March 30, 2024

From podcast: https://bengreenfieldlife.com/podcast/adeel-khan-eternapodcast/

[00:00:00] Introduction

[00:01:02] Who is Dr. Adeel Khan?

[0002:44] Traditional medicine and alternative approaches

[00:05:47] How did Dr. Khan get interested in stem cells

[00:07:34] What are the real stem cells?

[00:09:59] What are culture-expanded stem cells?

[00:13:48] Yamanaka stem cells and the risk of cancer

[00:21:17] What was administered to Ben in Dr. Khan's clinic?

[00:26:15] Drug approval process and follistatin gene therapy[00:34:13] Can follistatin gene therapy get you muscles without exercising?

[00:36:51] Ben's ad for his house

[00:38:31] cont. on Follistatin gene therapy

[00:39:02] Klotho injections

[00:40:14] Aging and low levels of NK cells

[00:41:56] Eterna Antiaging Package

[00:44:21] Vagus nerve block for treating mental health issues

[00:48:37] Dr. Khan and the fitness world

[00:54:44] End of Podcast

[00:55:45] Legal Disclaimer

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

Adeel:  Tony Robbins and Bryan Johnson both have a plethora of doctors on their team who look after them.

Ben:  And, they've both done follistatin.

Adeel:  They've both done it. And Bryan–

Ben:  With you?

Adeel:  Yes, yeah.

Ben:  Okay.

Adeel:  And, I think it's still probably going to be another maybe two years before, I think, other doctors catch on to how powerful this technology is and how safe it is. The reality is our clinical trial is published now. It's Phase 1 trial. Yes, we don't have Phase 3 data yet because maybe some doctors are waiting for the Phase 3 data, but I always look at it as, in medicine, there's something called number needed to treat versus number needed to harm, NNT versus NNH, which is essentially what's the risk and what's the benefit.

Ben:  Fitness, nutrition, biohacking, longevity, life optimization, spirituality and a whole lot more. Welcome to the Ben Greenfield Life show. Are you ready to hack your life? Let's do this.

Well, folks, I first interviewed the brilliant Dr. Khan in an episode in which we talked about the difference between getting stem cells internationally versus the USA. We talked about peptides, testosterone, hormones, tissue engineering, DNA editing, truths and myths of regenerative medicine, and a whole lot more. I will link to that original show if you go to BenGreenfieldLife.com/EternaPodcast. And, that's the name of Dr. Khan's medical clinic, by the way, Eterna.

And, I'm actually here at his Cabo location or at least near it. We're perched on a rooftop here overlooking the ocean in Cabo. And, Dr. Khan has just been blowing my mind this week since arriving here. And, even before that at his Unlock Longevity Conference, which we flew here to from Austin about all things regenerative medicine. And, while I'm here, I'm actually engaged in a lot of these protocols: Follistatin and Klotho and NK cells and many of the cool cutting-edge things that he does. But, since we're both here and even since that original show, he's got a lot more going on. I figure it was high time to get Adeel back on the show. And, he'll have a chance to give you his background here a little bit, but he's a Canadian board-certified physician. He's really carved a very unique path in the field and has cemented his reputation as a regenerative medicine expert, very forward-thinking guy, entrepreneur, and what I like about him too, engages in science-based bodybuilding, fitness, and he walks the walk and talks the talk, which is great. You do know how to talk, Adeel.

Adeel:  Once or twice, yeah.

Ben:  I've heard you on shows before. You actually do a great job. So, I'm happy to have you on the show.

But, just kind of a background for folks. What got you into this? And, especially I'm just curious. You do a lot of unique stuff. So, I'm curious what took you down the unique path that a lot of others didn't go down?

Adeel:  Actually, you touched on it which was a fitness background because it's interesting when you go into medical school, you're taught pathophysiology and then you're taught how to treat that pathophysiology using medications or surgery. But, for me, because I came from the fitness background, I was like, “Why aren't we talking about exercise or nutrition?” Because I've seen that firsthand treat people with diabetes, with high blood pressure, cardiovascular disease. So, it was kind of weird to me, and that's when I would say got suspicious, I guess. Not that I thought some sort of conspiracy, I was just kind of like, “Why aren't we learning about this other stuff that I know can work?

Ben:   Yeah.

Adeel:  And so, instead of just studying allopathic medicine, I started studying functional medicine and integrative medicine and alternative medicine. And obviously, there's a lot of not-so-great stuff in those fields too. So, you have to be careful and you have to be able to dissect that stuff and figure out what's actually evidence-based or gives you additional tools in your toolbox to help people. And, that's for me a lot of it was because I was a sports doctor by original training. When you do sports medicine, it's basically just cortisone physio surgery. And, that's pretty much it or anti-inflammatories, right?

Ben:  Yeah. I don't know if I shared this with you, but when I graduated from school and eventually started a string of personal training gyms and studios, my main facility was called Champion Sports Medicine. I was partnered up with the sports medicine doc, Dr. P.Z. Pearce. He was the doctor for Ironman and for Rock ‘n' Roll Marathon. And so, I saw a lot of traditional sports medicine. I mean, he's a great doctor, but a lot of it was analysis, cortisone injection, stringing through this injury, try and buy a little life out of that joint, and then maybe eventually down the road refer out to an orthopod for either a replacement or a debridement or some kind of pretty invasive protocol.

Adeel:  Yeah. No, that's exactly what standard of care was and it unfortunately still is for the most part unless you're going to a physician who's a bit more educated. And, for me, there was all these patients. For example, chronic back pain, I was the first doctor in Canada to do ortho biologics for back pain because we started using PRP and different types of regenerative tools to start treating back pain because there's all these patients who aren't getting better with just cortisone and a lot of them don't want to do surgery. So, it's like, “What's their options?” They've already tried physio, so it's like, “Is this end of the road for them? Do they just live on pain meds for the rest of their life?” And then, we know what oxy content and all these pain meds do for chronic back pain. They lead to all these issues. I think that was my biggest motivator to get into this whole field was to just help people who were suffering.

And then, that led to so much more because it just opened this whole Pandora's box, I guess, of regenerative medicine, which is much more than just interventional pain. It's also cell and gene therapy, tissue engineering, and then now combining those is kind of what we're trying to do.

Ben:  Do you remember where you were when you first heard about stem cells? At least not like high school biology stem cells but like, “Oh, this could work in regenerative medicine.”

Adeel:  Yeah. I think, like many people, it was probably that podcast with Mel Gibson and Joe Rogan. Because so many people sent it to me and that was kind of–

Ben:  That was, maybe what, seven years ago?

Adeel:  Yeah, seven years ago. Exactly. Yeah, 2017 or something. And so, I was like, “This is so fascinating.” I was very skeptical obviously. And, especially back then, I think we didn't have enough data on intravenous stem cells and knowing how exactly they work. Now, we have a lot more understanding of the mechanisms which we'll probably go into. But, that's when I first kind of got more curious about stem cells. And, at the time, I was working with Dr. Anthony Galea who's kind of the OG of sports medicine, regenerative medicine. He was the first one in the world to do PRP for it.

Ben:  Didn't he write a textbook?

Adeel:  He's written a few books. He treated Tiger Woods. 

Ben:  I think I have a book by him. And, he has written a medical textbook almost.

Adeel:  Yeah, he's really up there when it comes to sports medicine. And so, because I was working with him, he was doing autologous stem cells, which we talked about in the first podcast where he was taking bone marrow or fat. 

Ben:  From someone's own body, autologous.

Adeel:  Exactly, yeah. And, not really expanding them, but still using that for soft tissue injuries and maybe more mild cases of arthritis. But, that was kind of my first exposure to the word stem cells clinically. But then, as I went into it more and more, I realized, as we talked about the first podcast, those aren't true stem cells. And then, when I learned about what true stem cells are, where you isolate them, you culture expand them and then you have appropriate dosing then you can really do some really crazy things not just for pain but for autoimmunity and then now obviously aging as well.

Ben:  I don't understand what you mean when you say true stem cells and how getting them from the fat or the bone wouldn't be a true stem cell. What's that meaning?

Adeel:  Because that's what we refer to as a committed progenitor cell or Arnold Caplan.

Ben:  It's committed. It's married.

Adeel:  It's married, exactly. Exactly, exactly. Because stem cells, by definition, have the ability to differentiate into many cell lineages and have the ability to self-renew. Those are the two main core components of a stem cell. So, if it's not pluripotent stem cell, meaning you can differentiate into multiple lineages, then it's not really a true stem cell.

And then, the other component is the expansion of it. Because if you don't expand them, then they're not really a factory for producing new tissue, they're just kind of signaling molecules. And so, signals are still pretty good, like they still reduce inflammation. They're helpful, but it's just a misnomer that I don't think we can stop now because all the physicians in the U.S. are still saying, “I'm offering stem cells,” but they're not, they're just offering committed progenitor cells or medicinal signaling cells. Those are the words, appropriate word.

Ben:  What if you take one of these so-called committed progenitor cells like you're extracting stem cells from someone's adipose tissue or bone marrow and you are expanding them? 

Adeel:  Yeah. You have to isolate that.

Ben:  Does that still have the issue with them already being committed or if you expand them, do you skirt that issue?

Adeel:  Yes, you actually isolate the mesenchymal stromal or stem cell of that fat. So, if I just took your fat and I injected it, it's mixed in with all this other stuff. And so, you're not really isolating it. But, when you culture expand it, then yes, you are isolating the mesenchymal stem cell, and then that is technically a stem cell injection.

Ben:  But, a non-expanded fat or bone marrow and it's not really going to do much. And expansion, as far as I understand at this point in terms of legality, is something you can't do in the U.S., right?

Adeel:  No, it's still FDA not approved, which means it's technically illegal. It doesn't stop physicians from doing it, but I know there's doctors who listen to your podcast and other practitioners. And, they got to be careful because I personally have physician friends who are medical-legal experts and they've had physicians lose their licenses because something bad happened with the stem cell product like an infection and then they have nothing to fall back on because they shouldn't be doing this in the first place. So, of course, then they lose their license.

Ben:  I want to talk more about what kind of stem cells would be best to skirt some of these issues, but because I'm so often asked about this, I got to run it by you. What you just alluded to is probably one of the number one questions I get about stem cells is, how do you know they're pure, dude? How do you know what's getting injected into your body? How do you know?

Adeel:  Yeah. No, there's so much detail. And, this is actually something we didn't go into probably the first time because I've learned so much more working around the world, to be honest, in Europe, Middle East, and then in Japan, I learned a lot. In Japan, they've been using culture-expanded stem cells for over 10 years and that's where I really got in-depth into the manufacturing process. So, what you have to do is when you isolate, let's take umbilical cord tissue because that's what we're using for you when you're down here. And, why are we using umbilical cord tissue? Because it tends to have the best cytokine profile, which means it has the most amount of growth factors and the most amount of anti-inflammatory cytokines, which are proteins that reduce inflammation.

Ben:  Okay.

Adeel:  It's superior to, for example, umbilical cord blood. Now, does it have the same propensity to turn into cartilage as fat? Maybe not because I remember we talked about that last time about how fat may be better for certain soft tissue injuries, but at least for the first generation of stem cells, and we'll talk about what second generation means, when it comes to first generation of stem cells, it's really the signaling profile that's the most important. Because even culture-expanded stem cells don't stick around for months. They stick around maybe for one or two months and then they're cleared up by your immune system. But, they send signals to your own body stem cells to start the healing process and to reduce inflammation.

Ben:  So, even once they're out of the system, these cultured expanded, they're still having some benefit because they've upregulated your body's own stem.

Adeel:  Exactly, exactly.

Ben:  So, those are called paracrine pathways, is called.

Adeel:  Exactly, paracrine. Yeah, exactly. And, that's why a lot of people and physicians have a hard time wrapping their heads around it. They're like, “How can it have long-term effects?” And, we've seen it in many clinical trials. There's cases of inflammatory bowel disease, lupus, RA, where people go into remission. And, this is published data that's out there for many autoimmune conditions. And, that's just intravenous stem cells. So, how is it doing that? So, when we manufacture the stem cells, we have to grow them in a way that ensures your cell viability. 

So, there's two main things for people to understand. One is passages and then the other is the culture medium. So, the passages is how many times do you move it from one cell culture floss to another cell culture floss? Which is during those three or four weeks of expansion, when you're growing the stem cells, you have to eventually, there something called confluence and you have to change the cell culture flask. And, if you have too many passages, the cell viability decreases and you can actually have what's called replicative stress.

Ben:  So, more passages is not good, more replication during the expansion process is not good.

Adeel:  Exactly. And so, we use something called early passage mesenchymal stem cells. That's what you're receiving. And so, we limit our passages to three. And, this is something I learned in Japan. And, that's what they've been doing for over a decade because, I would say, they're the world experts on it because they're obviously the birthplace of Yamanaka stem cells and all that stuff. 

And so, most other clinics, if you go to Columbia, Panama, they're using six passages, eight, some are using 10. So, your viability is going to decrease and then also there is risk potentially with those because those cells can become senescent and then they can cause more issues. So, you got to be careful where you're getting your MSCs. And then, the culture medium, we're using something called conditioned media where it's conditioned beforehand. That just helps to improve the cytokine profile.

Ben:  So, it sounds to me maybe when it comes to the expansion process, it's almost a parabolic curve of benefit to where you want to reach the sweet spot of replication. And then, once you overly replicate, that's where you run into potential for buildup of senescence and some of the other issues.

Adeel:  Yes, exactly. And so, that's a really important nuance because people, I think, a lot of times they just don't know, right? So, they don't know how to ask those questions because there's not really a good amount of education on that.

Ben:  Okay. So, you referred to different, I believe you call them generations of cells. What's that mean?

Adeel:  Yeah. So, first generation, we talked about, which is essentially taking mesenchymal stem cells, which can be from fat, bone marrow, can be from umbilical cord tissue, blood. And then, second generation are what's termed synthetic biology. So, meaning they're all made in a lab from skin cells or from any somatic cell in your body. So, this is what the Yamanaka factors are.

Ben:  What else besides skin would be a source of somatic cells in the body?

Adeel:  I mean, you could use any really muscle tissue. You could use fat.

Ben:  Okay. But skin seems easy.

Adeel:  Exactly. Skin's the easiest and that's the reason why we use skin. And so, what it is, it's the overexpression of those Yamanaka factors. When you overexpress those Yamanaka factors, there's four transcription factors. It tells the cell it overexpresses pluripotent genes and it sends somatic genes. So basically, it takes the cell back into a baby stem cell state.

Ben:  I remember when this research first came out because I was at an anti-aging conference of this guy. This was maybe five years ago. I was super excited from stage saying all of this, but it wasn't yet available in terms of an intravenous infusion.

Adeel:  Exactly. You know why it wasn't available was because when you reprogram them, they become embryonic in nature. And then, if they're embryonic in nature, that's great for regenerating tissue because embryonic is what's called totipotent. Meaning, it can turn to anything; mesoderm, ectoderm, endoderm. But, the issue with embryonic is that it also happens to be teratogenic or has tumorgenicity. Meaning it can cause tumors or uncontrolled proliferation.

Ben:  Okay.

Adeel:  So, how do we use these cells clinically without the risk of cancer?

Ben:  Right. That's a pretty important question.

Adeel:  Right. 

Ben:  How do you?

Adeel:  Well, two things. Number one problem is, again, it doesn't stop people from using it. They are still people. You can go out there. You can get what are called Yamanaka stem cells or induced pluripotent stem cell, iPSCs. That's the medical term.

Ben:  Okay, I've heard of those.

Adeel:  And, iPSCs you can still get them and some clinics are offering them and even clinical trials that have been done, but there is probably at least a 1% chance of tumor growth. And so, for me, the reason I love regenerative medicine is because the high safety and low downside and potential upside. So, I don't want to use something that may cause a tumor, so that's why I wasn't using iPSCs until now and I'll explain why we're using them now is because we have a technology that can gene edit the iPSCs and prevent uncontrolled proliferation. So, it's called HSVTK, but it's a very specific gene edit of a loci, which essentially prevents or acts as a kill switch if the cells start growing uncontrollably. And so, it's called FailSafe. And, this is a built-in technology into the iPSCs that we have. 

Ben:  And, that automatically kicks in before they were to become, what you call, teratogenic or we could use the word carcinogenic, I guess, even though it's usually used for toxins or what have you?

Adeel:  Yeah, right.

Ben:  But, the idea is that that would kick in automatically. You wouldn't have to know that they become teratogenic and then hit some kind of [00:16:53] _____. It's automatically built in.

Adeel:  Exactly, yeah.

So, those are called gene-edited iPSCs. And then, we can differentiate those iPSCs into different cell lines. And, this is where it gets kind of cool. So, this is the second-generation technology that we have now and we're in the process of manufacturing. And so, iPSCs can turn into whatever you want. As we talked about, they're totipotent. So, we can differentiate them into MSCs, mesenchymal stem cells. And, why do we want to differentiate MSCs? Because MSCs are good for cartilage regeneration, for tendon, for soft tissue.

Ben:   Right, most uses in regenerative medicine.

Adeel:  Exactly. But, there's certain uses where we may want something more specific. For example, for Parkinson's Disease, we can create iPSC-derived dopamine-producing neurons.

Ben:  Oh, wow.

Adeel:  And then, you can transplant them surgically or maybe injection even into the brain, and then you can get new neurons that actually put patients into remission. And, this was shown in a phase 1 trial that was done by BlueRock Therapeutics this year.

Ben:  That's incredible. What about something like a diabetic case for pancreatic cell regeneration?

Adeel:  Yes, exactly. That's actually the trial we're doing. Hopefully, probably Q4 of this year or maybe Q1 of next year. But, we're creating iPSC-derived beta islet cells with the gene edit that we talked about so there's no risk of cancer. And, they're also going to be gene-edited, actually, this is important too, they're also going to be gene-edited to be hypo immune. And then, we use our cellular reprogramming that we use.

Ben:  Hypo immune, meaning less of a chance that the body's going to have a hyperactive immune response receiving those cells, flu-like symptoms, swelling, inflammation, et cetera.

Adeel:  And, also importantly, they're not cleared up by your immune system because then, they have more engraftment.

Ben:  Yeah.

Adeel:  So, we use iPSC-derived beta islet cells and it's a cellular reprogramming technology that we're using. You don't need immunosuppressant. And then, the hyper immunity adds another layer of longevity of those cells because you want those cells to stick around. This is the biggest problem in regenerative medicine. There's two issues. One is getting those cells to stick around and number two is getting those cells to actually send the signals that you want or differentiate into new type of tissue because we can't always control the dosing so to speak. So, if we want to make cells like drugs where we can control them and know exactly what they're going to do. It's basically standardization. And so, that's what iPSCs allow for that because they're genetically engineered and cellular engineering, essentially. And then, while transplanting them or infusing them into the pancreas, we can create new beta islet cells as long as we can get them to survive.

Ben:  That's incredible. Genetically engineered iPSCs are what you've just finished telling me about, I know people are going to ask this and I realize it's sometimes an awkward question to ask as a business owner, something like Eterna Health, but I'm going to ask this because it's similar to the purity question I'm often asked. People say, well, Panama, Costa Rica, Cabo, Dubai, it's all the same, I'm just going somewhere to get expanded stem cells that I can't get in the U.S. Is anybody else doing these type of genetically programmed cells? Is this a technology that you own and use? How's it work?

Adeel:  It's developed by a Canadian company and they've been around for seven, eight years. They have the patent for this technology. I'm the one, and this is my, I guess, kind of eye for it. I'm good at identifying technologies just like the minicircle technology. I was the first doctor obviously in the world to–

Ben:  Which we'll talk about later.

Adeel:  Yeah, obviously I'm the face of the brand because I was the first doctor in the world to identify it. And then, same thing with this technology, I was the first doctor in the world to identify. And so, we're creating these exclusive licensing deals. I didn't make the tech. I'm not a scientist by definition, but I am a clinician scientist now because obviously, I'm doing clinical trials, but I don't have a PhD. So, obviously, the people who have PhDs whose life's work this is, I'm the one to be able to bring it to patients. And, that's just the skill I think I'm good at. And, I could care less if people choose not to use our technology, but I just don't think there's anything better. Again, it's just being objective. Is there an iPSC technology out there that has a FailSafe technology? No, there's not. There's only one group in the world that has this and we have that technology.

Ben:  Okay, okay, got it. And, your clinic is primarily in Cabo and Dubai.

Adeel:  Dubai. And then, we're looking into Europe, Switzerland. We were working in Luganu as well.

Ben:  Okay. Luganu, where's that?

Adeel:  It's the northern part. It's 45 minutes away from Lake Como.

Ben:  Okay.

Adeel:  Yeah, yeah. Yeah, exactly. Yeah, it's beautiful.

Ben:  For someone who just wants to kind of like me do a little bit of age reversal, feel better, stave off some of the degradation that would occur with age, this idea of an intravenous stem cell infusion is just kind of a shotgun for the whole body. It seems like an interesting idea and this is what I did yesterday. And, just to clear any confusion, intravenous means you're not getting them injected into a joint, they're going into the blood. What was it that you administered to me yesterday?

Adeel:  Yeah. So, there's a few things. One, because intravenous stem cells happen around for a while in Panama, for example. But, the issue there is that there's no prep done for the body and I think that's really important. We put you on a peptide protocol. And, why did we do that? It was because we wanted–

Ben:  You mean, you had peptides in the IV bag with the stem cells?

Adeel:  Remember, you're also doing peptides before you did the IV, right?

Ben:  Yeah, I did a peptide protocol for three weeks before I came here with FOXO, SS31, and TB400, TB500.

Adeel:  Yeah, exactly, and FRAG1 to 4, I think, specifically. And, the reason we use that combination is to decrease senescence and decrease inflammation. Because the microenvironment in which we put the cells in is very important. And, if that microenvironment has too many cytokines, too much inflammation, because of senescent cells or just because of chronic inflammation, which a lot of patients who are looking to do this stuff–I mean if they're healthy and young, they're probably not. Like for you, it's probably not that much an issue. But, for some patients who are chronic pain or have autoimmune conditions, they're going to have a pretty inflammatory heavy burden.

And so, we want to prepare the body because intravenous stem cells, what they do mechanistically, most of them actually get trapped in the lungs. So, the question is, if they're getting trapped in the lungs, how are they having these systemic benefits? It's because they're interacting with something called BALT, B-A-L-T, bronchial alveolar lymphoid tissue. And so, similar to MALT, which is in your gut, it's basically a lymphoid. So, it's a lymphoid tissue, which means it's almost an immune organ which communicates with rest of your body. And, what that does is it reprograms or re-educates the cells. And so, it's called macrophage phenotyping or macrophage polarization. So, shifting the macrophages, which are white blood cells from a pro-inflammatory state to an anti-inflammatory state. It's called M1 to M2 shifting.

Ben:  Okay.

Adeel:  And, that shifting is how they work mechanistically. And then, a really interesting thing which just came out in the last couple weeks because we're still understanding how MSCs work. So, in the last couple weeks, there was a paper that came out showing that intravenous stem cells, one of the ways they work is actually through mitophagy. And, what they do is they help to trigger mitophagy of old mitochondria and there may even be mitochondrial transfer of the new cells. So, you're actually getting new mitochondria, and that's probably why people have better energy and better recovery and some of those benefits that we see after doing intravenous stem cells.

Ben:  It's important that you actually brought that up because I've always been, and even on this trip, very cognizant of my lifestyle leading into a stem cell infusion; a dieta of limited or no alcohol, wearing an EMF blocking suit on the airplane and taking hydrogen tablets and polyphenols, getting here a couple days earlier and doing earthing and grounding and sunshine and workouts that don't involve a hefty amount of met ton and inflammation from exercise.

Adeel:  Exactly, you don't want that oxidative stack, yeah.

Ben:  I think a lot of people don't think about that. I mean, that's just good for general body care and then the use of these anti-senescent compounds to further that even more, which you get, of course, from a diet with a wide variety of plants and herbs and spices, et cetera, but it's nowhere near what you get from peptides [00:24:55] _____.

Adeel:  And, I can say just anecdotally and obviously, I think we do want to do some trials. We are going to do trials with the iPSC, MSCs, IV, and with the peptide protocol to really show its efficacy. But, just anecdotally, I can tell you too. I've had patients, for example, who had IV stem cells and got no benefit from it. And then, we do it with the peptide protocol and they get a benefit.

Ben:  Wow.

Adeel:  So, I do think it makes a clinical meaningful difference. And, that's why some people are just like, “I'm just going to come and do the IV.” I'm like, “I'd rather you prepare for it.”

Ben:  Is there anything else in this magic bag?

Adeel:  Yeah. In the IV bag itself, we put thymulin, BPC 157, and TB4. And, the reason for that is enhancing that immunomodulation.

Ben:  What about exosomes?

Adeel:  Yes, we're mixing in exosomes too. So, exosomes are kind of the soup that the stem cells grow in. They're the broth so to speak. If the stem cells are the chicken meat, the broth is exosomes. And, the exosomes have all those cytokines, which we were talking about earlier.

Now, the issue with exosomes in general is that they're cleared up by your immune system even faster than stem cells. And so, they don't stick around that long, which is why just doing IV exosomes doesn't have the same benefit as IV stem cells for longevity and in terms of duration of results. Generally, they only last for four to six months, so you have to do them more periodically. Whereas, stem cells generally last for 18 to 24 months.

Ben:  Okay, got it. Now, that wasn't all that I came down here to do. On our first podcast, you talked about follistatin gene therapy. And, as a matter of fact, I was at the gym last night and I was listening to a podcast with a pretty well-known physician who was asking his guest about follistatin gene therapy and the guy was kind of like research and it's kind of like those before/after con photos that you see on Instagram. I'm not sure they were very well-informed on what it actually was, but let's say you were talking, a doctor and maybe some fitness guy they were interviewing and they said, “Oh, there's there nothing to this. This is silly. This is quack medicine.” Fill us in.

Adeel:  I mean, I can say this publicly because they've both talked about it. For me, Tony Robbins and Bryan Johnson both have a plethora of doctors on their team who look after them. And, it's not easy to get for them to, A, do the procedure.

Ben:  They've both done follistatin.

Adeel:  They've both done it. And Bryan–

Ben:  With you?

Adeel:  Yes. Yeah. Well, Bryan went down to Honduras and did it. So, it wasn't with me specifically, but obviously, it's our technology.

Ben:  Yeah, minicircle technology.

Adeel:  Minicircle technology, yeah. Tony, I did it personally myself. But basically, if first of all, they have such a big team of doctors, we have to go through this process over and over. And, I think it's still probably going to be another maybe two years before I think other doctors catch on to how powerful this technology is and how safe it is. But, doctors are always late to doctors, I think that's very clear just from the fitness.

Ben:  I don't think the litigious nature of medicine in the U.S. helps that out much [00:27:52] _____ on eggshells.

Adeel:  No, it doesn't Exactly. Exactly. And, that's why we're in Cabo, right? There's a reason. But, the reality is our clinical trial is published now, it's the Phase 1 trial. Yes, we don't have Phase 3 data yet because maybe some doctors are waiting for the Phase 3 data but I always look at it as, in medicine there's something called number needed to treat versus number needed to harm, NNT versus NNH, which is essentially what's the risk and what's the benefit. How many people are going to be harmed by this therapeutic in order for you to help X amount of people? So, you'd be surprised how many pharmaceuticals are approved that have a number needed to treat of less than 200 or 300 even. So, Trulicity is a drug that is perfect example of that, which is diabetic and cardiovascular kind of drug. And, it's number need to treat, I believe, is 1 over 337. So, that means you have to treat 330 people or so to have one significant impact on reducing mortality.

Ben:  And, do you factor in the number needed to harm?

Adeel:  Exactly, and how many people are being harmed. It's something like 10%. So, the number needed to harm is one in 10.

Ben:  So, higher way higher than the numbers treated.

Adeel:  Way higher. Yeah. So, the ratio is terrible for that drug yet is FDA-approved, yet is being prescribed by doctors all the time. Why is that? It's because they figured out the peer review process, they know how to get approvals, they know how to work the system. If people are curious to learn more, just watch Lex Fridman's podcast with Dr. Abramson.

Ben:  Okay.

Adeel:  So, he wrote a book called “Sickening.” And, he talks all about this and it's a 90-minute podcast.

Ben:  Okay. I'll link to that in the shownotes at BenGreenfieldLife.com/EternaPodcast, 90 minutes is short for Lex Fridman podcast.

Adeel:  Yeah, exactly.

Ben:  That's easy.

Adeel:  Yeah, that's easy. Yeah. But then, literally, he goes into the details of how pharmaceutical companies know how to game the system.

Ben:  Okay.

Adeel:  And so, it's kind of sad because the reason I'm mentioning this is because if you're getting these drugs that are approved, you can't hold something like follistatin to the same necessarily approval process or even stem cells because they don't have the same harm that a lot of these drugs have. A lot of these drugs have outside targets and often later we find out all the other risk with them. Whereas, these therapies, follistatin is a peptide hormone that's bioidentical to your body. It's like going on TRT basically. And, we know even with TRT, there's always this debate about, “Oh, maybe it raises risk of prostate cancer and all this other stuff,” but it turns out it actually decreases mortality. You got to go back to first principle.

Ben:  When properly administered.

Adeel:  Yeah, because you have to go back to first principles. What are first principles? What are the fundamental biological principles that govern health? It's muscle. It's inflammation. It's oxidative stress. Those are probably the most important, right?

Ben:  Glycemic variability but that's kind of a [00:30:31] _____.

Adeel:  Yeah, exactly. Yeah, insulin resistance and all that stuff, right? And so, TRT, for example, is going to improve energy. It's going to improve your quality of life, better libido, and all that. And then, it's also going to improve your metabolic stuff because you're going to have more energy, you're going to exercise and maybe you'll be even more compliant because now you're exercising and you'll be better with your nutrition.

Ben:  Arguably, if you wanted to have children, you would probably want to consider something like enclomiphene or something like that.

Adeel:  Exactly. For sure, yeah.

Ben:  Instead of turning straight to TRT.

Adeel:  No, for sure. Either way, let's just say optimizing your testosterone.

Ben:   Yeah, optimizing testosterone is a better way to put it.

Adeel:  Right. Yeah, exactly. Because some people don't need testosterone, they just need the precursor.

Ben:  Sleep, destress, lift heavy weights with your legs, get creatine, vitamin D, zinc, magnesium. There's a lot of low-hanging fruit before you turn to injections.

Adeel:  And endocrine receptors. There's probably 9% of the population that doesn't need TRT. But obviously, again, that's a whole other topic but a lot of people just go straight to that. But, in terms of follistatin, the reason why I'm not concerned about any long-term risk is because you go back to first principle.

What is follistatin doing mechanistically? It's inhibiting myostatin. So, that's going to allow for more muscle mass. It's going to make it easier to put on muscle. It's also highly anti-catabolic. And, we know after age 30, you start losing, it's something like half percent of muscle mass. So, if you're not doing progressive resistance training and periodization and eating enough protein, you're going to be fighting uphill battle. So, follistatin is going to make that easier. And then, the other thing is as you get older, the amount of muscle mass you lose, and just to keep on what you have, becomes even harder after your 60s. So, if we can decrease that and shift it to a more anabolic environment, that's going to have so many benefits.

And then, people are like, “Oh, what about cancer?” Well, mechanistically there is no pathway.

Ben:  I was going to ask you about the teratogenicity, if I get that right, of follistatin.

Adeel:  Yeah. There's no mechanistic reason to believe there would be cancer risk and we measured IGF-1 too which doesn't increase. But, even if it did, again, you can make an argument that who really cares if you're putting on more muscle and you're decreasing systemic inflammation because follistatin, the other pathway it activates the one myostatin inhibition and number two activation of FOXO3. FOXO3 is a pathway that reduces systemic inflammation and it upregulates T regulatory cells, which are kind of the cells that help with immunotolerance, which means it can help potentially decrease autoimmunity, but more importantly, decreasing systemic inflammation. And, we know inflammaging as a word is termed is one of the biggest drivers of aging, and slowing that down is going to help to fight aging. And, we saw this in our clinical trial because we saw some people, this was people age 60 or over, on average their intrinsic biological age reduction was 11 years with one injection.

Ben:  Wow. Was that using the DunedinPACE clock?

Adeel:  Yes, exactly. Yeah.

Ben:  Okay. Yeah. I mean, obviously, none of these aging clocks are great.

Adeel:  No, none of them are great but it's the best we have. I think Generation Lab, which is the one company we're probably going to be moving for our Phase 2 trial, they use something called biological noise, which is just entropy. And, I think on that longevity event, there's a lot of discussion about entropy because it seems like entropy is really the reason why our body ages. And so, if we can measure that entropy, then that will give us a better indicator of actual biological age, I think.

Ben:  Is there an impact of follistatin gene therapy on hair, skin, nails?

Adeel:  Yeah, anecdotally. Yeah, for sure. Anecdotally, people see their skin looks younger. But, even with the IV stem cells, I've had people say their skin's tighter, they don't have that loose skin as much. So, our anti-aging protocol is combining follistatin with intravenous stem cells and the exosomes and the peptides and all that stuff that we talked about.

Ben:  Right, right. So, I'm here, I did the stem cell infusion on Monday and then I'll do the follistatin on Thursday kind of spaced out a few days.

Adeel:  Right. And, you're getting the full package, which is also natural killer cells and placental tissue which we can talk about.

Ben:  Which we'll talk about in a second.

Another question that I have about the follistatin. If you look at some data, if you're on massive doses of testosterone, there's even studies that show that you can gain greater amounts of muscle than you would with lifting and lower amounts of testosterone. With follistatin, let's say someone, though I wouldn't advise this, weren't subjecting the muscles to stress and lifting weights, would they still see some type of muscle gain or muscle maintenance?

Adeel:  So, it comes down to probably genetics. We don't fully understand it yet, but we did have some people because we did DEXA scans on everyone in the trial. And, we did have some patients who, for example, gained muscle and they weren't exercising. It wasn't like 5, 10 pounds of muscle, it was 1.5 to 2 pounds of muscle. But, that's still pretty significant for someone who's not really exercising and eating a lot of protein.

Ben:  I'm very curious to see what happens to my own body composition because I already lift.

Adeel:  Yeah, exactly. 

Ben:  Combining a strategy this with lifting.

Adeel:  Oh, it definitely and this is what it is. It's a body recomposition tool. It metabolically makes it easier to lose fat and it also makes it easier to put on muscle. So, if you're in a calorie surplus or a deficit, it's probably going to shift one way or the other. Now, having said that, we have had patients who've had both. For example, they lost fat and they gain muscle at the same time. So, that newbie game phase almost, again, when you first started working out. So, it's pretty cool what it can do, but obviously, it plateaus but then it's not like you lose that muscle afterwards. As long as you maintain it, then you've gained new muscle. And, gaining that new muscle is going to be so beneficial for your longevity and health. That's why I have I have zero concern about follistatin. And, that's the reason why you also chose it as our first target because our gene therapy plasmid vector can be used for any peptide that's less than 10,000 base pairs.

Ben:  Oh, wow.

Adeel:  And, let me talk about klotho, but we're going to do–

Ben:  Klotho.

Adeel:  Yeah. Klotho, GHK, which is copper peptide LH. There's a lot of other things in the pipeline too. We made CAR antigen now, C-A-R. The reason we're doing CAR plasmid is because we can transfect car into T cells and into NK cells. And, that makes it better for homing in on cancer cells. So, we're going to do a clinical trial for that. So, CAR-T and CAR-NK. And, CAR-T and CAR-NK are out there already but the companies using it are using what's called adeno-associated viral vectors, AAV. And, the problem with AAV vectors is you sometimes have immunosuppressant and there's risk of viral vectors. Whereas, with the plasmid vector, it's nonimmunogenic, there's no offside targets and it's very simple and it's scalable and it's a lot cheaper.

Ben:  It's reversible.

Adeel:  Reversible and has a kill switch, the viral vectors don't have that. So, this is a really breakthrough technology and it's hard for people to understand unless you really have your pulse on the finger in terms of cellular medicine.

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You mean, if you ever wanted to undo all of the follistatin gene therapy you would just get an injection?

Adeel:  Or an oral antibiotic, tetracycline.

Ben:  Really? Oral tetracycline could just knock it out.

Adeel:  Yeah.

Ben:  Now, what if you get it and you get an antibiotic?

Adeel:  Yeah, exactly. Let's say you got like–

Ben:  Probably something to tuck away and know.

Adeel:  I mean, most antibiotics you're taking, Amoxicillin or this or for most common infection. So, for most people, it's probably not an issue, but let's say you have an allergy or something and you have to take that, then for sure you would have to repeat the therapy afterwards.

Adeel:  Expensive allergy.

Ben:  What about klotho? What's that?

Adeel:  Yeah, klotho is a really interesting. I think it has something 3,000 studies now on it in PubMed. And, it's a super fascinating peptide because it's this large peptide that has all these cellular benefits for not just reducing inflammation but for enhancing cognition too. So, it's kind of like the ultimate nootropic.

Ben:  Wow.

Adeel:  But, the issue with klotho as with many other peptides is a short half-life. Follistatin also has a short half-life. So, it's not really practical to inject yourself multiple times a day to sustain the levels. So, that's why this delivery mechanism is so cool because one injection can sustain your levels for 18 to 24 months.

Ben:  Wow.

Adeel:  But, that's the beauty of it. It's a convenience factor. It's not like klotho is new.

Ben:  And, this is like an intramuscular injection?

Adeel:  Yeah, intramuscular or subcutaneous. Yeah, exactly. And, it takes literally 2 minutes and it lasts for 18 to 24 months.

Ben:  Incredible.

Adeel:  So, the convenience factor just for me and for you too I'm sure because you're so busy, it's just like, “Okay, what can I get done in a short amount of time that's going to have a big benefit on my health and longevity?” And, that's my favorite thing about the technology and the delivery vector that we have.

Ben:  How many fewer insulin syringes you have to keep on.

Adeel:  Exactly. You have to travel with it.

Ben:  Now, what about this other component of the trifecta that you referred to, these NK cells? Why would someone do those?

Adeel:  Yeah. So, a lot of our patients are, it's not like we're offering it as our anti-aging package, but we may probably will soon because so many people are requesting to do NK cells. And, you can do blood work too, right? You can do something like a lymphocyte MAP and then you could figure out what are your NK cells. And, a lot of people will be surprised how low they are. And, the reason for it is because they start getting signs of immune dysfunction. They may not have full-blown autoimmune disease, but they may be showing early signs of it.

Ben:  Could that just be thymus gland degeneration of age?

Adeel:  Exactly, yeah, or chronic inflammation in the gut and stuff like that. And so, chronic inflammation is always going to accelerate the degenerative processes. And, a lot of people are walking around with chronic inflammation and hence why their immunotolerance decreases. And, as their immunotolerance decreases, that's probably the biggest risk factor as to why you develop all these chronic degenerative conditions as you age. Because aging is the biggest risk factor for dementia, for heart disease, for cancer, right? Osteoarthritis. Aging is the biggest risk factor. So, if we can target aging, we're targeting all these different diseases. And, that's why it's hard for people to understand because in medicine, we're always taught system-based. But now, we're learning that maybe system-based isn't the best for chronic illnesses, it's coming back to the root causes.

Ben:  Right. And, when you're halting a degenerative process or restoring compounds in the body that disappear with age, that's kind of a true definition of regenerative medicine.

Adeel:  Exactly, yeah. So, the klotho should potentially increase IQ. We're going to measure IQ in a clinical trial.

Ben:  Oh, wow. Test me before and after.

Adeel:  We will. Exactly. The matrix progressive, that test.

Ben:  Yeah, just stick away or stay away from calculus. It'd probably be the same before and after.

Adeel:  Yeah.

Ben:  So, this whole treatment that I'm doing. Let's say someone is listening right now even though there's some other things I want to talk with you about and they were to call your clinic, what would they ask for? Just give me what Ben got or is there a name to this?

Adeel:  Yeah, it's called Eterna Antiaging Package.

Ben:  Eterna Antiaging Package.

Adeel:  Yeah.

Ben:  Okay.

Adeel:  Which is basically intravenous stem cells, exosomes, follistatin gene therapy, and then natural killer cells can be added on too. And, the reason we do natural killer cells too as we, I think you and me talk a little bit is that they can help to clear senescent cells as well. And, we know senolytics in general, which are oral medications to help clear senescent cells are becoming popular because we know senescence is one of the issues.

Ben:  It's popular, [00:42:39] _____ rapamycin.

Adeel:  Yes. Yeah, exactly. Yeah. But, rapamycin, again, it's an old drug that has some off-site targets which may not be the best. And so, the reason I like these cellular therapies is they're generally very safe and they don't have any real downsides to them. They're just expensive, which is the biggest issue. But, we're working on bringing the price down. Our price is even cheaper now than it was a year ago. So, I think in another couple years, it'll be even cheaper.

Ben:  And so, I can just fly into Cabo or Dubai or any of these other locations and stay there for a few days.

Adeel:  Exactly, yeah.

Ben:  Probably plan on what, five days or so.

Adeel:  Exactly, yeah. Just because we like to monitor you and do the whole thing. Yeah. And then, the NK cells and stem cells we do on different days.

The other component to it, which we're going to do for you too, is the placental implant, which is just a simple subcutaneous–

Ben:  I've always wanted a placenta.

Adeel:  Yeah, exactly. Who doesn't? So, it's a very simple subcutaneous injection. But, what we do is, in our manufacturing facility, we take the placental tissue and we lyophilized it. It's basically freeze-dried. And, what we can do is we could reconstitute it with saline and then we can inject it subcutaneously. And, what that does is it raises intracellular NAD levels. And, we all know about NAD I'm sure because of NMN and all the popularity with IV NAD drips. But, the problem with those things, NMN, I mean that's a whole separate can of worms, but there may be some potential risk with NMN with kidney and whatnot. And then, it's also something you have to take every day. And, IV NAD, maybe works, maybe doesn't because it doesn't really always raise intracellular NAD. I think you do the patches, right?

Ben:  Yeah.

Adeel:  Yeah. But, the injection, it's just one injection and it can raise levels for up to three months.

Ben:  Wow. And, that's placental one.

Adeel:  Yeah, yeah.

Ben:  It's incredible. Wow.

Adeel:  So, it's just convenience factor.

Ben:  I didn't know that.

Adeel:  Yeah, it's a convenience factor. And, that's why you feel boost of energy as well right after the procedure. And then, by then, usually the stem cells and the follistatin has kicked in.

Ben:  Yeah. Before we started recording, we were briefly talking about the vagus nerve and this idea of a vagus nerve block, which I've talked about a couple times on the show. But, you started to film me and I said, “Wait, tell me on the podcast about how the way that it's done is important or your kind of unique twist on it.” 

Adeel:  Yeah. So, the vagus nerve block or the stellate ganglion block has been around probably in medicine for over 20 years, maybe 25 years. We just put a regenerative medicine twist on it. So, the vagus nerve is around your C6 level, which is around this area here in the neck. I'm pointing for the people who don't see the video. I'm pointing to–

Ben:  Google C6.

Adeel:  Yeah, C6. I'm pointing near the carotid and the jugular, basically on your neck. And so, the stellate ganglion innovates your sympathetic nervous system. The sympathetic nervous system is what gets activated if you're running away from a lion or if you're stressed. And, for a lot of people living in the modern environment, they're in what's called sympathetic overdrive. They have sympathetic arousal. 

Ben:  There's a lot of lions out there.

Adeel:  Well, our body thinks they're lions. Public speaking, for example, triggers a lion response even though we're not getting, but we understand that evolutionarily, right? But, because of the modern stressful environment, so many people are living in the sympathetic overdrive and they're easily aroused, which means they get easily irritable, their hormones get easily dysregulated. And, that's because their sympathetic nervous system is becoming overactivated. This is very clearly seen in PTSD. “The Body Keeps the Score” is a great book that talks about how our nervous system remembers. And so, this nervous system dysfunction is what underlies a lot of PTSD, unresolved trauma, adverse childhood events, and it turns out a lot of mental health is actually rooted in unresolved emotional trauma: Depression, anxiety, not just PTSD.

And so, by treating the sympathetic nervous system, we're blocking it using anesthetic, but we're also putting in peptides. And, the reason we're putting peptides is because it helps to modulate or change the signaling. And then, at the same time, we're using a different syringe and injecting into the vagus nerve. But, the vagus nerve, it feeds into the parasympathetic nervous system, which is what relaxes your body. So, we don't want to block it, we want to modulate or fine-tune it so it sends the right signals. So, we use exomes and peptides because those are both signaling cascades that can basically reprogram the vagus nerve, which means it'll send the right signals. So, it's called neuromodulation.

Ben:  So, you can smoke a joint every night or drink a half bottle of wine or just get a vagus nerve blocked.

Adeel:  Well, that's it. And, that's what a lot of our patients. I've had people literally quit smoking or quit drinking from it. I've treated alcoholics. I've treated addictions. It's pretty powerful stuff. I've obviously treated people with PTSD, suicidal ideation and panic attacks, anxiety in young girls. It really is a wide spectrum. And then, some people just for honestly health optimization. I did it for health optimization. My friend did it for me because I just wanted to have more resiliency and I live a very fast-paced kind of go, go, go lifestyle.

Ben:  Yeah. Obviously, be careful who you go to for this because it's a needle in your neck.

Adeel:  Near your carotid. Yeah, you got to go to someone who's experienced.

Ben:  You use ultrasound-guided imaging for that?

Adeel:  Exactly, yeah. You can't use X-ray. Some docs, old docs use X-ray. It's not a safe way to do it because you can't see [00:47:31] _____.

Ben:  That was incredible you found a meniscal tear in my knee yesterday that nobody had found with ultrasound.

Adeel:  Exactly. Ultrasound dynamic, high-resolution ultrasound is so powerful, but it's all user dependent and very few people know how to do it. Like I said, there's probably in one hand. I can count one hand how many people are good at it in the world.

Ben:  And, you think it's better than X-ray or MRI for finding issues like that?

Adeel:  For finding small tears, yes, because small tears get missed. Because MRI is done in slices and they're like 3-millimeter slices and they can often miss small tears.

Ben:  It only take you guys 10 minutes to find that?

Adeel:  Exactly. But, it's because my technologist is she's a brilliant technologist. 

Ben:  Yeah, [00:48:06] _____.

Adeel:  Yeah. This is just a side note, but what we're doing is to try to scale this technology, we're creating a machine learning neural net. So, we're going to train an AI system. [00:48:18] _____ who's my radiologist is training the AI to detect normal from abnormal. And then, eventually, it can guide the physician make a little circle and be like, “Inject here.”

Ben:  That's very cool.

Adeel:  Because that's only way you can scale this because obviously, the reproducibility of doing that is really hard.

Ben:  You mean, as far as a physician training [00:48:32] _____.

Adeel:  Yeah, it would take years and years and you can't scale it. So, we're going to use machine learning for that.

Ben:  Yeah. You started off explaining your background in fitness and yesterday you were telling me that you would like to do some more things in the fitness world. What's that look like for you?

Adeel:  Yeah. So, it's kind of this whole concept of Peter Attia coined the term Medicine 3.0, and I do like it because it gives you a good framework for understanding the evolution of medicine. And, Medicine 1.0 was kind of the ancient bloodletting and leeches and whatever else they did. And then, Medicine 2.0 was kind of the modern era, which is pharmaceuticals and surgery, which work great for acute infectious diseases. And then, Medicine 3.0 is this whole concept of trying to reverse or prevent disease in the first place with lifestyle interventions. 

But, the problem is with lifestyle interventions is how do we make it more accessible to the average person? Because, I think the bigger issue now isn't that most people don't know what to do is how do we actually get them to stick to it. And so, what we tried to solve for is behavior change by developing this health dashboard. It's called xALT, X-A-L-T.fit is a fitness tech company that we develop.

We're trying to basically deliver fitness at a large scale for the fraction of the cost. And, the way we're doing that is by keeping the sessions with the personal trainer short because you only need 15.

Ben:  Virtual or physical?

Adeel:  It can be both but virtual for the most part. As you know with virtual, you can do everything very well with a trainer who's especially skilled. And, you don't need 60 minutes four times a week, you only need 10 to 15 minutes a couple times a week to get the longevity benefits. And, there was a trial that showed that 11 minutes of exercise a day was enough to have longevity benefits.

Ben:  Yeah. And, you have to take that with a grain of salt and compare it to the studies that also show that when exercising consistently is paired with a sedentary lifestyle, meaning sitting for 10 hours in between, then it actually offers significantly fewer benefits than what you would think. And so, I think that anytime we say things like minimalist exercise, program exercise for 15 minutes, you'd never want to send the message to people that, well, engage in non-exercise activity thermogenesis and walking and staying physically active the rest of the day. And, for me personally, that's where the magic lies is I can get a quick session in at the gym but then I'm walking on my treadmill and I'm moving and I'm playing with the kids outside and taking the stairs.

Adeel:  But, that's because you've already built into your value system and this is so part of who you are. You're going to do that stuff automatically. For most people, they haven't built into their value system. So, that's why I believe every single person deserves access to a health coach. And, that's the only way to keep people accountable because that accountability is really what keeps people with sustained behavior change. And so, if we don't have that sustained behavior change, then you're never going to actually stick to these healthy behaviors. And, that's why we created xALT. And, that's why we're just finally launching it and scaling it now. We're starting with corporations because a lot of big corporations want to work with us because they want their employees to be more active and live healthy lifestyles because they're more productive. And, that's actually better for the employer. But, for the average person, they can't afford thousands of dollars of personal training. And so, this is much cheaper and we're using technology to help make it more accessible.

Ben:  How much cheaper like ballpark, what would it cost me to work with a trainer [00:51:47] _____?

Adeel:  You can get it for $1,000 a year.

Ben:  Oh, yeah. That's what a lot of people paying a month for a personal training.

Adeel:  Exactly, exactly, for one session a week. But then, if you want to scale that. But, even just having one session a week and having someone just check in with you, see how you're doing, and then do a quick workout session, that can make a big difference on sustained behavior change. We've seen that. And so, I think just a lot of people just need someone to keep them accountable and tell and remind them how to stay on track and give them those little tips on behavior change.

Now, Medicine 4.0, which is kind of what we are talking about now is using cell and gene therapy to allow people to live longer and healthier lives. So, it's not only about preventing disease, it's about using the latest cellular and gene repair to not potentially prevent it but also to treat chronic illnesses and then to allow people for more health span. Because the whole reason I like follistatin, for example, is not because of all these mechanistic benefits. Fine, it's cool how it works, but at the end of the day, it's going to allow you to stay healthier longer because it's going to allow you to perform more muscle and probably make you more compliant with the gym because you're going to get more benefits from the gym. People don't like to stick to the gym when they don't see the benefits from it.

Ben:  Right, right, or don't know what to do. When I checked into the JW Marriott in Austin, I walked around and was looking at the facility. As I walked in the gym, it was completely empty except one dude standing by the squat rack and that was you. I know that you practice what you preach. I think if folks were to combine our discussion we just had with the previous chat that we had in which we took some other dives into different forms of stem cells and regenerative medicine, they would have a really good source of regenerative medicine knowledge to rely upon. And then, I'm going to link to that as well as everything else that we talked about at BenGreenfieldLife.com/EternaPodcast, E-T-E-R-N-A podcast.

If you guys go to the Eterna Health website, what was the name of the protocol again, the antiaging?

Adeel:  Protocol.

Ben:  Antiaging Protocol. Yeah. So, that would be a good one to look into. I know you guys are very helpful via email and phone chatting with people about the questions that they have.

Adeel:  Yeah, we've hired furiously because we've grown exponentially.

Ben:  Yeah. And, you're working with obviously we can't drop names but celebrities and actors and pro athletes and then some really big names. I mean, you're kind of the go-to guy right now.

Adeel:  Yeah, I know. The reason I like working with high-profile people and the reason I'm grateful when they do promote us is honestly to reach more people. There are people who are falling through the cracks of the medical system who are suffering with chronic illnesses and those people are the ones I enjoy helping the most.

Ben:  Yeah, yeah. Awesome.

Adeel:  Cool.

Ben:  Well, thank you. Thank you, Dr. Khan. And, I'm looking forward to reporting back to my listeners how I feel and what I experienced in these protocols that occur the rest of the week. 

Adeel:  Yeah.

Ben:  Awesome. Alright, folks, BenGreenfieldLife.com/EternaPodcast. Check it out. Thanks for listening. Leave your questions and comments and feedback there. Hello from sunny windy Cabo. Thank you so much for tuning in. Have an amazing week.

Do you want free access to comprehensive shownotes, my weekly roundup newsletter, cutting-edge research and articles, top recommendations from me for everything that you need to hack your life, and a whole lot more? Check out BenGreenfieldLife.com. It's all there. BenGreenfieldLife.com. See you over there. 

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Are you tired of feeling the effects of aging, like sluggish muscles, persistent inflammation, and a general slowdown? Imagine receiving a treatment that not only decelerates these processes but also enhances muscle growth and restores your energy at the cellular level.

With a visionary approach that is changing the perception of healthcare, Dr. Khan stands at the forefront of modern medicine. As a Canadian Board Certified Physician, he has carved a unique path in the field, cementing his reputation as a regenerative medicine expert, a driven entrepreneur, and a dedicated advocate for science-based bodybuilding.

Recognized worldwide, Dr. Khan’s impact resonates among healthcare professionals, elite athletes, and individuals from diverse walks of life. His groundbreaking treatments have earned him the trust of renowned figures, including life coach Tony Robbins, Chris Bumstead (popularly known as “CBum,” a top fitness influencer), and even Mohamed Alabbar, the visionary developer behind the iconic Burj Khalifa. Dr. Khan achieves these remarkable results through innovative therapies, particularly stem cell treatments and antiaging procedures, pushing the boundaries of medical science.

As the CEO and founder of Eterna Health, a revolutionary concept in specialized healthcare, Dr. Khan's allure extends beyond borders. Patients from across the globe seek out his unwavering dedication to understanding cellular physiology and the art of cellular repair, leading to collaborations with scientists in Canada, the USA, Mexico, Dubai, Italy, and Japan.

Dr. Khan’s grand vision reaches beyond personal success. His ultimate aspiration is to democratize regenerative medicine, making it affordable and accessible to people from all walks of life.

Oh, and if you didn't catch our first interview together, I highly recommend checking that out here: “The Difference Between Getting Stem Cells Internationally Vs. The USA, Peptides, Testosterone & Hormones, Tissue Engineering, DNA Editing, Truths & Myths Of Regenerative Medicine & More.”

During this discussion, you'll discover:

-Who is Dr. Adeel Khan?…01:02

• Previous podcast with Dr. Adeel Khan:
  • The Difference Between Getting Stem Cells Internationally Vs. The USA, Peptides, Testosterone & Hormones, Tissue Engineering, DNA Editing, Truths & Myths Of Regenerative Medicine & More”
• Ben is in Cabo visiting Dr. Khan after the Unlock Longevity Conference in Austin

-What are Dr. Khan's thoughts on traditional medicine vs. alternative approaches?…02:44

• Fitness background
• Went to medical school but wasn’t satisfied
• Started in allopathic, functional, and integrative medicine
• You have to be careful and dig up what is evidence-based
• Ben’s experience with traditional sports medicine
• Options for patients with back problems without operation

-How did Dr. Khan get interested in stem cells?…05:46

• Joe Rogan Podcast with Mel Gibson 
• Got more curious about stem cells
• Working with Dr. Anthony Galea, a pioneer in platelet-rich plasma (PRP), and was doing autologous stem cells
• Autologous — from someone's own body
  • Good for soft tissue injuries and mild cases of arthritis
  • Not true stem cells
• Books by Dr. Anthony Galea:
  • The Real Secret to Optimal Health
  • Human Growth Hormone: Fact and Fiction

-What are the real stem cells?…07:43

• Stem cells, by definition, have the ability to differentiate into many cell lineages and to self-renew
  • If it cannot do this — it’s not a true stem cell
• Stem cells can expand
  • If you can’t expand them, they are not true stem cells
• False stem cells are called progenitor cells or medicinal signaling cells
• The use of real stem cells is not FDA-approved — technically illegal
• Some doctors have lost their licenses over procedures like these

-What are culture-expanded stem cells?…09:59

• Learned a lot working in Europe, the Middle East, and then Japan
• In Japan — culture-expanding stem cells for 10 years
  • Got in-depth into the manufacturing process
• Umbilical cord tissue is superior to umbilical cord blood
  • Umbilical cord tissue has the best cytokine profile
  • Has the most amount of growth factors and anti-inflammatory cytokines — proteins that reduce inflammation
• Fat may be better for certain soft tissue injuries
• Culture-expanded stem cells don't stick around for long
  • They're cleared up by the immune system
  • But they send signals to your own body's stem cells to start the healing process
• When it comes to the first generation of stem cells, the signaling profile is the most important
• Growing cells in such a way that ensures cell viability
• Passages and culture medium
  • If you have too many passages, cell viability decreases
  • Dr. Khan limits the passages to 3
  • Most clinics use 6 to 10
• Too many passages decrease cell viability and you can actually have what's called replicative stress
  • Risk of the stem cells becoming senescent and causing more issues
• Dr. Khan uses early passage mesenchymal stem cells
• For the culture medium, Dr. Khan uses conditioned media — a cell culture medium that has been exposed to cells for a period of time, during which the cells release various factors such as growth factors, cytokines, and extracellular vesicles into the media 

-What is the link between Yamanaka stem cells and the risk of cancer?…13:48

• First-generation cells — mesenchymal stem cells taken from fat, bone marrow, umbilical cord, tissue, or blood
• Second generation — synthetic, made in a lab, from skin cells, or from any somatic cells in your body
• Yamanaka factors
• When you reprogram cells, they become embryonic in nature
  • Great for regenerating tissue because these cells can turn into anything
  • But can also cause tumors or uncontrolled proliferation
• Using the cells clinically without the risk of cancer
• Yamanaka stem cells or induced pluripotent stem cells (iPSC) are in use but there is always a 1% chance of tumor growth
• Dr. Khan hasn’t used them until now
  • Access to new technology 
  • FailSafe — technology that can gene edit the iPSCs and prevent uncontrolled proliferation
• Gene-editing iPSCs
  • They can turn into whatever you want
  • You can differentiate them into mesenchymal stem cells (MSCs), which are good for cartilage regeneration, tendons, and soft tissue
  • For Parkinson's disease, you can create iPSC-derived dopamine-producing neurons
  • New neurons can put patients into remission
• BlueRock Therapeutics — phase 1 trials had new neurons; put Parkinson's disease patients into remission
• iPSC-derived beta islet cells with the gene edit
  • Not cleared up by the immune system
  • Hypo immune — does not require immune-suppressants
• Two main problems of generative medicine
  • Getting stem cells to stick around
  • Getting them to send signals that you want or differentiate into a new type of tissue
• Dr. Khan identified this technology — the face of the brand
• Their iPSC technology is the only one in the world that has FailSafe technology
• Dr. Khans’ clinics are in Cabo and Dubai

-What was administered to Ben in Dr. Khan’s clinic?…19:19

• Ben had a peptide protocol for three weeks to decrease senescence and inflammation
• Most intravenous stem cells get trapped in the lungs
• They're interacting with something called BALT (bronchus-associated lymphoid tissue)
  • Communicates with the rest of the body
  • It reprograms or re-educates the cells — called macrophage phenotyping or macrophage polarization
  • Shifting the macrophages which are white blood cells from a pro-inflammatory state to an anti-inflammatory state (M1 to M2 shifting)
• Intravenous stem cells actually work through mitophagy — a process in which damaged or dysfunctional mitochondria are selectively targeted for degradation by the cell's autophagy machinery
  • One benefit is mitochondrial recovery
• Peptide protocol with IV stem cells get benefits while some patients without the peptide protocol do not get the desired result
• The IV bag also had exosomes and thymulin to enhance immunomodulation
• Stem cells grow in exosomes, which have all the cytokines
• Cytokines in the exosomes are cleared up faster by the immune system
• Exosomes last 4–6 months; stem cells 18–24 months

-What happens during the drug approval process, and what is follistatin gene therapy?…26:15

• Tony Robbins and Bryan Johnson have had follistatin gene therapy
• Bryan was in Honduras but was using Dr. Khan's technology
• Minicircle technology
• Pharmaceutical companies in the approval process manipulate the system to get their drugs approved despite potential harm to patients
• NNT versus NNH (number needed to treat versus number needed to harm)
  • Risk versus benefit
  • How many people are going to be harmed by this therapeutic for you to help X amount of people?
• An example is Trulicity — its number needed to treat, Dr. Khan believes, is 1 over 337
• Lex Fridman's podcast with Dr. Abramson
• Sickening: How Big Pharma Broke American Health Care and How We Can Repair It by John Abramson
• Follistatin is a peptide hormone that's bioidentical to the body
  • Like going on TRT (testosterone replacement therapy)
• The fundamental biological principles that govern health
  • Muscle 
  • Inflammation
  • Oxidative stress
• The benefits of follistatin
  • Inhibiting myostatin — makes it easier to put on muscle
  • Activation of FOXO3 — a pathway that reduces systemic inflammation and upregulates T regulatory cells
  • Highly anti-catabolic
• After age 60, it’s even harder to keep muscle mass
• DunedinPACE
• Clinical trials show a biological age reduction of 11 years with 1 injection
• Ready to go to phase 2 trials with Generation Lab, a company that uses something called biological noise, which is just entropy
• Entropy is the reason why your body ages
• Measure of that entropy will give a better indicator of actual biological age
• Impact of follistatin gene therapy on skin and hair

-Can follistatin gene therapy get you muscles without exercising?…

• Comes down to genetics
• It happened in clinical trials — DEXA scans showed some patients who weren't exercising but gained muscle, some 1.5 to 2 pounds of muscle 
• Follistatin is a body recomposition tool
  • Metabolically makes it easier to lose fat and it also makes it easier to put on muscle
• The gene therapy plasmid vector can be used for any peptide that has less than 10,000 base pairs
• CAR (chimeric antigen receptor) plasmid vectors — DNA molecules that are used to deliver genetic material into cells, particularly immune cells like T cells
  • Transfect CAR into T and NK cells (CAR-T and CAR-NK) — makes it better for homing in on cancer cells
• Companies using it are using what's called adeno-associated virus (AAV) vectors
  • The problem with AAV vectors is you sometimes have immunosuppressants and there's a risk of viral vectors
• With the plasmid vector:
  • Nonimmunogenic
  • No offside targets
  • Very simple and scalable
  • A lot cheaper
• Plasmid vector is reversible and has a kill switch; viral vectors don't have
• Oral tetracycline to undo all of the follistatin gene therapy

-Ben’s ad for his Spokane house…36:51

• BiohackedSpokaneHome.com

-What are Klotho injections?…39:01

• Klotho — a large peptide that has cellular benefits
  • Reducing inflammation
  • Enhances cognition
  • Like an ultimate nootropic
• Like many other peptides, Klotho has a short half-life
  • Not very practical to inject yourself multiple times a day to sustain the levels
• A 2-minute intramuscular or subcutaneous injection lasts 18–24 months

-How do low levels of NK cells affect aging?…40:14

• Part of an antiaging package
• Many people have low levels of natural killer (NK) cells — a type of cytotoxic lymphocyte that plays a critical role in the innate immune system
  • Blood work or Lymphocyte MAP to figure out levels of NK cells
• Low levels may be a sign of an early autoimmune disease
  • Decreased immunotolerance — the biggest risk factor for developing chronic degenerative conditions as you age
• Chronic inflammation accelerates the degenerative processes
• Aging is the biggest risk factor for dementia, heart disease, cancer, and osteoarthritis
• Targeting aging addresses all these different diseases
• Regenerative medicine is halting degenerative processes or restoring compounds in the body that disappear with age
• Klotho could potentially increase IQ

-What is the Eterna Antiaging Package?…41:56

• Ben took the Eterna Antiaging Package
  • Intravenous stem cells
  • Exosomes
  • Follistatin
  • Gene therapy
• NK cells can be added
  • Helps clear senescent cells
• Senolytics — oral medications that also help clear senescent cells are becoming popular now
  • Rapamycin (use code BGF15 to save 15%)
• Cellular therapies are generally very safe, but expensive (the biggest issue)
• The placental implant — raises intracellular NAD levels
  • Lyophilized placental tissue (freeze-dried)
  • Reconstitute it with saline and injected subcutaneously
• 1 injection raises NAD levels for 3 months (boost of energy after the procedure)

-How can a vagus nerve block treat mental health issues?…44:21

• Vagus or ganglion nerve block with a regenerative medicine twist 
• Modulates the sympathetic nervous system to treat sympathetic overdrive or sympathetic arousal
• The Body Keeps the Score by Bessel van der Kolk
• Mental health issues are often rooted in unresolved trauma
• Treating the sympathetic nervous system 
  • Blocking it using an anesthetic 
• Using exosomes and peptides to basically reprogram the vagus nerve
  • Peptides modulate or change the signaling
  • Injecting into the vagus nerve which feeds into the parasympathetic nervous system
  • Needs to be modulated or fine-tuned to send the right signals
• Has treated people with:
  • Addictions like smoking and alcohol
  • Depression
  • Anxiety
  • Suicidal thoughts
  • Panic attacks
• It's a needle in your neck, near the carotid, so go to someone experienced
• Dr. Khan uses ultrasound-guided imaging
• Dr. Khan found a meniscal tear in Ben's knee that nobody had found with an ultrasound
• Powerful high-resolution ultrasound but it's all user-dependent
  • Better than X-ray or MRI for finding issues
• Dr. Khan is trying to scale this technology and create a machine learning neural net — going to train an AI system

-What are Dr. Kahn's thoughts on the future of medicine and fitness?…48:37

• The concept of “Medicine 3.0,” coined by Peter Attia
  • Involves using lifestyle interventions to prevent or reverse disease
• Medicine 1.0 — ancient bloodletting and leeches and whatever else
• Medicine 2.0 of the modern era — pharmaceuticals and surgery, which work great for acute infectious diseases
• The problem is how to make it more accessible to the average person
• xAlt — a fitness tech company
• The goal is to deliver fitness at a large scale for a fraction of the cost
• Keeping the sessions with the personal trainer short – 15 minutes
• 11 minutes of exercise a day is enough to have longevity benefits
• Every single person deserves access to a health coach
• Much cheaper at about $1000 a year
• A lot of people just need someone to keep them accountable, tell them what to do, remind them how to stay on track, and give them little tips
• Medicine 4.0 — cell and gene therapy to allow people to live longer and lead healthier lives

-And much more…

Upcoming Events:

• Health Optimization Summit — London: June 15–16, 2024

The Health Optimization Summit is the ultimate gathering for anyone passionate about biohacking, wellness, and living their best life. Dubbed a must-do event, it promises a transformative weekend filled with the opportunity to meet and learn from over 35 world-class speakers (including yours truly) in nutrition, longevity, mental health, relationships, and more. Learn best-kept secrets, try out the latest high-tech health gadgets, and discover the cleanest supplements and foods on the market. Don't miss this life-changing weekend — grab your tickets before they're gone here.

• The Longevity Circle Retreat in Croatia — Superyacht Wellness Adventure: Sept 4–10, 2024

Step aboard the ultimate luxury wellness journey: the longevity-focused Superyacht Wellness Adventure, set against the breathtaking backdrop of Croatia from September 4–10, 2024. This exclusive, invite-only event offers an unparalleled experience that blends opulence with the pursuit of wellness, disease prevention, and a long, happy life. With only 10 cabins available, this intimate retreat promises personalized attention and an atmosphere of elite exclusivity. Each day, I will lead 5–6 invigorating workouts, share insights through 1–2 enlightening talks, and engage in organic discussions and Q&A sessions, ensuring a transformative experience. Secure your spot here on this once-in-a-lifetime adventure and be part of a select group dedicated to elevating their health.

• Keep up on Ben's LIVE appearances by following bengreenfieldfitness.com/calendar!

Resources from this episode:

– Dr, Adeel Khan:

• Eterna Health
• Minicircle Technology
• The Difference Between Getting Stem Cells Internationally Vs. The USA, Peptides, Testosterone & Hormones, Tissue Engineering, DNA Editing, Truths & Myths Of Regenerative Medicine & More

– Books:

• The Real Secret to Optimal Health by Dr. Anthony Galea
• Human Growth Hormone: Fact and Fiction by Dr. Anthony Galea
• Sickening: How Big Pharma Broke American Health Care and How We Can Repair It by John Abramson
• The Body Keeps the Score by Bessel van der Kolk

– Other Resources:

• Rapamycin (use code BGF15 to save 15%)
• BlueRock Therapeutics
• DunedinPACE
• DEXA Scan
• FailSafe
• NK Cells Blood Work
• Lymphocyte MAP
• xAlt
• Joe Rogan Podcast With Mel Gibson 
• Lex Fridman's Podcast With Dr. Abramson

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