you scared that something's going to happen to him out of the blue? My response was, From a health standpoint, I'm not, because we're imaging, we're doing the clearly soft product analysis, we're looking at the brain, we're doing the MRI. It would be a very small percentage, but most people, it would be a very small percentage that something health-wise came out of the blue. Because we see where things are trending, right? And the second that I see that trending in the wrong direction, you take action, and then you can stop that from becoming a It's a massive issue. Sure, one of us could get paid by a car or something. That's a different situation. You don't have control over that. But I agree with you completely.

[00:09:39.370] - KAYLA BARNES-LENTZ

But I think such a very tiny percentage of people see it like that.

[00:09:44.210] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, right. Then there's these companies that are even doing full-body MRIs on people, and they're quite expensive. My cost is so much less than what people are paying out of pocket. Then when I see the reports, when people go and get these things and they bring them in, they're not very detailed at all. These radiologists are not. The radiologists that work with us, they're measuring everything. Then we're also taking that and we're sending it out to different AIs. Then those AIs can analyze things in a different way, clearly does for the heart, that a radiologist can't see. Yeah, it's right. Radiologist, they can see things with their naked eye pretty well, but it's really hard for them to pick up like, well, how much iron is deposited in this organ? And what degree of inflammation does this organ have? And what is the exact volume of this organ? That ties in with the thymus a lot. We know the thymus gland responsible for T cells and your immunity, it goes through this thing called involution, and it gets smaller and smaller as you age, and so it gets less effective. Not only does it get smaller, it gets infiltrated with fat.

[00:10:58.870] - ALEXANDER PAZIOTOPOULOS, MD

And so So you can see it with the naked eye a little bit, but the AI can see it a lot better. The AI can say, okay, there's this much fat there, and there's this much what they call parenchyma, which is the natural tissue of that organ. Then we can track that over time, then we can see, okay, are these things that we're doing that are supposedly going to grow the thymus back working? Or are they not working? We need to make changes.

[00:11:26.230] - KAYLA BARNES-LENTZ

Do you do any growth hormone and see any benefits with that?

[00:11:32.030] - ALEXANDER PAZIOTOPOULOS, MD

I like to use peptides that stimulate growth hormone rather than using growth hormone.

[00:11:38.650] - KAYLA BARNES-LENTZ

Something like a CJC or...

[00:11:40.640] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, and now we're limited on which ones we can use because the FDA.

[00:11:44.500] - KAYLA BARNES-LENTZ

They're bringing some back, though.

[00:11:45.670] - ALEXANDER PAZIOTOPOULOS, MD

Yeah. Cjc is coming back first quarter next year. Yeah. Which is great.

[00:11:50.050] - KAYLA BARNES-LENTZ

I think it's something that might already be back. Yeah. We can get it now.

[00:11:53.800] - ALEXANDER PAZIOTOPOULOS, MD

You can always get it for research use, but in the clinic, I can't do that.

[00:11:59.390] - KAYLA BARNES-LENTZ

No, we can I get it from actual FDA pharmacies now, but it might be state by state. Maybe they're rolling it out a little slower.

[00:12:06.050] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, but we shouldn't be able to get that back. I think a lot of the peptides will be able to get back now.

[00:12:11.060] - KAYLA BARNES-LENTZ

Yeah, which is... That's a different conversation. Well, actually, yes, I also agree with you. I think there's a very specific reason why we're going to go to a lot of peptides back here soon, but that's another conversation. Real quick to go back to the MRI. How are you getting the more detailed imaging? Do you guys own an MRI? Are you referring out?

[00:12:31.170] - ALEXANDER PAZIOTOPOULOS, MD

Well, I refer out. I just made a deal with a company that's nearby. They have a nice good three Tesla MRI. The Institute for Medical Maintenance Engineering, we're going to obtain a Siemens 3D, which is state of the art. Yeah. I've done one of those before. We were looking at a higher grade, like the seven Teslas that are out. I just had to laugh when I saw the sticker price because they're for research only right now. They're like $60 million.

[00:13:04.010] - KAYLA BARNES-LENTZ

$60 million?

[00:13:04.620] - ALEXANDER PAZIOTOPOULOS, MD

Okay, jeez. Then you have to know how to read them and set them up. Then that's the...

[00:13:09.250] - KAYLA BARNES-LENTZ

Oh, my God. I did not think you were going to say $60.

[00:13:13.140] - ALEXANDER PAZIOTOPOULOS, MD

Got it. A little out of my price right now. And then 11 Teslas are going to be coming, too. But a good three Tesla with AI, you're going to get to a very small resolution.

[00:13:28.500] - KAYLA BARNES-LENTZ

What's AI?

[00:13:30.070] - ALEXANDER PAZIOTOPOULOS, MD

There's different AIs that can look at imaging. When we talk about AI, one of the things that AI does the best is looking at imaging. If you go back and you look at Watson that was developed more than 10 years ago, and it was better than radiologists were back then because they fed so many different studies into Watson. Now every AI has access to all the stuff Watson I had.

[00:14:00.570] - KAYLA BARNES-LENTZ

What happened with Watson? Didn't something...

[00:14:02.950] - ALEXANDER PAZIOTOPOULOS, MD

I think Watson just evolved into other things. Okay. Basically, everything that Watson learned is now available to most AIs.

[00:14:11.780] - KAYLA BARNES-LENTZ

Okay, got it. That was ahead of its time, I guess.

[00:14:15.160] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, way ahead. It was amazing in itself. Now the new AIs are even better. I mean, a lot better.

[00:14:22.230] - KAYLA BARNES-LENTZ

Yeah. Is there a particular one, though, that you guys are using for the MRI? Something like, Clearly?

[00:14:28.410] - ALEXANDER PAZIOTOPOULOS, MD

Yeah. There's a Company, and they're out of England. How can I think of their name? And they do an organ scan. So they do a liver scan, and then they can apply that also to all the other organs, to the pancreas and all that stuff. And they do the same reading. So inflammation, how much fat, how much iron. They give you a bunch of different readings on it, and they can even do volumes and things like that. You're going to be able to program any AI. We have an AI that we're working with right now that we're programming. Nice. So it's our own. It's necessary for the IMME or the medical engineering because we're collecting all this data into a data lake. The big thing that I see that's a real need in this field is data, but data that has compliance. For instance, say you give somebody X amount of medicines and supplements and lifestyle stuff, you don't know exactly if they're doing that or not. You have to just see if they're doing that or if they're not. You just ask them subjectively. The problem with that is manifold, but mostly that people are not very good at observing themselves and knowing what they're doing.

[00:15:55.000] - ALEXANDER PAZIOTOPOULOS, MD

Since I've been tracking, I like to ask people because I have the data. I can go on to how we're getting the data. I'll say, Well, how good are you on your supplements? They're like, I don't know, 70, 80%. And I know that they're like 20%. Gosh, Yeah. Right? I can show you. In my bag upstairs, I have when we give supplements and medications, we give them in packs. Nice. People sign waivers. We had our lawyers work it out. Because compliance was so poor, even with the people, and people that come in to do this, I do an interview with them to see if they have what I call radical willingness. Because if they don't have radical willingness, I say, That's not really a good program for you because it's really demanding. Not so much demanding on your time. Maybe it does take some time, but more demanding on you just have to be disciplined to do these things.

[00:16:56.680] - KAYLA BARNES-LENTZ

You're not going to say demanding on your discipline.

[00:16:58.440] - ALEXANDER PAZIOTOPOULOS, MD

I'm like, And I try to I'm like as much away from them as I can. You go into somebody that's biohacking or something in their house and there's bottles everywhere.

[00:17:09.220] - KAYLA BARNES-LENTZ

Like supplements.

[00:17:10.680] - ALEXANDER PAZIOTOPOULOS, MD

Right. They're responsible for taking those things at whatever time of day or with food or without food. And that becomes a hobby and a hobby that takes up a lot of time. And so we pretty much eliminate most of that by just getting them in these packs. The next iteration of these packs are just coming out early next year is they'll be able to take their pack and just wave it over their phone, and it'll give us a time and date stamp. Then we know exactly what supplements, what medications, everything that's taken and what time. We'll have even better compliance than we do now, because now everything goes out in 30-day cycles. What will happen is people will be like, Oh, I still have stuff I don't need anymore. Then we're like, Okay. We're tracking month by month, but now we're going to be able to track not only day by day, but what time.

[00:18:03.270] - KAYLA BARNES-LENTZ

Yeah. You could just say that you're going to be fired from the program if you don't do it. That would increase compliance.

[00:18:09.600] - ALEXANDER PAZIOTOPOULOS, MD

Yeah. I mean, it's a little rough on people, but like...

[00:18:12.970] - KAYLA BARNES-LENTZ

But you know, sometimes you got to take the hard stance because it is for whatever reason. It's just something in my brain is different where being super disciplined to me, I'm obsessed with it. I love it. But for so many people, it's so difficult.

[00:18:28.350] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, it is. I think We're just trying to make it as easy as we can. The other thing is that we want to be able to get really good data so that we know what's working and what's not working and that we know what to change. Yeah. Right? Right now, they get checked in on once a week by a liaison. They call them. They call them a coach or something. They get a little questionnaire that's shot to their phone, so we can get more data that way. Yeah. Then they can also get a little encouragement and things like that.

[00:19:00.830] - KAYLA BARNES-LENTZ

You should make it a voice note. That would be a little easier.

[00:19:02.790] - ALEXANDER PAZIOTOPOULOS, MD

Which people need. Everyone's so different. We try to give them options of what they want. Yeah, I would love a voice note. Some people want to talk to somebody. Somebody wants to text. Somebody wants to fill out a questionnaire. So we just try to... I'm like, I just need the data. Whatever you're going to do, just do it. Sure. I mean, there's just humans, right? But Now we'll be able to feed that to all the different universities. We have a person from Berkeley that's in bioinformatics that's going to help us look at some stuff. Ucsd, they're going to help us look at things. As we start to get more and more data, we're going to be able to say, Okay, this doesn't seem to work. This seems to work. Right now, we're using as much as we can. Whatever I deem is nont Toxic, pretty much, that has great potential to help.

[00:20:04.260] - KAYLA BARNES-LENTZ

What are some of your favorites?

[00:20:04.950] - ALEXANDER PAZIOTOPOULOS, MD

Right. Oh, gosh. I mean, we're probably working with over 100 compounds.

[00:20:13.110] - KAYLA BARNES-LENTZ

Okay. How many people on average, like how many supplements on average is each person in this program taking?

[00:20:20.280] - ALEXANDER PAZIOTOPOULOS, MD

Probably over 100.

[00:20:22.110] - KAYLA BARNES-LENTZ

Per day?

[00:20:22.960] - ALEXANDER PAZIOTOPOULOS, MD

Not capsules, but as far as different compounds, for sure. What are top five? I would say top five would be nicotinamide riboside. Ornithin, alpha-ketoglurate. I know that people like calcium, but I like the ornithin a little bit better. You can take it in higher amounts, and it also helps with the nitrogen scavenging. All you really need is that alpha-ketaglutriate portion. That calcium part doesn't really matter. I really like that. What else do I really like? I like TA 65. We have that in there. We don't really know exactly the data, but I do see changes in the immune system response.

[00:21:13.340] - KAYLA BARNES-LENTZ

What is that? I'm not familiar How did you find them?

[00:21:15.760] - ALEXANDER PAZIOTOPOULOS, MD

So TA 65 was created, I don't even know, 15 years ago, and they wanted to lengthen telomeres. Okay. All right. And so they created this It's a proprietary way of... It's taken from Stragilis, but it's how they did it that allows you to somehow get lengthened telomeres. The telomere data is okay, but the data on the immune system is far greater. Yeah. And so I really like it for that. Anytime I can get the immune system to work a little bit better, we're winning. Yeah, I agree. I really like that. I don't give spermedine in a pill form.

[00:22:03.890] - KAYLA BARNES-LENTZ

Okay.

[00:22:04.460] - ALEXANDER PAZIOTOPOULOS, MD

I really like spermedine in its natural food source. Okay. So NATO. I'm a huge soy proponent.

[00:22:14.990] - KAYLA BARNES-LENTZ

Okay.

[00:22:15.560] - ALEXANDER PAZIOTOPOULOS, MD

A lot of that has to do with mitochondrial data. Interesting. I just gave a keynote in Andora. It was with Aubrey. Aubrey. Nice. Yeah, I was in and he gave his talk and I gave my talk. A lot of it came from Dr. Hemel Patel. When I was going through all the data for mitochondria, it comes down to how healthy are your membranes.

[00:22:45.960] - KAYLA BARNES-LENTZ

Yeah.

[00:22:46.850] - ALEXANDER PAZIOTOPOULOS, MD

Right? And mitochondria have to sense both the outside and the inside world. They have to know what's going on in the nucleus. They have to know what's going on in the cytoplasm. They have to know what's going on outside the cell. They When you do that by this, they're always in contact with these different membranes. And so membrane fluidity is really important. Most of what your membrane is made out of is Phostal cooling. And there's Some ways you can get phospital coine, but if you're eating soy, you're getting a ton of it.

[00:23:18.820] - KAYLA BARNES-LENTZ

Interesting. A couple of questions. First of all, how much NATO do you have to eat to get a clinically relevant dose?

[00:23:26.660] - ALEXANDER PAZIOTOPOULOS, MD

One teaspoon of NATO is going to give you about 15 milligrams of spermedine.

[00:23:33.310] - KAYLA BARNES-LENTZ

Nice.

[00:23:34.810] - ALEXANDER PAZIOTOPOULOS, MD

You're not going to get that in a pill. Or if you're going to get it, it's going to be incredibly expensive. There's so many other benefits to the NATO that I just tell people, just go buy natto.

[00:23:46.330] - KAYLA BARNES-LENTZ

Yeah, you have to figure out how to- Just go get it.

[00:23:48.900] - ALEXANDER PAZIOTOPOULOS, MD

It's like you got to get used to the taste. It's definitely an acquired taste because it's highly fermented. Yeah.

[00:23:53.840] - KAYLA BARNES-LENTZ

I love fermented foods, though. Also, I don't care too much about the taste. I just care about the benefit.

[00:23:59.470] - ALEXANDER PAZIOTOPOULOS, MD

Yeah. You're getting natokinase, which is awesome. It decreases fibrinogen, all that stuff, decreases inflammation. You're getting all the good fatty acids to maintain your membranes. You're getting the spermadine. There's a lot. Then you're getting all the phytosoyet estrogens that are going to block the over-excitation of the estrogen receptor. Because in today's life, due to all the toxins, everyone's estrogen receptors are just getting nailed. From all these plastics and all these other things. No, it's not about the estrogen or about the phytoestrogens. It's more about the fake stuff.

[00:24:45.060] - KAYLA BARNES-LENTZ

Because that was going to be my question. Obviously, yeah, we know that all of these endocrine disruptors and estrogen-mimicking substances are just caught running amok and causing chaos, right? I have always tried to I'm excited we're talking about this because I've always a little bit put the brakes on soy just because I felt like I already was potentially getting exposure. But you're saying that it won't increase the estrogen?

[00:25:12.640] - ALEXANDER PAZIOTOPOULOS, MD

It won't. I've never seen it. One thing I've really loved to do is I like to look at old medicine and just old health studies. When you looked in Asia before we started meddling and bringing Western culture over there, they had high soy intake and smaller breast size and less breast cancer, high soy intake. Interesting. Then they come and then those people from the same families that were living that way come to America, breast size increases, breast cancer increases. Now, it might not just be the food. There could be all the toxins and everything else going on.

[00:25:58.830] - KAYLA BARNES-LENTZ

Then maybe hormones, too, right?

[00:26:01.230] - ALEXANDER PAZIOTOPOULOS, MD

Hormones in our food, obviously. But in the state where they were at a high soy intake, they didn't have that. Interesting. That's just another thing, right?

[00:26:14.710] - KAYLA BARNES-LENTZ

Yeah. Interesting. Good to hear that. Okay, so we're down to not sperminine, but I'm pronouncing it wrong. How do we say it? Natto?

[00:26:25.400] - ALEXANDER PAZIOTOPOULOS, MD

Oh, Natto?

[00:26:26.180] - KAYLA BARNES-LENTZ

Natto. Yeah. Okay. What other molecules do you like How many of them?

[00:26:32.530] - ALEXANDER PAZIOTOPOULOS, MD

Let's see. As far as supplements go, there's so many of them. Urolithin A. Yeah, a lot. I like Urolithin A a lot. You can definitely get it from food. You're just not going to get in that dose. I also don't know. When they come up with these dosages, nobody really knows.

[00:26:57.660] - KAYLA BARNES-LENTZ

Yeah, that's true. Well, the dosage also It can't be the same because when I'm putting together my supplements and my husband's supplements, it's the same. It can't really be the same, but it's just a guess. That's right.

[00:27:08.780] - ALEXANDER PAZIOTOPOULOS, MD

I would still say eat the foods that are high in urolithin A. Like pomegranate and things like that. Gosh, I wish I knew what was really doing the bang of the work. Vitamin D and fish oils or algae oils, in my case, I'm vegan, gluten free since the '90s. They're the most important by far, hands down. I just always tell everybody, if we leave here, you never come back, just take your vitamin D and fish oil.

[00:27:48.550] - KAYLA BARNES-LENTZ

Yeah, out there, magnesium in the air, would you?

[00:27:50.890] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, that's funny. I mean, you can keep adding.

[00:27:53.990] - KAYLA BARNES-LENTZ

Those are the three. If you don't do anything else, it's like, do those things.

[00:27:57.580] - ALEXANDER PAZIOTOPOULOS, MD

There's pretty good data that a quarter of the diseases would just disappear with those two things.

[00:28:02.350] - KAYLA BARNES-LENTZ

I know. It's insane how... Well, first of all, the reference range is a joke anyway. How is it? What is it? 30 to 100? I mean, this is massive. We have so much data to say that 30 is not even acceptable. Then I heard an insane stat that 30% of the population has below 30. How do you even get below 30?

[00:28:26.790] - ALEXANDER PAZIOTOPOULOS, MD

Well, I mean, if you have dark skin, Okay. It gets really low. You just got to look back evolution. People living near the equator have darker skin. People living through the garb- Because they need a more-lighter skin, right? Yeah. You take somebody with really dark skin, and you take somebody with really light skin, and you put them out in the sun naked. The person with really light skin in 15, 20 minutes has made a whole day's worth of vitamin D. Yeah. The person with the dark skin might take four hours.

[00:29:01.670] - KAYLA BARNES-LENTZ

Yeah, I use this app. It's very fun. I do because they try to get... There's so many benefits, right? Obviously, we should take vitamin D supplementation if we can't get it. It's such a complicated, actually, conversation right now because, okay, we have the pros of the sun, actually the entire synthesis process of taking the sun and creating it into a usable form of vitamin D, which is super beneficial. But then we have the negative longevity impacts of the skin. Then we It's just- I would just take it. It's a whole thing.

[00:29:34.110] - ALEXANDER PAZIOTOPOULOS, MD

I mean, one of the analogies I give my patients is, imagine your skin is like a solar panel, right?

[00:29:42.210] - KAYLA BARNES-LENTZ

Yeah.

[00:29:42.860] - ALEXANDER PAZIOTOPOULOS, MD

Now, if you want to use your solar panel to make energy, what are you going to do? You're going to find a really nice sunny place where the entire panel is going to be covered by the sun all day. When do you do that with your skin?

[00:29:57.740] - KAYLA BARNES-LENTZ

Midday. Or are you So almost no one never does that, right?

[00:30:03.260] - ALEXANDER PAZIOTOPOULOS, MD

You have clothes on, and what percentage of your skin is actually available to the sun? Is it at the right angle to the sun? Is it there from the time the sun comes up to the time the sun goes down?

[00:30:14.500] - KAYLA BARNES-LENTZ

Oh, well, no, definitely not. Not that. I have the first few checked.

[00:30:18.090] - ALEXANDER PAZIOTOPOULOS, MD

It's like, I'm going to give you this as a solar panel, but I'm only going to let you use this much of it for only a half an hour a day. How much power are you going to make?

[00:30:24.770] - KAYLA BARNES-LENTZ

I know. Not much. I know. I try to get a little bit still. I have this app, so it'll tell you how many essentially I use. Then I'm lucky because it's super prior back here and you just don't wear clothes, and my husband and I lay out and get sun. I try to get some of the benefits, but yeah, then the rest of it, I just supplement with vitamin D.

[00:30:41.540] - ALEXANDER PAZIOTOPOULOS, MD

Because it's not a vitamin. It's a secosteroid hormone. Hormones turn on genes, and 200 genes of your immune system are dependent on vitamin D. If you look at meta-analysis, there's a a cutoff around 60. The people that have a vitamin D level higher than 60 are less likely to have cancer than the people lower than 60. It's quite a bit. If you look, there's all the different cancers have different numbers that they break off at. But I just try to keep everyone over 60. I like to keep people like 75, 80 just as a cushion. You'll hear people say, Oh, my gosh, calcium is going to get out of control. And if it goes too high and all that stuff. I've never seen it. Never heard about it. I've never seen it. It happened a couple of times where I saw really high levels. One was a bodybuilder, which was that level450. Wow. And I was like, Oh. And I did an AKG, and I got an INICE calcium, and I was like, Oh, my gosh. It was totally fine. No side effects, no nothing.

[00:31:55.050] - KAYLA BARNES-LENTZ

How does it think you get 450? It was popping 50,000 a day.

[00:31:57.790] - ALEXANDER PAZIOTOPOULOS, MD

Oh. Casual. Okay. Then I had another person when I was a resident who also was doing something crazy, and they were super high, and like, again, nothing. It's usually really safe. You probably have to have something else going on metabolically in order to have something go wrong with calcium. There's just a lot of checks and balances. I mean, imagine you're a primitive person and you're naked and you're in the sun beating down on you every single day. Like your body's making excessive amounts of vitamin D, you have to have fail-safe in order to deal with the high levels.

[00:32:36.110] - KAYLA BARNES-LENTZ

Yeah, that makes a lot of sense.

[00:32:38.290] - ALEXANDER PAZIOTOPOULOS, MD

Right? So, yeah, I think it's really safe.

[00:32:40.900] - KAYLA BARNES-LENTZ

Yeah. Trying to think if there's anything else I'm exploring. What do you think about Methylene blue.

[00:32:47.390] - ALEXANDER PAZIOTOPOULOS, MD

I played with Methylene blue quite a bit. In the little studies that I've done, and they're ends of five, so you're not talking a lot. Well, I like to I'll use the CNS vital signs test, and I'll have somebody do a CNS vital signs test, and then I'll give them a nootropic and do it again. I almost never see any differences. Really? You'll hear all these people like, Oh, it's so great. I'm like, get around your confirmation bias, get around your placebo effect and all that stuff. In that real world, it's minimal. But if it does make you feel better, why not? And There's a lot of cool benefits to Methylene Blue, besides your pea-tering green and stuff like that.

[00:33:36.780] - KAYLA BARNES-LENTZ

Or blue, depending on how much you take.

[00:33:38.560] - ALEXANDER PAZIOTOPOULOS, MD

You know what I mean? I don't know. Maybe I think once in a while, it might be good as an antioxidant, right? I do like... I like transcription's version of it because it's clean.

[00:33:56.160] - KAYLA BARNES-LENTZ

Yeah, it's really hard to find good methylene blue.

[00:33:58.260] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, you definitely do not I'm going to take lab methylene blue.

[00:34:03.140] - KAYLA BARNES-LENTZ

Yeah, agreed. Dr. Scott is a friend of mine.

[00:34:06.460] - ALEXANDER PAZIOTOPOULOS, MD

Okay, cool.

[00:34:07.230] - KAYLA BARNES-LENTZ

Hi, guys. I'm going to interrupt this episode for a brief announcement. As you may or may not know, I started a community for females by females, and it's a female longevity optimization community. This is a place that you can connect with like-minded women. We are all here to support each other, and there's a variety of different benefits to being a member. You get a monthly Ask Me Anything So submit your questions and I'll answer them directly. We also have an entire library of courses on all of the important components of longevity, such as labs, nutrition, exercise, sleep optimization, longevity optimization protocols that I'm doing, along with real-time updates to my personal protocols. There are so many benefits of being a member of the community. We'll also be doing in-person live events here in California and virtual events for anyone that can't attend. But if you're interested in joining the community, I would absolutely love to see you there, and I will include a link in the show notes. Okay, I want to go back to it, then we'll circle back to this because I'm interested in what we both think about these different supplements. Going back to this management system that you have.

[00:35:18.050] - KAYLA BARNES-LENTZ

Number one, I agree. I don't know if you've read up how often I'm doing labs, but I'm doing hundreds of biomarkers every quarter, super consistently. It's amazing because I see when any single thing changes. When we moved in here, I didn't immediately have a whole home water filtration system. I did have shower water filters. I did have reverse osmosis in the kitchen. Doing a lot already, right? Yeah. Nope, not good enough. I do a total tox burden again, and I see that those toxins are starting to creep up just because of shower water with a shower water filter. I love getting real-time feedback. My husband, for example, I bought all this paraben-free stuff. I'm the Chief Health Officer, he calls me. So I just give him stuff to take in his gym bag, and I see his total tox burn, and I'm like, your parabens have increased. What's going on here? What are you using? Yeah, and he's like, well, I just didn't grab it out of my gym bag, and I was using the one at the gym. And I'm like, it's amazing to me how fast you can catch things.

[00:36:20.910] - ALEXANDER PAZIOTOPOULOS, MD

Your skin absorbs. I mean, you ever see that chemistry experiment with chlorine?

[00:36:25.700] - KAYLA BARNES-LENTZ

I don't think I've seen it.

[00:36:26.940] - ALEXANDER PAZIOTOPOULOS, MD

Oh, it's great. It's like an undergrad The professor will do, right? They'll have a glass of water, like tap water, which doesn't have a ton of chlorine in it, but it's got enough. It's got enough where the pool test kit will pick it up. Horrible. Right? That's so bad. Then he'll put the pool test kit there and like, All right, there's chlorine in there, right? Then take your finger and just run your finger around the water for a while, pull it out, dry it off, and then do the test kit again. There's no chlorine in it. Interesting. It's all in your finger.

[00:36:57.310] - KAYLA BARNES-LENTZ

Wow.

[00:36:58.420] - ALEXANDER PAZIOTOPOULOS, MD

To me, I'm always just patients are like, Oh, I got to filter my drinking water. I'm like, Filter your shower.

[00:37:04.970] - KAYLA BARNES-LENTZ

Yeah, totally. But even the shower filters are not good enough, I feel like.

[00:37:10.190] - ALEXANDER PAZIOTOPOULOS, MD

You need a surface area, right? And what's crazy is you'll see these little disks, like this big for a shower water filter with high pressure. Yeah, it's tiny. And it's like there's just not enough surface area to hit all that water before it gets past it. You need a more robust filter The whole house is the best way to go, where you can get really big canisters of charcoal and bone char that are about this tall, 60 pounds. That's really the best way to go about it. But there is a company that makes a decent shower filter, and it's not that expensive. I think it's like 150 bucks or something like that. What is the name? We can always. It'll come back to me. They're great. Their slogan's the best. It's buy a filter or be a filter.

[00:38:04.910] - KAYLA BARNES-LENTZ

That's a great slogan. Yeah, I love that.

[00:38:06.720] - ALEXANDER PAZIOTOPOULOS, MD

They're called Vitasalis.

[00:38:08.330] - KAYLA BARNES-LENTZ

Vitasalis. Okay, great.

[00:38:09.330] - ALEXANDER PAZIOTOPOULOS, MD

They're a great little company out of Michigan, and their engineer will talk to you, and they won't just sell you a filter that fits all. They know most of the water quality from where you live, and if not, they'll have you send in a sample. Love that. Then they'll design the system based on your water.

[00:38:27.650] - KAYLA BARNES-LENTZ

Yeah, I love that. That's the way it really should be But I didn't know that was an option for shower water filters. That's the process for whole home, not only. But that's really helpful, and that is reasonable. I wonder how frequently are you supposed to change them every six months?

[00:38:44.270] - ALEXANDER PAZIOTOPOULOS, MD

I'm going to think it just depends on the quality of your water. If you're running really high chlorine in your area, you're going to do more often. I just like just getting these cheap kits and just measuring your own chlorine. Because there's no way that four months, six months, eight months, you don't know. It's just like once that charcoal is saturated, it's not going to pick anything else up. So just intermittently test. The big thing to test for is chlorine. If you see chlorine, well, then for sure, other contaminants are getting through, too.

[00:39:22.540] - KAYLA BARNES-LENTZ

Yeah, I know. Ideally, I think a whole home because I'm trying to... When you're looking at such a granular level at every single... Most toxin, not every toxin. But you can see because I can look at the water supply for Los Angeles, and I can look on the EWG, I'll look up our water supply and see the elevated levels. That time when I didn't have a warm water filtration, even with shower water filters, I could see some of those contaminants increasing. I mean, it's small, right? But it's like, if you keep doing it over time. Sure.

[00:39:56.620] - ALEXANDER PAZIOTOPOULOS, MD

You're somebody that song us.

[00:39:58.290] - KAYLA BARNES-LENTZ

Songs a lot.

[00:39:59.430] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, it's on Imagine the people that don't.

[00:40:01.560] - KAYLA BARNES-LENTZ

I know. That's why water filter, water filter, water filter, and an air filter. That's my first step for anyone who's like, I want to lower the tox. We have, I think, six of these.

[00:40:14.190] - ALEXANDER PAZIOTOPOULOS, MD

Okay, great.

[00:40:14.920] - KAYLA BARNES-LENTZ

Yeah. Could probably filter three times the amounts of house.

[00:40:18.920] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, and the same thing with the air filter, right? Hep is not enough. You have to have charcoal. Yeah. Pretty much charcoal for everything. Charcle, charcoal, more charcoal. Yeah, that's great. If If you want to take fluoride out, you need bone jar.

[00:40:32.590] - KAYLA BARNES-LENTZ

Yeah. Well, hopefully, now that we finally, however long it just took to figure out that fluoride is horrible for you, we finally are here, so maybe they'll start taking it out, but who knows?

[00:40:44.600] - ALEXANDER PAZIOTOPOULOS, MD

We can hope.

[00:40:45.830] - KAYLA BARNES-LENTZ

Yeah. All right. All right. So going back to the program, just walk me through. Say, I'm a new patient. What's going on here? Yeah.

[00:40:53.460] - ALEXANDER PAZIOTOPOULOS, MD

You're a new patient, or you're a prospective member of the institute is what we say, right?

[00:41:00.130] - KAYLA BARNES-LENTZ

Well, I have the discipline, so you can count on me for that.

[00:41:02.780] - ALEXANDER PAZIOTOPOULOS, MD

We do the whole interview with you to see, do you have radical willingness? We take you through a standard month, what's going to be required of you, and ask you, Are you willing to do all this? Are you willing to communicate with us? Are you willing to swallow all these pills? Because people don't want to swallow pills. They really don't. A lot of people, they give you a lot of flag for it. I I give them the rundown like, Did you ever see the sword swaluer at the circus? The sword swaluer at the circus didn't do that overnight. It's a skill. Can I swallow a whole handful of pills? Yeah, it doesn't even bother me. Do it in one second. But that doesn't happen overnight for most people, but you can learn to do it. I'm like, We're going to have little videos, and we'll show you how to do it. As long as you stick with it, you'll be okay. We take them through that, and then you say, Okay, I'm in. Then what we do is what we do with all maintenance engineers do. You start with what's called the discovery process. With the discovery process, we say, We want you to fill out these questionnaires, and we want you to give us access to as many of the old medical records that you have.

[00:42:23.130] - ALEXANDER PAZIOTOPOULOS, MD

Then we order all these tests. Everything from epigenetics to to the urinary hormones, it just goes down the gamut. Telomere length, all the labs, your mitochondria, and we get everything back.

[00:42:42.030] - KAYLA BARNES-LENTZ

What's your favorite test for measuring mitochondrial function?

[00:42:45.270] - ALEXANDER PAZIOTOPOULOS, MD

Oh, there's only one. The one that you mentioned. There's two. One, you can get a muscle biopsy, which costs thousands and thousands of dollars, and you have a huge large four needle going to your quad, or you do a Mi-screen.

[00:42:59.570] - KAYLA BARNES-LENTZ

Mi-screen. Meescreen. Yeah, I need to do that.

[00:43:01.250] - ALEXANDER PAZIOTOPOULOS, MD

That's one that I haven't done. Yeah. Mi-screen was developed by Dr. Hemel Patel on a grant from NASA. Nice. Because NASA wanted to be able to measure mitochondrial function of the astronauts without doing muscle biopsies. Icu, right? And they said, well, you also can't do a blood draw. He came up with this bilayer card. You put drops of blood in one well of the card, and then it wicks out the plasma to the other side, and it's stable for 30 days. You can send it to patients and they can just send it in the mail. That's great. It's fantastic information because it gives you all the different markers of mitochondria, especially how the mitochondria are acting when they're stressed. Great. Love that. I need to do that one. It's a great test. Really, the only reason that Dr. Patel is on our advisory board is that he ran that test on me about a year ago. He just gave me a free test, and he's like, I run this. Then I get a call from him and he's like, What are you doing? What? He's just like, We run 400 and something of these, and you're one of the best that we run, with them one or two.

[00:44:15.590] - ALEXANDER PAZIOTOPOULOS, MD

Nice. And they ran a bunch of 20 and 30-year-olds. Then I showed him my protocol and I'm like, Okay, we're starting the IMME, and he's like, Okay, I'm in. Love that. That was pretty cool. It's a really great test because I noticed that you run on people that you think are really healthy, and they're not.

[00:44:34.150] - KAYLA BARNES-LENTZ

Okay, so that was so interesting. You say some healthy people, you run the test.

[00:44:38.720] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, and I know we're getting off because you want to see what it's like to be a patient. But people that work out hard age faster.

[00:44:47.850] - KAYLA BARNES-LENTZ

Yeah.

[00:44:49.510] - ALEXANDER PAZIOTOPOULOS, MD

You can see it all over the board. I don't run the entire senalytic associated secretory phenotype, but I run a bunch of it. Yeah. They're making sonalytic cells faster, and their mitochondria are more stressed and less able to handle free radicals.

[00:45:07.580] - KAYLA BARNES-LENTZ

Got it.

[00:45:09.010] - ALEXANDER PAZIOTOPOULOS, MD

There's just really Goldilocks.

[00:45:10.980] - KAYLA BARNES-LENTZ

Yeah, let me clarify because I don't want people to hear that and think Oh, let's not work out. Because also I think that defining someone who works out really hard, it's not a big portion of the population, right? No. Because a lot of people actually don't push themselves. We go to an I don't say it's to be mean or anything, but you go to the gym and you see people that are just on their phone or doing nothing. But then mentally, they're like, I went to the gym, so that means I can eat more. This is really problematic, right? Let's define what is that Goldilocks role?

[00:45:46.480] - ALEXANDER PAZIOTOPOULOS, MD

To me, the Goldilocks... The thing that I really stress in people is you got to lift things that are extremely heavy. When you lift something that's extraordinary heavy for you, your brain lights up like a Christmas tree. So all these studies, whether it's QEGs, fMRIs, whatever, you think, Okay, what's the thing that stimulates the brain the most? It's like a deadlift. You're like, Wait a minute. So the deadlift stimulates my brain more than playing chest or doing calculus or something. It's like, yeah, logarithically more, like crazy amounts more. Doing mental activities does nothing for your brain. It's barely even turned on, at least voltage-wise. Yeah. Then the other thing is that you have to manage your Alpha1 motor neurons. You have your Alpha1 motor neurons, they're not different lines of motor neurons, but they're different sizes. The ones that can do long distance are smaller, and then the ones that do moderate, like intensity, are a bit bigger. Then you have this really small subset of them, that is massive Alpha1 motor neurons, and they're just for doing 100% output, like running a 100-yard dash or lifting that really heavy deadlift. If you don't use them over time, your body will say, This cell is not used.

[00:47:17.390] - ALEXANDER PAZIOTOPOULOS, MD

We're just going to recycle it. We're going to put it through apoptosis, and what do you need it for? You'll keep losing these cells as you get older and older, and your peak power goes down because you can't recruit the muscle. Yeah. You have to maintain power your whole life. More like you get older and you trip off the curb and you want to go catch yourself, you don't have that power to catch yourself. Because it's not just strength, it's power. Yeah. Really different. It's like power lifting versus Olympic lifting. And I do like people to do cleans if they can. I like people to do 100 yards sprints, but please do not do 100-yard dash. If you hadn't done it in a while, you will rip your hamstrings apart. You got to work up to it, right? But sprinting is really important. I try to get people, if you did sprints once a week and you lifted heavy weights twice a week, you'd be doing good. If you lift once a week, you'll maintain strength. You won't build. I think that the project is three times a week. If you can do full body stuff three times a week, I think you're doing fantastic.

[00:48:37.500] - ALEXANDER PAZIOTOPOULOS, MD

I really like the compound movements.

[00:48:40.220] - KAYLA BARNES-LENTZ

Agreed. Yeah, love those.

[00:48:42.080] - ALEXANDER PAZIOTOPOULOS, MD

I think they work the best. Overhead press, bench, that stuff, right?

[00:48:47.020] - KAYLA BARNES-LENTZ

Good for your bone, too, right?

[00:48:48.420] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, because you want to maintain bone density, especially women. They lose bone density really quickly if they don't do these types of things, and they don't replace their hormones.

[00:48:57.040] - KAYLA BARNES-LENTZ

Yeah, I agree. Okay, so going back to the goalie Gosh, rule. We're saying, are we saying strength training three times per week?

[00:49:03.860] - ALEXANDER PAZIOTOPOULOS, MD

Strength training three times a week, if you can, at least twice, full body, sprints once a week. The rest of it, zone two. Maybe you can do some intervals. Everyone's talking about four by fours and all that stuff. It's like, okay. But sometimes those real intense exercises will put too much strain on your mitochondria. You You just have to know your body and you know your recovery and whether you have an Apple Watch or a Oura Ring or a Whoop or something, get some data. Then when you do these really detailed tests like we do at the institute, you'll see. Whether you're working too hard or you're not working hard enough.

[00:49:47.220] - KAYLA BARNES-LENTZ

Yeah, that makes a lot of sense. It's pretty close to what I'm doing. I do 10,000 to 15,000 steps per day, which is great because these hills are amazing for in a zone 2. That's fantastic. Then I'm doing one to two days per week of zone 2 training, so it is like a four by four. But this is something I've done for a long time, so it's not like I'm throwing myself into something new. Then I do 3,000 to 4 days of strength training. But I'm only doing... I used to do a lot longer workout. I'm only at the gym for about 45 minutes now, so it's not as strenuous. But so, yeah, I think we're pretty aligned on that, too.

[00:50:24.430] - ALEXANDER PAZIOTOPOULOS, MD

Yeah. Anybody that doesn't know where to start, like Mark Ripto has He's got starting strength, and the app goes on your phone and it's got videos. The big thing with lifting weights is start very light and make sure you have perfect form and make sure you're holding your breath and bearing down against your... Not pulling in, but tightening your core because your back has super strong muscles, but there's nothing in the front of your spine to protect your spine, especially for slipping a disk. When you hold your breath and then you tighten your core really solid, you're creating a really strong air pressure to protect your spine.

[00:51:14.210] - KAYLA BARNES-LENTZ

Nice.

[00:51:14.880] - ALEXANDER PAZIOTOPOULOS, MD

And so learning that, learning really good form, don't let your back round when you're under load. That's really what will get you hurt. And increase your load as you can as long as you don't compromise your Yeah. Right? And if you're a beginner, you will gain strength so fast. It's not even funny.

[00:51:37.470] - KAYLA BARNES-LENTZ

Yeah. It's so fun, too. Like watching improvements. It's like the best feeling.

[00:51:42.500] - ALEXANDER PAZIOTOPOULOS, MD

And talk about energy. People get energy boosts like they've never experienced in their life from weight training, from real weight training.

[00:51:51.580] - KAYLA BARNES-LENTZ

And you get tired later. We're still out of sync, right? I can't imagine these people are staying up all hours of the night watching TV. At At 8: 30, I'm exhausted. I'm falling 8: 00, I'm starting to get tired because A, I optimize circadian rhythm, but B, I also I'm actually pushing myself during the day.

[00:52:12.110] - ALEXANDER PAZIOTOPOULOS, MD

Let's get back. We're doing all these tests. We go to all these tests, and then we create this protocol for you. Your protocol, depending on your age, obviously, and let's just say you're over the age of 40, which is pretty much most of the people. It's my cut off of where I I want to start doing age reversal medicine on someone.

[00:52:33.320] - KAYLA BARNES-LENTZ

Cut off in terms of you don't want people older?

[00:52:35.410] - ALEXANDER PAZIOTOPOULOS, MD

Younger. Younger, okay. I'll treat people that are younger. I'll optimize them, but I don't want to put them on full age reversal.

[00:52:43.430] - KAYLA BARNES-LENTZ

That makes sense.

[00:52:45.190] - ALEXANDER PAZIOTOPOULOS, MD

I'm just like, yeah. But technology in 10 years, you'll have it, and don't worry, you're not going to age that much. Yeah. All right.

[00:52:53.720] - KAYLA BARNES-LENTZ

And plus, I have to always remind myself, there's some things I'm not doing. So I turned 34 a week ago. Yeah. And there's some things that are exciting in the industry, like gene therapy, for example. I'm not doing it. I think it's great maybe for some older people, but for me, no. I haven't had kids, and I was 33 years old last week. So We have- In the next 10 years, it's going to get so much better than it is today.

[00:53:19.860] - ALEXANDER PAZIOTOPOULOS, MD

So Brian Delaney, he's also on our advisory board, and he's deep into the genetics, along with Liz. And Liz is working with vectors, dead viruses, basically, to get this genetic material into your cells. That works good. I mean, just looked at her. She stopped working out and her quads got bigger. She knows what she's doing. There's just new therapies that are more short-lived, and they're using plasmids. I think that that's going to be a huge thing in the future, and you're going to have to get them every year.

[00:54:00.010] - KAYLA BARNES-LENTZ

It's a tune up.

[00:54:00.670] - ALEXANDER PAZIOTOPOULOS, MD

It's tune ups. But I think that they're going to get much cheaper than they are now, and you'll have access to a lot more genes, and you'll be able to do more with it. And then it'll just get better and better and better. That's definitely in the future. Like, do I play with it now? Yeah. But only as a very last resort, there's my different tier system of what I want to do. And that's the last thing. It's top of the pyramid stuff.

[00:54:28.600] - KAYLA BARNES-LENTZ

Yeah. If someone maybe really needed to add a muscle mass or something?

[00:54:34.010] - ALEXANDER PAZIOTOPOULOS, MD

Would you think that- Yeah, they really need to. It's mostly like, say somebody was really sarcopenic, and they were really struggling, and they just wanted to live a little longer, a little healthier, and money had no object. Because if you're going to be in the institute and you're going to optimize all of your supplements, and you're going to optimize all your pharmaceuticals, and then you're going to optimize your age reversal, and you're going to optimize your hormones, and you're going to get all this testing on regular intervals, and you're going to use peptides, that's already a massive expense. And that's the majority of what's going to work. Yeah. Right? Yeah. Anything else that's left over, like exosomes or stem cells or gene therapy or plasma exchange, are we going to do it? Sure, we can do it. But it's more on top of all that.

[00:55:26.370] - KAYLA BARNES-LENTZ

Yeah. Right. Agreed. That's a good base.

[00:55:29.630] - ALEXANDER PAZIOTOPOULOS, MD

Yeah. We would do is we would create a protocol based on your labs for all of your pharmaceuticals and all your supplements.

[00:55:39.080] - KAYLA BARNES-LENTZ

Is it you doing it or in your team, or is it AI?

[00:55:42.880] - ALEXANDER PAZIOTOPOULOS, MD

I'm doing it. We run whatever I do through AI just to check and look and give me other ideas of what I might be missing. We also give it to the AI so that the AI knows what I started. Mm-hmm. The AI is aware of what is the protocol.

[00:56:03.930] - KAYLA BARNES-LENTZ

Is there a direct-to-consumer at all AI right now for people to do this? Not do what you're doing because you can't get the labs and then you can't, but where are we at with this?

[00:56:13.240] - ALEXANDER PAZIOTOPOULOS, MD

Not that I know of, right? Because Because say you are going to use a ChatGPT platform, you're limited in memory. Yeah. What you need is you need an AI that can access a data lake that you provide. Ai, right? And then can run an algorithm that you're constantly updating over time. And so most of the AIs are just ask a question thing, but they're not actually doing long term work for you. You have to program them. Eventually, what we're going to have with the IMME is we're going to have an app in your hand, and that app is going to talk to our system them. What we're doing is we're rebuilding the EMR. The EMR is atrocious.

[00:57:09.290] - KAYLA BARNES-LENTZ

All of them?

[00:57:10.440] - ALEXANDER PAZIOTOPOULOS, MD

None of them work for this.

[00:57:12.540] - KAYLA BARNES-LENTZ

Yeah.

[00:57:13.200] - ALEXANDER PAZIOTOPOULOS, MD

They're just not designed for it. They're designed for functional medicine. They do okay. I can do all my compounds and stuff like that, but they're not really great long term. The real big problem is I don't write a regular note. It doesn't work. I'm writing a maintenance engineering note. We're calling it a medical maintenance engineering note. What that means is it's an ongoing note. It's not like, okay, I write the note for this visit, and then I write the note for that visit, and then I write the note for this visit. I can't look at all that. I want to know, what is the status of this system over time? What have we done at what interval and where are you at? What's failed? What's worked? Where are we at? What's the current state of things? That's more of how I need it to work. It's more of a project management system than it is an EMR with a medical note. This has to be completely rewritten, which we've been doing.

[00:58:11.770] - KAYLA BARNES-LENTZ

Are you going to make that available to other clinics?

[00:58:13.880] - ALEXANDER PAZIOTOPOULOS, MD

Yeah. The whole idea of the IMME is that, say you're a physician or you're an owner of a clinic, say, either way, and you're trying to source all your supplements and you're trying to source all your pharmaceuticals so they don't have and all kinds of crap in them. Then you want to source all your compounds, and you want to make sure that they're in the right basis, and they're going to be the same every time and all this stuff. Well, you've never done that before. How much headache is that for you to do?

[00:58:48.190] - KAYLA BARNES-LENTZ

It's a ton of work. It's a ton of work. It's actually a ton of work all the time because it's not just the upfront work. The industry is changing so frequently that, Oh, there's a new compound, so where do you get it from?

[00:58:58.410] - ALEXANDER PAZIOTOPOULOS, MD

Then it's like, Okay, what lab What test are you going to work with? Are they always changing? The whole IMME was going to do is we're going to train physicians to be medical maintenance engineers. We're going to give you a platform so you can just use this platform and it has all the algorithms, the data The data lake is already in there. The AI is already in there. Helps you make your protocols, helps you follow up with your patients, pushes notifications to the patient. It reminds them, On today, you're doing this. Send this test in. On today, remember, you're doing this workout. Give me feedback. Did you do this? All that's automated. Then when you get to your dashboard of that patient, you can see all their compliance, or you can see what's going on with this patient, what's been good with this patient. You never had to worry about an orthomolecular account or a life extension account or whatever it was because you just created their protocol and their packs were made. The RFID is already in the pack. It's already laid They're labeled, their boxes are made. All of their stuff is dated for the day.

[01:00:05.260] - ALEXANDER PAZIOTOPOULOS, MD

That patient already paid for their membership for the year. Let's say they didn't take anything for the month of November. Well, they just throw all that in the garbage and they start with their December. What that is, is it's good for the patient. Because right now, say a patient doesn't take some of their supplements from a bottle, they're actually getting rewarded for that because they didn't spend money.

[01:00:33.520] - KAYLA BARNES-LENTZ

Yeah, that's true.

[01:00:34.910] - ALEXANDER PAZIOTOPOULOS, MD

All right? But if you took that bottle and you say, Oh, you didn't take it, and you put it in the garbage, and you did that every month in front of them, eventually, they're going to be like, Well, I don't want to throw that out. Yeah. I'm paying for that. That's a good point. All right. It's not that we want to punish them. It's just like, you're already paying for this. The membership price that includes all their testing, all their pharmaceuticals, all their supplements, everything that's included, it's the way to go to help them. It gives us really good data because then you know, even say it's something simple, like you're trying to manage their lipids and someone's saying, I take all my medicine, and then you start increasing, but you don't need to. They just need to increase their compliance.

[01:01:21.650] - KAYLA BARNES-LENTZ

Yeah.

[01:01:22.370] - ALEXANDER PAZIOTOPOULOS, MD

That makes a lot of sense. All of that's there. That's where the goal of the whole IMME is, is to make everything very simple for the person that owns the clinic and the doctors that work in the clinic. It just makes it. Then we'll get more and more buying power. Eventually, what we're trying to do is we'll be making our own supplements.

[01:01:43.650] - KAYLA BARNES-LENTZ

Nice.

[01:01:44.390] - ALEXANDER PAZIOTOPOULOS, MD

Because nothing against supplement companies. I work with all you guys, but it needs to go. Because especially for this level of care, so when you're dealing with hundreds of compounds, what you end up having is you have more filler than you have active compound. You have too much mass in capsules, even if they're veggie capsule. If we did it ourselves, we could do it at a fraction of the cost. I once was working for another clinic, and I helped them design their own line of certain supplements. When we did that, and we worked with this guy called Pharmacognicist, a bottle that we were buying for $50, we made for five. Yeah. If we can do that for the whole IMME, and then not price gouge, but pass those savings on, what will happen is that no one will be able to compete because of the quality that you're going to get and the price that you'll get and the data that we're going to get. This is really what I think A4M and IFM really wanted to be, but somehow they got off track. If they were in, maybe they just want to do the education.

[01:03:04.610] - ALEXANDER PAZIOTOPOULOS, MD

But the big problem is, say you go and you get functional medicine trainings, and you get advanced functional medicine training, you go to tons of these workshops and you take all the tests and everything like that, you didn't even know what to do. Because it didn't give you algorithms to follow. But if you're working for NASA, there's a damn algorithm to follow for that maintenance engineering to the D.

[01:03:27.500] - KAYLA BARNES-LENTZ

No, yeah. It's super complex. Then it's always hard to scale, right? Because if you find the one provider that has it figured out, well, you can't replicate that into another provider. It's just always different.

[01:03:43.520] - ALEXANDER PAZIOTOPOULOS, MD

We're finding that with the stuff that we have works, but it can be so much better once we start getting all this data. Once we really have people that are compliant and they have radical willingness and they're going to do this, I mean, this is just going to get better and better and better. It'll be a lot easier for these doctors to transition. Because then I'll be like, Okay, here's the business model, and we know exactly what it is. These patients pay X amount of dollars per month, and this is how much you're going to outlay. The other thing is you're not going to be tempted as a provider to upsell. We don't want to do that. We're trying to maintain the most complex machine on the planet. There's no need to upsell. It's already upselled. You're already at the highest. There's always going to be things you can add on for the people that have the extra money, for sure. But there's not going to be a need for it. There's going to be like, Okay, in order for me to function I'm going to have to have this many memberships. But by having the IME set up, people are already like, Oh, I already vetted out the IME.

[01:04:52.670] - ALEXANDER PAZIOTOPOULOS, MD

I already saw the protocols and stuff like that, and there's a location here. Yeah.

[01:04:57.330] - KAYLA BARNES-LENTZ

Is it actually going to be physical locations, or is it the software that you're developing and then implementing it into existing locations?

[01:05:03.190] - ALEXANDER PAZIOTOPOULOS, MD

We want to just make it the software, and we want to make it the distribution. Nice. So that all the supplement packs can go out, all the testing can go out, all that. And then the locations will beout will be up to the person, say you. You're like, Okay, I want a location. What's it going to cost me? It's to be like, Okay, well, you're just going to have this many royalties that will go to IMME to support the software and the research and that stuff. All the rest is yours.

[01:05:29.920] - KAYLA BARNES-LENTZ

Yeah, but you would also just integrate into other clinics, too, right? Yeah.

[01:05:34.100] - ALEXANDER PAZIOTOPOULOS, MD

Any clinic that wanted to take it on, they could do it. Yeah.

[01:05:37.160] - KAYLA BARNES-LENTZ

Well, that's smart. I think definitely standardization because everyone just like, We're figuring it out. We have an executive health program, and you're just figuring it out. But that's hard to replicate. And so, yeah, I think that's going to be a really powerful solution. Right.

[01:05:55.440] - ALEXANDER PAZIOTOPOULOS, MD

It's like, do we want to do individualized medicine For sure we do. Over the years of treating patients, I've noticed that it's not that great of a percentage. Do I treat women different than men? Yeah. Do I treat people different by age? Do I treat people different by genetic markers? Yeah. But 90% of it's the same.

[01:06:23.480] - KAYLA BARNES-LENTZ

Yeah. It depends on how deep you want to go in that individuality. But yeah, a lot of it is going to be a lot of this stuff you could even assume, right? Let's just say we can assume that most people have gut issues, like an imbalance gut microbiome, right? So you could assume that and then optimize it with- Sure. How many times are people getting tests per year? They're doing the intake test?

[01:06:50.590] - ALEXANDER PAZIOTOPOULOS, MD

Some tests, they're doing just once a year. Some tests, they're doing every quarter. Some tests, they're doing every six months. A lot of it right now has to do with cost, what people can afford. With OMIC testing becoming cheaper and cheaper or it can be able to get it more and more often. If your mitochondria are really bad, we're going to test them every three months. Yeah, to see them. They're pretty good every six months.

[01:07:19.710] - KAYLA BARNES-LENTZ

Describe to everybody listening what OMIC testing is.

[01:07:23.290] - ALEXANDER PAZIOTOPOULOS, MD

So OMICs, there's lots of different OMICs. So there's genomics, there's epigenomics, There's metabolomics, there's proteomics, there's the omix from your bacteria that live in your gut, and there's more. Basically, what it can tell us is your overall health. How are your genes being expressed? In a good way, not a good way. Epigenetics is basically how your genes have been modified with methylation or acetylation, different things like that.

[01:08:04.000] - KAYLA BARNES-LENTZ

Would that be like a true-age test?

[01:08:06.470] - ALEXANDER PAZIOTOPOULOS, MD

True-age can do some of it. Therium would have more. Some of the SASP testing can have some of that, too. Looking at interleukins, looking at cytokines, those things, you can pick up other things like that. There's new generation microbiome testing. Most of the microbiome testing that's on the market today is not accurate.

[01:08:31.850] - KAYLA BARNES-LENTZ

In what way?

[01:08:32.830] - ALEXANDER PAZIOTOPOULOS, MD

It just doesn't pick it up regularly. There's a bunch of, and this is where I get a little bit worked up about functional medicine is there's a bunch of tests where I've sent in three tests, but it was just my test three times, and I got back three different results. Whenever I find the test isn't very reproducible, I'm like, Well, use it with a grain of salt, because I want a reproducible test.

[01:08:59.280] - KAYLA BARNES-LENTZ

Yeah. But my only question would be, let's just say a popular gut test. Typically, if you get the results and then you treat them, then you'll see improvements. Maybe it's either just the protocol is just good or how does that work?

[01:09:18.320] - ALEXANDER PAZIOTOPOULOS, MD

Let's just say you take any person and you give them glutamine and you give them butyrate. They're going to get better. Yeah. They're going to get better.

[01:09:25.400] - KAYLA BARNES-LENTZ

Then when you pull it, they might not be as good.

[01:09:31.360] - ALEXANDER PAZIOTOPOULOS, MD

Yeah.

[01:09:31.580] - KAYLA BARNES-LENTZ

Do you like colostrum for gut health?

[01:09:34.420] - ALEXANDER PAZIOTOPOULOS, MD

I've played with it so many times, and I've used other stuff like IgG protect and things like that. Mixed results. The number one thing I do for gut health. The people that have really bad guts, what I've noticed is, and this is a long time ago I started doing this, is I would send them to a specific pelvic floor therapist that measures anal tone and perineal tone. I would get these crazy results back. Anal tone, 21 times normal. Anal tone, 17 times normal.

[01:10:14.560] - KAYLA BARNES-LENTZ

What does that mean exactly? 17 times normal?

[01:10:17.360] - ALEXANDER PAZIOTOPOULOS, MD

The tone of the anal sphincter was so tight that it's like, imagine, instead of your anus just being shut, it's like you're squeezing your fist as hard as you can all the time. This is that fight or fight response. The first thing you do when you see the tiger or whatever is you either defecate or you tighten your ass. Yeah. And what that does is it sends you into fight or flight. But the other thing it does is it sends a signal from the bottom of the vagus nerve all the way up. It shuts down peristalsis, shuts down all the other organs, and just turns on Like heart, lungs, brain, lungs. Yes. But a lot of people have that on all the time. You'll see this a lot with IBS. Because the IBS people, they're constipated, and then they have diarrhea, and then they're constipated, and then they have diarrhea. Because the intuitive neurology of your gut is going to say, well, screw you. I'm going to move after you've paralyzed me for 12 hours or 24 hours or whatever it is. Then there's this tug of war between the neurons and the gut want to do parastalsis.

[01:11:37.470] - ALEXANDER PAZIOTOPOULOS, MD

They want to move this food along. They want to digest it. But the fight or flight response is keeping it from going anywhere. Then when the food doesn't go anywhere, well, then you're promoting anaerobic bacteria and methane-producing bacteria, and now you're screwing up the whole microbiome. Then everything moves really fast, and now you screw it up a different way. You could give rifaximen, and you could give oil of oregano, and you could give glutamine, and ion biome, and all the other things, and you'll never fix it. It'll always go back because you didn't get to the root of the problem. That person is not in coherence.

[01:12:18.940] - KAYLA BARNES-LENTZ

Yeah. But that's the... Well, real quick before we talk about that, because this is a really great point. Okay, so then what is the gut testing that you guys are doing, for example?

[01:12:27.050] - ALEXANDER PAZIOTOPOULOS, MD

Out of the Hemel's lab, there's a Cierra, and she's doing a next level one, and it's all off of Omix.

[01:12:35.170] - KAYLA BARNES-LENTZ

Is there a name?

[01:12:36.230] - ALEXANDER PAZIOTOPOULOS, MD

Can people get it? It's not available yet. It will be next quarter. Ethereum also is launching theirs, next generation. Okay, nice. So Both of those labs are going to have it.

[01:12:48.250] - KAYLA BARNES-LENTZ

You'll have to ping me and tell me. Well, I know the Ethereum guys, too, so I'll keep up to date on that.

[01:12:53.810] - ALEXANDER PAZIOTOPOULOS, MD

They're going to have it. And I would go off of that because when you're trying to look at DNA The way of the stool, it's just not as accurate as you think you might be. Just because there's a certain species of bacteria there doesn't mean it's pissed off.

[01:13:09.820] - KAYLA BARNES-LENTZ

Yeah, that makes sense. But it is the best we have right now.

[01:13:13.060] - ALEXANDER PAZIOTOPOULOS, MD

It's the best we have right now.

[01:13:14.450] - KAYLA BARNES-LENTZ

It's better to get one and try to figure out what you say.

[01:13:17.390] - ALEXANDER PAZIOTOPOULOS, MD

I think one of the tests that I really like getting over the microbiome testing is the KBMolab.

[01:13:24.620] - KAYLA BARNES-LENTZ

Kbmolab, I don't know that one.

[01:13:27.060] - ALEXANDER PAZIOTOPOULOS, MD

There's only two labs that I for food sensitivities that tend to be accurate. Most of the other ones are just going off of IgG.

[01:13:35.970] - KAYLA BARNES-LENTZ

But real quick question. So don't you feel like, though, if the gut is leaky in general, you're going to have food sensitivities, right? If you heal that leaky gut, then you'll have less food sensitivities, right?

[01:13:44.880] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, you just got to figure out why is it leaky. Yeah. When you do a KBMO, you're going to get not only IgG, you'll get IGA, and you'll get complement. Because just because you have an immunoglobulin doesn't mean you really have a sensitivity. It's like a barcode. Yeah. Right?

[01:14:08.170] - KAYLA BARNES-LENTZ

Tell people what IVA first, IG is.

[01:14:10.360] - ALEXANDER PAZIOTOPOULOS, MD

All right. Immunoglobulins are basically proteins with a sugar attached or a carbohydrate attached. It's modified. These are glycans, which is why we use a test glycanage. Glycanage is a fantastic test. One of the most important age testing to get. Oh, good.

[01:14:34.910] - KAYLA BARNES-LENTZ

Yeah, I love that one.

[01:14:35.670] - ALEXANDER PAZIOTOPOULOS, MD

By far. Not on clock, but on data that you get from the glycans. Okay. All right? These are glycans, and they're important glycans to measure. So IGA is the immunoglobulin that lives on the mucosal surfaces, so like the lining of your gut. An IgG is more like in your bloodstream. Yeah. All Then there's IgE, and there's other types of forms. You can isolate, well, where is this happening? If it's only IGA, it hasn't really made it through, then it's more isolated in the gut. If it's IGA and IgG, well, then you know it's probably some leaky gut going on there because now this antigen is going across into the blood. Then if there's complement associated with the IGA, now you know you're having an inflammatory reaction to whatever it is that IGA is binding to. What an antigen is, is basically, say, the broccoli would be an antigen. This IGA doesn't like broccoli or something in one of the molecules in broccoli. It's attaching to that. Then it releases complement, and so now you have inflammation. Then you'll have other testing that it shows you, which is Zonulins and occludens. Zonulins and occludens tell you whether or not the barrier between your gut and your bloodstream are open or closed.

[01:15:58.270] - ALEXANDER PAZIOTOPOULOS, MD

Because the The king of your gut is really only one cell thin. They have these things called gap junctions that hold the cells really tight together. When you have a bunch of inflammation, the cells swell, and then you get spaces, and then things that should stay in the gut don't stay in the gut, and now you have a reaction.

[01:16:19.690] - KAYLA BARNES-LENTZ

Yeah.

[01:16:20.420] - ALEXANDER PAZIOTOPOULOS, MD

That's why I like KBM always. You can see which foods are bothering you, causing this inflammatory reaction, whether or not you have a Clotin or Xaneon products, and so that you can fix that leaky gut. You remove the foods, you give the things that help your gut out, the glutamine, the butyrate, probiotics, allo, You go down the rabbit hole. There's so many things you can give, and you get it to go. I really love I Am Bion from Dr. Zack Bush. That stuff works. Yeah, he's a great guy. Fantastic. I do a teaspoon in the morning and do a teaspoon at night. I think it's one of the best things to protect you from things like glyphosate.

[01:17:06.730] - KAYLA BARNES-LENTZ

Yeah, which is almost impossible.

[01:17:08.580] - ALEXANDER PAZIOTOPOULOS, MD

Which is ubiquitous in our environment.

[01:17:10.450] - KAYLA BARNES-LENTZ

It is. I love Zack Bush. I just saw him at Edamonia.

[01:17:14.680] - ALEXANDER PAZIOTOPOULOS, MD

Nice. How was that?

[01:17:16.120] - KAYLA BARNES-LENTZ

Did you like it? It was great. It was a really great event. Yeah, I spoke there and amazing speakers. I saw it. It was so fun because it felt like a class, a reunion. It's just so many people you know in one spot.

[01:17:27.790] - ALEXANDER PAZIOTOPOULOS, MD

It's a small world.

[01:17:28.760] - KAYLA BARNES-LENTZ

It is a really small world. It's like, Oh, I also saw you last week or last month at this other event.

[01:17:35.480] - ALEXANDER PAZIOTOPOULOS, MD

I've mostly been in Europe lately. They're way ahead of us. They're working with small interfering RNA, micro RNA. They're printing cells in an incredible way. Their genetics are ahead of us.

[01:17:56.940] - KAYLA BARNES-LENTZ

Yeah. I was Was at the Longevity Investors Conference, too, in. That was amazing things coming down the pet fund. Everybody always asked me, so we put this figure. I said 150. That's how long I want me and my husband to live. Everyone's like, Well, how are you going to There's a lot of things that you can get there, and it's like, Well, I'm really fortunate because I'm starting this really early, right? I need to just get to the, I think Aubrey calls it the longevity escape velocity, right? When we can actually rejuvenate. I believe that that's coming. I think that'll be in our lifetime, too.

[01:18:30.130] - ALEXANDER PAZIOTOPOULOS, MD

It'll definitely be there. Getting back to what you would get at the clinic with all these things. If you talk to Aubrey, he wants to just reverse age. There's two things. We want to slow aging down, but there's only so much you can do that for. Aubrey is right. You can only slow down aging so much. But reversing age is pretty much unlimited, depending on the technology. But we live today. We know that calorie restriction works in every single living creature that we know of. Calorie restriction mimetics, which are apologs work really well. If you look at Aubrey's new work, he's doing four things at once. It's really funny because I was talking to him in a Healthy Masters conference a few years ago, I was showing him all the different things I was doing at once. We were just saying, Why are you only doing one? Why do you guys keep doing one thing? It just cost, really. But now they're able to do multiple things because I'm like, I do everything. I'm just got a shotgun approach as long as they know that it's healthy and it's not causing problems and we're testing.

[01:19:51.480] - ALEXANDER PAZIOTOPOULOS, MD

What I like to do is let's slow aging down as much as we can. You'll hear people that promote protein, and it drives me crazy in the longevity space. It really does.

[01:20:08.470] - KAYLA BARNES-LENTZ

A lot of people do. I like protein, too, so I'm excited to hear about your %.

[01:20:12.120] - ALEXANDER PAZIOTOPOULOS, MD

They just love firing protein at people, and I'm just like, Okay, you're going against all of the calorie restriction data that we have. Here's how it goes. Lucine and arginine turnover cells rapidly to make you grow.

[01:20:31.870] - KAYLA BARNES-LENTZ

Yeah, it's boosting up MTOR.

[01:20:35.300] - ALEXANDER PAZIOTOPOULOS, MD

Boost MTOR. We want to reduce MTOR. If you're an athlete or you want to make your deadlift go from 300 to 500 in a short period of time, sure, jack up your protein. But it's like what Aubrey is saying, you're a metabolic machine, and it's the metabolism by itself that's making you age. What we want to do as much as we can is we want to slow down metabolism as much as we can without causing problem.

[01:21:07.530] - KAYLA BARNES-LENTZ

But this is where I always... Because I go over this idea in my head, right? Just a conversation here. Where is the line from... Well, I have two questions, actually. One, let's say for a woman. Caloric restriction, I used to be very calorically restricted. I mean, I still have a very low body fat percentage in general. I don't over eat by any means. But I watched as my thyroid started to tick down. I watched as my hormones became less balanced. It's like, where's that from a female side? Then from a general side, let's say you're a 55-year-old male, have very little muscle mass, and you're doing caloric restriction, your T goes through the floor. Where is that balanced? How do we identify where we land at?

[01:21:57.590] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, I mean, that's for When the engineering comes in, right? I'm down to 1 gram per kilogram of protein per day.

[01:22:07.760] - KAYLA BARNES-LENTZ

How much is that? Sorry, I'm not an expert on kilograms.

[01:22:10.670] - ALEXANDER PAZIOTOPOULOS, MD

You just take your pounds and you divide by 2. 2.

[01:22:15.310] - KAYLA BARNES-LENTZ

Okay. Right? Yeah.

[01:22:17.360] - ALEXANDER PAZIOTOPOULOS, MD

I'm about 190 pounds. I forgot where it is. Where am I at? 70 or 80-some grams of protein, something like that. I think I'm about 80 grams. Any athlete would be like, That's atrocious. So you're never going to be able to live your life. I'm not really in a gross phase. So My barometer is my DEXA scan to see is my muscle mass dwindling? Yeah. And my lifts. And they're I'm not sure, but when I can't deadlift twice my weight, then I know my strength's going down. Yeah. I don't really think anybody really needs a deadlift twice their weight, but it's a nice thing to have. Genetically, you could probably deadlift three and a half times your weight or something. I don't think it's necessary. I just want to make sure that my mitochondria are working and I have enough muscle mass to the frame of my body. By keeping my protein down, and especially it's what amino acids. It's the methionine, the arginine, and the leucine that I really like to limit. That's why I really choose a plant-based diet because animal protein is really high in those amino acids. It's also really high in the sulfur amino acids like methionine.

[01:23:53.610] - ALEXANDER PAZIOTOPOULOS, MD

What sulfur amino acids do is they get converted into sulfuric acid. Then it changes the PH of your body quite a bit, and you have to regulate your PH more. More in an esthetic environment causes a bunch of things. You get more dystopic calcification. It's a little bit harder in your kidneys, things like that. So that's where I like to keep protein down. Now, say I have somebody that comes in and they're sarcopenic from the beginning, or they're a woman that has been on a really low-calorie diet because they're just trying to stay thin and they're like that skinny fat. Low bone density, high body fat, super low muscle. They can't start out with one gram per kilogram. We have to do a build phase. That person might go up to 1. 8 grams per kilogram. We get them on a really good diet, and we strengthen their strength up, we get their muscle mass up. Then after they're strong enough, then we start to taper them back down to a maintenance dose. But the one thing that we learn from bodybuilders is when you want to build, you have to gain fat and muscle at the same time.

[01:25:11.230] - ALEXANDER PAZIOTOPOULOS, MD

You can't just keep building a little bit of muscle without gaining fat. This is just really, really difficult. I don't like a lot of things bodybuilders do, but there are certain things that they do really well. The other thing is that they weigh everything. They know exactly what they're putting in their body. I don't like what they put in their body, but they know exactly what they are. We could learn a lot from what they do about how they feed. But that's the thing is, because then why take a rapamycin or something that's going to lower Amtor, if you're just going to be feeding all of this protein? Because you're going to overcome a lot of this stuff. We want things to work synergistically together, but we also don't want to create disease. That's why they have to have engineering.

[01:26:03.800] - KAYLA BARNES-LENTZ

Yeah, agreed. It's on a case-by-case basis. If you're super low muscle, then yeah, that makes- Sure.

[01:26:11.290] - ALEXANDER PAZIOTOPOULOS, MD

It's like the discovery process. There's an airplane that just came off the line, and you don't have to do much for it. You run through a bunch of tests and it's fine. Then you have this 30-year-old airplane and you do the discovery process and you're like, Oh, shit. We got to replace this. We got to replace that. You got to work on this. You got to work on that. But they're both the same algorithm. It's just one of them a lot easier to do because you don't have much to do. It's just check, check, check, check, check. And the other one is like, Oh, no, got to work on this. Oh, got to work on that. But it's the same algorithm.

[01:26:40.600] - KAYLA BARNES-LENTZ

Yeah, that makes a lot of sense. Where do you think... I mean, what's the future of AI and longevity? Because ideally, we all have our own bot that helps us be on track. We upload our data.

[01:26:54.760] - ALEXANDER PAZIOTOPOULOS, MD

The whole idea is that there's a central AI that's built into IMME, and that AI is speaking directly to the individual, the member, through their app. It's also working on the algorithm because even with the amount of data that I'm dealing with, there's no way I can possibly process all of this as a human. It's impossible. You might think you can, but there's no way. It's just too much. There's just way too much data. I mean, just look at, say, something as simple as your epigenetic test. If you ever look at the raw data of that, it's insane. Yeah, totally. No human can look at that. You're looking at the score like, Oh, here's my Dunden pace, or whatever. But look, it's behind that. There's just so much data. We need this AI to look at it to keep us in check and to help us increase the quality of these algorithms.

[01:28:00.270] - KAYLA BARNES-LENTZ

Within that, you think predictive models of... Are there any predictive models now? You upload your data. I'm assuming there are, right? Then it tells you what your...

[01:28:09.440] - ALEXANDER PAZIOTOPOULOS, MD

Yeah. Ethereum has one. Okay. It is Hemel Patel with Meescreen. We're leveraging their platforms for the IMME in the future. Nice. One of the cool things that they have, and they both have it, and it's just different wording, is Ethereum talks about digital twinning. Hemel talks about more like digital cloning. It's already here, but it's going to get light years better. What it is, is we take your whole parameters. We take your Donte Genomics, which is your entire genome. We feed that into that. We take all of the tests that we did for your discovery process, and we feed that into that. We take on all your physical parameters, your blood pressure, all your other things, your DEXA scan, your MRI. We feed all that into it. Then what it does is it says, Okay, we're going to give you this much rapamycin, or we're going to give you this much disatinib, and we're going to give you this much resveratrol and this much NAD, and then run it out 50 years, what happens? Okay, make a different protocol and run that out. The AI could do millions of renditions of that and see which protocol for your physiology is really going to be best.

[01:29:36.400] - ALEXANDER PAZIOTOPOULOS, MD

Then as it gets to learn you over time, its predictions get more and more accurate.

[01:29:43.150] - KAYLA BARNES-LENTZ

Yeah.

[01:29:44.400] - ALEXANDER PAZIOTOPOULOS, MD

There's no human that could possibly do that.

[01:29:46.910] - KAYLA BARNES-LENTZ

Yeah, no. I'm so excited.

[01:29:49.270] - ALEXANDER PAZIOTOPOULOS, MD

Right. And that's the whole future of how we're going to use AI and how this entire field is impossible without it.

[01:29:57.230] - KAYLA BARNES-LENTZ

Yeah. I mean, yeah, absolutely. I agree. Is there anything else you want to say about AI and longevity?

[01:30:10.700] - ALEXANDER PAZIOTOPOULOS, MD

Use the AI that's already here.

[01:30:12.970] - KAYLA BARNES-LENTZ

Which one should we use, though?

[01:30:14.820] - ALEXANDER PAZIOTOPOULOS, MD

It's already built into all these scans. The two most important ones for everyone to get are make sure you get a good full body MRI where an AI is reading it.

[01:30:27.040] - KAYLA BARNES-LENTZ

Yeah.

[01:30:27.800] - ALEXANDER PAZIOTOPOULOS, MD

Right? And make sure you get a clear exam.

[01:30:30.350] - KAYLA BARNES-LENTZ

How do people request, though, that an AI reads it? Is there any company that you can- Yeah.

[01:30:36.150] - ALEXANDER PAZIOTOPOULOS, MD

There's a company out of Europe, out of England. What is wrong with me? I'm going to give you the information. You could put it on there. I'll put it on the I don't know. Just dub it in or something. You can link it in the show. All right. Just link it in the show notes. But they're doing not only the liver scan, but they're doing all the organ scans. The other AI is from... It's called the Neuroquant. Okay. Yeah, I've heard of that. And that's from CORE-TEC Labs. And so the one company is doing the organs, and then Neuroquant from CORE-TEC Labs is doing your brain. Yeah. And that's a volumetric assessment of your brain. So all the different components of the brain, it's looking and see what size is there, and it's comparing the hemispheres. Oh, great. So what's the hippocampus on the left versus the hippocampus on the right? And if If there's a difference, what's really interesting is people that have been exposed to mold or people with chronic inflammatory response syndrome or somebody that had some an infarct or something, you're going to see a difference from one side of the brain to the other in the size of those components.

[01:31:49.740] - ALEXANDER PAZIOTOPOULOS, MD

Then you can track that over time and you can figure out, well, all right, there's a difference here, so let me go down the rabbit hole and order some test that maybe I didn't test and see what else is going on here. It gives you a little more insight of what to do, and then you track that over time. We have data on different parts that we would have never had because what radiologist is going to have the time to sit there and measure all these parts of your brain and how accurate is that going to be?

[01:32:19.530] - KAYLA BARNES-LENTZ

Yeah, definitely.

[01:32:20.690] - ALEXANDER PAZIOTOPOULOS, MD

It's just not going to. You get all these great measurements that are impossible by hand. Right now, you have the font, you have the organ scan, and then with the CLEARLY, you can see unstable plaques that are not visible by the human eye.

[01:32:37.450] - KAYLA BARNES-LENTZ

Yeah, I know. It's amazing.

[01:32:39.930] - ALEXANDER PAZIOTOPOULOS, MD

If you do that, you're pretty much eliminating most of those single points of failure at the top end. Yeah, I agree. Because those top end ones are MI, stroke, cancer. Now that you're eliminating, but you're decreasing the chance that they're going to take you out.

[01:33:00.500] - KAYLA BARNES-LENTZ

Do you do liquid biopsies?

[01:33:02.820] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, I like the Grail test. It does have its limitations for sure, but it's one of the best of its kind. It's Just as far as the whole cancer community goes, the amount of really cool tools has never been better. There's a company called Immunisine, and they're making basically a vaccine for your cancer. Interesting. It's really expensive. It's like 100 grand. But they can take a sample of your tumor, and then they create a vaccine to it, and they inject it and it goes and kills your cancer without killing your normal cells.

[01:33:48.910] - KAYLA BARNES-LENTZ

That's great.

[01:33:49.870] - ALEXANDER PAZIOTOPOULOS, MD

Right? I love that. The CAR T cells are amazing, too. Those are awesome. There's a company out of Greece that's looking at circular living tumor cells. They've been around for a while. Yeah.

[01:34:04.260] - KAYLA BARNES-LENTZ

Like RCG2?

[01:34:05.680] - ALEXANDER PAZIOTOPOULOS, MD

Yeah. They've been there for a while, so they're doing that. There's so many cool tools for cancer. Right?

[01:34:14.540] - KAYLA BARNES-LENTZ

If you find it- It's because cancer is just skyrocketing us.

[01:34:17.380] - ALEXANDER PAZIOTOPOULOS, MD

The whole thing is, most cancers, if you find them stage one, stage two, they're curable, 85% with normal chemotherapy at the regular hospital. Right? Stage three, stage four, not so much.

[01:34:33.470] - KAYLA BARNES-LENTZ

Yeah, I mean, I know. Every year I do a liquid biopsy and all the things. Right.

[01:34:40.360] - ALEXANDER PAZIOTOPOULOS, MD

Women at least get mammograms, but they don't do anything for men's prostates. They just get a PSA, which is like a garbage test. Yeah. But if you do a full body MRI with a dedicated prostate scan, now you've got something that's useful.

[01:34:59.530] - KAYLA BARNES-LENTZ

Yeah. I actually like more the mammograms now. There's something called QT imaging. Yeah. Way less invasive, and you're not using any radiation. Yeah. The imaging is I just had one based on.

[01:35:12.370] - ALEXANDER PAZIOTOPOULOS, MD

Yeah. I'm trying to find companies that will do the breast with MRI. The only trouble with that is you have to be laying prone, and they usually have to do an extra scan. Yeah. Right. But they'll do it.

[01:35:29.610] - KAYLA BARNES-LENTZ

Yeah. I mean, I mean, I've interviewed a lot of breast cancer surgeons, cancer surgeons, breast cancer researchers, and it's just we have to have something better.

[01:35:38.670] - ALEXANDER PAZIOTOPOULOS, MD

Oh, yeah. I mean, stick to that hold is. I mean, it's an X-ray looking at soft tissue. Yeah.

[01:35:44.050] - KAYLA BARNES-LENTZ

And the people with dense breast tissue. It's only going to pick up certain types of cancer.

[01:35:50.270] - ALEXANDER PAZIOTOPOULOS, MD

If it's not well calcified, it's not going to pick it up.

[01:35:53.120] - KAYLA BARNES-LENTZ

Yeah. Well, this has been great. Awesome. This has been a good conversation. Thanks so much for coming on.

[01:35:59.390] - ALEXANDER PAZIOTOPOULOS, MD

Yeah, it's It's been a pleasure.

[01:36:00.280] - KAYLA BARNES-LENTZ

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