- I want to be admired
by the 25th century. (dramatic music) I think we really are at this stage of potentially the most
extraordinary existence in the galaxy. My objective is not life maximization, it's species maximization. It's trying to get life in this part of the galaxy to flourish. - When you know something is
gonna be shorter versus longer, is it fair to say we more
are likely to enjoy that? Are you essentially making
your life less valuable by living longer years? (tense music) Brian Johnson is the most
heavily tested human in history. After flipping Venmo
for a cool $800 million, Brian became obsessed
with Project Blueprint, his self-funded scientific endeavor to, for lack of a better term, live forever. He has adopted an extreme lifestyle where he's aggressively exploring highly experimental
treatments and research, all aimed at extending his
lifespan into infinity. And while longevity is admirable, quality is just as important. So I invited Brian to New York City to not only learn the ins and outs of his extreme approach to life, but also break apart the philosophy of a man who's not only
desperate to live to tomorrow, but to establish a legacy
500 years from now. Given the lack of quality of evidence behind most anti-aging therapies, I wanted to focus less on
the individual protocols, but instead discuss this unique philosophy of exhibiting complete control in a field where perfect is often the enemy of good. This is an episode unlike
any other that I've done, so please help me in
welcoming Brian Johnson to The Checkup podcast.
(logo trills) Where do you gain your inspiration for going on this journey,
and how do you stay motivated? 'Cause I know it's not easy to make sure that you're following
all the rules to the T. - Yeah, it's very hard to be human. - Yes. (chuckles) Understated.
- Yeah. I mean, really what I'm trying to do is to back up in a thought experiment. So imagine if we were speaking, if we could whisper in the ear
of those that lived in 1870, we might say something like, "Hey, there are these new
ideas about microscopic objects that cause infection,
they're called germs." Now, most people would hear that idea and say, "That's crazy. You're telling me beyond
the resolution of my eyes and that's the thing that's
doing this death thing? No." But it's always the case that
the future is always present. It's here right now. And
the question is, what is it? And so if we imagine the
same thought experiment from the year 2,500, the 25th century, and they whisper into our
ear, what do they say? That's what I'm trying to do. I'm suggesting that they say, "Don't die," is the only thing that we
as a species figure out. And that is because we're baby steps away from superintelligence. And when you have intelligence
that's a million times or a billion times smarter than you are, you have to figure out to do. And so people think that
Blueprint is about health and wellness or about
vegetables, and it's really not. It's what to do on the
eve of superintelligence. - And that task is to live
the healthiest life possible? For what goal? - It's an observation
that our intelligence relative to an insect, we're orders of magnitude
more intelligent than insects and we can do things
that insects can't do. AI is going to be orders of magnitude more intelligent than we are. It will do things we can't do. And one of those things
could be solving aging, we don't know, but it's
reasonable to contemplate that that could be a situation. Now, if that's the case
and we're this close to these tools being
available, then we may shift as a species from caring
about wealth accumulation and status and power to simply don't die. And so the observation is that don't die is the most played game by everyone all over the world, every day. You and I breathe every few seconds. We look both ways before
across the street. We all play, don't die. So it's played more than capitalism. It's played more than any religion. It's the most played game in the world. - If we take this thought
experiment further, once we get to the point of don't die and we've extended life so indefinitely that we're not dying, is it then survive and push out the people who
are coming on to the earth? Like what changes then-
- Yeah. - In this hypothetical or at least future thought
provoking experiment? - In doing that, I try to put myself in the position of Homo
erectus a million years ago. So imagine we travel back
in time, we're there, they have the ax in hand,
and we pose a few questions. We say, "Where's food? Where's danger? Where's shelter?" We listen to those three answers. But then we say, "What is
the future of the species?" We primarily listen for
entertainment purposes. They're not going to be able to riff on quantum mechanics, right? Or string theory or computers or all the things we have today. We may be Homo erectus right now. So our ability to imagine what may exist and what problems may arise. And so it's the first time
in Homo sapien history where we cannot predict
even three months out, we just no longer know and
we're up against a wall of fog. And so when we're in this situation, I come back to the simple question is, what is the one thing I do
know, is I don't wanna die. And by doing that, then I've
taken the systematic approach to say, okay, if you're going
to go about that process, how would you do it? You would go about measuring
everything you could in the body, trying to
assess scientific literature, measure again, and just
go through this process trying to figure your way
out, what can we do today? - Yeah, like the idea of
surviving is innately written in our code to some degree, right? That's why we have anxieties
when as a form of problem, of progress, when things
get safe, we become anxious for no reason at all, because we're our brains
were attuned to survive. And then at some point, we get to the age where we no longer can
sustain life and life ends. And there's people who claim
there's beauty in that, the fact that life ends. Do you disagree with that notion? - You know, humans are very clever, and we create clever stories to justify anything we feel uncomfortable with or anything we want to be excited about. And so if you look at the number
of things humanity has done to try to reconcile with
death, I mean, every religion is an attempt at reconciling with death. And we have cultural norms
like live fast and die young. And so we have all these, all these tools for us to say
that death is not only okay, but it's desirable. Now, you know, would we
have invented those stories if death never was, you know, or is it the reaction
to this inevitability that everyone feels pained about? And so even if you said two decades ago that death is a maybe or that don't die, you'd be ridiculous. It's not, it was never
possible until right now to even pose the question
that is that real or are you just like off in la-la land? - The notion of humans
creating stories after the fact and being like the Monday
morning quarterback, if you will, is so commonplace and happens all the time
in our logical reasoning as a form of fallacy. But isn't the thought of don't die just another version of that
story from the other side of the perspective, also
kind of without data knowing to whether or not this is just a story we're telling ourselves? - Certainly could be, yeah. And that's why I try to go
through the thought experiment of, if I try to be as aware,
self-aware as possible, and strip myself from all things, literally the only thing I
can say about my existence is that I want to continue
to exist in the next second and the next second. That's all I know. And so for me, I'm trying to
create clarity of thought. This is, again, is like when we look back at previous centuries, the 15th century, we compressed the entire century into 20 things that were accomplished. Everything else is gone. You know, you may have
an ancestor's biography, but that's your ancestor. But we as a species compress. That same thing is going to
be true for the 21st century. They're gonna look back at us and so much of what we care about and we think is the end of the world if something doesn't happen,
is gonna be lost to history. No one's gonna care. And so I've tried to, in
my own thought experiments, say, what is the 0.01%
stuff that does survive in this time compression? - And what is that in your mind? - That the 25th century, if we could listen into that conversation, they would say, "It's
amazing that Homo sapiens with their primitive brains
and primitive tendencies were precocious enough to figure out the only priority they had was don't die." Now don't die individually,
don't kill each other, don't kill the planet, and align superintelligence
with don't die. That it was a fabric of
all intelligent beings on a single philosophical
substrate of don't die. - It's very Darwin in
its perspective, right? Survival of the fittest,
survival of the longest. Right?
- Yeah. - We're just changing the
adjective here or the adverb. We talk about in medicine frequently measuring not just length of
life, but quality of life. If we get too focused on the
length of life, isn't it true that the quality of life
can then suffer as well in your eyes, or you disagree with that? - I think it's possibly that is a valid observation
in the 20th century. I think it's something that should be questioned in
the early 21st first century on the eve of superintelligence. And this is, I come back
to this again and again, I don't think we can say
anything about the future. It's like asking Homo erectus, you know, posing the same question and then saying, what do
you think about blank? There's just no intelligence there to even comprehend the reality. And so when you're talking
about the change of intelligence that's dramatic as we're
contemplating, it's hard for me to imagine that our
priors would map to that. - Well, I'm sort of speaking
more about the present in the situation of,
let's say we have a person who their quality of life is suffering because they're on a ventilator. They have no longer-
- Yeah, yeah. - Any brain activity, but their heart lungs are
working because of the machine. This person is technically alive and we can get a lot of
years of life out of them. - Yeah.
- But is that without the quality that
that person would've wanted for themselves?
- Yeah. - Where do you fall on the
spectrum of that line of thought? - Yeah, I mean, I actually
went through this as well in signing my will documents.
- Mm-hmm. - I had to go through
this thought experiment of how long would I stay on life support and under what conditions? I agree. It's nuanced and challenging. It's very hard. I think you're probably
aware of the literature where people who, people will say, who work, for example, with ALS patients, they'll say, "If I ever become an ALS patient and if I ever get to the
stage of deterioration, please just pull the plug." And then they arrive at that state and they don't want
someone to pull the plug. And so I've just seen again and again that a person's
imagination on what they may want is almost always wrong when
they arrive at that place. And so for me, I'm always
very careful imagining what I think I want when
right now I can say like, "Oh, of course that's a valid
point that just pull the plug. We don't want that." But there's very few things as strong as wanting to continue to exist. - Aren't you thinking about
that future perspective that you say we're so
inaccurately judging, every time you make your daily decision to eat the exact number of
calories, sleep the same number of hours, do the protocols
as you're doing them because you're thinking you'd wanna live as long as possible. Is there a world where
you do live much longer than would've if you had
not done those things and then wish you lived a shorter life? - I think that's possible
in a previous era. Now, I don't think so. - Why is that? If you look at the differential
between intelligence of what AI can do versus ourselves and the speed at which it's moving, I'm open to this idea that
everything I care about, everything I perceive to be valuable to me may be completely replaced
with some other framework. That if you look throughout
humanity, I mean, there's been thousands of
human civilizations rise up, each have their own
cultural and social norms. No one's exactly alike. So we've seen that human
intelligence can structure itself in a very wide variety of ways. And you walk into now with
that kind of new intelligence, and you look at how AI
agents play in games and what they, it is so
unintuitive to us what they do, that this is why I'm open to
this idea that it's a reality that may be incomprehensible to us. - Yeah, I definitely think
it's incomprehensible. And I think part of it
is what "makes us human" for lack of a better term.
- Yeah. - And again, that could
be something we say to pacify ourselves
surrounding the unknown. When you know something is
gonna be shorter versus longer, is it fair to say we more
are likely to enjoy that? If I tell you that there's less
of a certain baseball card, the rarity of it is higher, which is essentially a
shorter life, rarer years. - Right.
- Don't we put higher value on that? So are you essentially making
your life less valuable by living longer years? - That's not my lived experience. Like, I'm 46 right now. - And you look great for your age. - Thank you.
- Yeah. - If I were to live to 50, you know, that's a very, it's a finite
timeframe that I have to live and let's say in an alternate
universe, I live to be 90, you know, I'm not sure how
I would mentally reconcile with that and say like, those
four years were the best years of my life because
I was all in on living versus, you know, for the
remaining 40 years I got to live. I got to see the following things or do the following things. I don't know. To me that seems like a very
hard question to answer. - Yeah, that's a very reasonable answer. You know, you follow all these tools that give you ages of certain organs or your performance on certain tasks. And I'm gonna be very open about my bias and skepticism about those things because I've seen non-validated
technologies come and go throughout my young career as a physician. - Yeah. - And I've been hesitant
to recommend them widely to people outside of maybe entertainment or gamifying certain things like exercise. And I've also seen it
not be widely applicable to the general population. Like even something, if
we really simplify it to step counters, before we used to recommend
in our family medicine clinic, everyone give them a step
counter that will, you know, gamify and make them excited to walk. And it did.
- Yeah. - But once we tracked them
for a longer period of time, we saw like everyone fell
all out of love with them. It was the novelty of the
situation that caused them to use it, and then they stopped. So when I hear things like there's the age that your body currently is, or the age you're gonna live until, like there's the 10X Health that the insurance predictor
would tell you how long you technically will live if you continue living your current lifestyle. I find those to be widely inaccurate because I don't find
them very well validated. But what is interesting to
me is if I could tell you with certainty that you're 46 now at 50, guaranteed death from my new technology, would that make the next four
years more or less enjoyable? - Hmm. Than if I live past it? - If you didn't know. Because you're seeking knowledge, right? - Yeah.
- And I'm always like, okay, knowledge, but with knowledge that you can actually
change something, right? - Yeah. - Because otherwise
knowledge with more knowledge is somewhat scary in some scenarios. So if you could know age 50 is the end or not know, like I have a helmet here that I could put on and
give you exact estimate. Do you wanna know?
- Yeah. I would definitely wanna know. Yeah. My relationship towards data
is I want to know all of it. Yeah, I mean, I think that
your thought experiment, yeah. If you put a clear line on
death, then you definitely are self-generating a mental state that is an aroused state that probably isn't sustainable
over some duration of time. You're going to live differently. Yes. So I think it's a fair that that definitely plays
into human psychology. That I would live
probably, probably a, well, I live pretty ferociously right now, but like, yes, I would definitely have probably higher intensity
of living, I would imagine. - When you say higher intensity, does that mean you stop your protocol? - I don't think so. - So you get incredible enjoyment of doing and living this regimented lifestyle? - Yeah, I mean, my meaning making game, how I understand my value,
I want to be admired by the 25th century. I want them to point and say in the early 21st century, and now I built this model
based upon my reading of a lot of biographies of previous centuries, I admire them for having done
seemingly impossible things. So yes, I would do it because my objective is to point the species in a direction of don't die. I think we really are at this stage of potentially the most extraordinary existence in the galaxy. And that's what I want to be known for. That's what I want to try to accomplish. So my objective is not life maximization, it's species maximization. It's trying to get life in this part of the galaxy to flourish. - So you're hoping with
the results and knowledge and data that you gather by yourself, someone else could look at that and say, oh, I've learned from that and I too can help myself, my family, et cetera.
- Exactly. I'm trying to turn the... I mean, there's so many
examples throughout history where individuals or small
groups of individuals did something that changed
the course of humanity. And that's the objective here. - When you make some of these things that could be tangible
takeaways for others, isn't it somewhat problematic in that you're the most measured
man in the world, right? Is that correct?
- I think it is. - Or am I misstating it? Okay.
- Yeah. - You're tailoring your approach
very individually, right? Based on data markers, things you're gathering
about your hormonal profile, your growth, your physiologic state. Isn't it then difficult to
generalize that for people of different genders, different
activity levels, races, medical conditions? Or do you feel like it's
universally applicable? - Yeah, I think it's more universally applicable than it's personalized. If you look at the core
tenets of Blueprint of prioritizing sleep,
getting exercise, eating well, and not doing bad things,
most people that's on 0.4. And there are nuanced things
that are particular to me. I take rapamycin, I do
metformin, (indistinct). So those things are on
the outlier of Blueprint, but the primary is really the basics we all learned our entire lives, which are just the hard things to do. - So do you think then that takes away from the revolutionary aspect of Blueprint in that this is what's
been said to us for, you know, 100 years? - So it's not that the
science is revolutionary, it's that the philosophy behind it. Death has always been inevitable. And if we contemplate that
it may not be inevitable or that there's like a even a
maybe, it changes everything. So the don't die, if we just
pose, if we try to isolate and say what things threaten
the continued existence of the human race? I would say there's three things. One is human annihilation, either through weapons
of mass destruction. Two, is the earth becoming
unsustainable, the biosphere. And three is something with
artificial intelligence, that we don't build it correctly and there's some undesirable outcome. I tried to become all... I could try to become each
one of those problems. So what I'm trying to do, I am trying to solve climate change
through health and wellness, that we treat planet earth the
same way we treat our bodies. It's an identical relationship. Now, if you replace my
body with planet Earth, you do the same protocol. You get a whole bunch of
data, look at evidence, you'd create a protocol,
you'd go through the process of doing it again and again,
the scientific method. And so what I'm trying to say as a species is it's the philosophy and the way we approach our existence, which is what's important. Not that going to bet on
time is revolutionary. It's saying that we're in
this special moment in time, and the way we solve
our existential threats is through individual decision making. It's not blaming someone,
it's not pointing fingers, it's not asking someone
else to come in and save us. It's through individual powers. - Does the fact that as we multiply, if we don't die, the effect on the earth is disastrous. So is that a tenant that
kind of doesn't vibe with the original mantra of don't die? - Yeah, it certainly could be. It reminds me however of the
problem in early 19th century New York where horses were the primary mode of transport, and there was so much manure all over New
York where it was disastrous. The Hudson had all this manure,
people were getting sick, the drinking water was polluted, and everyone thought the
world was coming to an end. And then Henry Ford made the Model T, and that solved horse manure. Now of course, the car caused
all kinds of other problems, but still the horse
manure problem went away. And so I know overpopulation
is the imagination, but there's also a possibility that overpopulation is
a horse manure problem that is not really a problem. There's something else that's the problem. Now, it could be, but I just call attention
to this, that a lot of people hear the argument
and they jump to overpopulation and they foreclose this other thing so fast without giving
the other con other side of the contemplation any air to breathe. And so what I'm saying is
if we're cautious and wise, we'll realize that no previous generation has correctly mapped the
future as it's unfolded. Most of it has gotten wrong. So we're probably the same, the majority of our
imaginations are likely wrong. - Yeah. I mean that's very fair. If you ask anyone in November, 2019- - Yeah.
- What they envision the next few years would be like, everyone's guess would be wrong. - That's right.
- So that's true. When you say people foreclose
on the notion of, you know, overpopulation may
perhaps being a good thing or living forever could be a good thing. Who are those people
that you're referencing? - Oh, so if you even say
the idea of living forever, it breaks the human brain. You can't say those words.
Like no one can comprehend it. So it just provokes
this knee jerk reaction, which just squashes it. So I like to talk about living tomorrow because living tomorrow
and living forever, they're identical. You know, in my current
state as a 46-year-old, I in my mind assume I'm
going to live forever. Like, death does not seem real to me because I'm not yet in that state. Now, when it does creep up,
that's a different reality, but I don't live life with the expectation that's going to end anytime soon. I think I have all the time in the world. It's like this trick our minds play on us. And so I really focus on don't die and don't die for tomorrow, because that's what we understand. That's what we care about, and that's how we build habits for this moment. - So you focus your mindfulness
towards the don't die mentality, and you're
saying that you can plan for it once you get to that state, but in reality, most people
don't plan their deaths. - Yeah.
- I mean there are obviously unique exceptions, but most people, something happens and they're no longer living. So how can we guarantee tomorrow? And that's why I feel like it's hard for folks to comprehend.
- Yeah. - Because it doesn't
seem feasible right now. The same way that, you
know, the airplanes were- - Yeah.
- Not feasible back then, so- - Exactly. - The reason why it's
puzzling to me as a physician is because I see how flawed
science is currently. - Yes. - And how a lot of data
confuses us at times. - Yes.
- Like prime example of false flags on tests
that then require follow up or interventions that are problematic. Like I've read about you
receiving colonoscopies earlier than the traditional recommended
screening period of age 45. - I didn't.
- Oh, you didn't? - I didn't, no.
- Oh, okay. - I did a pill cam. - Oh, you did an endoscopy.
- Yeah, yeah, yeah. - So you don't do colonoscopies? - No.
- Okay. And is there a reason why
you chose the pill endoscopy versus traditional colonoscopy? - Yeah, because the polyp
detection was high enough that we thought it was a decent coverage and the risk of death, I think it was like one in
10,000 on the colonoscopy. So we felt like the risk
trade off of the detection was better for the pill cam. - And then you discount the
part of potential intervention and prevention aspect of colonoscopy. Like if there is a
polyp, you can remove it, versus on the colonscopy,
you can't do that. - Yeah, the pill was such a benign thing. I took, I fasted, I took some
laxatives, I did the pill, and then I drank laxatives for six hours and then I got the 40 or 35,000
images or whatever it was just to get a baseline of what do we think we can find here. And it was pretty good technology. - Yeah, and was there anything interesting that you took away?
- Nothing. - Perfectly clean.
- Yeah. - Perfectly clean, yeah. But an interesting video.
- Yeah. - And like, but I mean, to your point, like I agree with you. For me, the science doesn't
need to be true eternally for this to make sense in my mind. Like, we all know the
science is gonna move. Some things I do today are
not gonna be good ideas and it'll transform something else. Totally agree with you. Like that's what has always happened, it'd be naive to think otherwise. What I'm really trying to say is it's that we're vigorously engaged in this process because we have this practical question. So as you can tell, I
think a lot about AI. So we build these superintelligent tools. Then we have this question,
what do we do with them? You know, do we use them for war? Do we use them to get more
social media followers? Do we use them to kill
each other? What do we do? And so we're bringing AI into
all the games we humans play. That's potentially the most dangerous thing we can do as a species. And so the question is, if we don't bring it
into our existing games, what would be the new game
that replaces that game? And so what I'm betting
on is as AI progresses, it's going to create existential crisis for us as a species continually. And it will create questions like, what do we do for a living? Do we still work? Do we have identities? Does it create videos
better than any movie maker? Does it like... It replaces us in many ways. Does it do government? Like who are, do we elect leaders anymore? Like we have to basically
revisit every facet of society because this new thing is here. Now that's pretty traumatic
for us as a species. That's a lot of change. Like we look at a little virus, like it shut society down, and now we have a new form of intelligence coming on the scene that's going to shake every pillar of our existence. So what I'm trying to say
is, the process I'm going through is just simply a
process of trying not to die. We're doing our very best with
the science we have today. We're making mistakes, we're improving, like we're open to all this stuff. But it's just the process. And it really is meant to say, what do you do when you have
really powerful technology? You apply it to improve the
condition of all humans. - Yeah, like the idea of the
notion that you point out of folks, like the things we
do in science today will evolve and we'll look back 100 years from now and say, oh my God, I can't believe we used to do colonoscopies.
- Yeah. - We can just with this
thing see internally without even going inside the body. Right? There's gonna be plenty of that. - Yeah.
- Well, those things will come up and will be
tested on a wide population. When you're using yourself
as the benchmark for tests, especially when you're very
excited about the technology and the testing, do you see how bias can impact the
outcomes of those results? - Sure. - So how do you safeguard
against that? Or you don't? - Yeah, so we do our best. Yeah, but I think of
myself more like Magellan or Ernest Shackleton or Lewis and Clark or any other explorer before me. I'm trying to demonstrate
something that has never been done before, which is a bravery
to try to tackle death. Now this of course is a
story as old as mankind. For the first time, I think
this is the first time in history it could be
taken with a serious face. And that's what I'm trying to do. And so yes, I'm gonna make mistakes. Yes, you know, it's an end of one. It has all these kind of limitations. Totally aware of all this. And I'm not going to try to
make the argument otherwise. What I'm trying to say,
it's a worthwhile endeavor. - Yeah, I could see pushing
towards that endeavor to some degree brings tremendous value. The concern I have is there
are people that look to you as a figure who's very influential, who is looking great for your age and even for younger than your age, and say, I wanna do that too.
- Yeah. - And they don't have the
means of doing certain things outside of the pillars that you mentioned of sleep and exercise.
- Yeah. - And they start spending
their limited time, budgets, et cetera, to
try and chase that dream. And my thought is, anytime
you're prioritizing something, it's at what cost? Right, so when someone asks
me like, is diet soda bad? And it's like, for whom? For what condition?
- Yeah. - Is it replacing what? Like all these questions pop into mind. So it's, is this a worthwhile endeavor for the general public? 'Cause for you, who am I to
say what's right for you? That's completely your world. - Yeah.
- Right. You have bodily autonomy. But the question is, what
should the general public be taking away from your journey? - Yeah, I mean let's
imagine we pose a question, someone sees someone else gets wealthy through this thing called capitalism and they wanna start doing it too. And they start doing it at
the cost of all other things. Is capitalism a good thing? - Is capitalism a good thing? For whom? In what condition? I mean like, I would ask
all those same scenarios. - Yeah, yeah. I mean it's like any pursuit for humans. They lock in on a given
game they wanna play, whether it's their own wellness or whether it's trying to make money or whether it's trying to
get social media followers. I mean, there are these
pathways any human can take for any system they want. - In those pathways, a
lot of times what ends up entering into the space
is survivorship bias. - Hmm. - Of someone who has been lucky- - Sure.
- Taken the right path at the right time, et cetera, et cetera. And then people try and
follow that route one-to-one. And oftentimes it doesn't happen because you know, end of one. - Yeah, yeah, yeah.
- As you precisely put it. So I'm just trying to find what can I take away from
your journey to bring to my viewers, to my patients that's gonna actually make
an impact that is valuable to them in the long run.
- Yeah. - Besides the philosophical
thought experiment of, what if we don't die?
- Yeah. - Because I think that is a
valuable thought experiment. I think there's so much value
into thinking beyond death. And I think you said that a lot
of the cultures in the past, they lived very differently and they evolve very differently. And that's true to some degree, but there's some unique through lines. - Yeah.
- Like the thoughts, what happens after death, the fact that almost every culture had some sort of substance that allowed them to escape reality whether it was alcohol, opium, you know? There's these human flaws in us and that's always been largely celebrated. But now we're taking the other approach and celebrating potentially
getting rid of human flaws. - Yeah.
- Right? Is that the correct way to think about it? - Yeah, I mean, what I
suggest for your patients is that I'm making the observation that we humans have largely seen ourselves as martyrs for certain causes. So people take better care of their pets than they do themselves, better care of their kids
than they do themselves. They take better care of
their professional advance, their wealth accumulation. So people prioritize a
very long list of things higher than their personal wellness because they think they're
achieving this immortality of legacy and contribution
to these other vectors. And what I'm saying is
the age of martyrdom may be coming to an end where it may make sense
to put your mask on first. That means going to bed on
time, it means, you know, exercising, it means trying
not to engage in bad vices. And so it's really a fundamental shift of how we understand ourselves. That's why don't die, it is
a philosophical argument, but it also informs what
you eat for breakfast and what time you go to bed and whether or not you drink alcohol and whether or not you
smoke the cigarette. So it's extremely practical
on a day-to-day basis. - Well, practical is tough because, you know, the human psyche takes so many different forms. Like I've treated tens
of thousands of patients and not all successfully might I add. And some of it may be, you know, optimal treatment wasn't there, the presentation of the
condition wasn't very clear. - Yeah.
- But also, because patients don't
oftentimes take care of themselves as well as they should and the human psyche is so imperfect. So is it practical to say
that, you know, like how long of your day of waking hours
do you spend not dying? - Yeah, a lot for me, yeah.
- Like is that practical? - Well, so the people doing Blueprint are able to play the power laws. So what we did at
Blueprint that was unique is we went through all
the scientific literature, all health span, all lifestyle studies. We graded the effect, we
scored the effect size, and then we graded the evidence and we said, can we define power laws in health span, lifespan? And we put all those into me and then we measured everything,
we made it all public. So we basically were just trying to say, as a scientific
project, where are we with the fountain of youth? Like if you look at it from
an organ by organ perspective and every measurement we
have, whatever you think of those measurement modalities,
whether it's gold standard, silver standard, like
whatever the case may be, here's a rough assessment
on where things are at. And then we can distill it and say, all right, mom and dad, here are five things you wanna do in life and you can allocate, you know, 30 minutes a day to these five things. So I've tried to make it
very easy, approachable, low cost, that's why I've
made the whole thing for free. It's like my parents, my
my father's 71, you know, like they're pushing the ages
where they're really starting to deal with their ravages of aging and they've been able to
implement these power laws and dramatically change their health. - What are the power laws? - So the five big ones are not smoking, exercise six hours a week, a Blueprint or a Mediterranean-like diet, a BMI of 18.5 to 22.5, and
then moderate to no alcohol. And then sleep you would
add there as, well, as the- - Sure. And that's the part that you get for free with the Blueprint Protocol? - That's the influence. So I mean, so I spend a lot of time doing all these measurements and testing all these therapies, but the takeaway for someone else is, you know, do those five things. And so if you don't smoke, not a big deal. If you don't drink, not a big deal. Here's the rough dietary
protocol to follow, maintain a proper weight,
get some exercise, and like you're there for a power law. Now that also means try to
eliminate vices, you know, which is probably the hardest thing. - Sure.
- And so, yeah, but it's like these really basic things that most people know but
they're not implementing. Now, if you wanna go to
a more graduate level, then I've got those things for you too. But I've tried to just meet
people where they're at and say, here are some things you can do with baby steps to be in a better spot. - If you went on social media and you talked about
those pillars exclusively. - Yeah.
- Or sorry, power laws. - Yeah, yeah.
- Power laws. You would probably not
build much of an audience, not because anything against
you, but just because- - Yeah. - There has to be something
sexy and fun and unique and that's why folks are
paying attention, right? So as much as you're saying like these are the five healthy habits that everyone should follow, they're more interested
in what you're doing to the extremes. Am I right in thinking that,
or you think I'm disconnected? - It's the entryway. Yeah. But when they have to,
they can observe it. But when they pull it back to their life and say, now what do I do? It comes back to those things. - And those things that you
do, like some of it, you know, seems really out there for me. At one point, were you doing
plasma transfusions from- - Yeah. - One of your younger children? - Yeah.
- Yeah, take me through like the logic of that and
why you decided to do that. - Yeah, so we were exploring
various therapies we could do, and plasma came up as one. The effects in animal studies
are pretty convincing, and not convincing, the
effect size is good. So we thought we'll try it. So what happened is, I
was talking to my father, he called me one day and he said, he's in the law, legal profession. He said, "I just wrote a brief. I walked away, I came back and it was a scrambled bunch of words." And he's like, "I couldn't believe it because I didn't see it
when I was writing it." So he realized that he
was experiencing a lapse and he wasn't aware of
it, which terrified him. And so he said, I will do
anything for my cognition. And in our research in doing
this, we had seen that a lot of trials were being done for
Alzheimer's or Parkinson's. And so we said, interesting. I said, "Dad, I'll be more than willing to give you a liter of my plasma as an experimental therapy." And he said, "I would do
anything to try to combat this." My son overheard the conversation. He's like, "Hey, I'm in
too." So we're like, "Great." This is like a multifamily, it's like a multi-generational
plasma thing. How fun, like-
- Okay. - Some people go to the
beach, some give plasma. (both laughing) - Okay, very interesting. So we went there and it
was actually really fun because my father was mostly
missing from my childhood because he was engaged in hard drug use and I always wanted him to be around and he never was. And it was very hard on me. We've always worked very
hard at our relationship, but he just has had a lot of challenges. And then my son, I was
married and I had three kids. I got a divorce and my
three children were split between dad who had left their religion and mom who had been in their religion. And so for 10 years I
was the other, you know, I couldn't be trusted
because they were part of this religious group that said, this is how we understand reality. Dad is not part of that,
therefore we can't trust him. And so weirdly, I was without father and now I was this super engaged father trying to raise my children. And they were like, "Thanks
dad, but we got this." And it was this form of torture. And I had one of my three children come decided to live with me. And he and I had become best friends. And so it was this moment
where, yes, it was about plasma because we thought it was safe, but it was also about my
dad, myself and my son, and the three of us getting together. And so I know from the outside
looking in, it seems crazy. It's eccentric. It's everything that triggers
people in so many ways. It was also one of the most special
moments in my entire life. Now when I measured my biomarkers, there were no change in my biomarkers. We didn't see any effect. When we looked at my dad's biomarkers, we looked at his DNA methylation using the DunedinPACE algorithm. His speed of aging lowered by
the equivalent of 25 years. Now speed of aging, the DNA methylation is still
a silver standard, right? It's not, it doesn't
have all cause mortality. So it's not gold standard. We still don't know what it means and why. Still, it's, you know, a legitimate... It's a legitimate technology with a lot of scientific publication on it. And it stayed, his speed
of aging stayed down 25 age equivalent for six months, had a meaningful impact on his biology. And he would say in his
subjective experience as well. So from my father's perspective, it was one of the most
substantial interventions he's had in his entire life. And so I know that from
the media's perspective looking in, it's absurd. From my personal experience, is one of the best experiences of my life and meaningfully impacted my father. - Yeah, that's awesome that it brought you guys
closer together as a family. And I think the reality
of all of these things is everyone has their own risk tolerance. - Yeah. - And some people can
look at a rock climber and say, "You're ridiculous
for risking your life. You're ridiculous for
jumping out of a plane." I became a professional boxer. And they're like, "You're a doctor, you're getting head injuries." - Yeah. - Yeah, and I agree that it's, you know, not healthy and I don't recommend it. The issue comes in when we say lines like, "The test has a lot of
scientific research behind it." That statement to some ears, well, sounds like it has
validity to what we're doing. And we have to be really
careful on how messages land to the general public where
the validity of the weight of evidence is unclear. - Yeah. - And I don't want folks thinking that that is the answer to their longevity or that this is mandatory and they can skip out
on certain health habits or they can't be healthy unless they have plasma
of someone younger. So my goal of educating on science is really just getting people to think about the scientific process of what evidence means. 'Cause you're a brilliant person in terms of your knowledge, right? You can think much deeper
than the average person. You, way smarter than
I am in your knowledge of understanding evidence levels even. And I think about the general
public not having the depth of understanding of what
a DNA methylation test is and hearing it and sounding like sci-fi and them craving it as
if that's the answer. I'm like, man, I wish
they would just listen to your five power laws 'cause that's what I
want them to listen to. - Yeah, yeah. - And that's where probably
the biggest criticism would occur from the medical community. But the fact that you and
your family bonded over this and someone finds it weird, humans do all sorts of weird stuff. - Yeah, yeah.
- I mean like- - Yeah. - That is, should be without judgment what you and your family do. So I don't think that's valuable. Is there anything that
you've done in this journey that has ended up harming your health? - I'd say the worst outcome
was using human growth hormone. - Mm. - We were repeating a study that was done for thymus rejuvenation. So the gland responsible
for the immune system. So we did 100 days of
human growth hormone 0.6, 1.8 IU was the dose. And we successfully changed
my thymus fat fraction by seven years equivalent. So according to three MRIs, we regenerated my thymus by seven years. That was positive. But it came at a pretty extreme cost. I had intracranial pressure increase, I had my blood glucose were messed up. It was pretty disastrous for my body. And so I don't think
we would do HDH again. I think we'd probably
take a different approach, maybe look at some peptides or something. But we were trying to go
after, no one had, not no one, only one group had tried
to do thymus rejuvenation. It's a really hard one to get at. And we wanted to take a stab
at doing something hard. - And why was the thymus the primary organ you were focusing on with
human growth hormone? - Because, well, I guess we've been trying to rejuvenate all my organs. So we take each one, the
heart and liver, lungs, and then we say, how do we do that? And then what therapies are available? And the thymus just has such a huge yield because it's the immune system. You know, very few things have
such a power law in the body. So we wanted to put our targets on that. And we found there was
a therapy that had been through a study, so we had some data on some number of participants. - And when you undergo
one of these trials, you take a lot of measurements in order to see how one
therapy impacts the others. Because you're doing
many therapies at once, is there ever a fear that
they're clouding the judgment of what's actually
happening when you're trying to perform a measurement? - Yeah. We've borrowed from pharma. So pharma has the same problem when you introduce a drug into the body. They have a statistical
process where you go through a questionnaire
and you try to isolate. And they use probabilities to determine whether a given
therapy has a given effect. So we've tried to use stats too, but it doesn't create a crystal ball. You're still dealing with probabilities and you're still dealing
with potential confounds. - Yeah, and I mean a lot of that statistical power
comes from the number of people involved and
the randomization of it. - Yes, yes.
- So that is also tricky. I'm just thinking-
- Yes, that's absolutely fair. - The guidance that, again, we can issue from some of these things.
- Yeah, yeah. - And- - I mean, knowing all
these things we do our best knowing full well we just,
because it's end of one, we're limited, but we do genuinely try to be intellectually honest. - That's great. I have a theory about
like fitness trackers and it's gonna be widely
different than your viewpoint. So I'd love for you to
critique me on my viewpoint and what you think, but give
me a genuine like reaction to what I'm saying.
- Yeah. - When folks come in and they say, "Should I monitor my sleep score? Should I monitor my fitness tracker? Should I do these things?" My usual answer is no. And I'll explain to you why and you tell me if you think
you agree, disagree, and why. My thought is when you
have a sleep tracker on, a fitness tracker on, it potentially makes it more difficult for you to understand and
listen to your own body. And one of the most important
things, when I see a patient, let's say they come in
for the symptom of pain, knowing is that symptom of pain urgent? Is it scary?
- Yeah. - Is it an ache from a hard workout that they can push through? That sort of knowledge
comes from trial and error without outside measurement. It comes from intuition of
your own body's functioning. So for example, when someone sleeps well, but then we tell them as scientists, "Hey, you actually got
a bad night's sleep," we lie to them, they
perform worse on tasks because we've led them to
believe that off of their device. - Yeah.
- Even though we were tricking them.
- Yeah, yeah. - And then people will say, "But Dr. Mike, when I have a drink of alcohol,
my sleep score goes down. That in incentivizes me to not." And I think that's wonderful. But the question I would ask
them is, if you had the glass of alcohol and you didn't sleep well and you wake up and you feel like shit, did you need the watch to tell you that? So it's like I could see the instances where it helps, it would've helped anyway and you would've known.
- Yeah. - I could also see the instance where it tells you something that could potentially even be harmful 'cause it leads you to believe something negative about your body. And because there's so many
confounding variables happening in life at the same time-
- Yeah. - It creates a notion of control that I believe we don't
have and we don't have yet. - Mm. - What do you think about my stance? - Yeah. This year, I achieved eight months of a perfect sleep
score using my wearable. I don't think anyone in the
world has ever done that before. And it was my personal experiment to see could I achieve high quality sleep every single night? And to do that, I needed to
create quite a few intuitions. I needed to understand what happens when I eat pasta at 5:00 PM, what happens when I watch a movie, you know, on a big screen an hour before? What happens in like
hundreds of questions. I basically was trying
to build intuitions, what happens when? You know, and when I go to
bed, can I deduce my heart rate and my resting heart rate is my predictor of my night's sleep. And so I would say I would
never have been successful at doing the eight months of perfect sleep had I not had a wearable. I just would not have known
how to connect these variables. And because I was doing
this in a systematic way, I could isolate these effects more. I could isolate a given day
at a certain dietary thing or whatever the case may be. And so, yeah, I think that
for me it was the only way for me to figure out sleep. - Do you think eight months
of perfect sleep is necessary for a healthy lifestyle? Like if you had every seventh day you had a shitty night's sleep, do you think that would
derail your ability to live a healthy lifestyle? - I was... So I don't know about that. I was doing it because I come from the entrepreneurial community and that culture is
very much grind culture as you're a martyr. I mean, I'm sure as, as a doctor, yeah. - Sure. They abuse us all the time when there are 24 or 36 hour shifts. - Exactly. So you come from a culture where people will tell stories about your bravery and courage if you stay up for multiple nights working on a project or if you're so tough you don't need sleep or you only need two hours of sleep. And so there's all this lore and mythology and status that comes around, comes along with not prioritizing sleep. And so I was trying to
change that zeitgeist to say, I'm from this tribe and I'm gonna show you
that I can be equally as productive in life and
do so on high quality sleep and even improve my productivity. So I was trying to prove
something to my community that it really is important
to prioritize your sleep. That if you think about it
from, so you take a leader of a company, let's say it's
100 employees or 500 employees, when that person is sleep
deprived, they're inebriated. It's as though they're actually drunk. So you have a drunk person
leading the company you work for. I don't want that. I don't want to tell stories of how bold and courageous they are by missing sleep. It's really stupid.
- Yeah. - And so I was trying to make that point and I was trying to
say, you too can do this and achieve the best
performance of your life. And so I had a number of objectives, whether you can miss one night, that's kinda like a cheat
day to me where that's one of the most common questions I get. I don't want a cheat day. Like I've now got to a point where I can imagine doing a
given thing, eating a donut or ice cream or whatever,
or a pizza, it makes me sick because I know how I'm gonna feel. I know it's gonna ruin my sleep.
I know I'm gonna be groggy. I'm gonna hate life the next day. The pain is so intense and it's so long for that teeny moment of maybe pleasure, but now I'm past it. And so the cheat day thing,
I think is a bad idea. It's a bad cultural moment. And I wouldn't want it. 'Cause then we're so, we're such an uncontrolled
form of intelligence, right? Like we're just totally outta control. And if you give anybody
a vector to be like, and today you get do anything you want, it just becomes disastrous. 'Cause then like tomorrow's like, "Well, one more day, I'll spend
next week's day tomorrow." - Yeah.
- Runs away. - I could see how, I mean, we're talking about
extremes of situations. You know, giving someone unlimited runway or giving them extremely limited runway where they have none.
- Yeah. - Neither of those are gonna
be ideal just on the way that the human body
works through homeostasis if it's trying to keep a balance. And there's frequently a
statement in healthcare that I've referenced where the enemy of good in medicine is perfect. And I've seen that time and time again, either from a procedural
standpoint where we're suturing and we're trying to
make something perfect. And when we do and we
try to make it perfect, it actually gets way worse,
whereas we had it good. Or we try and normalize someone's hormones and when we try to make
the perfect or higher and achieve hyper optimal performance, it backfires and creates
a negative effect. So I worry that chasing to the extremes, chasing perfect, chasing don't die can create negative impacts on people. Do you think there is
potential negative impact from chasing don't die? - Yeah, I think I could
definitely respond to this comment and make and use words that would make sense in
the year 2024 of like, yes, like I agree and like here's all... But I'm really gonna comment on this from the 25th century perspective 'cause that's the one that I think that is not included in the conversation. And so I know when I built my software, my payments company, Braintree, Venmo, we weren't like if the transaction $97.28, we're like, "It's okay
if it's a penny off." Like you need absolute
precision for that transaction. And if the servers are down, you can't process a transaction. If it's down three hours, you know, three minutes a day, that's okay. Like absolute precision. So we build technology with absolute precision
because that's what we can do and it demands. We tolerate this idea
in any part of our lives where we don't have control
of certain circumstances. We say, well, here's a
way to think about it and here are the pros and
cons of a given thing. But I think that's the framework we have because that's the
possibility of the technology. We humans are, we're
not built to be perfect. We're kind of messy creatures. Now that may not be true for the future. We may be able to build
ourselves with precision that is unimaginable to us right now. And so right now that I would say, yep, reasonable opinion, totally agree. Also, we're going into this new future and so I'm building myself,
I want to be the example of what we can build. And so I go to these lengths to say, yes, you can achieve perfection and it's great. And so we'll have all this
help from all these tools of biological engineering,
molecular engineering, artificial intelligence, like
they're gonna converge on us. So we're becoming a new species and new possibilities are there. And I'm trying to bridge this new reality. - So you're thinking about
it from like a philosophical standpoint of the future. It's so interesting that
throughout this conversation we're talking about, you know, answering questions
from the future, right? - Yeah.
- Of the 25th century. But at the same time, you're
very wise in predicting that we don't have the power to predict, we suck at predicting.
- Yeah. - Predicting.
- Yeah. - So how can we, how
can you be answering me from the 25th century if
we're so bad at predicting? - I look at the systems
that can be predicted. So-
- Like which? - For example, if you say intelligence is currently increasing. That is like, and you say a general trend, like whether you know, whether you think it's
an exponential increase or linear increase or some other curve, it's generally increasing. So more intelligence in the world. We're getting better at
harvesting energy from the sun, from all sources. So that's improving. We're getting better at
storing energy in batteries. We're getting... So you can take these macro trends and say what's happening
at a civilization scale and then map towards humans. We're getting better at augmenting humans. So in my car, my car is gonna drive itself or it's gonna gimme little vibrations that I'm on the side of the
lane, or like all these things. So you look at the apparatus, those are the things I
model out with accuracy and to say, if we're on
this general trend line, I can follow those. But as to the specifics, you
know, like, I don't know. So that's how I try to
map my personal life is systems, structures
on the inevitabilities of what appears to be society, absent some kind of catastrophic event. - Yeah. I struggle around that concept
of prediction with trends 'cause I just, the humans are so imperfect from just their ability to predict things that aren't available to us. Like the idea of a virus coming in- - Yeah.
- And destroying us. 'Cause before that, our
idea of a terrible virus was original SARS virus,
which was incredibly lethal. So when SARS-CoV-2, the
virus that causes COVID-19 came about, people said,
"Oh, well it's not as lethal. This is gonna be great." And actually because it was less lethal and more people walked around asymptomatically and spread it- - Yeah.
- It killed exponentially more people.
- Yeah. - So like the idea that
something is even less worse could be worse.
- Yeah. - And that's where I
feel like the human flaw and why when you say like you're trying to put your spreadsheet together
without any inaccuracies is because that is a measurable thing. You can define it, you
can count it, it's there. And with humans, when I
look at a blood test result, I have ranges.
- Sure. - And those ranges suck.
- Yeah. - Our temperature that we use to gauge non-fever versus
fever is horribly inaccurate. - Yeah.
- When I try and lower someone's blood pressure to what we call the ideal standard to reduce rates of heart attack and stroke, the idea that it's gonna work for the person sitting in front of me that I'm actually treating this with, even though I have good
research to say that it is, it's not gonna work 99% of people that I'm giving the medicine to, and yet it's still valuable. And that's coming after trials- - Yeah.
- That have failed 99.99% of the time with
biomechanical mechanisms that rationally made
sense or were proven right in animal models or Petri
dishes or lab models. And I'm like, oh man, there was so much failure leading up to this point and yet I still have
such a lack of control of my patient's well-being.
- Yeah. - I struggle to know how I
can compare someone's health to their spreadsheet, which is counting digital dollars or- - Yeah.
- Physical dollars. That's what is hard for
me to wrap my head around. - Yeah, yeah. I mean, I'm
sympathetic to what you said. I mean, there are some things that the power laws of evidence, like, you know, is smoking
going to shorten lifespan, increase the probability of cancer? Pretty reasonable. You know, is exercise
helpful to increase lifespan? Pretty reasonable based upon the data. So I think if you score the data and you try to isolate those, you can step away from
a total chaotic world into more predictability. But the things I'm talking about for predictability is not
whether a virus is going to show up, not the lethality of it. Like those things are outta control. I'm trying to say, you know, what is the total compute
power on planet earth? What is our ability to engineer biology to perform the functions
that we design it for? What, like, I'm trying to
say system laws as a species because within humans and human systems, we have the element of chaos that is just very hard. - Yeah, yeah, there's a lot of chaos. And you know, I think what your message that I hope resonates with my audience is that you've spent a
lot of time researching and measuring things and still the pillars and the power levels that you find most valuable are the things that are the most simple-
- Yes. - And available to everybody.
- Yes. - And I hope that's what folks
take away from this message of, you know, putting on sunblock and, you know, protecting themselves from excess sun exposure. - Yes.
- UV exposure. Not drinking, not having bad habits or limiting those habits,
making progress along the way. So I think that message is so invaluable. - Yeah.
- And the fact that you've developed a passion for it is truly, truly admirable. It's like really cool to see someone who's genuinely passionate about it and also recognizes the weaknesses of it. And at the same time, there's
some critiques, you know, I have as a skeptic of
looking at it whole picture and saying, you know, I love that you're thinking about
it from the 25th century, but are we gonna get to the 25th century? Are humans a thing in the 25th century? Is the way that exponential
growth gonna continue? - Yeah.
- I just, I'm such a strong proponent of saying, I don't know.
- Yeah. - That it's hard for me to be able to give definitive answers-
- Yeah. - In such an uncertain
place that the world is. - Yeah, yeah. My protocol does not need to be right for my message to be correct. - That's powerful.
- Yeah. - Because I think it's more
of a philosophical message of, hey, don't let thought limitations limit how you think about
what potentially can happen. - Yeah, we have built
a society around die. If you look at the die economy,
so fast food, junk food, cigarettes, environmental toxins, grind culture, you know, lack of sleep, there's a huge amount
of money spent in die. If you look at the don't
die economy, seat belts, medical care, smoke alarms,
it's equally as big. And my prediction is the
amount of money we're going to spend on do die is an exponential, is a right up to the right, and the amount of we spend
on die is gonna go down, that we as a species are going to mature past our primitive ways
of the death culture we have right now and walk into a new era. And so it's the gist that matters. It's that I am going to take care of my... It's like the way you take care of a car. Like you want the car to last a long time. You're doing the same
maintenance for yourself. Like you want your body and yourself to be able
to go on this journey. And that's what I'm trying
to do is, I'm trying to say, get us in the right spot in this moment after 4.5 billion years and we could have the most
spectacular existence ever. - Well, thank you so much.
- Thanks, friend. - Awesome having you on the podcast. - Yeah, thanks for having me.
(logo trills) - Medicine from the future? How about medicine from the past? Click here to see a video of me reacting to medical devices from
the medieval times. And as always, stay happy and healthy.
