Welcome to Pushing The Limits, the show that helps you reach your full potential with your host Lisa Tamati. Brought to you by lisatamati.com.
Lisa Tamati: You’re listening to Pushing The Limits with Lisa Tamati. Fantastic to have you guys back with me again. I hope you're ready and buckled down for another great interview. I really do get some amazing people and this lady is no exception. So today I have Dr Elizabeth Yurth, who I originally heard on the Bulletproof Radio Podcast with Dave Asprey, who I love and follow. And she is a longevity expert. But Dr Yurth is also a medical director of the Boulder Longevity Institute, which she founded in 2006. And she's double board certified in physical medicine and rehabilitation and anti-ageing and regenerative medicine. So she's a specialist in sports, spine and regenerative medicine.
She's an orthopaedic surgeon, and she's also heavily into the whole regenerative stuff. So from stem cells to different supplements to working with the latest and technologies that are available to help us slow down the ageing process and to help people regain function. So it was a really super exciting episode and I'm going to have Dr Elizabeth on a couple of times. She's also a faculty member of the 25 mastermind physicians fellows at the Seeds Scientific Research & Performance group, which allows you to stay abreast and teach others in the emerging cellular medicine field. She's also been an athlete herself and works with numerous sports teams and both of the collegiate and professional levels. She's a wonderful person and I'm really excited to share this interview with her.
Before we head over to talk to Dr Yurth, I just want to let you know about my new anti-ageing supplement. Now this has been designed and developed by Dr Elena Seranova, who is a molecular biologist who is also coming on the podcast very shortly. And this is an NMN. It has nicotinamide mononucleotide. I recently read the book Lifespan by Dr David Sinclair, who's a Harvard Medical School researcher in longevity and anti-ageing. And he's been in this field for the last 30 years. And his book was an absolute mind blowing, real look into the future of what we're going to be able to do to stop ourselves ageing to slow the ageing process down. And very importantly, increase, not only our lifespan, but our health span so that we know we stay healthy for as long as possible and don't have this horrific decline into old age that most of us expect to have.
So Dr Sinclair in this book talks about what he takes and one of these things is an NAD precursor called nicotinamide mononucleotide. I searched all over the place for this. I couldn't get it in New Zealand when I was searching for it. And so I went and found Dr Elena Seranova, who has developed this product and I'm now importing that into New Zealand. So if you want to find out all the science behind it, please head on head over to nmnbio.nz. That's N-M-N bio dot N - Z and all the information is on there. And you can always reach out to me firstname.lastname@example.org, if you've got questions around that.
We've also updated our running coaching system. So the way that we are offering our online run training system is now on a complete new look. We are doing fully personalised, customised training plans for runners of all levels and abilities. So we will program you for your next goal doing a video analysis of the way you're running, improve your running form through drills and exercises. Build your plan out for you. You get a one-on-one consult time with me as well. And just really help you optimise your running performance and achieve those big goals that you've got. So head on over to runninghotcoaching.com to check that out. Right now over to the show with Dr Elizabeth Yurth in Boulder, Colorado.
Lisa: Well, hi, everyone, and welcome back to Pushing The Limits. Today, I have Dr Elizabeth Yurth with me from Colorado—Boulder, Colorado, and she is a longevity and anti-ageing expert. She's an orthopaedic surgeon. She's a real overachiever. And I'm just super excited to have her on because I have been diving into Dr Yurth’s world for the last couple of weeks since I heard about her on the Bulletproof radio show. So Dr Yurth has kindly given up an hour of her time to come and share her great knowledge. I know we're only going to skim the surface, Dr Yurth, but it would be fantastic if we can gain some amazing insights on how the heck do we slow down this ageing process. So, Dr Yurth, welcome to the show.
Dr Elizabeth Yurth: Thank you so much, Lisa. I've been actually stalking you ever since you asked me to do this. And I've been fascinated with all the things you've been doing and teaching and I love it. I love that there's people like you out there who are now getting the masses involved in this and interested in this because doctors aren't doing it and so it has to be that educate the public. And people like you are paramount to that, so thank you.
Lisa: Thank you very much. Yes, I think, yes, this is the beauty of podcasts and such things and will in the internet whenever we can go direct to the best minds on the planet, get the information direct to the consumer, cutting out all the middle people, so to speak, and really get this information out there. Because what I've found in my research in the last few years is that there is so much amazing, great science out there that has never seen the light of day and certainly not in local clinical practice being utilized.
So Dr Yurth, can you tell us a little bit about the Boulder Longevity centre before we get underway and what your work there is all about and your background?
Dr Elizabeth: Sure, I'd love to. So basically, I've been in the orthopaedic medicine world for 30 years. And about 15 years ago, I actually became very frustrated because I saw people coming in and they would get injured or just have arthritis, chronic pain and we would sort of patch them a little bit and nothing ever really got better, and then something else will get hurt. And it really was just this downhill process from square one. I mean, I tore my first anterior cruciate ligament in my knee at the age of 18 and subsequently, had torn two or three more times between the two knees, had four more surgeries and then it was just a downhill decline.
And so, we started looking at is there a way to stop this, because you don't learn it in medical school, and you don't learn in orthopaedic medicine. And when I started looking into—and this was a very early time in the whole functional medicine space, it was really early, there wasn't a lot. And so I went back to American Academy of Anti-ageing Medicine, which is really the only thing available at that time, and did a fellowship in functional medicine and regenerative medicine and tried to incorporate that into my orthopaedic practice as much as I could. But it's difficult in 10 to 15 minute appointments to do that. So we realized that you can't really do good medicine in that model, and so we opened Boulder Longevity Institute about 15 years ago now.
And I really sidelined did both practices, because what I found is that people are still looking for that insurance-based practice, and I try as much as I could to educate them there. And then some of them would transition over to here and over time for 15 years, Boulder Longevity Institute has really grown and developed, and subsequently is now my full-time practice. But we do a lot of orthopaedic regenerative care here, the targeting, taking care of people and getting them healthier in that realm.
But much like you, our focus is very much now on education and we have a whole, what we call, Human Optimization Academy. We're trying to bring the just like you said, the research to the people. Peter Diamandis, who runs Abundance360—is very well known, you probably know him — he has a great quote where he says, ‘Researchers don't do medicine. And doctors don't do the research and learn the research and use on their patients’. And so, there's a lag of about 15 to 20 years since when something is available to us that will make us better and ever getting to us.
Lisa: Exactly. I had the exact same conversation with another doctor, Dr Berry Fowler and we were talking about intravenous vitamin C and I said, ‘Why is it taking so long and critical care to get this in?’ And he said ‘because it's like turning a supertanker’. He says, ‘It's just so slow’. And so people are not getting the benefit of the latest research. And for an orthopaedic surgeon to go down this anti-ageing functional medicine route is a very rare thing, or at least in my country, it would be a very rare thing.
Dr Elizabeth: Yes, orthopaedics does not cross over this line at all. And ultimately, it's one of the reasons I had to leave my other practices because my partners were very much like, ‘Stop talking about medicine. That's not what we do here’. And you have to—even arthritis is a disease. It is not that you ran too much and wore out your knees. There is a disease process going on in your body that is now making your joints wear out. And so you have to systemically treat it or you're not going to make any progress.
Lisa: Oh man, people so need to hear that because it is an inflammatory process that's coming like out of the immune system. And I've heard you say a couple of times on some of your lectures, I listened to one on mitochondria. And mitochondria is sort of the basis of where a lot of other things are coming from, isn't it, and diseases are probably...
Dr Elizabeth: Everything. Honestly, I think what we're going to find is that every single diseases—every single disease is going to come down to mitochondrial level. In fact, I was just reading a new research article on autism and mitochondrial dysfunction, that they're actually linking this mitochondrial dysregulation in even autism. I don't think that we're going to find any disease that is not linked first to mitochondrial dysfunction, which is fascinating because mitochondria are fascinating. So it's really my passion is, is how do we repair mitochondria. But that you start looking at—you can pretty much do that. You guys go out there and Google mitochondria and any disease you can think of and you will find research to support it.
So, in arthritis it is exactly the same, right, Lisa? You're right. It's damage to now the mitochondria and the chondrocytes. And that damage—you get these damage from chondrocytes, which then are actually spewing these reactive species that are damaging the next cell and the next cell. And simply sticking steroids in that joint is not going to help it.
Lisa: Wow. So we want to talk a little bit today, like we talked about our foundational health—a few foundational health principles so that we can then get on to some of the cooler, more sexier stuff that I want to talk about, like things like spermidine and peptides and NAD precursors, perhaps, and all of these sort of really cool things.
But what are you seeing in your practice—like you're seeing a lot of people who are becoming aware of their health, they're looking at everybody knows the basics about nutrition now, I think. Like, fried foods are not good for us, sugar is not good for us—the basics. But what are you seeing as missing in that foundational side of things?
Dr Elizabeth: So I think this is the biggest thing I've seen over the past—probably a year. And as I've done more podcasts, and I've listened to more podcasts, and now you have all the bio hacker groups and the peptide group, so everybody is doing all this cool thing. So now, like, ‘Oh, I got to go do my hyperbaric and I have to go take my growth hormone, peptides’. And they come in to me, and I was just telling you about a patient I saw who literally had a worksheet, spreadsheet of all the things he was doing. And I said, ‘Well, are you taking testosterone’? And he was 56 years old, I said, ‘Are you taking testosterone’? ‘No’. And I said, ‘Have you ever looked at your nutrient pound’? ‘Nope’.
So, what I really want to encourage your listeners is the cool stuff is cool, and there's a place for it in all of us, but you still got to start at the basic stuff. So, when we look at people we have to go through and we have to fix—so we look at all the hormones and you just did a great podcast looking at hormone metabolism, right? Because people are so scared of hormones and they’re terrified that these hormones are going to cause cancer. And we know that's not true. It's how you metabolize the hormones that's important, which has genetic and environmental. You just gave an incredible podcast with your guests the other day on that.
Lisa: With Dr Mansoor; he's wonderful.
Dr Elizabeth: Right. And your epigenetic background, that the key is how these hormones are processed. So when we look at hormones, we actually do a urine metabolite test. So we know exactly where those hormones are going, and are they going down bad pathways or good pathways?
So you've got to repair all that, first, fix all the pathways, which you do, and you know your CYP genes and all that kind of stuff. How do you alter it? There's nutrients that you can use to do that. There's tons of things, exercise. So, fix all the hormones first. Men and women all need hormones. I think testosterone’s neglected in women all the time, right? They're on estrogen, progesterone, and I'm like, ‘You’re not on testosterone’? Like, ‘No’. And so even within the realm of our type of medicine, we are neglected in that realm. Right?
Testosterone is huge for women. If you want muscle, you need testosterone.
Lisa: I basically got good muscles.
Dr Elizabeth: Right, that’s right. So, you've got your testosterone on board, and it has to be not alternating into estrogen—all that has to be involved. So you've got to fix that. And then, there's so much information in these really simple lab studies that you've gotten from your primary care doctor. So, a complete blood count, a CBC, a CMP. Everybody has them, and everybody's doctor looks at and goes, ‘Yep, looks good. There's no reds in there, everything's perfect’. You can actually take that—and Dr Levine, anti-ageing expert, did a whole algorithm that just taking some of these blood work give you very comparable estimation of longevity as doing telomere length or doing methylation.
So, we have all these expensive tests to look at DNA methylation and telomere to look at age, and you could come up very close to the same number, simply by feeding some of these parameters, like your albumin level and your metabolic calculator that would...
Lisa: Wow! Is that available publicly, that calculator?
Dr Elizabeth: I'm not sure how publicly available it is. We actually have access, and we utilize that in our patients to follow it. But it's great, because these other tests are expensive. And if I want to put you on a protocol and then see if I'm making headway, how do I follow that? So, I don't think people know that, for instance, what is one of the most valuable numbers on your CBC? It’s actually the size of your cells, the mean cell volume, and the rest of distribution?
Lisa: Yes, I'm just studying cell distribution.
Dr Elizabeth: Isn’t that fascinating?
Lisa: We are completely unaware.
Dr Elizabeth: And have any of your listeners have had the doctor ever mentioned what their MCV is? Or their RDW is? And those are very, very important. So is albumin. So albumin alone, which is not just dietary. There's a great study that you could predict who is going to get out of the hospital alive based on their albumin levels. And so simply looking at things like that. So if your albumin levels are low, maybe it's because you're not eating enough protein, but that doesn't—it tends to be something else wrong.
Lisa: Liver not doing something.
Dr Elizabeth: Definitely. And sometimes that's the need for more beta carotene. Sometimes it's need for more copper. Copper has to help carry the albumin and copper deficiencies are super low. Nobody measures copper. So, you can look at a low albumin and try putting somebody on a little copper, it’s quite GHK copper as a peptide, I might get to the fancy stuff. Using copper as a peptide is an amazing peptide. It's very longevity promoting because copper is super vital to our health. And so sometimes just putting people on two milligrams of copper can markedly improve their health.
Lisa: But isn’t there copper’s also a toxicity problem? Isn't that quite a lot of people have high copper levels?
Dr Elizabeth: Less than you think. So it's gotten a lot of market to that, right? It has to be that zinc copper balance has to be imbalanced. So that's one of the things. But actually, copper toxicity is pretty easy to tell. When people become copper—toxic on copper, you'll see the lunula, the fingernails start turning, a little discoloured, a little bluish in colour. So it is a little harder to get toxic in copper than people think. I use it a lot for wound healing in my patients. So, it really helps with wound healing. It's why it's in all skin, expensive skin creams, copper peptides are because it's so good for collagen function, it’s so good for wounds. So I think we may scare people a little bit from copper. But it actually has some value.
And a lot of times, it's not so much that you have too much coppers, you don't have enough zinc and that balance is not there. It has to be balanced between zinc and copper. So those are simple things that you can actually look at and measure. And you can—I don't have to do it on everybody.
So I see somebody who has a low albumin, I might say, ‘Hmm, we better look at your zinc and copper level’. So we take the CBC and CMP. And how about simply creatinine? If your creatinine is above point eight, that is not good for longevity. So, why is that?
Well, maybe you're eating way too much protein, right? We will erase any high protein diets, super high protein, the kidneys can only process so much protein and your kidneys depend on your genetics, maybe less. So that's all things I think you have to go back when you talk about foundational health.
I spend literally 30 minutes going through a CBC and a CMP with people. They’re so valuable, and those are $12 tests. Not these big, fancy, expensive tests, they don't cost $500 or $600. And by the end of that test, I can give them, this is what your biological age, your pheno age, this is where we really need to target and start with them some very basic, inexpensive things.
Lisa: Crikey dex, that's amazing. I didn't know we can get to that. I mean, I've only been studying blood chemistry for a couple of months and like it's a big topic isn't it?
Dr Elizabeth: It has some really cool value to it that you can actually look at. Some ranges that—we have all gone from the normal range, right? All your listeners now know this the normal range, there's an optimal stage. Within that optimal range, right, there's one number above that you'll see you start to see a change in ageing. The curve on your projected longevity, you look at albumin levels, and you look at the curve on your projected longevity. If your albumin levels are less than 4.6, your projected longevity is five to 10 years less than somebody who's above 4.6.
Lisa: Crikey. No one's ever told me any of these things and I’ve been studying blood chemistry and from functional doctors, like that's all news to me.
Dr Elizabeth: Yes, I think that that's the problem. I think even the functional medicine space sort of went beyond the step of looking at some very, very basic things that are inherent to life. And now start focusing, ‘Oh, let's look at hormones, right? Let's look at the gut microbiome’. All super important, but all going to be messed up, if the other stuffs messed up, right?
Lisa: You’re basically not in the right place.
Dr Elizabeth: And so I—that's where I get a little frustrated. So now we're targeting back to that whole cellular health, it all comes back down to the cell, fix the cell. As the cell gets fixed, the mitochondria get fixed, everything else falls. So once you've refined that now, we can look at gut microbiomes, if the person is not doing well. We can look at things like micronutrient profiles, and I love micronutrient profiles because I don't know if how much vitamin D you need or how much vitamin B12 you need. Micronutrient profiles, particularly one that gives me intracellular and serum levels, as you know genetics plays a huge role in your micronutrients.
Lisa: Yes, vitamin D, for example. I mean, I know I have bad vitamin D genetics, so I need to supplement with vitamin D. Right?
Dr Elizabeth: And B12, you've got the SUV people of B12. I’m one of those who need a lot of B12. It's all very genetically based. So, you can predict it from genetics. But then are you accomplishing your goal? I think you need some…
Lisa: Measurements. And this is where the combination of what I'm—like the combination of doing your genes and finding out your innate pathways and what they do, and then seeing actually where you are, getting that snapshot of ‘Okay, we are actually in their hormones and stuff’. And it's quite complicated.
And this is the problem is that you go to your local doctor, at least here where I live, and none of this is offered. And none of this is—and so you left as a lay person trying to work this stuff out yourself. And that's quite frustrating and quite difficult.
Dr Elizabeth: It's hard. And it gets caught up again, in the glitz and glamour. I'm going to be attracted to my podcast that's talking all about the coolest, newest thing, it's just our nature is to want the coolest, newest thing. And we just talked about that. We want that cool new thing, because that is on the forefront. And we use those cool new things to help fix the basics. But you still got to know where you are in that standing, and that's really now become, I think, one of my frustrations as I'm seeing more and more people walk in my door, who are doing everything they’re thinking of.
And so we are trying to teach people this. We're trying to teach people how do you interpret your own blood work? How do you look at every one of those parameters and say, ‘What should my albumin be? Okay, it's too high, it's too low. What can I do to fix that’? Whereas, if my MCV is, mean cell volume. If your mean cell volume, and you look at your own. As we age, I look at my 19 year old son, he has a mean cell volume of 83. If I look at your average person who's in their 50s, and 60s, who's our age, it's going to be 97, 98. So the higher that number goes, the more your stem cells are wearing out, the more your bone marrow is wearing out, the more that whatever you're doing isn't working.
So we can use those things, like you can use your infrared, you can do all those great things. Me, I infrared, I cryo, I do all that. But I will tell you some very basic stuff that sometimes has been the things that made changes in those numbers. I want people to know, that's them that, honestly, is why we decided you're never going to train doctors, you've got to train people. But we've also got to get people back to understanding that you've got to sort of learn these things and kind of a fashion of can learn this, learn this, learn this. When I understand everything about how hyperbaric oxygen improves my cell function, have I really learned how to just look at the cell at that molecular level from looking at basic labs? And that's what we're trying to teach people. Start there, and then we give them tools.
Lisa: Fantastic. So people can join Dr Yurth, and get us some of this education. And I've started delving into it and I can't wait to see what else comes along because I mean, this sort of stuff, I'm like already going, ‘Oh my god, I didn't know that’. So I've learned something today already as well. And I'm very definitely guilty of going after the shiny object and love it.
Dr Elizabeth: It’s human nature. That’s human nature.
Lisa: Yes. And so people can go to the Boulder Longevity website and I'll put the links in the show notes and there is a Human Optimization Academy, join up for that and it's actually free at the moment, isn't it, Dr Yurth?
Dr Elizabeth: Right. Right now, it's free. And we'll start putting together—so right before COVID hit, we actually had an in-person course. We're actually going to teach how to look at your own CBC and CMP. And COVID hit, and it all sort of fell apart. But we'll be putting that back into sort of a virtual course with people so you can actually get your bloods run. We will walk you through. So, here's how to interpret every one of those little numbers you see on there because I will tell you, every one of those little numbers is important. Everybody just looks at it as a piece of paper, and there's no red marks highs or lows, they sort of discard it. And we'll show you how to look at that and give huge value.
And just from those simple things, you can now say, ‘Maybe I better get a micronutrient panel’, or at least test a copper or zinc or a B12, or D based on some of those numbers that you see being off. And then take the tool, now fix the basics. ‘That's not working? Okay, now, maybe I need to add this, this, this’.
Lisa: And then now we can get fancy. Well sign me up for that course because I need it. And I'm already up on some of it, but I wasn't that familiar with some of the things you've just said. So like, that's just like, well.
Okay, so we're looking at foundational stuff. Now let's go and look at cellular health, per se, because it all comes down to the cell. The more I look into things, the more everything seems to be about mitochondria in the cell, and what they're doing. and when we're made up of what? 10 trillion cells or something ridiculous. So cellular health, can you give us a bit of a view—it's a big topic, isn't it? But where should we start?
Dr Elizabeth: Yes, well, I'm going to start with first kind of explaining what that means. So, functional medicines, we went from a disease-focused medicine, right? And then we all got very savvy—well, not the doctors—but the rest of the world who got very savvy said, ‘Oh, this isn't working. It's making somebody money, but it's not working to make anybody happy’. So we went to a functional medicine part. Let's look at organ systems and let's start. So then we went to the organ system, let's look at the adrenal glands and let's look at the liver in this and let's now fix the organ system that's dysfunctional. we got to fix the thyroid, we got to fix the endocrine organs and we have to do all that.
And then now, and this is really super recent, we're realizing that every organ system comes back to a cellular dysfunction. And there's not really anybody who has one disease that is not have something else wrong. It's just impacted lots of times in different ways. So if I have osteoarthritis. So if you have osteoarthritis, your risk of dementia is about fivefold higher. So why is that? Right? Osteoarthritis... because I ran 800 miles a day. But that's not the case, I have patients who run 800 miles and they're fine.
Lisa: Oh, I'm fine. Like, my joints are fine, and I haven't got any osteo.
Dr Elizabeth: And then you have people who are like, ‘Oh, yes, I just wore myself out because I ran too much’. No, not the case. So, there's something wrong. So now we have to go back and look at what is wrong in the cell. So if you think about what power, what is the cell all about? It is the mitochondria. Mitochondria, what gives the cell energy, right? And so as we start getting damaged to our mitochondria with time and life and environment and genetics, and we start getting damage at the mitochondrial level. So, now have these damaged mitochondria. And now we start getting these cells that are in this altered state of energy. And that's when you start getting that senescent cell—cells that are basically sitting there…
Dr Elizabeth: They’re zombie cells.
Lisa: And there's zombie cells, right? And they're producing these reactive oxygen species. And that's why they're called zombie cells, it's because the things that are being spewed out, are now toxic to the cells around them and then toxic to those cells. And so, it truly is like a zombie takeover.
So that's where we look at when we're going back to a cell level. First thing we have to do to try and heal any disease is clean out the bad cells. Clean up the zombie cells. That’s why fasting has been utilized for years in every disease process because we know that fasting causes autophagy, causes bad cells to go away, and now we can rebuild. I think one of the biggest mistakes people make is that if I start throwing a lot of rebuilding things into my network, tons of NAD and I'm trying to always be in this state where I've got a lot of antioxidants going. I'm throwing a lot of NAD and well then, I'm actually contributing to that cell senescent state. I've got to get rid of that first.
Clear out the bad stuff and do that periodically. And we use things like rapamycin, you can use it for fasting. And most recently what my go-to has been this spermidine for that talk. And I fell in love with spermidine a few years ago, actually and couldn't get it here in the US. That basically—it came onto my radar because there it worked at a very sort of primal level. Every single organism has spermidine. Anything that every organism has, is vital to life. And so we know that—and then all these studies that show that well, if you have higher level spermidine, you live longer, so.
And it was only available in—I don't know if you guys could get it—but it was available in Europe.
Lisa: I’ve just got my first order on its way. But I had to get it via Colorado, and I've actually being in contact with the guys in Austria. So, working on that one, I'm getting it down here.
Dr Elizabeth: We couldn't get it. And like six months or so ago, we finally could get it here in the US. And it works as an autophagy inducing agent. It basically tells the cells to get rid of the bad stuff, it helps to restore the good parts of the cell. And really, at a baseline level is probably the one supplement that I know of, and probably the only one I know of, that is going to be actually balancing cell health continuously.
Lisa: So it's homeostasis as opposed to...
Dr Elizabeth: The homeostatic state. Right.
Lisa: So like, just to backtrack a little bit there because we covered a heck of a lot of ground in a very short time there. So, fasting, I mean, we've heard, like fasting and intermittent fasting and longer fasts are very, very good for us and all that. While a lot of us don't want to do it because it's not very nice... I do intermittent fasting, but I must admit, I don't enjoy it. And I certainly—when it comes to doing longer fasts, I struggle. So I'm always like, fasting mimetics, how can I get some fasting mimetics going? Because like you say, if I'm going to put in the antioxidants, the precursors, which I do as well, which are very important piece of the puzzle, but just that is not enough. So, this is like we've looked at in the past, like resveratrol as being a possible fasting mimetic. And wouldn't it be great if spermidine turns out, and it looks like it is going to be another fasting mimetic that's actually even more powerful. So, I know you do a lot of fasting, you're very disciplined, unlike myself.
Dr Elizabeth: No extra weight, I still have extra weight so fasting’s easier for me.
Lisa: But yes, it is a difficult thing to do. So intermittent fasting is probably for me is the easiest go-to because I can sort of coke for it.
Dr Elizabeth: Time-restricted eating. Really, yes, more doing a 16, 8, kind of thing as opposed to the longer fast. And there's a lot of questions, we don't really know, do you need to long fast? We actually don't know the answer to that. There's a lot of people who say, ‘Oh, you've got to be hit the 48 to 72 hours to really get the full autophagy phase’. There's not a lot of data that actually really says that. You may still be able to get the same benefits from doing time-restricted eating. So we don't know the answer to all these questions.
Lisa: But so what we're targeting with fasting is autophagy. So, autophagy, just to define what autophagy is, is getting rid of the bad stuff, basically. The bad proteins that are damaged, the mitochondria, or mitophagy, in that case. And recycling the parts that we can reuse and getting rid of it. Does the body sort of lock at it when you're fasting, and you haven't got anything coming and going up, ‘I've got no fuel supply, I better start recycling the old stuff’.
Dr Elizabeth: Yes, exactly. Yes, autophagy is self-eating. And so basically, the cell basically says, ‘Oh, I need to preserve. I'm going to take the good things from the cell, get rid of the bad stuff I don't need. It’s a waste of energy. Getting rid of cells that shouldn't be utilizing my energy’. So and then really by going into a ketotic state, and that's, not utilizing glucose has a huge benefit.
Lisa: So ketosis and autophagy, are they hand in hand? Are they part of the same thing? Can you have autophagy without being in ketosis, or are they very much married together?
Dr Elizabeth: No, you can actually have autophagy without being in ketosis. And you can basically be in ketosis and not necessarily have autophagy. So that all kind of depends on the cell, the state the cells in.
One of the problems with resveratrol as a fasting mimetic, you mentioned taking resveratrol continuously, is there's also very potent antioxidant. Remember, one of the benefits of fasting is oxidative stress. So, I want oxidative stress while I'm fasting. If I'm taking resveratrol, for instance, while I'm fasting, I'm actually not getting as much of the oxidative stress. So, it's working a little different level. That's why I like spermidine a little bit better as it doesn't have that same effect to sort of negate the oxidative stress.
Lisa: And for how long for people to get their heads around? I know because I mean, I've been struggling with this one, like the antioxidants sort of paradox. Yes, sorry, you carry on.
Dr Elizabeth: I think the key to remember is you really don't want to be doing any protocol continuously. I was just talking to a guy and he said, ‘What do you do to look like you do’? because I have more muscle. And I said, ‘I don't do anything continuously’. There's nothing—workout, nothing continuously. My food, my eating is never continuously, my supplements are never continuously.
And I think it's a problem as people get in these patterns where they are taking all these antioxidants continuously. I always am going through build-up, breakdown phases. So there's only a few supplements that I will continuously take. One is, I will take spermidine at a baseline level. But if I'm doing a sort of a fast autophagy phase, where I really want to do a big tie up off of everything, I want a very high dose spermidine, much higher dose than just until that time of day.
Lisa: Because spermidine works at a level lower if you like, at the base level. So, when we're talking about antioxidants, what the job is in the cell is to basically scavenge and donate electrons to where you got oxidative stress, and reactive oxygen species and to get rid of it there. But we're actually going a step back and actually stopping the reactive oxygen species, or oxidative stress from happening in the first place. And this is why spermidine at that base level, seems to be one that you can take continuously. And it even builds up to some degree, perhaps in your body or upregulates some of the bacteria in the microbiome. And whereas, antioxidants, we want to sort of cycle in and out. It's like exercise, isn't it? Like when I go to the gym, I'm not going to have my vitamin C right next to when I go to the gym, because that's going to mitigate that cascade of effects that vitamin C has. Yes.
So I'm doing things. I'm taking my vitamin C away from that. And so there's, none of this is good or bad, it's cycling. And I think the more I've looked into things, the body likes this push and pull. It likes a medic stress. It likes to be cold. It likes to be hot. It likes to be pleasant, but it likes to be fasted. It likes to have a good amount of food. It's this whole—because that's how we've evolved, isn't it?
Dr Elizabeth: That's the way life for it was, yes.
Lisa: We didn't come from this neutral environment where the temperature is the same all the time. And we're sitting on comfy couches, and we're not exercising and we're not cold, or we're not hungry, and we're not hot, and we're not not anything, and we've got an abundance of everything. And therefore, if we look at our evolution, and how we've come about that sort of a push and pull seems to go right through nature.
Dr Elizabeth: Yes, you're exactly right. Remember, there's that balance between mTOR and AMPK, right? We know that AMPK is breakdown. And we know that when we block mTOR, our lives are longer, but we also don't build as much muscle and we don't have as much energy. And what you do is go through phases, build up mTOR, build up AMPK, build up and do that balance, so that you keep things in a very homeostatic state. And you said exactly right, there's great benefits to being hot. You have all the, how great being cold is and doing our cold showers in our cryo and everything. But there's a study that came out recently, I think I quote it in some podcasts I was in recently, that showed that in hotter environments, bone density is much better. So why is it that?
Lisa: Yes, I heard that.
Dr Elizabeth: There's some effects from the warmth on our body too. So you're exactly right. We want to go back and forth between different things and we want to make sure we're cycling. Any of you who are staying on the same patterns all the time, that's not serving you. Your body needs to have this back-and-forth balance. And you're right, that is—whenever you give the quote of well, ‘That's how cavemen lived’. You're like, ‘Well, but cavemen died in 18 whatever’.
So how our evolution occurred, right? It's still what, what got us to survive. And it really is how our world is designed, and it's how our cells are designed.
So I think that the use of thinking about your body as ‘Okay, I'm going to go through a fast, autophagy phase, and then I'm going to build up and I’m going to build my muscles’. You can build muscle while you're in a fasted state, but it's not nearly as easy as it is when you're eating a lot of food.
Lisa: Yes. And but we're wanting to keep everything in balance so that it doesn't get just mTOR because, if we're in a state of like, activated mTOR all the time, then we are growing, but we were possibly growing things like cancer cells and things like.
Dr Elizabeth: And we know that mTOR activation all the time is closer to death.
Lisa: But isn’t it weird, like there's nothing simple about...
Dr Elizabeth: It actually, honestly, it makes very little sense to me, right? The things—the mTOR, everything's muscle building. Super high IGF all the time and it is muscle building. You would think it would be kind of pro longevity, right, and healthy, and yet, it's not. And the only way I can really—in my mind, reason that out is that if the zombie apocalypse hits, you're better designed to be able to survive without any food and without any—nothing just huddled away in your little house, right? And so maybe the evolution of our body that's for longevity, the genes have kind of stayed there are the ones that really make us survive through famine, right? And yet, that's probably not where we all want to be. We don't want to be huddled in the back of our houses not moving.
And so yes, if you look at Valter Longo and his research on—really low IGF people live longer, they don't have cancer. Yes but they actually don't necessarily feel great. And they don't necessarily see low IGF people all the time, who are fatigued, who don't have good energy, who can't build muscle, who don't exercise. So I think that the thing here is build your IGF, bring it back down, build it up, bring it back down. So, I think that that's where we really need to look at things, as this kind of waxing and waning of everything we do.
In our cellular medicine fellowship program, it's one of the things we're really, really focused on is that's what the cell needs, is a push and pull to it, to really help it become a healthier entity. And I think if we start doing that, we're going to start seeing that that's really where we're going to see that big focus to health and longevity occurrence. It's not going to be ‘Everybody eat this diet’.
Lisa: No, no. And this is like, even as a coach of athletes and stuff. And I did this in my athletic career where I didn't know all this stuff. I ran long, because that's what I do, it was ultra-marathon running. And that's all I did. I didn't train at the gym. I didn't do—and I was not fit. And I was not healthy. I could run long because I've trained that specific thing, but I wasn't healthy. I was overweight. I was hormonally imbalanced. I ended up with hypothyroid. I couldn't have sat on the couch and ate chips all day and probably come out better than I did. Because I'd been doing one thing and one thing that was actually not suited to my genetics either, ideally. And so understanding all of this is not as simple as well, ‘I'll go and do the same old thing, same old and then we'll be good’.
I want to sort of flip now and go a bit of a deep dive into spermidine because I think spermidine is the one thing that, this is going right down to the base level of before. Because we want anti-ageing. I mean. We compared ages before this podcast and I mean, I won't share your age, but I was shocked. You look amazing. And I'm like, ‘I want a piece of that’. What is it that you're doing? So spermidine is a part of your—that is one of the things you do take on a pretty much a daily basis. Can you dive into the research? There’s 10 years behind the spermidine and it's only just becoming available. Guys in New Zealand, it's not here yet. I'm working on it. Give me time, I'm getting, I'm working on it.
Dr Elizabeth: So, what we know is as we talked about spermidine is on every single living organism. So, we know it's critical to life, it's what's called a polyamine. It's what a three poly means is spermidine, spermine, and putrescine. And they all have some value. Putrescine is what's in rotting meat. You're probably not going to go eat rotting meat. But there's actually some value to putrescine in our bodies, too. Spermidine appears to have—spermidine is converted typically this into spermidine. Spermidine is innately in our gut. So, it's made by our gut bacteria but it's also in some foods. It's in some a lot of fermented foods, in wheat germ extracts. It's in some peas and mushrooms. It's in some algae.
Probably the richest source of it is a specific type of wheat germ extract. It's apparently very difficult to extract, it's only a certain type of wheat germ that has it's difficult to extract a pure form of it. And so, there is companies that make it from algae as well. But you have to take—actually before we could get spermidine from spermidine life which is wheat germ extract, we actually bought an algae extract one. You really had to take 40 of these little green pills. I mean your hands are green, your teeth are green all the time. 40 of them, I mean, I did that because I wanted it but once we got spermidine.
I get the question all the time about well, it's wheat germ extract. Interestingly, I've celiac patients on spermidine and even though it's not advised for celiac patients, it probably actually is perfectly safe because it's actually working on one of the pathways, that's what makes the gluten exactly unsafe those patients. So, it's probably even if you're—I'm very gluten sensitive, I don't do gluten. I have no problems in spermidine. So, it tends to be pretty well-tolerated in those people.
Lisa: Yes, but I've got a brother who’s recently examined and she said, ‘Yes, I can’.
Dr Elizabeth: Yes, I have two celiac patients on who've done fine. And again, the bio says not to take it if you're celiac, but I think cautiously, there is some research that supports it actually may be useful in treating some of the celiac patients.
So basically, the study is now—there's so many studies on it. In terms of preventing almost every disease in the book, and that's where you and I come back to that whole, is mitochondria the answer to everything? Because we've seen spermidine—you can Google spermidine. I do this. I mean, Google ‘spermidine and Alzheimer’, Google ‘spermidine and cancer’, there's not a disease that we don't have a study on where you can find some connection to higher or lower levels of spermidine being better.
Some of the major research has been on cardiovascular and its benefits and cardiovascular disease. It's one of the things we've been using when we see high inflammatory cardiovascular markers in our patients. We measure what's called myeloperoxidase, which is an inflammatory cardiovascular marker. It's interesting, we've seen it very high in our lot of our post-COVID patients. So patients who have had COVID recovered, coming for labs, we're seeing very high levels of myeloperoxidase. So, we think that's probably from some of the vascular damage that COVID seems to create in some people with certain genetics. And that’s very hard to bring it back down, and spermidine has been one of the things that's been really helpful there for us.
So, it's also any of your patients who have a high Lp little a. Yes, so by Lipoprotein little a, you'll know is basically genetic.
Lisa: Yes. And there's not much you can do.
Dr Elizabeth: Nothing much you can do about it. You use high-dose niacin, but it's hard to take, the liver toxic. Spermidine actually has some research to support it in lowering Lp little a and we've seen that in our practice, it's one of the things we lower Lp little a. So the other place that's been really studied is an immune system support. So we've seen improvements in lymphocytes. So, one of the other labs that you want—when you're looking at that CBC is looking at your neutrophil-lymphocyte ratio.
Lisa: Yes, I've just like I've got a problem with my brother at the moment, lymphocytes, neutrophils down. No, sorry, your neutrophils down, lymphocytes, high.
Dr Elizabeth: That's a little uncommon, that might indicate some kind of viral illness going on. Typically, what happens as we age is, we start to see the lymphocyte number go down and the neutrophil number go up. So that ratio, which should be around 1.3:1, 1:1, 1.3:1, starts climbing. If you look at the typical person our age is, 3:1. And so, it's hard to get—how do you get back lymphocyte function? You don't have thymus glands anymore. And so the two things that we've been able to utilize to really restore lymphocyte function in our patients who have ageing immune systems is spermidine. And then the other one is a peptide, thymosin alpha-1, which is a thymic peptide.
What our thymus gland does is it takes those two lymphocytes, it tells them what to do and, and once—your best immune function is at puberty. After that, your thymus gland starts getting smaller. And by the time you're 60, you don't really have much thymus gland. And so your immune system starts going a little haywire, it doesn't know what to do. And so what we can do, because really crazy people are trying to transplant thymus glands, or eat sweetbreads, which doesn't work. They do it in France, maybe they taste good, but I don't think it replaces your thyroid function. But you can get thymic peptides. So, two of the things that the thymus gland really makes is thymosin alpha-1 and thymosin beta-4. And thymosin alpha-1 is a very immune modulating peptide, and it really helps to restore normal immune function. So, the combination of spermidine and thymosin alpha-1 and your people who have immune dysregulation, autoimmune diseases. You could start normalising the immune function. So instead of attacking self they start attacking viruses.
Lisa: Wow. And autoimmune is just like, a huge, huge problem. I mean, it's just epidemic levels now.
Dr Elizabeth: It is epidemic.
Lisa: Sorry, so this would help with that. Oh, my God. Okay. So that's another reason to take spermidine and the peptides. I mean, peptides are harder to get hold of like…
Dr Elizabeth: It’s still harder to get hold of. Your people who are in Europe, thymosin alpha-1 is actually a drug. It's called Zadaxin. We can't get it here as a drug. We've made us a peptide but it actually is a drug. They use it in their chemotherapy patients in Europe and Asia. And so oddly, it's available as approved drug. Probably pricey.
Lisa: Most of these drugs are for some unknown reason.
Dr Elizabeth: Yes. Spermidine—someone's early studies and where it actually sort of panned out, as people went after it initially was actually hair growth. And again, if you think about, the tissues, we're talking about, like cardiac here, those are all fast-growing tissues. And that's where spermidine sort of had its nice effect and sort of that whole regeneration process. And so even in guys with thinning hair, spermidine has huge benefits. Just taking on like a milligram a day dose will start the thickening of hair. I noticed when I first started, my nails grew really fast means, I mean, super fast. And so even in those basic things, like hair growth, nail growth, spermidine has some really marked effects.
Lisa: Fantastic. We’ve got to get it here.
Dr Elizabeth: Yes, it is amazing. I mean, honestly, I feel a little—whenever I see my patients now and I see something wrong. I'm like, ‘Well, spermidine, oh’.
Lisa: Yes, yes, yes, yes. And this is all to confirm because it's such a wide panacea, and it works at base level of the ageing and pathologies and things…
Dr Elizabeth: It’s too good to be true.
Lisa: It's too good to be true, but actually now, it makes sense. And so, it’s fantastic if we find something that is a panacea for many, many things. And also, I've got my first shipment coming from the States, and I'm super excited.
Dr Elizabeth: One of the hard things in what we do, right, is it takes you awhile to feel better, and just starting from a low level, right. Or if you're like us, and you're at a high level, then making this little extra. And so, what I tell people to monitor, because one things I noticed was, when I started spermidine was a pretty—I don't sleep enough, I study too much. But I use my Oura ring, and I monitor my HRV. And so, I know a lot of your listeners have the Oura ring and HRV is very fluctuating. And so it's one of those things, it's very easy to see a change.
So, if I do something like start taking spermidine, I can say no, and you can look at the trend on your Oura ring. And you can say, you can take—started spermidine here, and I had about a 15 point jump in my HRV, which I won't say what it is because it’s just from starting spermidine. So I know it's doing something at a very basic level because HRV is predictive of almost every disease state; so low HRV, you know you have a higher incidence of all Alzheimer, we know we have a higher incidence of cancer. So I know if I'm affecting my HRV, I'm positively affecting my health.
So something really simple that you can do to say, okay, I started this here, and then look back in two weeks, go to your little trends thing and see ‘Wow, look, my trend is going this direction’.
Lisa: Wow, I can't wait to see that because yes, I mean, I haven't been able to move the needle on my HRV really.
Dr Elizabeth: Yes, me neither. And mine's not good.
Lisa: Yes, and mine isn't great either.
Dr Elizabeth: Yes, the downside of sometimes what we do is we're reading all the time and staying all the time and trying to do too much and…
Lisa: Brain doesn’t turn off.
Dr Elizabeth: And that's not so good.
Lisa: Adrenaline driven.
Dr Elizabeth: Yes, so it is really, honestly one of the first things I did that really made a dramatic change.
Lisa: Wow, I will let you know how I go.
Dr Elizabeth: Yes, let me know.
Lisa: When mine comes, whether my HRV is now turning up.
Dr Elizabeth: I will say sometimes you need a higher dose which gets pricey.
Lisa: And this is the problem with everything, it's the same with the deep precursors and all the stuff that's fantastic, it does cost. But you know what? I don't have money to burn but I would rather go without a fancy car, go without fancy clothes, go without cosmetics, go without all that to have supplements that work or to have biohacking technologies that work because that's my priority, it’s my health. Because what good does it do me if I have a fancy car, but I'm sick?
Dr Elizabeth: I know. And it is funny, I was giving this lecture and this woman came in, she asked how much this program we do cost? And she said, ‘Well maybe when I pay off my Lexus, I'll be able to do that’. And I'm like, ‘You’re really willing to spend a lot of money, a $1,000 on an iPhone and’...
Dr Elizabeth: …and car and we just still have to keep putting this focus on your priority, absolutely has to be this your health? And it’s so hard to convince people of that.
Lisa: And I'm constantly shocked at people who expect to like, they take a supplement and they don't see anything change for three days and then they're like, ‘It didn't work’. And I'm like, ‘You've got to be kidding’. Like you know your hair is growing, right? But do you see it growing every day? No.
But if you keep going—and with my listeners have heard me rabbit on about my story with my mum and bringing her back from a mess of aneurysm. The reason I have been successful with her is, is not any one particular thing. I mean, yes, hyperbaric, yes, all of these things were a big part of the puzzle. But it was the fact that I keep going when there was no signs of improvement. And I keep going every single day for five years, and I still go. And that is the key is that persistence. And that just keep doing it and prioritizing this, even when you see no results. And that's a really hard sell because people want to see, how long will it take for this to kick in?
Dr Elizabeth: I think it's one of the hardest things about our jobs is—listen, it is very hard. But this is stuff that I'm looking at a future that's 10 years, 20 years, 30 years, 40 years down the road, I know these things—I know that they do, they've been proven. So to say they're not working for you is why in every study did they work and oddly, they don't work for you? It just doesn't make sense. It's just that if you go back to that cell level, by the time my knee is arthritic, number one, I've already lost 25% my cartilage, that process started 30 years ago. Now I've got to go and fix the cells at the very base level and then start repairing that cartilage.
Lisa: And it takes time.
Dr Elizabeth: A long time. Right?
Lisa: And you didn't wake up one day with wrinkles and grey hair, it happened as a process over time. But I know that if I'm doing all these things that I'm doing, in my anti-ageing strategies that in 10 years’ time, I'm going to look better, feel better than if I don't. And that's the bottom line, or hopefully still be alive and avoid cancers. Those are my goals.
Dr Elizabeth: You have to trust the research to some degree, right? If something's—there's not research—and that's hard cause you have to weed through a lot of research, right? And you have to say ‘That study is trash, that study’s trash’. Well, actually, ‘Here is a good study. This, this, this, here's a good thing’, and then put it all together. And I do this. There’s a fresh article, I go, ‘Here's an article that says this, this, this’. And it's not until the articles that outweigh the articles that say that the negatives by a certain amount that I even say, ‘Okay, this is a reasonable thing to do’.
Lisa: And that's where you like your spermidine, there is 10 years now because it's 10 years of full-on research and in many places and in many different diseases, where like, now that you're willing to say, ‘Yes, this stuff is actually looking really bloody good’.
And we are learning all the time, the science is changing. And I think this is what frustrates people too, is that you can go on—I do this, go into PubMed, and I do a deep dive and then you end up like, ‘Whoa’. One contradicts the other one and some of them are poorly designed. And so, that's why we need people like you who can interface that for us and go, ‘Hang on. I've distilled down into the most important things. This is what you need to know, guys’.
Dr Elizabeth: Yes, I'm involved with this group, it's called Seed Scientific Research & Performance among Faculty with it, and it's a group of really—we're doing a fellowship program in cellular medicine, but it's 25 mastermind doctors are kind of the group that we've been getting together and we meet quarterly. And we talk about the stuff and now you've got these brains, you have 25 brains of people who are not only reading and utilizing this stuff, and you can put it together and you can start weeding out what works, how does it work? Who doesn't work in? And that's what it takes. It takes people like that getting together and actually now meshing their minds and using their experience and all their knowledge and all their reading.
And so this group has been phenomenal for me because it's I'm forefront leading thinkers. Because even when you go to the conferences, if you go to my orthopaedic conferences, I just learned the same old stuff. So this fore group, but actually talking amongst ourselves.
Lisa: Such top-level people, I wish I could be a fly on the wall of such.
Dr Elizabeth: Yes, I mean, it's amazing stuff. And that's where we're going to make a change. And then you have to trust that we will bring that to you guys, but you got to stay tuned to people like you, Lisa, and the people who are trying to bring this to you because if you rely on medicine to do it, and your doctor to tell you it, you're going to be dead before it happens.
Lisa: That’s exactly what’s going to be.
Dr Elizabeth: Or feel horrible. I mean, I just lost both my parents in the past and also lost mum. They were in their 90s but my dad really kind of gave up. His arthritis has gotten so bad. He was a guy who at 80, he was climbing mountains, but at 90, he couldn't hardly walk because his arthritis was so bad. And none of us want to be that way.
Lisa: No, and this is why we're desperate.
Dr Elizabeth: You've got to do this stuff now. Ideally, in your 20s.
Lisa: Yes, exactly. Oh, we've missed that boat. I’m so sorry, you lost your parents. I mean, I just lost my dad six months ago. And again, he was super fed, 81-year-old, but he smoked and I couldn't ever stop him smoking and had an aortic aneurysm. And then I was stopped in the hospital from giving him intravenous vitamin C because once again, they are way behind the eight ball in our local hospital, in our ICU unit, they'd have no idea of what vitamin C like they think it's an orange you take. And my dad died as a consequence of that.
And I can't say for sure, but I believe in my heart that if I had been able to give him the things that I wanted to give him from day one, ozone and intravenous vitamin C, and all the other stuff that I had up my sleeve, my dad will be with us still. And that just breaks my heart. And because I know that there's these things available, and we can't get it for our people?
Dr Elizabeth: I know, it's horrible. And then you've got the doctors—I mean, like with hormones. I put patients on hormones, their doctor takes them off the hormones.
Lisa: Oh, my God. And you've looked at the genetic pathways, you're not doing this out of—you’ve looked at it all. Like you know