The Future Is ALREADY Here… At-Home Blood Testing Will NEVER Be the Same: *Affordable* Blood Tests, Wearable Data & AI-Driven Analysis (All In One Place?!) with Michael Dubrovsky

Ben Greenfield [00:00:00]: My name is Ben Greenfield, and on this episode of the Ben Greenfield Life podcast.

Michael Dubrovsky [00:00:04]: You put blood on these squares. This is called a serum separator card, and this basically separates red blood cells from serum. Once the serum is dried onto this card, as long as it's in the desiccant packet, it's good for two weeks. So this allows you to realistically, you know, do home testing. Using this card, we were able to put together what's called a CLIA Lab Test. So it's a central lab. The card goes there, it gets rehydrated and runs. We were able to put together the best test in the industry by far, the base test, which takes one card, and then we have add-ons that take one more strip and do, 17 biomarkers.

Michael Dubrovsky [00:00:34]: Whereas normally, if you're taking a test like this, basically for almost the same price, you're getting three markers or something like that. We've tested thousands and thousands of people, and we continue to do so. It's growing very quickly. People are getting tons of value from being able to get these markers easily.

Ben Greenfield [00:00:48]: Fitness, nutrition, biohacking, longevity, life optimization, spirituality.

Ben Greenfield [00:00:55]: And a whole lot more.

Ben Greenfield [00:00:57]: Welcome the Ben Greenfield live show.

Ben Greenfield [00:00:59]: Are you ready to hack your life?

Ben Greenfield [00:01:01]: Let's do this.

Ben Greenfield [00:01:12]: In a world of home blood testing, there are a lot of options out there. I mean, they're all over the place. All the podcasters talk about the different blood tests that we're doing. I talk about self-quantification all the time, and it kind of seems like it's a little bit of a dime-a-dozen scenario, with all the different ways that you can test your blood at home. I have, of course, been trying all these different tests, as I'm prone to do, and one that has kind of caught my eye is called SiPhox. S I P H O X. They're a Boston-based company run by today's podcast guest, who is a materials chemist and serial entrepreneur, Michael Dubrovsky. And I have actually been pretty impressed with the platform and the results and the ease of the testing, but more importantly, some of the stuff that they have on the horizon, as far as some pretty technologically driven initiatives that should make home blood testing pretty crazy cool.

Ben Greenfield [00:02:16]: So, as you listen in, I will link to some videos, I'll link to some resources, I'll link to some of these tests that Michael and I talk about. If you go to BenGreenfieldLife.com/siphoxpodcast with an S-I-P-H-O-X, BenGreenfieldLife.com/siphoxpodcast is where you can access the show notes, Michael, assuming you're done pricking your finger and testing your blood and whatever an engineer in charge of a blood testing company does in the morning. Welcome to the show.

Michael Dubrovsky [00:02:48]: Thank you. Thank you, Ben. It's good to be here.

Ben Greenfield [00:02:50]: Yeah. I actually am curious. How often do you test? And the reason I ask is like, I did, I did a podcast with a guy who was actually at an event with you and me, Michael, down in LA a few weeks ago. Dr. Matt Dawson, who's running true age diagnostics, and he said he's testing like once a week or something. Now, as far as this home triage diagnostics test goes, but I'm just curious how often you do it.

Michael Dubrovsky [00:03:18]: So when we first launched our product, we had like an internal team of 30 people that tested every week for quite a while, maybe like six months. And we just wanted to see. There's not a lot of research on frequent testing because it's just been so expensive and difficult to do tests. So, you know, the literature is not very good on like, okay, if you're actually testing every week, what are you gonna see? So we wanted to kind of build some of that up ourselves. So we did. I did weekly testing for about six months as part of that group, and now I'm down to probably every month. I think that's like the trade off of like, how much effort it is to do the test versus how quickly things change. Once a week is like, if you're really making big changes, it's worth it to do it once a week.

Michael Dubrovsky [00:04:03]: But I think once a month is where it starts. That's like where I found my balance since then over the last, let's say a year and a half. But that's been very helpful, actually.

Ben Greenfield [00:04:11]: Yeah. I don't know if it was you or somebody from your team who gave me these tips, but they were super helpful for my own blood spot test because we can get into what the SiPhox test actually is, but part of it involves, you know, pricking your finger and putting the little drop of blood on the card. And I have just, I don't know if it's a thickness of the skin in my fingers or maybe lack of blood flow, I don't know. But anyway, for the longest time, I had trouble with it. And then you guys taught me. I'm going to show people in the video how to kind of like pull back the skin of your finger, put the lance on there, and then kind of milk the finger from the base of it to the tip. But you know what the game changer was, was making sure my finger was warm. So now I, on the day I'm going to do my blood test, I get up, and I go down into the sauna.

Ben Greenfield [00:05:01]: I flip the sauna on and leave it on for like ten minutes so it's nice and warm. Then I go in there and put the card on the floor of the sauna and blood just gushes. I mean, I can fill up that card in like 60 seconds.

Michael Dubrovsky [00:05:12]: Yeah, that's very funny. Yeah, I think, you know what we found is when we launched it first you'll have like, a distribution. So basically, some people bleed too much, and some people bleed too little. And it definitely has to do, like, for example, like, if you're weightlifting, you might have thicker. Depending on, like, what kind of how you lift weights, you might have, like, thicker skin on your fingers. So I kind of am in the same position as you. Like, I have trouble getting enough blood, but I think there are a lot of good hacks to do it. I think nobody besides you has reported doing the sauna.

Michael Dubrovsky [00:05:39]: I think that's actually a very good idea. Kind of like the poor man's version of that is just like very hot water before you do the prick. You know, you kind of like put your hand under water for two minutes. But what I do actually is I have a weight rack in my yard and I actually go out and do like ten squats. And basically, after that, you get kind of the same effect. You just get warmed up and a lot more. But especially in the morning, like if you're sleepy, then it's, you know, your hands might be cold and so on. But I think once people figure it out, like, whatever works for them, it gets very easy.

Michael Dubrovsky [00:06:09]: Like, like after I figured out a, you know, some hacks to do it, I've never really had an issue collecting the sample.

Ben Greenfield [00:06:15]: I don't know, doing those squats and stuff before your blood test might throw off your cortisol or your testosterone or your blood sugar or something like that.

Michael Dubrovsky [00:06:21]: Yeah, yeah, that's, that's true. There might, I mean, it's kind of like, probably the simplest thing is like putting your hand under warm water, but it's more, I mean, the squats are more fun. Yeah, that's a good point. I mean, the response, right, like your body, if you do it right away, I think by the time whatever response you have to the squats gets in your blood, I think is probably okay. You probably have like ten minutes or 15 minutes before that that has an effect. But a lot of the markers are pretty, they're relatively slow-changing. You know, like inflammation, uh, some of the hormones, and also, like, insulin, stuff like that. That stuff is slow changing, unless you're really, you know, if you.

Michael Dubrovsky [00:06:56]: If you're fasted and everything, it should be fine, right?

Ben Greenfield [00:06:59]: It's not like if you, I don't know, um, do a few squats, it's going to jack up your testosterone within the five minutes it takes to do the test.

Michael Dubrovsky [00:07:06]: Yeah, exactly.

Ben Greenfield [00:07:07]: Anything like that. But we can probably talk for a full hour about how to get your fingers to bleed more and things to do before a test. But I want to get into SiPhox, man, because honestly when I first got the kit, I kind of thought it was just going to be the same as all these other blood tests that inevitably get sent to me. You know, being a podcast or any guy who writes about a lot of self-quantification stuff, but you guys are doing, some interesting things. And, I mean, I actually would love to just jump into the deep end with this idea of the chips and the semiconductor technology. So I don't know if you have a perfect place or a story starting point for that, but fill me in on how you built this and what's unique about it.

Michael Dubrovsky [00:07:47]: Yeah, sure. So originally, we started out as actually, as a pure semiconductor company, so we weren't doing blood testing. And there's a subset of chips, silicon chips, that run the Internet, which are actually operating with light. So the data centers are connected with fibers. There's light going through those fibers. That's how all of our data is. Like, that's how this phone call is happening and so on, like this recording. And there are chips at the end of those fibers controlling the light.

Michael Dubrovsky [00:08:15]: So using that technology, we were working on building more complicated systems out of that technology that can do more than just process data, but kind of next-generation systems. We realized we could take a tool from a central lab which is full of optics. Like, if you go into a Labcorp request and you open up one of the analyzers, it's all lasers and lenses in there, so it's very optics-heavy. That's one of the reasons those tools are expensive and large.

Ben Greenfield [00:08:40]: Okay, and just, just to pause for just a second here. When you say Labcorp, in quest for people who might not be familiar, these are one of the locations, you know, spread around the US, where you'd often get a rec form sent to you, a requisition form sent to you after your doctor or after you have ordered a test, and then you get in your car, you drive to the lab, you wait for an ungodly amount of time unless you have an appointment, and then you get your blood drawn and you leave. And that's what they're using in those labs, the semiconductor technology.

Michael Dubrovsky [00:09:09]: No. So actually, in the labs, there's more like older school stuff going on. And that's why those tools, it's like a whole table, the tool that does the blood test normally. So we decided to take all the optics in those tools and get them onto several chips. So basically several silicon chips to make it very small, something that you can use in the home. And, you know, people have talked about doing this for years, but one of the things that's happened is this technology has matured that allows you to take a lot of optical components and put them onto a silicon chip. So over the last, you know, four years, we've been developing a home device that we're eventually, in the next year or two, going to go through the FDA with to allow people to test at home. So this is an example of a cartridge where you have a small silicon chip right there, and that chip can do 15 different tests at once and normally really like to do.

Michael Dubrovsky [00:10:02]: It's called an immunoassay. These are protein and hormone tests. So we don't do, like blood counts, for example, but we're focused on proteins and hormones. And so that type of test normally, really, the instrument is like a whole table. It'll be like your whole desk. So we're leveraging some really powerful technology that's scaled the Internet over the last 20 years. So it's not that we built this from scratch. We're using this supply chain that already exists and applying it to blood testing.

Michael Dubrovsky [00:10:28]: But it's definitely a long road to miniaturize a home device. The nice thing about doing it at home with this technology is it's also very low blood volume. So actually what we sell now is like ten times more blood than we plan to use in the fully at-home device. We launched this intermediate solution because we realized that using pretty conventional technology and just our expertise, like, we have a team of 15 PhDs at the company amongst, it's about a 50-person company, but 15 or 20 people have PhDs. And so just we figured out that we could launch this mail-in test that would crush the market and have many more markers, many more useful markers per amount of blood and per dollar than everybody else so kind of what you see on the market now if you want to get a home blood test is you have two choices. Either they'll send you to Labcorp request. So, you know, it's a website that looks like you're buying an at-home test, but really they're just going to send you to the standard, like, two companies that do blood tests and that there, you're going to get a venous draw. So it's going to be a phlebotomist.

Michael Dubrovsky [00:11:25]: They're going to get your blood. The other option is to have the phlebotomist come to your house. And those are both very flexible. So you can get like 400, 500 markers, you know, 20 tubes of blood drawn, whatever, right? But we were looking, okay, what can you do at home? And if you look at what you can do at home, you have companies like, let's get checked every well and so on. There's a whole bunch of them that are selling kind of like two, three biomarker tests. So typically they'll sell like, okay, here are your lipids. You know, but if you look at, like, what do I have to do to get these lipid numbers? Okay, I have to order this box. It has to come to my house.

Michael Dubrovsky [00:11:54]: I have to go through the, you know, be fasted, prick my finger, do all of this stuff, mail it back, right? And then I just get three results. So we realized, okay, there's an opening here to just maximize how many markers you can get out of that one collection. And what we did is we used, this technology has been around for about five years, so it's not ours, but we work with this company is you put blood on these squares. This is called a serum separator card. And this basically separates red blood cells from serum. The interesting thing here is that this allows us to. The blood is good for once the serum is dried onto this card, as long as it's in the desiccant packet, it's good for two weeks. So there's not like this risk of, okay, I've collected my blood, I mailed it, but then they get stuck for a day and it's no good or whatever.

Michael Dubrovsky [00:12:36]: So this allows you to realistically do home testing. The nice thing is that all the instruments typically work with serum, so you want to get the blood cells out right away. When the person collects the blood, usually they use a centrifuge. They spin the blood very fast, and the cells come out. But basically, using this card, we were able to put together what's called a CLIA Lab Test. So there's a central lab, the card goes there, it gets rehydrated and run. We're able to put together the best test in the industry by far. So it's 17, the base test, which takes one card, and then we have add-ons that take one more strip, does 17 biomarkers.

Michael Dubrovsky [00:13:10]: Whereas normally, if you're taking a test like this for almost the same price, you're getting three markers or something like that. So that's turned out to be a breakthrough, even before getting to the point of selling an at-home device, which is really what we're driving at with the company. And over the last year and a half, we've tested thousands and thousands of people, and we continue to do so. It's growing very quickly, and we're seeing that there's a lot of value in it. So people are getting tons of value from being able to get these markers easily, and that's kind of where we're at. So we're both building this very futuristic technology where you can get a very small drop of blood, put in a cartridge, get a result in three minutes, and then in parallel, we run these operations, a heavy business of shipping these cards, getting them back and so on. So we're kind of doing both things at the same time.

Ben Greenfield [00:13:59]: So is the idea here eventually going to be that you'll take the same technology that you guys are using in your lab when I send that blood spot card that you were just holding up back to you guys when running my test, and instead I would be able to actually do the analysis in real-time in my home.

Michael Dubrovsky [00:14:16]: Yeah, the technology, it's a little bit different. So this is more advanced than what happens with the blood on the card, but one of the benefits is that it cuts the. It cuts the blood blood requirements. So we're going to be able to do all 17 of the markers that we're doing now with the cardinal, with a smaller quantity of blood in the home. And in a very short time, you can think of it the way you would make espresso, right? So you take out, like, a cartridge, you know, like a Nespresso. You take out a cartridge, you put your blood in there, throw it in the machine, you walk away, and in half an hour, in your app, you have all the data. So that's kind of the user experience that we're working on.

Ben Greenfield [00:14:51]: It sounds kind of expensive. Like, would it cost a lot of money to actually have one of these machines in my home?

Michael Dubrovsky [00:14:56]: No, I don't think so. So if you think of, like, the kind of thing. So if you look at, like, a Nespresso, it's only 150, and it's an extremely complicated machine, like, super well made. Another thing you can think about in your home that's very complicated but very cheap is a printer. Like a home consumer printer. You can get it for $100, and it's actually like a circus inside. If you ever take apart a printer, it's an extremely complicated machine. Actually, the printheads have a semiconductor chip that shoots out tiny ink droplets. So it's definitely possible to make something complicated and give it to consumers at a reasonable price.

Michael Dubrovsky [00:15:33]: So our price target is like, $100 or below.

Ben Greenfield [00:15:36]: Oh, that's super affordable. And so if I do that and you have this printer-like device in your home using this chip technology, and I'm putting a little drop of blood in there, let's say I'm testing. I mean, you can tell me how far out this is going to be before this is available, but I'm then able to right away look at my results or on a phone app or computer software. See? Right away.

Michael Dubrovsky [00:16:00]: Yeah. So we're just, you know, evolving the. So the offering we have now is you put your blood on the card, put it in the mailer, put it in your mailbox, USP picks it up, and in three to five days, you get your results, the next version. And again, this isn't tomorrow, but, you know, 80% of the company is working on commercializing this home printer-like, or Nespresso-like device. That'll be in a year or two, and that'll be 30 minutes, right? So you put your blood in there, you know, you walk away, and in 30 minutes, all the data is on your phone, and you can, of course, share it with your doctor and so on.

Ben Greenfield [00:16:32]: Right? Which is great for kind of like the self experimentation crowd who wants to run a lot of stuff in real time, like what my sauna session do to me, how this smoothie compared to yesterday's steak and eggs. Like, why am I not sleeping well, I'm going to test in the morning when I wake up and not have to wait five days, seven days for my results.

Michael Dubrovsky [00:16:50]: We see, like, with CGMs, you can really see that instant feedback matters. People get a lot of value from the instant feedback. And that's something that we want to bring to hormones, inflammation, insulin, things that right now might get measured once a year, maybe never. You don't get measured until you have symptoms. Things like so we want to bring that almost like a CGM experience to those markers.

Ben Greenfield [00:17:15]: You said 17 markers. Run through them with me.

Michael Dubrovsky [00:17:19]: So we think of it as like, if you're doing a, you know, trying to get like a comprehensive panel, right? Because every time you test, you know, you're taking out the time to collect blood, whatever. We're trying to make the most out of that and cover as many bases as we can. So we look at, inflammation, metabolic health, cardiovascular risk, and hormonal health. And we, you know, in hormonal health, we include some nutritional things, like, for example, ferritin. So your iron levels, which tend to be like, a lot of women have low iron levels. Don't know it, for example. And the opposite for men a lot of men have high iron levels and don't know it. But those are the four.

Michael Dubrovsky [00:17:53]: Those are kind of the four pillars that we try to cover with the test.

Ben Greenfield [00:17:56]: Yeah. A lot of male endurance athletes, which since I got my start in triathlon and marathoning and this podcast, you know, my first probably 50 episodes were just all about Ironman and endurance training. A lot of my male audience, cause I still do consults and look over lab results and things like that. They tend to kind of fall into the female category of low iron, and low ferritin. You know, sometimes it's absorption issues, it's copper to iron ratios. But yeah, you're right, there's also a large subset of men who have to deal with the whole body rusting from the inside out. Hemochromatosis, high iron scenario.

Ben Greenfield [00:18:35]: But regardless, you've got a. These 17 different markers. And then you guys also have kind of like a. Tell me about the dashboard from a software interface standpoint, as far as what you've built into that, do you think is most helpful?

Michael Dubrovsky [00:18:49]: So the nice thing is, like, when we went to build this product, we're a hardware company. We're not a marketing company. We're not an e-commerce company. So the way we built the product is we just said, okay, we need to build something we're going to understand. And we tried everything out there and we said, okay, what would we want? And the simple thing is, okay, we tried wearables. We tried the blood tests, and the wearables are very good. So you can get a nice CGM, you can get an Oura ring or a Whoop or whatever. Eight sleep.

Michael Dubrovsky [00:19:17]: There are lots of ways to collect wearable data. No great blood tests. So we said, okay, we're going to build a dashboard where you can see all that data in one place, so you can connect any wearable to the dashboard. We're not going to compete with, let's say, the Oura app, right, or the Whoop app, that gives you, like, a ton of information about your sleep. But what we do is we aggregate the. Like what happened to you before you took the blood test. Let's say you took the blood test, you know, April first, so we'll look at the 15 days before that in March, and we'll average your sleep quality and other sleep data and put that next to your blood test results.

Michael Dubrovsky [00:19:49]: So you can see, okay, like, when I took the test in April, my sleep was poor, and that correlated with low testosterone. Then when I fixed my sleep, I saw an improvement in testosterone. Let's say you take the test again in May. You see, I fixed my sleep. My testosterone's back up. That's something that I've seen a ton in my data. When we look at our aggregate customer data, we do these meta-studies. You can see, let's say, to take that example, testosterone and sleep, for 50% of men, it's very correlated.

Michael Dubrovsky [00:20:21]: The more sleep they get, the higher their testosterone. For 50% of men, it's uncorrelated. So basically, whatever is causing their testosterone to fluctuate is just not sleep. And so I think seeing that on a personal level is valuable. So just we allow you to connect, any wearable you have, it's like 200 different wearables that we support, and we put all of them in the same place as your blood test data. The second thing that we do is we have a pretty big bank at this point because we've done so many tests. We have a very big bank of insights that we've built up that are evidence-based. Again, the company is full of PhDs.

Michael Dubrovsky [00:20:53]: We actually put a lot of effort into making sure that we give people good information. So you have a ton of evidence-based insights that allow you to quickly. Okay, I have this marker that's out of range. I don't know what it is. Okay, I can read up on this. I have a suggestion for at least a starting point where I can try to start optimizing this. So we try to give people the context around the markers, and we also combine them into scores. So, like, you'll get an inflammation score, hormonal imbalance score, cardiovascular risk score, metabolic score, and that allows you to just, like, have a snapshot of what's going on, because once you have a large number of markers, it starts to take some effort to think about, okay, is this improving or not? So we give you a score that weights the markers based on real data, like on population level.

Michael Dubrovsky [00:21:33]: How important are these?

Ben Greenfield [00:21:35]: Have you ever thought about doing, from an integrated marketing standpoint, kind of a different option in which people who are already opening up, let's say, their Oura Ring data? I've been experimenting with a new one called Ultra Human, which has a blood testing section in it, your whoop, your biosensor, whatever, and having an API in which your SiPhox results could appear in that platform. Like, have you thought about partnering up with these wearable companies instead of the API featuring your wearable data in the SiPhox section? Kind of do the other thing as well. And when I check in on my whatever, my Oura Ring data, let's say in the morning, my SiPhox Blood Testing results are on that same platform just for the purposes of consolidation.

Michael Dubrovsky [00:22:26]: Yeah, for sure. So there are also people kind of building these consolidation engines, and now they're adding AI to them to make them even more powerful. But basically, we're talking to several of the wearable companies. We already actually sell tests through one company that sells a ring in Europe, for example. And then we're kind of in slow conversations with all the big wearables companies.

Ben Greenfield [00:22:52]: Are you able to say which company it is in Europe, or are you sworn to secrecy?

Michael Dubrovsky [00:22:56]: So they sell it under something called Circular XYZ. And then there's also another company called Spren that uses our tests, which is like, they have an app that does, like, body mass index or body fat percentage, just from. They scan you, like, using your phone camera, and they use our tests. But there a, you know, these wearable companies. I mean, one of the issues is, I think Ultra Human is different in this sense because they're a little bit more adventurous. But if you look at, like, the whoops of the world, I think they're all looking at blood test data, and how do we integrate this? But it's just a little bit more, I would say, like deeper or more scientific, more medical than what they're used to. So they're all trying to figure out, like, how do we correctly integrate this? But it's coming. Like, I think, you know, in a year or two, you're going to see that from.

Michael Dubrovsky [00:23:38]: From the major companies.

Ben Greenfield [00:23:40]: I was trying to open up my Ultra Human app because when I was in India, I got one of these rings, and they sent a phlebotomist to my hotel room. I got the blood data. And now when I open the app, the blood data is in there. And yeah, it seems like some kind of API. You know, selfishly enough, just because I've been kind of geeking out on the Ultra Human one, I think seeing my SiPhox data in there would be cool. But I actually, didn't know that you integrated with that many different wearables on the SiPhox platform itself. So, I mean, are you saying that I could theoretically, instead of, let's say I'm using an Oura ring, instead of opening up the Oura ring in the morning to look at my sleep score, if there's an API tying that data into SiPhox, I could just open the SiPhox app and have it all there, both my blood work and my sleep score.

Michael Dubrovsky [00:24:28]: No, we don't support that just because at least right now, we don't feel confident that we can give you that day-to-day experience that Oura provides at the same level of quality. What we focus on is more long-term trends, because blood testing today, at least you're doing it, let's say, once a month. The question is, how is my sleep affecting these longer-term changes? If I'm trying to. This is probably not a problem for you, but let's say somebody has very high ApoB, so they have high cardiovascular risk.

Ben Greenfield [00:24:59]: I actually, by the way, and I can tell you what I did later on, I had extremely high ApoB, but go ahead.

Michael Dubrovsky [00:25:04]: Yeah. So basically they get a recommendation, okay, you should do more high-intensity interval training. So that training that they're doing is going to end up reflected in the activity data because you get minutes in high intensity if you're wearing a tracker while you're exercising. And we can show you how those changes, like, okay, over this past month, I've done twice as much high-intensity training. You can see how that affects your ApoB. So it's more, what we're offering is different than what the trackers normally do, which is more of like a day-to-day. We're showing summaries that are, well, easily, like, it's for somebody lazy. Like, in many ways it was built really for a person like me, who's not a biohacker but is trying to do their best.

Michael Dubrovsky [00:25:47]: Like very busy, whatever. I have two kids, so the idea is like, okay, if I'm going to take this blood test once a month, I'm just going to wear my wearables and ignore them. And once a month I'm going to check the digest and see. Okay, how is this affecting my blood work? That's more how it's meant to be used right now, because we can't, at this point, we haven't built out, like, an amazing app that would compete well with, like, a Whoop or an Oura where the app is, like, one of their main. That's the main part of their product. So that's what. That's what we do now. But we, you know, obviously, we intend to add more and more to it, but that's the part that we thought was missing is like, okay, here's my blood test. Here's what I've been doing for the last two weeks or months before the blood test.

Michael Dubrovsky [00:26:20]: And this is, you can see the clear, like, is this affecting my biomarkers or not, Evan?

Ben Greenfield [00:26:25]: Yeah, and your trends are fantastic. When I go through and look at my data from my SiPhox results, because I've been doing it now for, gosh, I can't believe we're just now doing the podcast, because I've been testing, I think, for almost a year now, maybe a little less with the SiPhox, but back to the ApoB thing. One of the main ways that I've been tracking my heart health during this heart health journey, is I've been bringing a lot of my listeners on, initially influenced by my concerningly high levels of plaque that I discovered on a CT Angiography, later verified with a Carotid Intima-Media Thickness score. And so I've been taking a deep dive into heart health and tracking it. As I told you, my ApoB used to be very high. My LPDD and my plaque were elevated. My cholesterol, although I think it's necessary but not sufficient for heart disease, was very high. And if I open my SiPhox dashboard right now, my lipids are pristine.

Ben Greenfield [00:27:24]: They look fantastic. So I've been doing. I have a list here because somebody asked me last night. I've got it on my phone because I don't have it all memorized, but basically, I've been doing Nitric Oxide Support. So I use a supplement called Vascanox by Calroy. I've been doing what's called Endothelial Glycocalyx Support. So I use another product called Arterosil. That one's also by Calroy.

Ben Greenfield [00:27:47]: I take vitamin E in the form of Tocotrienol from Designs For Health, vitamin K, and then I use a PCSK9 inhibitor, which is a twice monthly injection that down-regulates LDL receptors. And after having done all of that, not only is my plaque dropping but everything just across the board looks fantastic on lipids. That's an example. And I've been doing SiPhox probably once a month to track this, and every time the results come back, they just get better and better.

Michael Dubrovsky [00:28:24]: That's great to hear. Yeah, I think that's an ApoB. And heart health in general is one where it's boring in some ways. Boring. Like, it's not as. It's not as cool as testosterone, for example, which a lot of people want to get their testosterone measured, but I think it's one that it's a very high impact. Like, we have some trust pilot reviews that are like, okay, I was running half marathons. My LDL was normal.

Michael Dubrovsky [00:28:46]: Never had my ApoB measured. I took aSiPhox test and found out my ApoB was very high. I went and got it. He got, I think, a CT Angiogram or something similar to that, maybe a CAC scan, and he ended up getting two stents because he was literally about to have a heart attack. And now he's back. This guy's back to doing half marathons and whatever, and he's fine. But I think that's like a very low-hanging fruit thing. Like, if somebody hasn't had this stuff measured, they should just at least get it measured once, because it's really like, if you take 100 people that haven't had it measured and you measure them, you're going to find this.

Michael Dubrovsky [00:29:18]: So that's one that I think is. I mean, it's starting to get very popular, right. But just five years ago, it really wasn't being discussed.

Ben Greenfield [00:29:26]: Yeah, I think Peter Attia did a podcast series with Thomas Dayspring, which was excellent. And that kind of catapulted a lot of my deeper knowledge of lipids than what I learned in college. So that that was like a five-part, twelve-hour series that was good on this whole Apple B, LP, LDL, particle size, type of discussion, I wish the guy had gotten the stents. I'm not a doctor, I don't mean this to be misconstrued as medical advice, but there's a book called Prevention Myths. I just finished it. Gosh, I'm blanking on the author's name, but he goes into all the different tests. CT Angiography, Calcium Scan score, the Carotid Intima-Media Thickness score, the CIMT, and some different types of blood, make a pretty strong case for stents being a very last-ditch effort considering the other arguably more natural or less invasive things you can do to reduce ApoB, and potentially get rid of plaque. Now, I'll admit if there's hefty plaque, let's say, in the left ventricle ascending or the LVA, and you're on the verge of a widowmaker, you have to do something about it.

Ben Greenfield [00:30:34]: But in many cases, I think, especially after reading this book, prevention myths, I'm not convinced stents are as necessary as they seem to be indicated to be with their frequency of use.

Michael Dubrovsky [00:30:46]: Yeah. You know, from our perspective, just catching these things early, right before they. They get to the point where you're in a position where, yeah, your doctor saying you have to get a stent, and then, you know, you're thinking, okay, do I want this? Ideally, you know, as many people as possible, you get catch them before that, and they can just reverse it with lifestyle or, you know, low dose, like low dose statin or something else. Right. It depends, you know, kind of depends on them. But there are many ways to slow down or even potentially reverse these things. But I think the way we view it is it's our position just to get people the information.

Ben Greenfield [00:31:21]: So this blueprint, I think this is interesting. Tell me about what you guys have for this SiPhox blueprints.

Michael Dubrovsky [00:31:30]: So I think what we realized basically from doing thousands and thousands of tests over the last year and a half with our mail-in test kit, is that you know, in the end, the testing is very valuable. But once people discover they have an issue or whatever, there are, you know, some of them can go off and solve it on their own, or they're going to, like, find some way to deal with it or go to their doctor. But there's a good percentage of people that want, like, an all-in solution. They just want a solution, right? So let's say, I think ApoB is a good example. You have hypo-B. What do I do now? Right. I. And we saw an opportunity.

Michael Dubrovsky [00:32:08]: It actually came along a little bit. I mean, we wanted to go in this direction, but we accelerated it because one of our users, one of our customers who was testing for about a year, approached us. So he's an MD PhD, also based here in Boston, and he has been working in clinical trials in pharma drug development for his whole career. But he's himself a biohacker, so he's, like, trying to live to 120. He's always, every biomarker is super optimized, whatever. He's tried every single thing out there. And he said, okay, SiPhox has the best product, and I want to work with you guys on basically doing preventative medicine somehow. So we told him, okay, we've been thinking actually about doing programs based on specific areas of health that are out of range.

Michael Dubrovsky [00:32:51]: And we ended up launching this, what we call the blueprint program, which is a combination of testing. So you get frequent testing, plus there's a coaching component and even prescriptions. So basically not everybody wants a prescription, a drug prescription, but basically having the whole toolkit, right? So we'll connect the person to an asynchronous telemedicine visit and they can get their prescription as part of the whole thing. But the way we see it is actually, you know, it's getting people on a prescription to get them, get them off. So rather than saying, okay, you have to take this statin for the rest of your life, it's all right, you have super high ApoB, let's get it down. And then work together on getting your lifestyle to the point and your diet to the point where you don't need the statin anymore. But even if somebody's going to be on a statin, for example, right now, the way it works, your doctor just gives you the average dose.

Michael Dubrovsky [00:33:44]: But our perspective is, ok, we're doing frequent testing, so we can give you a titrated dose. You start with the lowest, see how it affects you see how it affects your liver markers also, like, are you getting side effects, all these things, rather than just, you know, the way it's done now, it's like with a hammer, right? So you have, you know, high LDL, they don't even care. What's your metabolic state? Whatever, just, you know, get the statin. A lot of people say no, and that's kind of it, right? Or if they say yes, they take it, the dose is too high. There's a, there's side effects. So kind of our view is, can we build a program that takes 80%? So if you go to concierge medicine, right, like Peter Attia, whoever, that's not scalable to the whole population, right? You can't have Peter Attia for every, every person. But maybe, you know, 50% of that, 80% of that can be turned into a program that's partially automated, still has that, you know, super high expertise team behind it that's designing it.

Michael Dubrovsky [00:34:39]: But a lot of it is based on automation, based on software, based on blood biomarkers. Rather than having it, like literally, you know, you're paying for the best doctors to be spending, you know, 10 hours on you a month because most people can't afford that so we kind of try to find a way to build something that carries a lot of that value of concierge medicine. But, you know, that can be scaled to millions of people because that's our, you know, we're chip company. Like, we want to build things that, you know, for semiconductors, 1 million is like the beginning of quantity. You know, like, if you're like, think of like phones, right? They're made in the billions. So our thought is like, how do we scale up something to millions and millions, maybe a billion people? It has to be mostly software and something like blood testing, and other scans that are scalable, and that's what the blueprints program is about.

Ben Greenfield [00:35:25]: It seems like kind of the major sticking point in that funnel for concierge medicine because if you look at an executive screening panel, you highlighted some of the issues there. Right? Huge expense, the need, if you're going to deliver good care for frequent testing and frequent adjustment of supplementation or pharmaceutical protocols based on that testing. But the one-on-one interaction, whether telemedicine or in an office with a physician, that's the most difficult part to scale. So I'm curious for you guys, from an AI standpoint, would you be able to take a lot of these really good doctors, a lot of their advice, you know, articles, books, etcetera, and create an AI engine that could provide pretty decent advice and analysis of this blood work?

Michael Dubrovsky [00:36:15]: Yeah, so we do it in kind of two parts. So basically, on one side, we have our in-house team, including Phil, who's running this program as our head of clinical product, and then advisors. So we've managed to bring on, you know, a couple of really good advisors for heart health. And then we're looking to the next program already. That way we can take, what is world-class information, from somebody like Thomas Dayspring, somebody who's an expert in the field. We've talked to him quite a bit about this, although he's too busy to specifically advise on this program. But we're talking to the best people in the field, getting a lot out of them and also out of what's the latest research, everything else. And our in-house team is working with those advisors to build the protocols.

Michael Dubrovsky [00:36:59]: Right. So that's step one. Step two is using our own data. So we have a ton of data on our existing users, and we know, like, what are the trends in their lipids and all these things? And the second thing that we're doing is everybody that's doing the blueprint program today. So, so far, we just, we launched it as a beta. It's nowhere near the size of our normal, like, testing subscription, but we have 50 people in it already and every single person, when they get a test report, what's going on behind the scenes, there is, there's 2 hours of Phil and other scientists and clinical people on our team looking at that data and trying to figure out, okay, what do we do with this profile? How do we bucket this person? And right now it's very manual, but we're going from taking that two-hour analysis down to five minutes. That's the part that you can do with automation. Once you've seen enough cases and you've built enough rules and enough analysis, you've brought in enough data, you can actually get the time down quite a bit.

Michael Dubrovsky [00:37:53]: And that's something that we're actually very confident will work, especially for heart and metabolic health, where there's a couple of profiles that you see that start to emerge of what's going on with the person. You can see that in their blood work and their medical history. We ask a lot of questions about their medical history as well to be able to pull that data in. We do that, build the analysis, but if they actually want medicine, meaning prescriptions, an actual patient-doctor relationship, we have a third party that we work with where they have like, you know, it's a typical telemedicine startup thing where you get connected with a physician by SMS, but they're working from the protocols that we built out of the best available data. But the actual relationship with the doctor is separate. We do separately have a coaching service, which is more about understanding your data. So if you look at, okay, here's a report that came back, you can speak to a coach and they'll actually, they'll walk you through it, answer all your questions. And that's very important because people want to have like a face-to-face conversation at least once. After all, this is, I mean, this is serious, right? It's their health, so they'll have, they usually have a ton of questions.

Michael Dubrovsky [00:38:56]: So that's kind of how we deal with it. We do the one coaching session and then we have a lot of automation to produce these reports as you go. And one of the things that are automated that I think is pretty cool is there's actually, you can get a ten-year and 30-year risk score of like your chances of having a heart attack, cardiovascular event, whatever, that's. Yeah, yeah. So we're able to deliver that score and that's built by the. I mean, literally by the American Heart Association, they have a calculator that if you get enough data in there, it'll tell you, like, for an average person, you know, across the population, you have a 3% chance of having a heart attack in 30 years or ten years or whatever it is. Right. And then you have stratification of, like, what's a normal risk, what's a high risk, and so on.

Michael Dubrovsky [00:39:38]: So we provide that based on the first assessment. And that's because we're doing. We actually test, like, 17 markers of heart and metabolic health. So across, like, liver, kidneys, heart, and cardiovascular, and then metabolic, like, your insulin, HBA, one c, sugar control. So, taking that all in, we're able to provide risk scores, which grounds the person, like, okay, this is kind of on average, where you're at, and then they can work on that.

Ben Greenfield [00:40:04]: I didn't know about the risk scores. Are those only on the beta blueprint or are those on the general app right now for anyone?

Michael Dubrovsky [00:40:10]: No, that's just. That's just very specific to heart disease, and that's only in the blueprint today.

Ben Greenfield [00:40:15]: Okay, but you guys do have these. I think I saw it on my app. Like, a biohackers report or, like, kind of like a weird, deeper dive. Is that correct?

Michael Dubrovsky [00:40:25]: Yeah. So we have a. Basically, when you look at your blood work in our app, what you can do is what you're seeing is kind of like the. We try to show, like, what do we call, like, clinical ranges. So, like, these are reasonable ranges that, like, if you're in the green, you're doing better than most of the population.

Ben Greenfield [00:40:42]: Right. Absence of. Absence of disease ranges, right?

Michael Dubrovsky [00:40:46]: Yes. But the. If you select the Biohacker toggle, what it does is it actually compresses the ranges to the ones that are considered optimal. So it basically allows you to see, okay, if I'm really targeting, like, to optimize my body, like, not just for my age. Right. But, like, actually, like, what can. What is the best thing that I. That I can achieve? That's where you actually see optimal ranges.

Michael Dubrovsky [00:41:09]: And then all of your scores, like, your inflammation score, everything changes based on that as well. So it allows you to kind of see, like, okay, if I'm just trying to stay healthy, this is where it's at. If I'm trying to, you know, be in the top 5% or whatever, this is what it looks like.

Ben Greenfield [00:41:22]: I have a hunch most of my listeners are automatically going to switch over to the biohackers view after learning that the part about payment tells me, I. What does the industry look like for home blood testing as far as coverability by insurance or the use of things like FSA or HSA tax-deferred funds to pay for something like this?

Michael Dubrovsky [00:41:44]: Yeah. So we're covered by HSA, FSA, which is great, and it's like straightforward to do it, but insurance is a long way away for, I think, most of these optimization services, because it's. What's the reason? I mean, it's interesting, you know, everybody complains about the healthcare industry. One of the reasons is that most people stay on their insurance for only, I think the average, two and a half years. And so if it's anything that's going to benefit you more than two and a half years away, it doesn't make sense for them to cover it. So that's what I've heard. I mean, this is, you know, not my theory, but this is like the one that I've heard that makes the most sense for why insurance doesn't cover more blood testing. If your employer typically has more interest in your long-term health, because let's say, you might work there for five or ten years, they're sometimes more open to covering things like this.

Michael Dubrovsky [00:42:35]: So you can talk to your employer and ask them to add it to their employee benefits, for example. But HSA and FSA do cover what we do in most other home test kits. I think the benefit of SiPhox is that if you wanted that 17 marker panel and you go to your typical marketing company that's selling test kits if you google lipid test or whatever, you're going to have to get five or six boxes from them to cover that 17 marker panel. And that's where we shine. So once, when you want a big panel at home from a finger prick, that's where we have a big cost advantage. Blood volume, like convenience, everything.

Ben Greenfield [00:43:06]: Yeah, it's a lot that you can get out of a small amount of blood. Yeah. So I'm sure some people are going to ask, but there are things you can't test on blood, like, let's say, parasites in a stool evaluation, or maybe a cortisol awakening response paired with how it might fluctuate throughout the day. Unless you're going to do multiple blood measurements throughout the day, some people will use saliva or urine for something like that. DNA would be another example. Do you guys ever want to roll out other fluids that can be tested or other testing protocols for looking into some of these things that you might not get from these SiPhox tests?

Michael Dubrovsky [00:43:52]: One of the things that we do is we're pretty conservative about the biomarkers. So we use. We don't want to be like that. We're more about the blood testing technology and access and cost. We try to stay conservative about what we offer to test. So we're very evidence-based. Like, we're probably not at the cutting edge of every test that you can get. We did add a couple of saliva tests carefully that we think we believe in.

Ben Greenfield [00:44:15]: Yeah, I actually forgot about that until you just said it. I did one at that event in LA. Yeah. Okay, cool. And what's that? Looking at the saliva?

Michael Dubrovsky [00:44:23]: So, basically, we do a three-point cortisol test, which is like a. You can use it as a follow-up to the blood cortisol test because that's just one point. You know, whenever you're. Let's say you're taking your test in the morning, if that's out of range, you can get a three-point and see, like, what does my curve looks like? Or even if it's in range, but you're just not. You don't feel good. Like, maybe you're. You're waking up in the middle of the night or whatever. So that'll allow you to see your profile.

Michael Dubrovsky [00:44:45]: Like, are you getting the correct diurnal cortisol profile? And then we do the GrimAge methylation test for just. It's a biological clock, and we think that probably GrimAge is one of the better ones. And that just allows people to say, okay, here's the biological clock data. Here's how it correlates to my blood data. So they can get a feel for it. If they want to start tracking that, they can get a feel for how these things actually correlate in their body in terms of microbiome. I'm very bullish on the microbiome. I think it's actually very important.

Michael Dubrovsky [00:45:16]: But we don't offer tests on that now. But that's something that might come down the pipe once we find a partner that we think, okay, this is very evidence-based. We also offer. I mean, this is just something that's convenient again. But let's say you think you want to improve your metabolism, one of the best tools is a CGM. I saw you were wearing one. I'm wearing one right now. I do it once in a while just to, like, keep myself honest about where I am with.

Michael Dubrovsky [00:45:41]: With my metabolic health. And so we do that at cost. So, you know, we just. We make it easy to buy one because, in America, you actually need a prescription to get a, to get a CGM, which I think shouldn't be the case, but we help our users out with that. Just to make it easy.

Ben Greenfield [00:45:54]: You tie the CGM data into the SiPhox app, right?

Michael Dubrovsky [00:45:57]: We do, yeah. So we'll do, we'll give you summaries of your CGM data alongside your blood tests. And we do. We kind of, our philosophy is like, whatever we can do to make it, like, just, you know, you want to optimize your health, but you only want to spend, like, x time a month. Like, okay, we make it as just as easy as possible. And then obviously some people are going to want to spend way more time and they can go, like, for example, levels are probably a better CGM experience than ours, right? So we don't try to match levels. But if you're just, if you just want to throw on a CGM and see what's going on, that's like, we offer that just for convenience, right?

Ben Greenfield [00:46:30]: Yeah. And some of them do get pretty fancy, like, levels. Lets you run experiments on steel cut versus regular oatmeal or cold bathing versus hot showers, etcetera. But you guys are kind of keeping things scalable and simple as far as the data and the markers that you looked at. So if you want to know if you have a tapeworm, then maybe you wouldn't get a SiPhox panel. But if you're one of those self-quantified nerds who's constantly trying stuff out, you want an inexpensive and scalable way to test things, using just a little bit of blood in your home. This is a pretty good solution.

Michael Dubrovsky [00:47:01]: Yeah, exactly. And I think there's a lot of, if you look at, like, the surface of this, there are, there's definitely, like a core of people that are very serious about optimizing their health. But we're, we think we can serve those people very well, but we're actually looking like, how can we get the people that are on the fence? Like, maybe they kind of know about this, they've heard about it on podcasts or whatever, but they've never actually gotten any of these markers tested. And we're trying to just decrease the barrier where they can start doing it and getting the benefit. So that's our goal is like, to basically increase the size of the tent where make it very easy for people to get started.

Ben Greenfield [00:47:32]: Awesome. Well, if folks are listening or watching, or if you're listening or watching, you go to the show notes BenGreenfieldLife.com/siphoxpodcast I'll link to some cool articles and videos that I have about SiPhox and how it works. They even have a little walkthrough of their lab, which is kind of cool. And then if you have questions or comments or feedback for Michael or I or you want to order a SiPhox Test, I'll put all that in the show notes again at BenGreenfieldlife.com/siphoxpodcast S-I-P-H-O-X podcast Michael, this is cool. I've been digging the test, and doing a little bit of experimentation. I like that. It's quick, and convenient, especially now that I'm doing it on the sauna.

Ben Greenfield [00:48:15]: And I appreciate you man. So thanks for coming on the show.

Michael Dubrovsky [00:48:19]: Yeah, thanks for having me.

Ben Greenfield [00:48:20]: Alright folks, I'm Ben Greenfield along with Michael Dubrovsky from SiPhox Health, signing out. Have an amazing week.

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