August 19, 2023

From podcast: https://bengreenfieldlife.com/podcast/ahvie-herskowitz-anatara2/

[00:00:00] Introduction

[00:01:37] Hydrodissection procedure for the nervous system

[00:08:42] How does hydrodissection procedure look like? 

[00:11:56] The electro-current devices for vagal nerve stimulation

[00:15:03] Patient's feedback

[00:21:10] How to find a well-versed person for the procedure?

[00:23:12] Immediate impact of the procedure

[00:27:21] The use of stem cells

[00:37:32] Protocols for stem cell treatment

[00:45:34] Closing the Podcast

[00:48:12] End of Podcast

[00:48:44] Legal Disclaimer

Ben:  My name is Ben Greenfield. And, on this episode of the Ben Greenfield Life podcast.

Tierney:  The other thing that I wanted to bring up about that C1 is because it's altering your blood supply to your brain, it can modulate your immune response to a certain extent through your autonomic system. When people have cold and flu and allergy symptoms, we do a lot of times see those dissipate and just with that hydrodissection and instantaneous relief of that congestion, of that runny nose, of that cough, of that altered temperature.

Ben:  Wow, that's crazy. So, it's almost like it can be an instant fix for just an acute sickness.

Ahvie:  That's correct.

Ben:  That's crazy.

Tierney:  We talked about heart issues, blood pressure issues. We can kind of turn somebody on a dime and make a real impactful change.

Ben:  Faith, family, fitness, health, performance, nutrition, longevity, ancestral living, biohacking and a whole lot more. Welcome to the show.

Female Speaker:  Please enjoy part two of Ben's interview with Dr. Ahvie Herskovitz, a follow-up to Thursday's episode. You can find part one along with a background and introduction at BenGreenfieldLife.com/Anatara. That's BenGreenfieldLife.com/A-N-A-T-A-R-A. And, the shownotes for this episode are at BenGreenfieldLife.com/Anatara2, Anatara with a number 2.

Ben:  This is obviously a big adventure through Anatara Medicine and everything that they do, but what we haven't talked yet about are some of these injections, particularly a flavor of injections called hydrodissection. I've talked about hydrodissection when it comes to joint health before on the podcast and a lot of these treatments that people will do for knee pain, elbow pain, carpal tunnel, et cetera, but there's kind of this weird component of hydrodissection that's related to the nervous system, related to stress and I haven't talked about that too much. There was a podcast a couple months ago go where I'd mentioned these nerve blocks like stellate ganglion and briefly mentioned it, but apparently from what I understand and Ahvie was filling me in on this briefly and said that you had a lot of flavor to add on this as well, Dr. Tierney, there's this idea of hydrodissection specifically for the nervous system with things like cervical spine injections or vagal nerve treatments. So, tell me a little bit about that.

Tierney:  Well, one of the things that maybe is lacking in healthcare is this addressing peripheral nerves. And, what's come to light with COVID is how essential there's some plexus of nerves are. So, you think of nerves as traveling through the body, but we don't often recognize how much they need to move. Literally, if you move your neck, the nerves are moving several inches as you move. So, if there's adhesions around the nerves or a webbing around the nerves, this may be caused from inflammation and infection and injury, then you start to have nerve problems. So, just take a look at when you scrape your skin off with a cut, you notice as it heals, it kind of gets pulled back together, which is very useful because you throw out these webs and stitch things together. But, if you have an infection or an injury or arthritis and you're throwing these webs out between the muscles and now you're restricting the nerve's ability to move between the muscles and the nerve starts to become dysfunctional.

So, when we look at what group of nerves do we least want to see dysfunctional, it's probably the C1 plexus, which is your vagus nerve, your sympathetic chain or your internal carotid plexus. So, that's basically your heart rate and your blood flow and your blood pressure to your entire body along with your digestion. So, a low blood pressure can be very bad, a high blood pressure can be very bad. And, it goes along to the hypoglossal and the glossopharyngeal nerve along with the vagus nerve which are sensory and motor to the tongue. And then, we go on to the superior laryngeal nerve that controls your ability to swallow and your vocal abilities. And, we also have the facial nerve that's going to control not only the muscles of the face but also your ability to focus your hearing and adjust the pressure in your middle ear.

Ben:  And, these are all the so-called cranial nerves.

Tierney:  That series of nerves for whatever reason with COVID and with other infections that are chronic tends to get adhered and then people have these symptoms where their vision is not okay because those nerves control the pupil dilation constriction and the blood flow to the brain. Their hearing is altered. They have ringing in their ears. They have loss of taste, loss of smell. They have lower blood pressure especially when they stand up, we call it POTS. So, they have this situation where their blood pressure may go down, their heart rate, which should probably for them be 60 is down at 30 and they pass out when they stand up.

So, we can literally just simply hydrodissect that plexus of nerves. And, within 10 minutes, that person's heart rate goes from 30 to 72. And then, that person was headed for a pacemaker and trouble. And, that's just such a common thing right now, so the same thing happens for these visual changes or the hearing changes. And, that's the one area that those nerves being dysfunctional can be a matter of life and death.

Ben:  Yeah, yeah. And, I remember back when I was taking anatomy in college and we had all these different cranial nerves snaking through the head, I believe, the what was the mnemonic on Old Olympus' Towering Tops, a Finn and German viewed some hops. And, the first letter of each of those words, I think corresponded to a different nerve like the vestibular, the vestibular cochlear, et cetera. And, I think that these days a lot of people who are into biohacking technologies or stress mitigation strategies, they'll use things like vagal nerve stimulators. There's all these different devices. I've gotten some sent to my house over the past few months that kind of deliver this mild electrical current over the vagal nerve area. And, that seems to actually help people a little bit with stress or people who, as you were alluding to, have this what is a postural orthostatic hypotension where they'll stand up and they'll get dizzy. And, a lot of times that'll correlate to having been through a period of stress, et cetera. And, I think a lot of people have felt what you're describing. But, beyond these vagal nerve stimulators, which people use at home back to this concept of hydrodissection, you can actually go in and adjust these nerves using ultrasound-guided imaging and needles from what I understand.

Tierney:  So, we have better than a tenth of a millimeter accuracy to put a needle right in that very delicate plexus and then just push the muscles apart, then the particular muscles here would be the rectus capita anterior and a digastric. But, regardless of that, it's the big guns. I think you have your big guns for adjusting your nervous system. Your autonomic system is probably stellate ganglion block and that C1 plexus hydrodissection. And then, you have all these other things like the vagus nerve stimulation, breathing techniques, exercise, weight training is it trains your autonomic system, even acupuncture is adjusting. So, you have all these tools, biofeedback, meditation, breathing that we can use, but the big guns would be that hydrodissection.

And, one of the things I talk about with hydrodissection is it's really hard from any other technique that we would use, anything that I imagine, to create more mobility and more health in those nerves. So, you can relax those nerves, get them functioning, but they're not going to stay functioning if they're continuously restricted. So, you have this opportunity to make a change that's a lasting change.

Ben:  Okay. So, as much fun as it would be for Ahvie to just come over here and jam a needle in my neck, I don't think this is going to be one that we demonstrate right now. But, describe to people how this would actually work? I hear you talking and I find a doctor who's well versed in these hydrodissection procedures, and I asked him about stellate ganglion nerve block and I go in for this stellate ganglion or the whole C1 plexus. What somebody actually experienced during one of these? How's it go down?

Tierney:  On the C1 plexus case, you're going to be lying on your side and we're going to look at the anatomy in that area and we're going to kind of be aware of the things that we want to avoid and the things that we want to address. We're going to avoid any major vessels, especially the occipital artery, internal jugular vein. Those are the two things that are in that plexus along the nerves. And, we're going to make a plan of, are we going to come from the back or the front so you'd be lying on your side? And, it would come either from posterior or from anterior and it would go to that fascial plane and we would just inject fluid and that fascial plane would open up and you would just see that space created, breaking those adhesions around those nerves and making a lasting change. And, the nice thing about this kind of work is always to make a lasting change but we can actually see within 10 minutes of dramatic change in somebody's function in most cases.

So, it's not unusual to say, “Okay, your blood pressure was low, now it's normal. Your blood pressure was high, now it's normal. Your visual acuity is very low, now it's normal. Your ability to clear your ear.” So, you have this instant feedback that it makes it easier for us as providers to guide you through your best care.

Ben:  And, you do this on both sides of the neck?

Tierney:  Yes. Now, that's the one thing that's different between a stellate block–the stellate block is we're blocking the sympathetic side so that the vagus side or the parasympathetic side can express itself, and also so that the nervous system can recover when it's been overwhelmed metabolically and spinning too fast. So, that stellate ganglion block is lower, you're laying your back and you're turned to one side. So, the stellate ganglion block is lower and it can only be done on one side per day. And, the reasoning for that is that there's a nerve, the laryngeal nerve, and if that is blocked, which is the branches of the vagus nerve, that nerve is blocked, then you may not be able to swallow normally or talk normally on one side. But, if we block both sides, then you would be able to breathe without being intubated, so we only do one side per day to avoid that issue.

So, with the stellate block, it's one side. And, with the E1 plexus, we can do both sides because there's not an anesthetic, there's not that risk of doing both sides on the same day.

Ben:  How do you think these compare to those vagal nerve stimulators, the electro-current devices?

Tierney:  I think it's like I talked in general, when you're treating something that needs a hydrodissection, not doing a hydrodissection, it's essentially like a massage. So when you get a massage, it feels better if you have a lot of adhesions around your nerves. And really, muscles don't have a sensation for pain, so we just think, okay, muscles don't have a sensation for pain. So, if I have pain and I feel like I need a massage, then I'm going to feel better if I get a massage. But, if the nerves are still restricted, in a couple days, I'm going to feel the pain again. So, the same thing happens when you're dealing with your autonomic system.

So, if I use a vagus nerve stimulation to get the vagus nerve to function better, to relax and be more healthy, it's a really useful thing and I don't discourage in any way but you're not being realistic if you think that's going to last when the vagus nerve dysfunction is related to adhesions that are restricting the vagus nerve from moving and getting to normal circulation. So, it's a great thing. I think it's an additional thing to do, but you would likely have to continue doing that and not have a lasting result; whereas, a C1 hydrodissection is something that you may have to do one or three times period to solve the problem.

Ben:  Like ever and then your nervous system is just kind of reset at that point.

Tierney:  Right, right. You just freed up that nerve. So, even if the muscles get tight, even if there is inflammation in your body, even if something happened, unless something created that re-adhesion of most muscles, that connective tissue around the nerve, you're not going to have to go through that again. And, it occasionally will happen that it comes back if there's an inflammatory process and we come back with different biological tools that will make it last.

I'll give you an example. I had a patient that came in. She had COVID and her heart rate was 30 beats a minute. She happened to be in the office for something else, but she was scheduled for a pacemaker the next week and I said, “Well, sometimes we can help out with this, why don't we do this? It's a minimally invasive thing to do. It's not extraordinarily expensive.” So, we did that procedure and her heart rate went from 30 to 72 within 10 minutes and it stayed there for four days. So, she come back and started go walk. I said, okay, “Well, if it doesn't last that usually means there's an inflammatory process. So, we'll come back with this a product that kind of stops that.” So, we did the procedure with that product and now she's had a heart rate of 72 for the past year. And, that change was, like I said, within five minutes of the procedure.

Ben:  Wow, wow.

Ahvie:  I just want to say a few things, Sean. When I ask our patients, “When you come around twice a month to the office here,” I want to thank you for that, “What's the most effective thing that we've done for you this month or these last two months?” And, they say, “Well, that's C1 injection.” Woke me up. So, wake up, it's not just–again, COVID is a great unveilor of pathology underneath and it's not just giving us sore throats, it's inflammatory in the neck and can tie up all your cranial nerves. But, the majority of people that we use them in the real world are folks that they just want an extra boost. So, it's cognitive boost, energy boost, even performance boosts. And so, that's the average thing. We'll talk later about the German resetting of the nervous system using intravenous procaine later. 

But, the other thing about the stellate ganglion block which we've used on all of our cancer patients to basically allow their parasympathetics to come up so they have more calming effects because their stress is reacting to the real world. So, that's not going to go away and they want to have it done repeatedly. So, this is not painful. It's very fast, very quick and they say, “I can't wait to do the other side, I can't wait to do the other side.” And, also that there's this issue about one other thing that comes up a lot is, and I wasn't aware of until you told it to me and you said that hydrodissection at that level one way or another is in the neck area and in the head area is outstanding treatment for migraine.

Ben:  Interesting. Yeah, I could see that that being the case with migraines. You've actually experienced that as well, Dr. Tierney?

Tierney:  Oh, yeah. Well, what we have to look at with migraines–and, I've only ever had, to my knowledge, one patient that I couldn't get rid of the headache with hydrodissection, and that's not just that C1 plexus, and that was my nephew. We actually get rid of his headache. It ended up being from the circulation to the brain and abnormality in the brain circulation. But, aside from that story just to go over the basics of headaches, now headaches, it turns out, are really nerve impingements and the migraine headache has the nerve impinged and also next to an artery, usually the occipital artery sits next to three nerves. We have really three nerves that do the same thing. So, without looking and pushing and doing a good exam–by talking to somebody, I don't know which of those three nerves it is and it's pretty simple. It's the greater occipital, the lesser occipital and the least are third occipital. And, all those nerves are going to wrap around to the forehead to behind the eye.

So, just to kind of basically get you an understanding of that, and I like the greater occipital as one of the best examples of why hydrodissection is important. So, I'm just going to turn here as you can see. So, the greater occipital is the only nerve that comes posterior kind of between the laminar, between the ponticles of C1 and C2. So, this nerve comes out between C1 and C2 and goes posterior. Most nerves come out and go anterior or lateral coming out of the spine. So, this nerve goes posterior and it turns and goes all the way to midline, all the way to midline, and it turns all the way back to about halfway to the lateral side, then it shoots right over the head.

Now, the reason that that nerve comes out and goes to the left and goes to the and shoots over the head is because if I turn my head like this, now that's a straight line. That means that nerve is going to be moving that much inches, 3 inches through the muscles just for me to turn my head that way.

So, when I have restriction between the muscles or webs between the muscles and I restrict that motion, that nerve is going to be very vulnerable. So, when we hydrodissect and push those muscles apart, the nerve can glide as you move your head, then we really enhance the function and the circulation to that nerve. And, the other nerve is kind of complex too. I'm not going to bore everybody with it, but the third occipital nerve actually comes out of C2, goes down to C6, back up, and wraps around another muscle and goes around. So, you have all these different wrapping and turning that just allows your nerves to not tear as they move through your body. And, there's a lot of places where you need inches of glide and those nerves that cause headaches that there's two of the three really needs inches of gliding.

And, the reason that we have that C1 plexus here is because that's the least amount of motion that's going to happen as we move our head as anywhere other than right in front of C1, we have to have these loops where nerves can move and accommodate for that motion, that stretching of our muscles.

Ben:  Interesting. And then, I guess if somebody's dealing with a migraine headache right now or they're incredibly stressed that they might be googling stellate ganglion nerve block, name of their city or whatever. But, I guess we'd seen the elephant in the room here, these are sharp objects going into one's neck near extremely vulnerable arteries.

How does somebody know if they're going to somebody who's actually well-versed in these protocols and knows what they're doing?

Tierney:  Well, I mean the most predictable thing is it's what their experience is. To an extent, there is an RMSK certification and people that are experts at ultrasound tend to have. So, you can look for somebody that has RMSK certification or you can just look at somebody's experience, talk to them, look at their background.

I've been teaching these procedures for 13 years, so I do know a lot of the people in areas all over the world. I mean, I'm teaching from China, New Zealand, Australia to Canada, in South America, and all those areas, so I kind of know who's going to have it. And then, I think if you know somebody who's an expert in it, you can call them and say, “Hey, I'm in Phoenix, who's the closest person that you trust and we can kind of guide you to the best of our ability?” So, it is kind of tough. I think that there is probably less than 50 people in the United States, I would say possibly less than 20 that are going to be really skilled at those procedures. And, the numbers maybe more. I personally know of 20.

Ben:  Yeah, okay.

Tierney:  Hopefully there's a lot more. Basically, they're looking at less than 1% of the providers out there.

Ben:  What I'm going to do is I'm going to put the name of your website and everything in the shownotes so people could at least start there as far as some digging goes. I'm sure Ahvie knows some good folks for this as well. So, if you're listening in right now, both Dr. Tierney's and Dr. Ahvie's clinics are going to be in the shownotes at BenGreenfieldLife.com/Anatara if you're interested in getting a procedure like this done because I think it's absolutely one of the most profound things I've seen for nervous system management. So, I'm super appreciative if you fill us in, Sean.

Tierney:  Yeah. I mean, there's a tendency to have people go one direction or another direction. For me, C1, that plexus, I feel really, really good. And, some people that tend to run really high, they feel better after getting a stellate block. But yeah, you have that almost a personality that it's going to do better with one versus the other.

The other thing that I wanted to bring up about that C1 is because it's altering your blood supply to your brain and it can modulate your immune response to a certain extent through your autonomic system. When people have cold and fluent allergy symptoms, we do a lot of times see those dissipate and just with that hydrodissection and instantaneous relief of that congestion of that runny nose, of that cough, of that altered temperature.

Ben:  Wow, that's crazy. So, it's almost like it can be an instant fix for just an acute sickness.

Ahvie:  That's correct.

Ben:  That's crazy.

Tierney:  It is really and even in looking at people that are, okay, like we talked about heart issues, blood pressure issues, we can kind of turn somebody on a dime and make it real impactful change.

Ben:  I'm really glad folks are finding out.

Ahvie:  The last time Sean was here, last week at the office here in Anatara, we had a woman with a malignant form of hypertension and tachycardia. And, after the procedure, blood pressure was 113 over 67 and the heart rate was 72.

Ben:  Wow.

Ahvie:  So, it can have an immediate effect, the question is whether it'll last. And, of course, the way we performed it on this particular woman, it should last, but let's just see how it goes. But, you can have an immediate impact, the thing about the immune system connected to the nervous system is sort of really cool pearl that you can take out of this because it's not to be expected, but of course, they're connected.

Ben:  Yeah, yeah.

Ahvie:  I mean, of course, they're connected to the brain, of course, they're connected to the autonomic nervous system.

Ben:  Yeah.

Ahvie:  But, to have that type of instantaneous turn-off, it's pretty remarkable.

Ben:  Wow, amazing.

Tierney:  I have four patients that every so often we'll have visual deficits so far as their ability to focus and we kind of concluded over the years that, “Hey, this is what they need.” So, hope they'll literally come in. I won't see them for a year. My vision's starting to get a little blurry again, let me get another C1 plexus. And, within five minutes, they're like, “Okay and I'm back and I'll see you when we see you.” And, sometimes it's a year or two and we'll come back in and say, “Hey.” It does make sense because really your pupillary size, the size of your pupil is controlled by your autonomic system. And, if that system is out of balance, you may lose that ability to focus. And, the latest medication for actually focusing for somebody like me who needs reading glasses, the little drops that just make your pupils smaller, and then all of a sudden you can read the small print again without glasses. So, there's a lot of science and technology and physiology behind that being effective.

Ben:  Wow.

Tierney:  And, the other thing that I see those repeat people coming in is people get tinnitus or tinnitus where they have ringing in their ears and/or some loss of hearing and that those people kind of come back, and that's, “I need another C1.” Maybe it's been a year, maybe it's been a couple years, but it started to come back, so let's just get it taken care of. And, that's going to be a devastating condition to have.

Ben:  Yeah. This is fascinating.

Ahvie:  Thank you, Sean.

Ben:  Appreciate it.

Ahvie:  Appreciate it.

Tierney:  Yeah.

Ben:  Alright, man. Good to see you on the internet.

Tierney:  Yeah. Alright, bye-bye.

Ben:  Alright, see you later.

Tierney:  See you.

Ben:  Well, one thing we haven't talked about yet that is obviously a hot topic in the whole anti-aging longevity medicine sector stem cells. I've talked about stem cells a lot in the podcast before, but I'm curious in your office if there's a specific flavor or approach that you use to stem cell management because you obviously talk to a lot of people about this and you're kind of forward-thinking on the whole topic. So, I'm curious how you do things as far as stem cells are concerned.

Ahvie:  Surely, I'm happy to discuss that. We've taught stem cell therapies in under the umbrella of ACAM for about six years but we started doing using our own adipose-derived stem cells here around nine years ago and they were quite effective in a very wide range of population.

Ben:  And, when you say adipose-derived, do you mean taken from the patient?

Ahvie:  Take it from the patient.

Ben:  Okay.

Ahvie:  Yeah. And actually, the mom of one of the oldest employee that we have who was at that time she was 96 years old, she was the second patient that I did it on.

Ben:  Wow.

Ahvie:  And, I got an amazing number of stem cells out of her fat. 

Ben:  You took the stem cells out of the 96-year-old?

Ahvie:  Yeah.

Ben:  Oh, wow, or the fat of the 96-year-old.

Ahvie:  Yeah, yeah, usually in the flank.

Ben:  Flank make you sound like a cow, geez.

Ahvie:  Well, coming from Brooklyn I didn't know about cows. But, we were able to get sufficient amount and it's done under local honesty, it doesn't hurt. But, we've had, let's say, five years of experience with that, completely safe. And, the more cells you were able to derive and you could predict who would have low yields. The lowest yields were the people with diabetes.

Ben:  People with diabetes have the lowest yield. That's interesting.

Ahvie:  Had the lowest yield because they have–I mean, whether it's type 1 or type 2, they had the lowest yields. And, that was just the learning from it. And then, the higher yields got better longer effects. And then, the FDA came in and said that the material we were using to digest the connective tissue off of the fat and then get the fat to release the stem cells was an intervention of some kind that went against their rules. So, they put a hold on it. And then, ultimately five years, six years later, they lost that case.

Ben:  From what I understand, the problem was they essentially were treating it, reviewing it as the creation of a pharmaceutical product.

Ahvie:  Right.

Ben:  Yeah.

Ahvie:  And, of course, it has no standardization. There's no way to standardize my fat cells with stem cells in yours. There's no way to standardize it. So, they didn't like the whole concept of it. And so, we then had to move on to other stem cell products.

So, we went through the whole gamut. And, if you look at my formula in the front of office, you'll see that we test a lot of different formulas. And so, we went through them and came up with a few of the better ones, both on the whole cell side, the whole mesenchymal stem cell side. This is umbilical cord cells, fresh taken out of C-section, umbilical cords and then set up and cultured and frozen. I mean, not cultured but frozen. And then, tested and so on.

And then, the problem, that was the first group that came up and we tested and we found one or two of them beat the others. And so, we focused only on those two. And, at that point, the exosomes came up, exosomes are simply the small particles from which the whole stem cells communicate with their neighbors. So, once they're infused into the body, one controversy is still out there that people think that stem cells given to you either your own or someone else's replicate in your body. And, there's very little data that suggests that that happens.

Ben:  So, stem cells do not replicate in your body. There's not a lot of data that shows that.

Ahvie:  Not that I'm aware of. 

Ben:  Why is that important?

Ahvie:  Well, because it's not the way they operate.

Ben:  Okay.

Ahvie:  Yeah. They don't operate that way. They operate locally when they're homed into an area that's a molecular signaling that the body produces. We don't produce it. And, we can mimic it by saying if I want to give, let's say, a cardiac patient stem cells intravenously, I will put the laser pads on his chest.

Ben:  Laser pads?

Ahvie:  In this case, the same device that you had attached to yourself. The intravenous lasers also has a way to put them locally. And, one of the ways that you can put them locally is with a pad.

Ben:  So, it's like a transdermal absorption of the wavelengths instead of going into the blood.

Ahvie:  You can. Yeah, because infrared will penetrate 10 centimeters.

Ben:  Yeah.

Ahvie:  So, we've known that from the very beginning that in my laboratory at Johns Hopkins many years ago, we were leading on the immunology side, we were leading on the transplant side. We started experimenting with how to get stem cells into the heart and we realized that you didn't need to go an arterial route, you can go a venous route. You can get them there that way.

So, we knew that that was still a good mechanism and you can get them to stick there for 30 minutes. They'll probably preferentially stay there. The fact is once you infuse stem cells into your body, they typically migrate to the lung lymphatics and to the spleen until they're called on for a specific task. And, when exosomes came forward, then we had a much easier approach to get the signaling molecules that they're using with the appropriate RNA signals into tissues that normally the larger stem cells would not be able to reach. And, the most important of which is the blood-brain barrier.

Ben:  And so, that's where you combine with exosomes to get the stem cells to go to places they normally wouldn't otherwise go.

Ahvie:  Yeah. Well, you don't need the stem cells anymore because these are products from the stem cells. So, the exosomes come from activating your stem cells in vitro and then collecting them and counting them and proving that they're sterile and so on, and then giving it to the patients. There's controversies in terms of how many of these stem cells do I have, how many of these exosomes do I have. The number doesn't count. You can be off by a factor of a thousand and say, alright, my exosomes have 15 billion and yours have 15 trillion and the 15 billion work better. It's not the number because you can adapt the counting device to any range of size you wish and come up with a bigger number.

So, at the same time, there's a counting war going on but the exosomes can traverse in very tiny spaces. And, they can easily traverse the blood-brain barrier, probably easier to traverse bone in terms of difficult areas to get into. So, we now use both umbilical cord cells as well as exosomes. The science and the technology on the stem cell side is no clear arguments that the stem cell technology is better abroad than it is here. Whether or not I like to use them with the lasers but that's not a technology per se. We're not culturing them. We're not expanding them here in the United States. You can get that elsewhere, but when we had experience with culturing and expanding stem cells early on for the first several years and then giving them back to patients, we noticed that there was a differential between the activity level of the stem cells given fresh versus the activity level culture.

Ben:  Yeah.

Ahvie:  If you get five times more cells in the culture, it doesn't mean that's five times more potent.

Ben:  Right.

Ahvie:  It may be better but it may not. So, it's not crystal clear to me that the number is important, it's the viability and the potency of the stem cell.

Ben:  And, if you had to choose, you care if you're using an umbilical source versus the patient's own factor of stem cells?

Ahvie:  Again, the older you are, the better it is to use umbilical. We just have that experience that we could derive the effect that everyone was looking for with our own cells typically except when we got too low a number. And, the value of that systemically, it was strong enough to be equivalent or certainly as good as the umbilical cord cells or the exosomes that are derived from the umbilical cord cells.

Ben:  Okay.

Ahvie:  The trouble with it is, and they have to be clear about is the stem cells are not a panacea. They're not the holy grail at this point in time. They're primitive, but they're mature enough that they can't become an organ system and they're not primitive enough for that. And so, they're not going to take you from kidney failure to normal kidneys.

Ben:  Right, or a second heart.

Ahvie:  It's not going to do that. At the same time, they're the strongest type of treatment of its kind. So, the strongest global reparative, global antioxidant anti-inflammatory therapy that we have. I won't waste it. You can't come to see us and just come in and get stem cells and leave. I won't do it. You have to first give someone a month of gut repair, a month of hormone replacement, a month to get the signaling correct.

Ben:  Right. You don't want to basically put stem cells into an inflammatory messed up body where it's almost like a waste.

Ahvie:  Yeah. Now, they still work interestingly enough because we had a lot of clients that used to come from China before the pandemic and they were not interested in any anti-aging strategies, they just wanted stem cells and they wanted stem cells they could trust.

Ben:  Yeah.

Ahvie:  So, they would get that and they warned us clearly that they're not going to listen to anything else we're going to say. And then, they'd complain about four months later say the effects are gone, maybe we didn't get the thing. I said, well, we told you exactly that that's what happened because you can't go back and smoke and drink every night.

Ben:  It'd be the ganglion nerve block that we talked about and something like the hyper-stressful lifestyle and using that as a band-aid.

Ahvie:  Right. But, that's in fact a reasonable way to go, it's not going to get you to live longer. But, if you wanted to maintain that life, that ridiculous–

Ben:  Damage control so to speak.

Ahvie:  Damage control lifestyle, then you need to do it three, four times a year.

Ben:  Yeah.

Ahvie:  So then, the question is who do we treat? So again, the diagnosis is for anti-aging. We treat people who have difficulty reaching their performance goals. Locally, the majority of folks that are above 60 don't reach their performance goals because they have a local issue that has to be taken care of. And again, it's either going to be taken care of now. That's the reason I brought hydrodissection to Anatara because it's so profoundly not used and it's so potent.

So, for example, with hydrodissection, there's nothing as good as that for low back pain and upper neck pain and fingers and joints and smaller joints and so on just to be very, very, very precise. The other way we sometimes need to use them for a large joint is to be able to place one of the Weber laser needles into the joint when we give the stem cells.

Ben:  Oh, that's interesting.

Ahvie:  And so, that's using both the lasers and the stem cells together at the same exact time. This larger needle, you have to know where you are, so it's better to do that under ultrasound guidance. Otherwise, a knee injection like we did four, five years ago, we did it just with anatomical markers. We didn't need to go with that.

Ben:  So, basically, if somebody wanted to feel really good, they were going to come in here, they'd do something in addition to getting a diagnostic from you as far as bloods, mold screening, the urine test, et cetera, and the blood cell analysis, they do something very similar to the protocol that I'm on the tail end of today, looks like that NAD is still dripping in as we talk, something like ozone, vitamin C, B complex cocktails, phosphatidylcholine, antioxidants and that would be a protocol for somebody for a gold standard full body health type of workout.

Ahvie:  And, understanding that someone at your age, if you wanted to do it more, you can, but you probably don't need to do the stem cell component more than once a year because it depends on how competitive an athlete you are today versus the way you used to be three, four years ago. But, when you reach 60, 70, even 80 and there's so much to pay back that the only folks that use the stem cells correctly are the ones that make a long-term investment and say, “I need to do this every two months for the next 18 months to pay it back and then I can come in every twice a year.”

Ben:  Yeah.

Ahvie:  But, without that, now in the same time doing a lot of other things, making sure their hemoglobin A1c drops to 5.1, 5.2 and the C-reactive protein goes down and they're repairing properly, the methylation is proper, their true age from the methylation test goes down. Otherwise, it's just a shot in the dark and it makes people feel good but it's not accomplishing what they hope. It just doesn't.

Ben:  That makes sense.

Ahvie:  Now, you can take someone with moderately severe hip arthritis or knee arthritis and delay surgery with a single injection. If you want to avoid surgery, it's going to be a series of injections over 18 months. Once they get to bone on bone, it's simply just delaying surgery because you have to buff them up for other reasons.

Ben:  Yeah.

Ahvie:  But, that's the way it's poorly utilized. It's something everyone wants to do.

Ben:  Yeah, yeah. From a business standpoint, if you like branded the type of thing I'm doing today where let's say somebody listen to this podcast where they live in the Bay Area, where you're at or freaking flying from China or whatever, if they call the office and they ask to come in and just do a full body feel good and also eradicate some viruses, mold, et cetera, is there a name for the type of package that I was just doing today?

Ahvie:  Well, I guess the name–

Ben:  The Ahvie super special?

Ahvie:  Yeah, the name has been used by others but when someone like that wants to come in, I'll do that whole day or two days one afternoon and one morning, the next day with Dr. Tierney here.

Ben:  Okay.

Ahvie:  We have to reorganize or reset your autonomic nervous system also to make sure that a single treatment will stick and you can go back home and don't have to worry about it for six months or a year for that matter. But otherwise, we can mimic the total body approach that's being done elsewhere in the country, but we won't likely do it one day because I'm a hormesis type of a guy and I just think it's too much.

Ben:  It's a lot to do in a couple of days.

Ahvie:  It's a lot to do, but unless you're super healthy, you'll get away with it. If you're not, you'll get sicker before you ever get better.

Ben:  Yeah, yeah. And then, afterwards people feel kind of run down from all the procedures. I mean, right now, I feel my energy levels have gone up throughout the day, but I would imagine I'll probably sleep pretty well tonight after all these.

Ahvie:  Yes, you will sleep well tonight.

Ben:  Yeah. The URL, is it anataramedicine.com?

Ahvie:  Yeah, A-N-A-T-A-R-A, Anatara, it's a Sanskrit word that means core but typically when people misspell it, they'll get Anantara, which is a hotel group in Asia.

Ben:  Okay.

Ahvie:  A luxury group.

Ben:  Okay. Well, good, that's at least good that it's not some fringe bugs and herpes in your bed sheets hotel.

The thing is also you and I had another podcast I've alluded to a couple of times four years ago where we talked about food, constitutional assessments, and some of these other things that you do. If you're listening in right now, I recommend you go listen to that one too because it would pair pretty well with this one as far as wrapping your head around some of the nutritional components and body typing components and the Chinese medical approach that Ahvie alluded to a while ago in this podcast. But, what I'll do for everybody listening in is there's going to be a bunch of videos, photos, really cool visuals that you guys can follow if you go to BenGreenfieldLife.com/Anatara, A-N-A-T-A-R-A. And, in those shownotes, I'll link to the previous podcast that Ahvie and I did as well if you guys want to listen that.

And man, it's pretty cool what you're doing. And, I'm just super grateful to be able to cover it and open people up to this kind of procedures that can change their lives and make them feel a heck of a lot better.

Ahvie:  The whole purpose of Anatara when I first started was to figure out how to treat people who've been overdoing it for years. So, from my group of people, it was social entrepreneurs that dealt with global health and had entities in Europe and in Asia. And, we're up 24/7. And so, the concept of having social entrepreneurs like yourself doing good things is the whole point of this to optimize and do it in our way that's more international and more open to older stuff and not stuck with only what's going on now.

Ben:  Yeah, I've learned a new name for myself too today, social entrepreneur.

Ahvie:  Yeah. Well, you're for-profit but you're not motivated but you're motivated by doing social good.

Ben:  Information. Yeah, I consider myself to be a teacher and a storyteller.

Ahvie:  That's right. So, when I consider myself a doctor and a philosopher. So, that's the way it used to be.

Ben:  Yeah, yeah. You're right. Well, Ahvie, you're a good man. Thanks for doing this. I appreciate it.

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