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Stem Cells & Peptides: The Secret to Reversing Chronic Pain and Aging | Dr. Adeel Khan
01:17:04
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- [00:00]
Dr. Mark Hyman
Coming up on this episode of the Doctor's Pharmacy.
- [00:03]
Dr. Adil Khan
These things should be called committed progenitor cells, which is a fancy word for just saying that they can't turn into new tissue, that they can reduce inflammation, which is still, which can still be useful in some conditions. But it's just misleading because a lot of patients are like, oh yeah, I got stem cell injections. It's like, well, it wasn't really a stem cell per se. It was more just something to reduce inflammation.
- [00:24]
Dr. Mark Hyman
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- [02:10]
Dr. Adil Khan
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- [02:33]
Dr. Mark Hyman
Before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice, there's simply not enough time for me to do this at this scale. And that's why I've been busy building several passion projects to help you better understand. Well, you if you're looking for data about your biology, check out Function Health for Real Time Lab Insights. If you're in need of deepening your knowledge around your health journey, check out my membership Community Hyman Hive. And if you're looking for curated and trusted supplements and health products for your routine, visit my website Supplement store for a summary of my favorite and tested products. Hey everyone, it's Dr. Mark Hyman. Ever wanted to ask me your health and wellness questions directly? Well, here's your chance. I have an exciting exclusive event coming up that you can be part of as a thank you for being a loyal listener on the doctor's pharmacy. On Wednesday, December 4th, I'm hosting a live digital experience called the Diet wars and I want you to join me. I'll be chatting with Dr. Gabrielle Lyon, a board certified Family Doc and New York Times bestselling author as we tackle one of the biggest wellness questions out there. Which diet really gives you the best.
- [03:35]
Dr. Gabrielle Lyon
Shot at optimal health? Should you be a vegan?
- [03:38]
Dr. Mark Hyman
Should you be a carnivore? Or somewhere in between? From Paleo to vegan to Carnivore and GLP1s, we'll break down the science, debunk the myths and share our expert perspectives. Help you make the best choices for your health. And here's the best part. You'll be able to interact with me and chat with our amazing community in real time during the event. Plus, if you're a VIP ticket holder, you'll get to join an exclusive Q and A after party where you can ask us all your questions directly. The Diet wars is a one time only experience that you don't want to miss, including limited edition merch. It's all happening live on Moment by Patreon. So mark your calendars for Wednesday, December 4th at 9pm Eastern, 6pm Pacific and head over to Moment Co forward slash Markheimen to get your tickets.
- [04:25]
Dr. Gabrielle Lyon
I can't wait to see you there.
- [04:33]
Dr. Mark Hyman
Hi, I'm Dr. Mark Hyman, a practicing physician and proponent of systems medicine. A framework to help you understand the why or the root cause of your symptoms. Welcome to the Doctor's Pharmacy. Every week, I bring on interesting guests to discuss the latest topics in the field of functional medicine and do a deep dive on how these topics pertain your health. In today's episode, I have some interesting discussions with other experts in the field, so let's just jump right in.
- [04:56]
Dr. Gabrielle Lyon
Adil, welcome to the Doctor Pharmacy Podcast. It's great to have you here. Last time I saw you was in Cabo when you're about to inject me with a bunch of interesting compounds that are biological compounds they use in regenerative medicine for my disc issues, which helped tremendously. And I think you've been in the leading edge of this whole field of regenerative medicine, and I think most people don't really understand what is regenerative medicine. So why don't we start by talking about your own story or how you kind of went through medical training, where your frustrations were, and how you ended up in this place where you're practicing a medicine that most people probably have never heard of and don't know what it is. And we're gonna describe today in detail, but is, I think, in many ways the future of repair, healing, renewal, longevity, managing orthopedic issues, which I've certainly used for my own body. So tell us about your journey, how you got here, and then what the heck is regenerative medicine?
- [05:57]
Dr. Adil Khan
Yeah, yeah. No, actually, it's funny because I watched your TED Talk when I was in medical school, and I remember you talking about depression and how you have to look at micronutrient deficiencies, the gut health, neuroinflammation. And that just. That whole concept just made so much sense to me. So you were definitely a part of the inspiration for me to pursue this. So thank you for that. And in terms of. Yeah, I read your books. I read, obviously, Jason Bland functional medicine book, like his textbook. Jeff Bland. Yeah, Jeff Bland. Yeah. So. And, you know, integrated medicine textbooks. Luckily, medical school was fairly easy, so I had lots of extra time and I could read. I had a lot of time to read other things. But the reason I got into it was partly because I saw patients not always getting better, and even my own mom had some medical illnesses. And it was kind of frustrating when the doctors were just like, well, there's nothing else you can do. And then I started digging deeper, and obviously I came across functional medicine and all this kind of root cause work. And then I'm like, wait a minute, there is stuff you can do, we're just not learning about it. So then it was kind of like, why aren't we learning about it? And then you realize it's just because doctors don't know what they don't know. And that's just how medical school is. You're being taught by specialists who might be the best cardiologist at their, in that center. And they're amazing, they do amazing work, but they don't know much beyond what they do. And that's just the limitations of their knowledge. And so oftentimes we're only being given one perspective, which is allopathic medicine. But it turns out there's a lot more than just allopathic medicine out there. And when you look at the totality of the research, you realize there's a lot of stuff out there that can be quite beneficial with less harm. And that's really what drew me to this field, was just because, hey, if I can do less harm for my patient and have the same benefit, why wouldn't I do that first? And that's kind of what got me into regenerative medicine. Because regenerative medicine is just a playoff of functional medicine, which is you're trying to restore tissue or restore dysfunction of the cell back to normal. And now you can do that using cell therapy, gene therapy, or tissue engineering, or the combination of those three is kind of what we label as regenerative medicine.
- [08:14]
Dr. Gabrielle Lyon
Yeah, it's really interesting because, you know, as I, you know, I think about functional medicine, it's really about how do you restore optimal function using compounds that support and enhance the body's function as opposed to interrupt, block or interfere somehow. And most traditional drugs are anti drugs, right? They're antibiotics, they're inhibitors, like ACE inhibitors, They're you know, blockers, like beta blockers. So they're anti inhibitors or blockers. Right. And that's fine for some pathways in some medical therapies, but there is an incredible healing system built into our biology that most people are not even aware of. When you cut your skin, how does it know what to do to repair your skin? When you break a bone, how does your body know what to do? Well, you have a built in healing, regenerative repair, renewal system. We just don't know how to activate it. And that's a lot of what functional medicine is. But regenerative medicine, my understanding of it is that it actually uses the body's own repair and healing systems to actually help facilitate repair by extracting them from biological sources and then repurposing them and putting them back into the body so they can go and do the repair and healing work without a lot of the side effects and consequences. Is that right?
- [09:34]
Dr. Adil Khan
Yeah, exactly. Our slogan is empowering the body's natural healing abilities. So that's what we live by. But to your point, it's not just limited to biological substances. You can even use something like bioelectricity or shockwave electrical signals that can manipulate the body at a cellular level to help it to heal. So essentially it's anything really a signaling wise that can facilitate healing or regeneration in your own body. And that's why even peptides, in my opinion, fall into this category of regenerative medicine. Because a lot of them are just sending signals. Especially obviously there are some peptides that are more regenerative in nature. They're just sending signals to help your body to heal better. And of course there's biological substances which we'll go into too. But at a very high level, we're just giving your body the right tools and the right signals so it can heal on its own.
- [10:27]
Dr. Gabrielle Lyon
Yeah, that's exactly right. And it's really quite amazing. And it's unfortunately not accessible through traditional medicine. I've had back issues for the last 30 years because I ruptured the disc and really damaged the nerve when I was 32. And that left me with sort of chronic limp and then chronic back pain as a result of changed biomechanics. And I sort of managed it with yoga and stretching and massage and sort of managed my way through. But as I've gotten older, it's gotten more degenerative and there's been more issues. And I was in a place where I just was really a mess. And I looked toward regenerative medicine as a way to solve it. And I'd had steroid injections, I'd had radio frequency ablation, which I didn't know, and when at the time would cause secondary consequences of damage to my back through damaging the muscles in my back. And so basically I really struggled. And the only thing that's helped me take away my back pain are these compounds that are from this toolkit of regenerative medicine. So maybe we can sort of talk about there's two parts in my mind to regenerate medicine. One is orthopedics, basically healing, repairing trauma, injury, stuff that hurts, right, and pain management. And the other is sort of renewal rejuvenation around various chronic illnesses or longevity that's more systemic. So there's like injecting a knee with something, or there's just putting something in your veins. And we're going to talk about both those things. But in the orth, before we start getting into the details of it, I would love to sort of run through at a high level what are the sort of tools and the toolkit of regenerative medicine. What are the kinds of things that are included in that bucket you mentioned? Peptides, which are things that all of us have tens of thousands of these running around our biology that are the communication superhighway regulating all of our biological processes. You might have heard of Ozempic. That's a peptide. Insulin's a peptide. They're very powerful. But there are things that the body makes that we can then synthesize or extract, and then we inject back into the body to help accelerate the healing. But that's just one component. So maybe you can take us through what are the kinds of tools in our toolkit that are considered regenerative medicine.
- [12:35]
Dr. Adil Khan
Yeah, and I think that's really the key. The tools that we have now are much better than they were even five years ago. So regenerative medicine is moving at an accelerated rate. And that's to your point, A lot of physicians don't understand that there's so much innovation happening in regenerative medicine. And so they still have this concept that they were taught in medical school or maybe they learned, you know, or 10 years ago when, you know, stem cells had all this hype and they don't actually end up doing anything. And so in their mind, that's what they still think. And of course, stem cells is the first one I have to talk about, just because I think that's the one people always think about with regenerative medicine. And so stem cells is a very broad term. Number one. Number one, what that means is that it's not specific to any type of nomenclature. So if you go to a stem cell clinic, they're not specifying what does that mean? Right. Like, does that mean. Does that mean you're getting a stem cell from, like, the fat, the bone marrow? And even if you get the stem cell, is it culturally expanded? How is it being engineered? How's it being isolated?
- [13:39]
Dr. Mark Hyman
Is it yours?
- [13:40]
Dr. Gabrielle Lyon
Is it somebody else's? Right.
- [13:41]
Dr. Adil Khan
And there's so many questions. There's so many questions that just don't go answered when you ask these clinics that. And that's a problem still to this date with a lot of the offshore clinics, too, is, you know, there's all this excitement around stem cells. But in the day, stem cells have two functions. One is to self renew and the others to differentiate and turn into other types of tissue. So the analogy I like is kind of think of it like a, you know, like a master key. And that master key can replicate itself and then it can, you know, open up like different doors, or it can divide and clone itself and then open up other doors that way. And so if, if that's a function of a stem cell in theory, then it should be able to repair tissue and fix things in your body when we put them there. But it turns out when we take stem cells in the test tube and then when and versus when we put them in your body, they behave differently. So it's not as simple as we thought. And there's very. And there's a lot of different types of stem cells. So.
- [14:38]
Dr. Gabrielle Lyon
So stem cells are one of the big categories of regenerative medicine. That's one of the. So keep going around that. I'm just sort of contextualized because there's a lot of other compounds that are.
- [14:48]
Dr. Adil Khan
Used besides, there's so many. But even in stem cells, I mean, you can just do a whole podcast just literally about that, because stem cells are such an in depth concept, but at a very high level. What people need to understand is just when you take something from your own body. Like, for example, if you go to the US Right now, there's a lot of stem cell clinics, but they're not actually true stem cells. Because if you're just taking your bone marrow or your fat and then you're just isolating that, injecting it, it doesn't actually have the ability to turn into new tissue, but it does have an ability to reduce inflammation. And so a better term for it that Arnold Kaplan, who's the guy who coined the term mesenchymal stem cells in 1992, he's a, he's the guy who coined it. He wrote a paper about this. But basically he said that they, you know, these things should be called committed progenitor cells, which is a fancy word for just saying that they can't turn into new tissue, that they can reduce inflammation, which is still. Which can still be useful in some conditions. But it's just misleading because a lot of patients are like, oh yeah, I got stem cell injections. It's like, well, it wasn't really a stem cell per se. It was more just something to reduce inflammation. Because it's not. Because whenever. Because remember, the definition of a stem cell is something that can actually regenerate new tissue. And if you're just taking your fat or your bone marrow and injecting it, that's not regenerating new tissue through the mechanism of that stem cell. It may send signals to your own body stem cells to help with some regeneration, but for the most part it's an anti inflammatory product. And so that's the number one thing to understand about these. And we're talking about the broader category of mesenchymal stem cells, which is an embryological term. But essentially what it means is this is from, you know, these. The reason we use mesenchymal stem cells is because they're the easiest to source, because they're in the fat, they're in the bone marrow, they're from a melanchol tissue or dental pulp. There's so many different sources now. But that's the reason why MSC or mesenchymal stem cells are so popular. And the other reason is because mesenchymal stem cells only have a finite ability to differentiate, which means they can, they won't cause tumors or cancer. Of course, that's always been a concern with like embryonic stem cells, which if you're taking them from aborted fetuses, which some clinics still do, and obviously during the Bush era there was a lot of controversy around that. And that's why stem cells kind of got categorized into this unethical thing. But that's not how we're sourcing our stem cells. We're sourcing them, obviously we're not harming any babies. And they're being sourced from C section births after instead of being thrown away, they're donated. So it's a very simple collection process. But the problem with the mesenchymal stem cells, as we said, is first of all, there's a lot of clinics saying that they're taking your fat and bone marrow and claiming their stem cells, which are not. But let's say you go offshore somewhere and they can isolate them and then they can do what's called culture expansion, which means they can grow them and they can replicate them. So then they can actually have some sort of dose that can be a therapeutic and potentially regenerate tissue in theory. But then what happened? It turns out when you take these stem cells, whether from any of these sources, when you put them in the body, most of them don't survive. And when you do them intravenously, most of them get trapped in the lungs or die. And that's why the results have been very inconsistent. And that's why stem cells haven't taken off the way we thought they would 10, 15 years ago. And that's why the clinical trials have been so mixed. And so unfortunately there's still a lot of clinics claiming that we can regenerate tissue. You can do. And it's just misleading because. And even I thought this, which is that I thought IV stem cells were great, but it turns out a lot of them just get trapped in the lungs and most of them die. And even with that, you still get some people who get benefits. And that's the old generation technology. But now we can isolate the best stem cell population and use that one. So it turns out that when you take a stem cell, a mesenchymal stem cell, there's actually 17 subtypes, which is kind of crazy if you think about it. So it's like there's something called single cell RNA sequencing, which is basically to look at gene expression of individual cell profiles. So that way you can see how different cells behave and then you can see that, hey, there's actually these 17 different cliques that they hang out together and they behave differently and some of them are more useless and some of them are more useful. So we don't necessarily want all 17 subtypes, which is what most stem cell clinics do. And that's what we were doing up until a year ago. But as you know, I spent the summer in Japan. And in Japan they won the Nobel Prize for regenerative medicine, Professor Yamanaka for cellular reprogramming, in which we can talk about those stem cells. But there was another professor, Professor Mary Dazawa, who discovered something called mu cells, which stands for multilineage differentiating, stress enduring cells. So it's a mouthful. All you need to remember for people is that these are cells that are muse. Exactly. The muse. The muse is the cool stuff. They're able to, they're pluripotent, which means they can differentiate into all 220 cell types in our body, or over 200 cell types. And they are stress enduring, which means they can survive harsh environment. So that's really the key, so they don't die when they go in the body. So we can isolate these using self sorting technology and filter them out so that we're injecting primarily new stem cells instead of just injecting all the different type of stem cells. And so that's now what we've moved on to. And of course you talked earlier about your back and that's what we use for you and that's what we're using exclusively. Just because the Results are so much more consistent, and the science makes a lot of sense. And I'm in the process of doing some clinical work with Professor Dazawa as well. And we want to investigate these new cells for a lot of different conditions. But in Japan, they've already published trials for als, for heart attacks, for stroke, and these are not easy to treat conditions. And with intravenous MU cells, you do see benefits. And of course, we're seeing that in the real world, treating patients with all sorts of degenerative conditions and actually seeing a real meaningful difference. And that's just because these cells are actually surviving and doing what they are meant to do, which is reduce inflammation, repair cellular function, reduce oxidative stress. We know one of the biggest mechanisms by which they work is through mitochondrial DNA transfer and mitophagy, which is repairing damaged mitochondria. And I think everyone now knows the mitochondria are so important not just for energy, but for regulating cellular metabolism and aging. So that's why there's so much interest in this space for longevity and not just orthopedic conditions. And so those are mesenchymal stem cells, and then there's also induced pluripotent stem cells, ips, and that's the Yamanaka stem cells, where you can take any old cell and you can make it young again. So, of course, when you think about that, you're like, holy. Wow, that's great. Shouldn't everyone be doing this? But it turns out when you make that old cell young again, it all. It makes it almost embryonic in nature, which means it can cause cancer or tumors. So IPSCs, as they're called, or Yamanaka stem cells, to honor Professor Yamanaka, they're great, but the problem is they have the risk of tumor genicity. And so we don't actually use them clinically yet. There's a lot of work being done on it, but it's still, I think, a few years away from clinical translation. So that's why the MU cells, because we know they don't cause cancer and we know they're naturally occurring in our body. So they have a lot more clinical translation than the Yamanaka stem cells.
- [22:19]
Dr. Mark Hyman
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- [23:33]
Dr. Gabrielle Lyon
Hey everyone, it's Dr. Mark.
- [23:35]
Dr. Mark Hyman
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- [24:39]
Dr. Adil Khan
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- [25:09]
D
Brought to you by Etsy. Oh, hear that?
- [25:12]
Dr. Adil Khan
Okay, thank you.
- [25:14]
D
Etsy knows these aren't the sounds of holiday gifting. Well, not the ones you're hoping for. You want squeals of delight, happy tears.
- [25:24]
Dr. Adil Khan
How did you.
- [25:25]
D
And spontaneously written songs of joy.
- [25:28]
Dr. Adil Khan
I am so happy. Oh yeah, oh yeah.
- [25:31]
Dr. Gabrielle Lyon
Oh yeah.
- [25:32]
D
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- [26:00]
Dr. Gabrielle Lyon
So these are basically these different kinds of stem cells and most of the kind in the first generation seems like they were getting, you know, an anti inflammatory effect but they might not be doing the full effect. We had thought they might and why there was variable results and they get trapped in the lungs. The mu cells seem to be stress resistant so they hang out more, they have time to do their job more and they have the ability to actually work in a different way because they're not sort of chewed up so fast. And these don't get also trapped in the lungs, they are resistant to that.
- [26:33]
Dr. Adil Khan
Yeah. So about 10 to 15 times more are able to go into circulation. So there is still some that get trapped in the lungs. But Professor Dazawa has shown work showing that it's, you know, it's not like two times more, we're talking an order of magnitude like 10 times more are able to go into circulation. So it is still a big difference compared to standard MSCs.
- [26:54]
Dr. Gabrielle Lyon
And you know, there's two kind of uses as you mentioned. One is injecting it into a joint or a back or some damaged traumatic tissue or injecting them intravenously for systemic effects around really things like ALS or stroke. Those are really, like you said, almost impossible to treat problems. And what kinds of results are they seeing when they do these systemic treatments? And what are the kinds of conditions where it Might be applicable for.
- [27:22]
Dr. Adil Khan
Yeah, look, I just had an ALS patient I treated a couple weeks ago, and I was blown away because it was my first ALS patient I treated with Mu sells and she couldn't swallow because of the bulbar symptoms, you know, and now she can swallow, she can speak clearly. She couldn't. She was barely able to speak before. And that was just one iv. And I mean, it was pretty incredible to see. Obviously that's anecdotal, but the clinical trial that was done also showed some slowing of progression. And we all know how devastating ALS is. And if you can, if there's something that can slow down even. I think we just don't know the exact dosing for ALS yet. But I think for now, I think we could certainly say it can be helpful and it's not harmful. And then for stroke, we can be much more, much more kind of certain that they are going to have positive results. Because in stroke, for example, she showed that 30% of patients in the clinical trial were able to go back to full time work when they were disabled. Like we're talking patients who are disabled. And so imagine you're.
- [28:19]
Dr. Gabrielle Lyon
So are you saying someone's in a wheelchair and can't move the side of their arm or leg?
- [28:23]
Dr. Adil Khan
Exactly. Yeah, exactly. And they go back to full time work. So now 30% of people and the other 70% had still had significant clinical benefits and were able to get off, you know, were. They weren't necessarily able to return to work. A lot of them were able to get back to like normal functioning of ADLs and IVLs and stuff like that.
- [28:39]
Dr. Gabrielle Lyon
Which is still activity living.
- [28:41]
Dr. Adil Khan
And you know what the most interesting part was? 25% of the patients in the clinical trial had reversal of gray hair. And that was just like an accidental finding.
- [28:52]
Dr. Gabrielle Lyon
That's amazing. That's wild. So what other kinds of conditions might this be helpful for autoimmune diseases? Longevity.
- [29:00]
Dr. Adil Khan
Yeah, Well, I mean, I know it's. You almost sound like a, you know, like a used car salesman or something when you're like, this can treat everything, you know, but it. But once you understand the physiology of chronic disease as you do, you understand that there's certain hallmarks of aging and there's hallmarks of chronic disease that overlap. So I'm not going to list all 12 of them because I'll bore people. But there's basically 12 hallmarks of aging. We've listed a few of them. Mitochondrial dysfunction, you know, stem cell exhaustion. Yeah. Chronic inflammation, which is related to aminosines and you Know, there's lots of protein, like protein just. There's so many protein misfolding, there's so many other ones. And so basically, but these 12, let's call them the 12 hallmarks, they actually underlie not just aging, which is, you know, arguably the most complex chronic disease. They underlie all chronic diseases, from heart disease to asthma to dementia to cancer even, and just components of that that are overlying. And a lot of them are metabolic in nature. And so that's why these stem cells have this ability to restore metabolic health because of that mitochondrial DNA transfer and helping to repair the mitochondria through mitophagy. And then of course, the mitochondria are the ones that help to regulate metabolism, right? That's where they have, that's where when you eat food and your body has to process it, it has to go through your mitochondria to produce energy. And if your mitochondria aren't working properly, which is what happens to everyone with aging and chronic disease, then guess what, your metabolism is messed up. And that's why metabolic disease is really the root cause of so many different problems. And that's why they call dementia type 3 diabetes and all this other stuff, right? Because a lot of them are metabolic in nature. And if you can restore metabolic health, which stem cells can do, then that's why you can treat so many chronic diseases. And that's number one. And number two, the other beauty of these stem cells is their ability to regulate your immune system. So this is called immunomodulation. That's the medical term, but that just basically means we're shifting your body from a pro inflammatory state to an anti inflammatory state. So this is called immunomodulation, which is reprogramming your immune cells, specifically your macrophages. And if there's one cell that you need to understand, it's your macrophages. They're probably, they're my favorite style in the body.
- [31:21]
Dr. Gabrielle Lyon
They're like little Pac Man. They like go and chew up all the stuff that shouldn't be there. Right?
- [31:25]
Dr. Adil Khan
Exactly. So they're like your little, they're like your little Pac man, controlling and surveilling and making sure the bad guys don't get in. And they eat the bad guys. When they're around, they take them away and they'll dispose of them. But what happens to a lot of Pac man or police officers as they like to call them, is they get fat and tired with age and then they start eating too many donuts and they can't do their job anymore. And this is actually called lipid associated macrophages or lambs. And so they accumulate fat and lipid perioxidation inside of the macrophage. And then they can't do their job anymore. And which. And their job is so important. And then they start releasing the wrong signals. They start saying, so the macrophages start releasing pro inflammatory signals and then that causes the cycle of chronic inflammation. And that's really the root, as we know, of so many disease processes. And that's why if you can treat chronic inflammation, you can treat so many different chronic diseases. And that's why these IV mu cells have so much potential. And even with iv, let's call it the first generation, even with the iv, you know, first generation stem cells, there are clinical trials that are published showing that inflammatory bowel disease can get into remission, that rheumatoid arthritis can get into remission. It's just the dosing is quite high and people need a lot of frequency of those. But with the new cells you can get, obviously you can get a lot better results. But it's the same principle, which is you're just regulating the immune system.
- [32:45]
Dr. Gabrielle Lyon
That's incredible. Yeah. So for autoimmune disease and for chronic inflammatory age related diseases, for just rejuvenation, longevity itself, these seem to be helpful. One of the things I'd love you to explain is how do stem cells work? Because you kind of alluded to the fact that they don't actually work as we thought they did, which is you inject them and then they go. If you have a liver problem, they become a liver cell, or if you have a kidney problem, become a kidney cell. They just have certain compounds inside of them that go out and kind of earn.
- [33:15]
Dr. Adil Khan
Yeah, exactly. So stem cells. So mesenchymal stem cells primarily work through.
- [33:20]
Dr. Gabrielle Lyon
Let me just before you kind of go into that mesem, for everybody listening, that's a big word. It means just your body's tissue. What? The other kind of stem cells come from umbilical cords or from embryos. We're not doing embryos at all. We're talking mostly about umbilical cord blood that actually has basically baby stem cells as opposed to mine, which are like almost 65. Right. So. And they're not as antigenic. In other words, they don't tend to cause this foreign reaction. Like if you were to take, if I was taking your stem cells, I'd have a rejection of those stem cells as part of my biology because we don't like foreign stuff. But with these kind of umbilical cord cells, it's not like that. So you can use these umbilical cord mu stem cells to actually kind of bypass that thing, but actually have the benefit of these younger stem cells, right?
- [34:13]
Dr. Adil Khan
Yeah, exactly. Unfortunately, using your own stem cells, there's many reasons not to, but the biggest one is definitely they've gone through a lot of replicative stress because they've gone through their own aging process. And so they can. They can actually have markers of senescence and other, even cancer markers as you get older. So you don't want to take your own stem cells and put them in your body, especially if you're over age 40. But. But anyway, yeah, back to. Yeah, back to the point about, you know, what these stem cells are doing inside of your body. The mesenchymal stem cells are primarily reducing inflammation via this, what's called the secretome. So the secretome is kind of the soup that the stem cells grow in or release. And there's signals. So there's micro RNAs, there's what are called cytokines, which are these proteins that, that help to reduce inflammation. There's growth factors. So this is all what's called the secretome. And depending on what type of secretum the stem cells are releasing, dictates their ability to change the microenvironment and help with these different cellular processes. So, for example, the secretome of a stem cell from your own body isn't going to be as good as a secretome from umbilical core tissue. And you can probably understand that intuitively because it's like, oh, yeah, it makes sense. Micelles are old. They've gone through X amount of cell damage versus umbilical cord tissue, which doesn't. And that's why exosomes are such a hot topic. Because if the most of the benefits of mesenchymal stem cells are due to the signaling process, then why not just isolate those signals and inject those? And that's what the exosomes are.
- [35:47]
Dr. Gabrielle Lyon
Okay, so hold there for a sec. There's stuff that the stem cells secrete, right? That's why it's called the secretome or secretome, which is. I pronounce it right. So there's stuff that it squirts out basically in its environment that goes out and does all these good things. And what you're saying is that these inside of the stem cells, there are these little vesicles, these little packets of healing factors called exosomes. And they're maybe where most of the benefit Comes from, from the stem cells. So you can actually take the exosomes out of the stem cells. You grow the stem cells in a lab, you remove the exosomes, you can concentrate them. They don't have any DNA material, They're much safer, they're less expensive, and then you can use them also. So now explain to us what are exosomes, because that's another part of this whole field. Every into medicine, we kind of sort of basically skirted the surface of stem cells. I hope you got a good sense of that. But I want to get into a few other things. So exosomes are the next topic. And let's kind of explore what are exosomes, how do we use them, and why do they work?
- [36:49]
Dr. Adil Khan
Yeah, I mean, you kind of just said the definition, which is they're a type of extracellular vesicle, which are just packages by which your cell communicates with other cells. So they help with cell to cell communication. And there's different type of extracellular vesicles. So there's something called apoptotic bodies, there's something called mbbs, which are microvesicle bundles. And then there's exosomes, which are the smallest type of extracellular vesicle. So extracellular vesicle, or evs is kind of the class. And then there's different types of EVs, and exosomes are the smallest type of EVs, and they're basically to help facilitate cell to cell communication, which interestingly changes as you age. So exosomes are also becoming a hot topic in diagnostics because it turns out the exosome profile of your cells as they become cancerous or as they become chronic diseases, you can detect certain exosome products. Because we didn't have this technology right, like five years ago, and now we do, and now we can figure out, hey, the signals your cells are sending are changing. This means that you might be developing this problem. So that's why exosomes are becoming a hot topic in diagnostics too. And then of course, in intervention or therapeutics, then it makes sense because like you said, it's all about the signals that they're that are being sent by the stem cells that dictate their ability to modulate or change the cells in a favorable way. And now the exosomes can be isolated in a lot of different ways. Previously, it can only be done through, you know, ultracentrifugation of cells that are replicating. So you have to have cells that are replicating. But now that technology is improving so that you can actually get exosomes from terminally differentiated cells. So, meaning, even if they're not replicating, you can basically homo. It's called homogenization, which is basically like, you know, you're blending. You know how you. You know, you blend like fruit to get, like, the pulp out and the juice. It's like taking the juice, basically, and of tissue, and that's the exosome. So you can do that now with any tissue. So, for example, there's people working on natural killer exosomes, dendritic cell exosomes, exosomes from liver, from muscle. So there's so many interesting exosome products being worked out. There's 290 or 281 patents or something like that on exosomes in the last, like, couple years. So that can tell you. That tells you the scale.
- [39:09]
Dr. Gabrielle Lyon
Yeah, there's different kinds of exosomes.
- [39:11]
Dr. Adil Khan
Oh, yeah. So that tells you the scale, though. Over 200 patents on just exosomes alone in the last couple years. So that tells you the scale and the magnitude of research that's happening right now in this.
- [39:21]
Dr. Gabrielle Lyon
Yeah. You know, interesting. I actually, you know, there's. We're gonna talk about some of them in the Muse exosomes, But I. I had Covid, and like many of us out there in the world, and. And after one course of COVID I got seriously depressed, and I. I don't have that as a thing that I deal with. And I felt like it was a physiological depression of inflammation in the brain, because we know that depression is inflammation in the brain. And I felt my cognition was off. I had severe brain fog. I kind of could understand why people would kill themselves. It was a really strange experience. And I had, you know, my higher self was there knowing, hey, this is just your Covid talking. And I was able to get some exosomes and inject them intravenously. And almost, like, instantaneously, it went away. It was quite striking. I was like, wow, you know, like, this is quite an interesting tool. And I also had back surgery four years ago that went badly. And I had bleeding into my spine and had severe disc pain afterwards for months. And I saw a regenerative medicine doctor before I knew, and I had Matt Cook, and I had exosomes injected right up into the spinal canal through the bottom of my spine. It's called a caudal epidural, essentially, of exosomes. And within, really, almost minutes, I was feeling dramatically better. And so I began to kind of understand by using this on my own body with my own Degenerative arthritis with all the messed up things that are going on my back with the discs, with the inflammation, that these products actually really help relieve this chronic pain that I've had for so long. And it was really striking to me because I, I, you know, I didn't know that this was possible just with these simple therapies. And yes, it's anecdotal and the problem with stem cells is that they've been a neglected area of research in America. There are people doing it in academic centers, but it's kind of on the margins. Traditional medicine hasn't recognized it. You have to go to other countries like Mexico or Costa Rica or Panama or Dubai or Japan or where all.
- [41:24]
Dr. Adil Khan
The places, Lithuania is. Other place we work now.
- [41:27]
Dr. Gabrielle Lyon
Lithuania, Albania, whatever.
- [41:30]
Dr. Adil Khan
Yeah, seriously.
- [41:31]
Dr. Gabrielle Lyon
So, and it's, and so we're often sort of trying to find solutions for people, people and I have to send them other places if they want to try these things. And it is, it's still sort of, I would say in the experimental phase there's, there's concerns about certain risks of it. There's more data needed. But I would say, you know, when you're in pain, you don't really care about what the randomized control trial says. You just want to be at a pain and if something can help, you try it. And a lot of athletes use it, A lot of people in professional sports use it. I know you work with a lot of professional athletes. And these regenerative compounds, whether it's stem cells or exosomes or peptides or other, even compounds like placental matrix, which is kind of mashed up placenta, which I found incredibly helpful for pain relief, all are available. And there's other kinds of things that are also being used systemically that are part of regenerative medicine, including cord blood plasma, which is the fluid the cells run in. There's gene therapies that are available to help improve muscle, for example, like Follistatin. There'll be Clothogene therapy, which is another sort of longevity gene that's there that some people have some but don't. But you can actually provide it into people through different vectors that actually then can activate it and turn on these longevity factors. So it's a really extraordinary field of medicine that is, I think, going to be the future. And I think it's not really available widely because it's hard to get to, it's expensive. What other tools besides sort of the exosomes, which you can use, by the way, systemically or you can use them directly into an injured area. What are the other kinds of things you're seeing are being effective? And talk a little bit about the museum exosomes, because I think these are special, sort of like special forces, I think of these, like these special forces and the, you know, the Navy Seals and the Army Rangers. The great berets of stem cells.
- [43:21]
Dr. Adil Khan
Right, exactly. Yeah, there. So, yeah, a few things. First thing I would say, just because you touched on a little bit, was there's a lot of politics limiting regenerative medicine's ability to really get mainstream in US and interestingly, Japan has the opposite politics, which is that because of Professor Yamanaka, they spent $8 billion of taxpayer money on regenerative medicine and they have lobbyists for regenerative medicine. So it's very different environment that's actually favorable for regenerative medicine. And unfortunately, the US has taken a really archaic stance to the point where they regulate exosomes, which is an acellular product, meaning it doesn't have any cells, like you said, no DNA material. And therefore we know it's very safe. They're just signals that stay in the body for minutes to hours. And then, you know, they're, they're more or less, they're gone and then. But they help to change the microenvironment and help to change the functioning of cells. And so the safety is so high of exosomes, but FDA has decided to regulate it like a drug. And so therefore an FDA has still not approved any, any drug or any exosome product. So technically, you know, I mean, obviously there's so many clinics offering it, which is very interesting, but technically none of them are FDA approved. So it's just something to understand the regulatory environment. I don't agree with it, but that's the world we live in. And that's why people have to travel offshore, unfortunately. And that's, I think that's, that's going to be the way it is for the next few years. It'll take a while before, you know, even someone like us gets FDA approval for the muse exosomes. It takes, it takes seven years, you know, five to seven years. You just got to, you have to go through the phase one, the phase two, the phase three, the post market, like you have to go through all that and even then you may not get FDA approval. And so they, they've really made it difficult for regenerative medicine, which doesn't make sense.
- [45:06]
Dr. Gabrielle Lyon
But, but other countries are, other countries are moving forward, right?
- [45:10]
Dr. Adil Khan
Oh, yeah, exactly. US is being left behind us is being left behind, basically.
- [45:14]
Dr. Gabrielle Lyon
And so the data is in. How strong is the data around these things? Are there.
- [45:17]
Dr. Adil Khan
Are there clinical trials going? It's always about safety. Safety is always number one. Exosomes are so safe. And even, you know, mesenchymal stem cells have so much safety data around them too. It's always about first do no harm. And this stuff does not have harm. And so why not try it as an alternative to opioids or to surgery for chronic pain especially? Right. Like, it doesn't to me, it baffles my mind, but it's very clear, unfortunately. Do you know what the most profitable drug now is?
- [45:45]
Dr. Gabrielle Lyon
Ozempic.
- [45:47]
Dr. Adil Khan
No, it's actually methotrexate. It made. It made something like $26 billion last year. So it surpassed. It surpassed statins. So methotrexate.
- [45:57]
Dr. Gabrielle Lyon
Methotrexate, which is a chemo drug, but it's used for autoimmune disease. So you're saying it's the autoimmune rise of autoimmune disease.
- [46:02]
Dr. Adil Khan
It's an epidemic of autoimmune conditions, probably related to toxins in the environment. Probably covet maybe, you know, everything else that's going on in the modern world. And so it's just an epidemic. And you and I both know you can treat many of these just through nutrition and lifestyle. But most doctors don't know anything about that, so. So of course, they're just prescribing medications and we know these things. Wouldn't you rather be on something that's going to regulate your immune system and fix it than just suppress it, which may cause cancer? Right. Like it doesn't the risk, benefit. It just makes no sense, you know, And I think you always have to look at what's called number needed to treat versus number needed to harm. And that's essentially just a fancy, fancy way of just saying benefit versus harm. And if you look at that for a lot of the pharmaceuticals, it's not that great. You know, it's like for statin medications, the number needed to treat is not. It's not one to one, meaning not every person who gets their life is going to be saved from a heart attack is something like 1 in 200.
- [46:56]
Dr. Gabrielle Lyon
Yeah. You have to treat for people for preventing a heart attack. You have to treat 89 people to just prevent one heart attack and death. But, you know, it's quite amazing. It's not really good data on and how effective these are. It's like. So talk more about why you brought that up.
- [47:17]
Dr. Adil Khan
Yeah, because to me, then you have these interventions that we're seeing that are reducing inflammation, oxidative stress, that are helping with so many different chronic diseases. And they don't have harm. So why not have them as a first line as opposed to going straight to a lot of these pharmaceuticals that have risk. And that to me is kind of the logic. And on your note of muse exosomes, the reason they're superior to standard exosomes is simply because they're from that mu cell lineage. So when mu cells are replicating and when they're growing, the soup that they're growing in, that's what we're isolating, which has the signaling profile, meaning that secretum, which we talked about earlier, is superior than just a standard mesenchymal stem cell. So it has a better profile, number one. And number two, because it is from a stress enduring lineage too, meaning the exosomes can stick around longer than standard exosomes, which have cleared up pretty quickly.
- [48:10]
Dr. Gabrielle Lyon
So, so like, what is the difference between stem cell use and exosome use? Like some people say, oh, you can just use exosomes, you don't need the stem cells because it's actually the exosomes that are doing all the work. So why bother with the stem cells? It's more of a hassle, more expensive.
- [48:22]
Dr. Adil Khan
Yeah, that was, that was my take, honest. Until I had the mu sales, that was my take, more or less. I would only use the stem cells in very specific situations. But now that's changed because the new stem cells are actually pluripotent, which means they. And they mu stem cells are very interesting because they act kind of like macrophages. So they actually eat, they gobble up damaged cells and then they turn into the new tissue. So they'll, for example, in the heart, they'll go to the heart, they'll eat the damaged cardiomyocytes, so like the damaged heart cells, and then they'll actually regenerate new cardiomyocytes. So they're actually pluripotent. Right. And that's the key difference, because they're not just reducing inflammation. And that's why new stem cells are of course more powerful than muse exosomes, because they're actually going to regenerate new tissue versus just reducing inflammation, which is what the old generation stem cells used to do. And that's why when I was using the old generation stem cells, I was kind of just using exosomes for the most part, because I didn't see the point, because I'm like, you're just really reducing input. But now that we have something that's pluripotent, if I'm injecting it for something degenerative and I actually want to regenerate something new, then I'm going to use the stem cells. So, for example, with advanced osteoarthritis, if we want to actually stimulate cartilage regeneration, using the new stem cells makes a lot more sense. But if you just want to reduce inflammation, then you can just use the exosomes.
- [49:43]
Dr. Gabrielle Lyon
So you kind of have to use both of them in practice. And there's different uses for different people depending on what the issues are they're struggling with.
- [49:54]
Dr. Adil Khan
Yeah, and there's studies out there showing that the exosomes can create a micro mic, can create a favorable microenvironment for stem cell differentiation and for stem cells to do their job, basically. So that's why I tend to just combine them, because the exosomes are only there for like minutes to hours. You know, like we said, like they equipped, kill it up pretty quickly, but then they, what they do is they go in there, they reduce inflammation, they make it a better microenvironment so that the stem cells can do their job more effectively.
- [50:26]
Dr. Gabrielle Lyon
And there's other kinds of tools out there with regenerative medicine that I think are really emerging and interesting. And in terms of the orthopedic part, you know, you can inject peptides, you can inject stem cells, you can inject exosomes, you can inject placental tissue we call placenta matrix. What are all the kind of things that you tend to use and inject to help with these kind of orthopedic chronic injuries? And what kind of results are you seeing?
- [50:54]
Dr. Adil Khan
So the results since the new stuff has been honestly incredible. And as a physician, you always want your patients to get better. And now we have much more consistent results. With the older stuff, the results were a bit more inconsistent, meaning some people would get better, you know, some people wouldn't. And whereas this stuff just tends to be reproducible, and the way we do it is it's still very specialized. Right. And this is the problem too. There's so many stem cell clinics, but they don't know how to inject properly. You have to, you have to have a very high skill level. You can't just. Yes, there is a certain homing mechanism, but at the end of the day, the treatments are going to work better if you get them to where they need to go. So for example, if you have a rotator cuff in your shoulder and you don't get the right spot, your results aren't going to be as good as getting it right in the right spot. So. And that takes a skilled, that takes a very skilled. You know how it's skilled. You have to be very skilled at ultrasound and you have to have a high level of proficiency to be able to do that image guided injection. And so that takes years of training. And then on top of that, you have to know which products to use. So I think people don't realize this is a very specialized field. It's not like anyone can just do it. Despite a lot of people just offering stem cells, you know what I mean? A lot of people are like, yeah, I do stem cells. It's like, well, you can't. It's not, it's not just like, you can't just like do that. It's like doing. To me, it's like almost doing surgery. It's like, I don't just do surgery just for the sake of it, you.
- [52:16]
Dr. Gabrielle Lyon
Know, I mean, intravenously, anybody can do that. But when you direct it to specific tissues or injuries or spots, you have to hit that spot.
- [52:23]
Dr. Adil Khan
Yeah. And so the image guidance is very key to it. And the results for musculoskeletal conditions, chronic pain, even neuropathy, pain has been, has. Is very consistent. Meaning the only patients that I find that don't get better usually just need a second treatment or sometimes a third in very rare cases. So it's just a dosing thing. We don't know the perfect dosing for everyone, but we're starting to learn that more and more now.
- [52:47]
Dr. Gabrielle Lyon
The dosing of the stem cells or the exosomes.
- [52:50]
Dr. Adil Khan
Yes, because some people respond great to one treatment and some people need two treatments, and we don't really know why.
- [52:57]
Dr. Gabrielle Lyon
Now, can you talk a little bit about gene therapy? Because this is an emerging area of treatment. Most people have probably never heard of it, but I mentioned them a little bit before, like follistatin gene therapy or Clothogene therapy. What are these therapies? How do they work? What is the science behind them and what are the risks and what are we seeing in terms of the benefits?
- [53:21]
Dr. Adil Khan
Yeah. So I work with a company called Minicircle and Mini Circle has the world's first reversible plasma gene therapy. So what that means is it's basically a way for us to transmit any gene of interest up to a certain size to your body. So, for example, if there's a gene like follistatin, which is a bioidentical peptide Hormone in your body. And we want your body to produce more of that. We can put it onto this mini circle vector. We call it mini circle because literally it's like a circular strand of DNA. And you insert that phallostatin gene onto there and then you can inject it and then that will transmit it to your cell and tell your cell, hey, your cell will now read that instructions and then it'll say, hey, I need to produce more follow statin. And then follow statin goes into the blood and you raise your falsettin levels. And that has all these downstream benefits, which we can talk about in a second. But the vector is what people need to obviously, is, you know, probably being like, holy, what was. What is he talking about? Right?
- [54:21]
Dr. Gabrielle Lyon
It's kind of scary. You're like, what are you doing?
- [54:23]
Dr. Adil Khan
Like, yeah, exactly. Modifying. Are you modifying my DNA?
- [54:27]
Dr. Gabrielle Lyon
Are you g. Are you a GMO human?
- [54:29]
Dr. Adil Khan
Yeah, exactly. Yeah. So it's not. It's not as. It's not as, you know, advanced as crispr, you know, which is kind of the gene editing technology where you're actually like cutting out different strands of DNA and kind of putting them back together. This isn't as complicated as that. It's not as powerful as that either. But it is still a form of genetic modification because we are inserting a foreign DNA into your body. Where does that foreign DNA come from? It comes from E. Coli. So we're not injecting bacteria into your body, but we're injecting something called plasmid. The plasmid is kind of think of it like exchanging cards with people. It's how bacteria exchange information. So we're isolating that plasmid from the E. Coli and then we're using that as a vector. So plasmids have been around in microbiology for, you know, two, three decades, are not new. But the new breakthrough was just getting the plasmid to not shut off. Because normally when you put a plasmid in the human body, your cell, it does something called transgene silencing, which is just says, hey, this doesn't belong here. I'm going to shut you off. And then it just shuts it off and then. But we figured out a way for it to keep. Remain on specifically to express whatever gene of interest we want, which obviously are longevity genes. We're not going to put something in your body that's not useful. We're going to put something in your body that's going to have some real longevity benefits. And Follow Statin has been studied again for two decades. Follow Statin is something your body makes. It's basically a way for your body to put on more muscle because the higher your follistatin, the lower your myostatin, which is basically imagine the brakes on your muscle. And so if you take the brakes off a little bit, it's not like you're going to get jacked like the anabolic steroids, but it will make it a little bit easier to put on muscle. But much more importantly, and this is why I like Follow Statin. It's very anti catabolic, right? And because as you get older, especially after age 60, your catabolism increases like exponentially.
- [56:23]
Dr. Gabrielle Lyon
So what is catabolism? Ideal.
- [56:24]
Dr. Adil Khan
So basically, yeah, so there's anabolism and catabolism. So anabolism is building more tissue. And catabolism is what happens with aging, which is loss of tissue. We actually lose, I forgot the exact percentage, but we lose some like, you know, very large percentage of our total tissue mass as we age. And that's loss of mitochondria, that's loss of muscle, that's loss of bone density. So we lose a lot of tissue as we age. And so if you can maintain as much tissue as possible, possible, that's going to be a net positive thing. And especially muscle tissue, because muscle tissue is the most metabolically active. It has all these protective cytokines that are released called myokines that, you know, turn off tumor suppressor, that help prevent cancer, help with diabetes. I'm sure most people know about the benefits of muscle and anything we can do to help preserve that I think is going to have a net positive effect on your health. Because obviously a lot of people get concerned. They're like, how do you know this is 100% safe? Because it's new. It is new, obviously. And I'm not saying there's not enough long term data to know is it going to do something to you 20 years from now? We can't say that for sure. But what I can say and the reason I'm a believer in it and the reason I've done it for myself and obviously patients and many I've injected hundreds of people with it. And the reason is because, and the reason patients like it too, is because the net positive of having more muscle and having reduced systemic inflammation, which is what Follicatin does to me, is going to outweigh any theoretical risk that maybe we don't know about, but I think it's unlikely anyway. Because we understand how follistatin works.
- [57:55]
Dr. Mark Hyman
Let me just break this down, because.
- [57:57]
Dr. Gabrielle Lyon
That was a lot. So, first of all, just to make sure I understand, you can insert into your cells through something called a plasmid, which essentially is a communication vesicle that can then take a gene that produces a certain protein. And it's something that you normally would make, but you don't make as much of as you get older. And so you don't have the benefit of this molecule at the same level you had when you were younger to build muscle. So you can insert this gene that produces this thing called follistatin, which then inhibits the thing called myostatin, which then myostatin is the thing that prevents you from building muscle. So that's why, as you see, people get older, they lose muscle, they look more frail, they don't have as much bulk, and that's because they're having lower levels of this follistatin. So by actually putting it in your cells and having like a little factory to make extra follistatin, you actually can stop this process which prevents you from building muscle as you get older. Is that right?
- [59:01]
Dr. Adil Khan
That's exactly right. And it's one of the drivers. But that's a great summary. Yes.
- [59:08]
Dr. Gabrielle Lyon
So is there a risk of inserting this gene from who knows where into your body? That. Because it sounds scary, right? If you. Oh, my God, I'm going to get some.
- [59:16]
Dr. Adil Khan
Yeah. I mean, what if the gene. What if the particle, like some of the risks, for example, in theory could be, what if the vector that we're using migrates? What if it goes somewhere we don't want it to go? But plasmid vectors are very well studied and very well kind of documented how they work. And they have a very high, you know, they have a high safety profile because they're very inert, meaning they don't stimulate your immune system. They don't cause. They don't have any, you know, known serious risk. But there are vectors, for example, so people can understand, like what is with the vector. For example, when they use the COVID vaccine, they use something called a lipid nanoparticle vector, LpV. But the LpV, if you read about LpV, the vector that they use, unfortunately can migrate. And that's why some people get myocarditis or pericarditis, and the vector can also be immunogenic. So that's why it stimulates some people's immune system. And that's why they get autoimmune conditions.
- [60:12]
Dr. Gabrielle Lyon
And that's why we know neurological conditions.
- [60:15]
Dr. Adil Khan
Exactly. We know that the vaccine actually has some harm more than we probably thought when it first first came out. And so basically the plasmid vector, though, as compared to like a lipid nanoparticle vector, is a lot safer, just for comparison.
- [60:29]
Dr. Gabrielle Lyon
It's incredible. So there's really two main gene therapies that I've heard about. One is Follistatin, which is around and available now. When you go offshore, you can get it, not cheap. And then there's this new emerging technology around the Clotho gene. Now, can you tell us about the Clothogene clothing therapy, where we are in the research and what it does and actually how we're maybe going to be able to use this clinically soon?
- [60:57]
Dr. Adil Khan
Yeah. So Clotho is a really, really interesting peptide because the word itself comes from the Greek of saying the one who controls the threads of life, which is a bit dramatic, but basically, but basically it's like, whoa, holy. What does this Clotho do? Does it control my life? Yeah, well, yeah, well, they thought what they realized, they found this accidentally in some animal research and they found out that animals that had higher levels of Clotho lived 30% longer. And then they've seen similar data in humans of people who have high levels of Clotho naturally not only live longer, but they're protected against dementia, even if they have the APOE4 gene, which is super interesting. And then it can actually help with kidney, chronic kidney disease too. So the two levels where most of your Clotho is produced is your brain and your kidneys. And so those are the two main medical indications which Clotho is being very, very, like, looked at. Like, there's a lot of research going on right now and there's a lot of biotech companies looking at Coco, but our platform, I believe, has the most applicability just because of the ease of use and obviously being able to just give it same technology through a plasmid vector, which is just an injection in your arm or in your stomach and then optimizing your Clotho levels. But Clotho is more definitely more high risk than follow statin, because if you're. You don't want your CO2 levels to go too high either. If Follistatin levels go too high, it doesn't really have any harm, it just saturates and there's not really much that happens. But Colto, if your, if your culture levels go too high, it can cause your PTH to go down and it can, it can kind of mess up your hormonal system and there could actually be other detrimental side effects. So Clotho is definitely exciting, but I think we're still, you know, at least a year, a year and a half away before, you know, after the clinical trial that we're starting now, before we can start offering it to people. I'm going to be doing it on myself actually next month. So I'll keep you posted.
- [62:47]
Dr. Gabrielle Lyon
Oh, wow. Okay. Well, I hope you're okay. It caused some level of something to go down. What was that you said?
- [62:53]
Dr. Adil Khan
Pth. Parathyroid hormone.
- [62:55]
Dr. Gabrielle Lyon
Yeah, parathyroid hormone.
- [62:56]
Dr. Adil Khan
Hormone.
- [62:56]
Dr. Gabrielle Lyon
Right.
- [62:57]
Dr. Adil Khan
So you have to monitor. So you have to do blood work for that.
- [62:58]
Dr. Gabrielle Lyon
Yeah, so, so this, what does this do? Because it's, you know, the, the phenomena seems really clear. It just prevents the breakdown of muscle. What does Clotho do biologically?
- [63:10]
Dr. Adil Khan
So it, it activates WNT genes, which are these regenerative pathways, the WNT gene pathways. Kind of well known for being one of the more important ones that a lot of different regenerative molecules work on. And Clotho helps with that too. So it can facilitate regeneration and repair as well. And it can also in terms of, in terms of helping with neuronal death. So there's something called the integrated stress response, which is what your neurons, when they are under stress, they have this stress response called isr. And Clotho can help to mitigate that. So there's less neuronal death. And that's why it can help with various. That's why there's so much interest for so many different neurogenic conditions.
- [63:51]
Dr. Gabrielle Lyon
And, and so this really fascinating kind of field of different things that we're discovering that the body has built into it innately, whether it's certain proteins it produces or stem cells, or whether it's, you know, peptides. And there's seeming to be kind of this explosion of research in this area. I mean, Ozempic is a peptide. It's one of his biggest prophet drug in history, I think. But it's just something that the body naturally makes. A GLP1 agonist is something the body naturally uses to regulate its function. And so a lot of these compounds we're talking about are being explored which are actually helping activate the body's healing repair system by using these different compounds that come from different sources. And we're still sort of sorting through what works, what doesn't work, what the research is. When do you feel like this is ready for prime time? I mean, this is going to be covered by insurance, that healthcare, because right now it's not accessible to those people. The prices are so high. I mean, I remember I bought my first computer in 1988. It was a Mac SE30 and it was $3,500 for four megabytes of hard drive and one megabyte of RAM on a floppy disk. You know, and it was like this tiny little black and white screen. And now, you know, you, I get my iPhone, which is, you know, we can probably have more computing power than what took men to the moon for the first time.
- [65:11]
Dr. Mark Hyman
Right.
- [65:12]
Dr. Gabrielle Lyon
So how, how are we looking at this field in terms of, you know, the research advances, when it's going to be clinically kind of more widespread and when the costs are going to come down?
- [65:24]
Dr. Adil Khan
Yeah, so the costs will come down. And then I believe in the net really, like not. We're not talking like 10 years, we're talking with the next five years because we're very close to this kind of automation and of manufacturing. There's a company in Silicon Valley that actually just started that's. And they're doing well. They basically figured out how to automate cell manufacturing using robotics. And so using that plus bioreactors, which allow to grow a lot more cells a lot quicker, will significantly reduce the cost of manufacturing, manufacturing these cells. And obviously, if the cost of manufacturing goes down, then the cost of the consumer goes down. But then there's also like, it's almost.
- [66:04]
Dr. Gabrielle Lyon
Like the, you know, to get rare diamonds, it's hard, but now they make these artificial diamonds that. Right, exactly.
- [66:10]
Dr. Adil Khan
Right, exactly, exactly. Yeah. And so that's, so that's, that's the first thing. And then the, the second thing is there's economies of scale, which just means as more people do it and there's more demand, then obviously you can lower the pricing as there's going to be more people who are willing to do this type of treatments at a lower price point. And that's one of the things, you know, I'm, I'm very adamant about making this stuff accessible to the average person. And the only way that's going to happen, as you, as you just said, there has to be early adopters. Right? You bought a Mac in 1988, and probably not many people had a Mac back then. So it's like. But there's going to be early adopters for every technology. Just like, you know, I was an early adopter of Tesla personally. I bought an electric vehicle before anyone else really did. And I was, I was. And. But now it's becoming much more common. And so I think it's going to be the same thing with this, where it's like, okay, there's going to be the early adopters, there's going to be people who are more into this stuff. And also, I think the way to think about it is if you have the means to do this stuff, you're kind of. You are paving a better way for the future of people. Because we're at least our company, you know, we're. We're investing all of our profits back into R and D and trying to push this field forward and trying to really make a difference in regenerative medicine, you know, as opposed to just trying, you know, as opposed to just kind of using it for. Just for profit for yourself type of thing. So. And that's why I'm. And. But the. But the only way to push this bill forward is you have to, at the end of the day, do controlled clinical trials, because that's the only way you're going to get insurance companies and regulators to buy into this. And that's the long game. But by being able to offer these offshore treatments that people are willing to pay for and people actually get real results for, they're funding our ability to do the research, which ultimately will be used as justification for regulators to approve it, which I think will take probably seven to 10 years in terms of getting approvals for specific medical conditions. I think osteoarthritis, for example, is not very far away. We're already getting incredible results with the Mu Sells and Hydrogel scaffold, which is kind of, you know, like a jello that protects the stem cells and allows them to stay there so they don't migrate. And the results are already incredible. And, you know, just before I came on this call with you, I was talking. We're working with a company that's making custom scaffolds using 3D bioprinting and that can actually resurface an entire joint. And they've already done that in large animal studies. So the human trials are next, and that's what we're going to do. And so this stuff is not that far away.
- [68:37]
Dr. Gabrielle Lyon
So this whole field of regenerative medicine is definitely super exciting to me because it's always what I thought of in functional medicine, which is how do we use the body's own healing power to get better? How do we just get rid of the things that are causing harm and adding in the things that are supporting the body's own repair and healing? And so now we have all these exploration of these biological products that. That have been discovered really over the last decades that now are being used clinically and there are these sort of longevity enthusiasts or athletes or kind of early adopters who are starting to use it, including myself, and seeing quite significant benefit. Do you see this becoming part of mainstream healthcare at some point? Insurance covering it?
- [69:24]
Dr. Adil Khan
Look, in Japan, I keep bringing up Japan because they're just so far ahead of us. But in Japan they actually cover intra articular stem cell injections for knee osteoarthritis and cartilage defects. And so, and those are culture expanded stem cells. And so you know, the fact that, and the reason I bring Japan up too, because it's not like Colombia or Mexico or Panama or you know, some random country that doesn't really have a, any sort of developed economy. And like rigorous, like Japan, Japan has like rigorous standards. Like they're very meticulous with everything. And so, so to me, the fact that they're able to approve, not only approve it, but actually have insurance companies reimburse people already just shows you like what's possible. But I think America, there's just so many politics, right? And the politics unfortunately affect the ability for us to offer these to patients. And what I believe is a solution is personally, you know, if our company becomes big enough, I'm going to get some regretted medicine lobbyists and you bet you, bet you. I'm going to get, I'm going to get them to start lobbying for us because I think that's the only way to really get this stuff moving in the U.S. yeah.
- [70:30]
Dr. Gabrielle Lyon
I mean, so are there, there are, there seems to probably a lot of companies involved in producing different products and compounds. And, and there's a lot of money going into this. But is there a lot of funding of research on regenerative medicine? And who is this something coming from?
- [70:43]
Dr. Adil Khan
Government.
- [70:43]
Dr. Gabrielle Lyon
Governments? Is it coming from.
- [70:44]
Dr. Adil Khan
Well, no, it's, that's the problem. Right. Like that company I was just talking about, for example, that 3D bioprinting company, they got, they got a NAS National NIH grant, you know, for $18 million they're able to do some animal studies and some preliminary phase one stuff. But now they're hitting a roadblock because obviously they have to, they need more money to do more trials and it's so expensive to do clinical trials in the US that you, and they can't get any more money from NIH. So basically they have to go to VCs, venture capital or private equity and try to raise money. And they're having, they can't get it. It's like too hard because they're biotech and it's high risk and yada yada yada. And so it's really hard for these regenerative medicine companies to fund and find money and to, and honestly, that's, that's actually been my strength is I'm good at finding technology and I have, I have a good networks and I'm able to help. Like the Musells, for example. Professor Dazawa unfortunately hasn't had the, you know, she, she, she had funding but then lost her funding because again, politics and, but I'm able to, you know, help her with that stuff. And I have, and then obviously I have marketing and other resources and so we can, and that's, that's kind of my, I guess, vision with this stuff is being able to actually drive this stuff forward by doing the controlled clinical trials of very promising technologies that I believe that, you know, based off the science, I think are going to be a huge part of the future of medicine.
- [72:01]
Dr. Gabrielle Lyon
Yeah, it's pretty, it's a pretty exciting moment. I mean, we're seeing the advances in healthcare and medicine happening so fast. But just the sad thing is it often takes decades between the discovery of something that works and actually having it end up in the doctor's office or your clinic. And you created an incredible.
- [72:20]
Dr. Adil Khan
I think that's going to change thanks to social media, funny enough, because alternative media is becoming more and more popular and I think people will demand that their doctors or people know that, hey, like I deserve to have this as an option, you know, And I think that's what it comes down to. Patients have the right to have all their options explored and especially options that are safe and can be just as effective as surgery. So I think it's, it's, you know, it's unfair to patients to not be able to, for the doctors to not even know anything about this stuff and not be able to have a conversation with their patient about it just because they don't know, unfortunately, they don't know anything about regenerative medicine. And just because, I mean, you and me didn't learn anything about regenerative in med school. Right. So there was no education.
- [73:01]
Dr. Gabrielle Lyon
No. That's amazing. So, so tell us more about how people can find you about your clinics where they are, because maybe people listening want to go try it out. So how do they, how do they get to learn more about what you're.
- [73:13]
Dr. Adil Khan
Yeah, well, I mean, I'm in Dubai now, but we do have clinics in Los Cabos, Mexico, which is probably closest for most of our U.S. patients. And then we have a clinic in Europe and then we have a partnership in Tokyo as well. And then maybe Mark Hyman and I, maybe, maybe we'll have something in Abu Dhabi soon. But, but yeah, our company is called Eterna, like Eternal without a L and Eternal Health. But my Instagram, I have a, you know, I'm very responsive on there and it's at Dr. Akon K H A n. And I try to be as helpful as possible. I, I've, we've helped many patients with chronic diseases and you know, sometimes we know affordability can be an issue and we do try our best to help those patients with hardship pricing and stuff like that. And so it's not, you know, it is expensive. But we are also, we are trying our best to work on that and also starting a foundation to help cover those costs for like, you know, for veterans and for people on disability and stuff like that.
- [74:08]
Dr. Gabrielle Lyon
That's amazing. So we'll put the link in the show notes to your website, which is Eterna Health and to in social media so people can find more about you. We'll link to some of the sort of research that we've talked about and it's an incredible field. I just can't wait to see where it's going. And for me, as a guy who's coming up on 65, I'm like, thank God so I can keep getting all the old injuries kind of fixed up and keep moving up so I can keep skiing and playing tennis and climbing mountains and having fun. So I really appreciate the work you've done, your enthusiasm, your dedication to thinking about this, to learning about what's on the leading edge, trying to sort of navigate a very difficult and complex world. And I know we'll be hearing more about this from you in the future. So thank you so much, Adeel, for being on the Dr. Swarmsky podcast.
- [74:56]
Dr. Adil Khan
Yeah, thanks for having me.
- [75:00]
Dr. Gabrielle Lyon
Thanks for listening today.
- [75:01]
Dr. Mark Hyman
If you love this podcast, please share.
- [75:03]
Dr. Gabrielle Lyon
It with your friends and family.
- [75:04]
Dr. Mark Hyman
Leave a comment on your own best.
- [75:05]
Dr. Gabrielle Lyon
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- [75:07]
Dr. Mark Hyman
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- [75:10]
Dr. Gabrielle Lyon
And follow me on all social media channels at Dr. Mark Hyman and we'll.
- [75:14]
Dr. Mark Hyman
See you next time on the Doctor's Pharmacy. I'm always getting questions about my favorite books, podcasts, gadgets, supplements, recipes and lots more. And now you can have access to all of this information by signing up for my free Mark's picks newsletter@drhyman.com forward slash marks picks. I promise I'll only email you once a week on Fridays and I'll never share your email address or send you anything else besides my recommendations. These are the things that have helped me on my health journey and I hope they'll help you too. Again, that's Dr. Hyman.commarkspicks Thank you again and we'll see you next time on the Doctor's Pharmacy. This podcast is separate from my clinical practice at the Ultra Wellness center and my work at Cleveland Clinic and Function Health, where I'm the Chief Medical Officer. This podcast represents my opinions and my guest opinions, and neither myself nor the podcast endorsed the views or statements of my guests. This podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. Now, if you're looking for your help in your journey, seek out a qualified medical practitioner. You can come see us at the Ultra Wellness center in Lenox, Massachusetts. Just go to ultrawellnesscenter.com if you're looking for a functional medicine practitioner near you, you can visit ifm.org and search find a practitioner database. It's important that you have someone in your corner who is trained, who is a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health. Keeping this podcast free is part of my mission to bring practical ways of improving health to the general public. In keeping with that theme, I'd like to express gratitude to the sponsors that made today's podcast possible.