Dr. Kay Durairaj 0:14
Well, hello. Hello, guys. You're listening to beauty bites with Dr Kay secrets of a plastic surgeon. Today on the podcast, we have Dr Natalia Mitton. She's a leading authority on immune aging and cellular senescence. So I want us, I want us, to learn more about biologic Aging. Aging clocks how, how and why. We quantify the trajectory of our aging. She's a really prominent voice in the science of aging and immune aging. She has a PhD in molecular biology and a foundation in chemical engineering, and she's served on faculty at UNC Chapel Hill before she's become the founder and CEO of Sapir bio. This is a longevity tech company that's reshaping how we measure and manage biologic aging. So I think you guys are going to be fascinated. Her studies have been investigating natural aging process and age related conditions like cardiovascular disease, metabolic disease, cancer, Alzheimer's. This work really allows us to do personalized longevity management and really empowers people when they understand how their aging clocks of their body are going down trajectories very quickly or very slowly. So, Natalia, welcome to the podcast. Dr Mitton, so excited to have you here and to learn about Sapir Absolutely. Thank you so much. Dr Kay, tell me why the name Sapir, Sapir, bio, Sapir x is your product. So Sapir is Italian or Latin for to know.

Dr. Natalia Mitin 1:43
And we thought it would be very fitting, because what superior bio as a company, sort of as a general goal of superior bio as a company, and our product line, that is called superior acts, sort of very for various populations, what we do is we're able to give you insights into your aging well before you feel like you're aging, or certainly well before your doctor notices your aging. So this aging happens well before you develop chronic diseases that we sort of traditionally think of aging. And so it allows you, because it's early, it allows you to understand your aging trajectory early on, so you can intervene early on and not wait till you have an onset of chronic diseases that become much harder to manage than early prevention.

Unknown Speaker 2:33
I think it's important for the audience to understand immune aging and cellular senescence. So can you explain why these are so critical to understanding longevity Absolutely. And I think it's, it's a really fascinating area of science, and longevity science more specifically, because sort of, we intuitively all understand that immune system is really important. And certainly, as we learned with pandemic, immune system is really important to protect you from disease and protect you from from those sort of environmental insults. But in the last few years, what numerous scientific studies started to understand is that immune aging is not just the aging of immune system, but immune aging sets off the aging for the entire body. So in every mammalian species, including humans, once you start to have aging in the immune system, that aging in the immune system is what ages the body. So if you look at the lifespan of different species, their lifespan correlates with the health of immune system. And what do I mean by the health immune system? So the term we use is immune resilience. And again, sort of it kind of sounds, it does what it sounds like. So it's a resilience against foreign things, whether it's viruses bacteria. So it's resistance to infections and its ability to suppress chronic inflammation, because, because immune system will respond. When you have a challenge, immune system will respond. And it's really important for the immune system to be able to respond, but then it needs to return to the to the sort of on, you know, on, on perturbed condition. If it doesn't, it creates chronic inflammation. And so as we age, kind of accumulation of this chronic inflammation, what's called sterile inflammation, is what drives the decline in tissues, and you're feeling fatigued and you're feeling achy and all of that. So sort of the ability to be resilient to your environment is basically is the health of your immune system. And so if we can measure that, if we can capture the resilience of the immune system, we can capture basically longevity trajectory, so we can understand where you stand. And specifically for cellular senescence, your audience might be familiar with it.

Unknown Speaker 4:56
Cellular senescence sometimes is referred to as zonal.

Unknown Speaker 5:00
Cells, and so in which we don't really like the term, but that's sort of colloquially what it's known for. But what that really means is when your cells undergo all sorts of insults, at some point, they decide that they are not healthy enough to continue being part of your tissue. And so they stop their normal function. But they don't die. They stay in the tissue, and they stay in the immune system, and they start to secrete these inflammatory markers. And so they create these pockets of local inflammation, and then inflammation spreads to healthy cells and converts them to senescent cells, and it's kind of starts the ball rolling. And so again, the ability to maintain low senescent cell load is really important for the health of the organism and immune system specifically. And so being able to capture those two things really allows you to look on the inside. We like to call it molecular mirror. It really allows you to look on the inside and say, Where are you on that trajectory? Because

Unknown Speaker 6:05
the sort of the ability to see that will precede all the other clinical presentations of disease. One thing that we like to kind of distinguish is, if you

Unknown Speaker 6:18
think about biological clocks, sort of the way, kind of the right to consumer products exist. They they report the values in years. So you can have a test, and the test will say that, you know, you're 45 but your biological age is 35

Unknown Speaker 6:38
and it's sort of, it's an easy way for our brains to kind of comprehend the number. But what it lacks is it

Unknown Speaker 6:49
lacks the it lacks the the depth, I guess, of sort of scientific meaning. Because what does being 35 mean? Like? What like 35 135? Is very different from another 35 so what does being 35 actually mean? Right? Because what we see when we look at our markers, what we see is there is a huge heterogeneity across the population. You can have 30 year olds who have markers like 80 year olds, and you can have 70 year olds who have markers of a 20 year old. So it's sort of so there's such a huge heterogeneity. Then anchoring to age, you kind of lose this ability to actually see where you are in a population. And so we feel like showing you, so in our reports we have, basically, we're showing you what the population looks like, and we're showing you where you are. So it doesn't matter what age you are. This is where you are. So you can anchor yourself to each group if you want to, but it it shows you where you are in a population, and then you can take it from there. And I think that's a really important distinction, because it's, it's simplistic to assign years it's easy and it's easy, like it's, but it's, it misses the ability to actually understand why does that make sense? That makes a lot of sense. Yeah, I think people are already seeing consumer facing biologic age testing kits. There's so many already that are out there. And then

Unknown Speaker 8:15
can you have any thoughts on those kits and how accurate there are? There's some controversy about it, because you can, there is, yeah, and there is definitely, so I think again, is there. So there is a, I mean, there is sort of in it. So sort of, you know, it can be very complex technical discussion, but there is, each test has accuracy, right? Anytime you measure something, there is accuracy, inherent accuracy, in the measurement. So, and that depends on, you know, instrumentation in the lab. It depends on sample stability, it depends on all sorts of technical things. What's more important is your ability to calculate these things. And so what we do is we measure the expression of actual markers. So when we give you a number, it's a number. It's the expression of that marker in your body. What biological tests do is they measure it, and let's say, 1000 people, and then they do the model. They build the model, right? They say, on average, a 30 year old will be this, and the four year old with this. So they kind of create the model for the population. So if you are an outlier, your number will no longer be considered. And so you sort of, you create the average population, and that's where the difference comes in, because when everybody's reference point is different, if you take measures from different companies, in addition to just technical measurement precision, there is also, kind of, everybody has different algorithm, so you can take different measures from different companies on different days and have a difference of, you know, seven to 10 years. And again, it like because you're converting to years, it becomes nonsensical because you can't be different by 10 years, you know, since last week. But that's how the number comes back. And.

Unknown Speaker 10:00
So I think it's sort of the in the in the pursuit of simplifying things, I think sort of the the biology and the science of it got lost. Yeah, there, there. I know there was a recently, a woman who lived to be age 117

Unknown Speaker 10:17
or 118 and they looked at her biologic markers. Were you able to read that article? And what did you think of that? So that's that's so, yes. So there is a woman. So she actually was born in California, but then she lived most of her life. She lived in Spain, and so she is the longest centenarian. So when she was 113

Unknown Speaker 10:37
they collected a sample of everything, and then looked at gene expression, protein expression, metabolite, I mean, sequenced. I mean, they did everything they could think of, right? And it was fascinating. So there were serious reports. The most recent one came out a month ago, maybe a couple months ago, and what they found is what was specific to her and why she was healthy is her ability to resist viral infection was like that of a 30 year old. She had really low chronic inflammation, and then her gut health was really good, and they attributed it to her having yogurt, like full fat yogurt, like three times a week, or something like that, for decades, right? So, but it's the ability to maintain the gut health and therefore suppress chronic inflammation and ability to resist the infections.

Unknown Speaker 11:26
That was the feature, right? So it's, again, shows that and she had, she had genetic predisposition to cognitive health, like she she had other genetic traits that obviously, you know, allowed her to live to 117

Unknown Speaker 11:40
but on the sort of on them, she was resilient, right? So her body, her biology and her lifestyle allowed herbit to be resilient to these stressors. And so it was really fascinating, because it's, you know, it's kind of one technically, but it just shows you that, you know, immune system is really important, yeah, when everything comes together correctly, it has a really, exactly, exactly, how early in life do we start having senescent changes in our bodies? Is it after puberty? Is it in our 30s? So, so the So, to give you an idea of sort of how hard to do this, so you the out of billions of cells you have in your body, up to 5% can become senescent. So it's a very tiny fraction of cells that can ever in your lifetime become senescent. So measuring the cells becomes really tricky, tricky because it's a super low amount of cells. So we are able to detect senescent cells in

Unknown Speaker 12:41
like in the natural aging setting. In in adults, young adults, 1819, 20 year olds, if children who had like, for example, they had cancer treatment. So if you had sort of other things that can potentially accelerate DNA damage, you can detect it even in sort of, you know, in their single age years. But in general, young adults already have sort of levels that you can detect by the assay.

Unknown Speaker 13:09
And then it's, it's, it's really fascinating, because, again, there is, sort of, there is this really tight connection between immune system. So immune system

Unknown Speaker 13:19
is, is capable of monitoring senescent cells and depleting them. So it has that surveillance capacity. And so if your immune system is impaired, like, for example, you have asthma as a child, you will start accumulating senescent cells much faster than a 20 year old that doesn't have asthma. So it's sort of this ability of so there is a so we like to think of it as kind of, there's two pieces to it. There is induction of senescent cells because, you know, you have too much stressors you like, it's either physiological stress or maybe you're like, over exercising. That was another interesting finding, that people who over exercise routinely will have increased cellular senescence, which is kind of the opposite of the goal of exercise, right? But then breaking down the immune system is also what allows for the senescent cells to accumulate, and so being able to measure all these components, that's sort of again and again and again. The feedback we get from clinicians is being able to look at individuals domain, individual domains, and ask a question where the breakdown is happening. Allows you to understand not just the immune system bad, but it allows you to look at individual domains and understand where, where the difficulty is occurring. So then you can fix that

Unknown Speaker 14:33
and restore this natural surveillance. So potentially, we should start earlier than we even think that we're having senescence depending on how we're raised, how stressed we are, what factors hit our body at what age? Yeah. And I think it's sort of, I mean, you know, as a clinician, I think it's going to be obvious to you, but maybe not the audience. I think there is, especially in the consumer space, there is sort of, like, I'm a big proponent of, are you going to do something about it? Yeah.

Unknown Speaker 15:00
If you're going to measure because you want to know and you think you're going to do something about it, by all means, if you don't think you're going to change your lifestyle or do anything about it, then there's really no point, you know, I mean, and also it, or if it's going to be really scary, and that, you know, sort of, some people are mentally predisposed to be sort of, to have, you know, negative, sort of severe response. So it's, it's really, it's, and that's where, like, we like to work with clinicians for that reason, because clinicians know their clients, they understand they can deliver the report, they can explain the report, so they they can manage that conversation in a way that sort of the true direct to consumer, where you just get the report in the mail doesn't accomplish, because everybody has a different reaction, and so be able to manage it and put in the context of medical history is really important. Now, what are some of the most important biomarkers or hallmarks of aging that you're looking at when you're deciding someone's kind of biologic age? So cellular senescence is a critical one, and so that's so the marker that sort of, I mean, again, your audience might be familiar with and sort of what marks as zombie cells is called P 16, and that's been described for

Unknown Speaker 16:09
at least 30 years now.

Unknown Speaker 16:12
Initially it was found as a tumor suppressor, and so it's some levels of this marker are essential for protecting you from cancer. And so therefore some level of senescent cells, some level of P 16 positive cells, are essential for protection from cancer. And that's where the controversy exists, whether you want all the senescent cells gone, or do you want have some left and then just have lower level than age appropriate. So that's something to consider. And then, from the immune system standpoint,

Unknown Speaker 16:43
immune system is a is a dynamic system, but it's also a system where a lot of things are linked. And one of the functions of the immune system is called T cell exhaustion. And so what happens is, when you have your so you, when you respond to infection, your T cells respond to the infection, and they form memory cells. So next time you see the same infection, immune system can respond much faster, because it memorizes the insult. So those memory cells can become exhausted, and it is what it sounds like. So immune system cannot respond to infections as effectively anymore, and that, again, is a been identified a lot of this research, but not on cancer, but now is being seen in longevity space. The T cell exhaustion is the primary marker of the immunotherapy targets. So all the immunotherapies we hear about that you use for all sorts of cancers, that's the primary target of those therapies is T cell exhaustion. So if you can repair a T cell exhaustion, then the immune system can see the cancer cells better and can respond. Same goes for surveillance for senescent cells. If you can repair T cell exhaustion, you can repair the ability of immune system to see senescent cells and deplete senescent cells. So it's basically the same process the T cell exhaustion. The T cell exhaustion. T cell exhaustion is a really important target for therapies in sort of multiple places. So in there, in the longevity space, there are two drugs, specifically that's been shown to work on T cell exhaustion. So one is rapamycin that you again, your viewers might be familiar with. So rapamycin specifically targets T cell exhaustion out of all the immune components in the immune system, it targets T cell exhaustion to repair the immunosurveillance. And the other one is the class that are called sglt, two inhibitors. So these are the kind of gluflozin and pegla. So they are sort of colloquially referred to as flosins, because they all end with flossin. So these drugs are initially, were developed as a diabetes drugs, then during covid, sort of in the post, post market surveillance studies, what we call people, realize that they also have kidney protection and cardiac protection. So people who are taking these drugs for diabetes had a much better

Unknown Speaker 18:59
so they had less cardiovascular events. And then, more recently, we're starting to realize, as time goes on, we're starting to realize that they also kind of becoming longevity drugs. We think GLP ones will act the same way. So GLP ones are kind of, you know, a decade behind this GLT two inhibitors, but we think they will respond the same way, where they will work in the immune system and then improve the longevity drug for that. So that's so that those studies are ongoing, but basically there are.

Unknown Speaker 19:28
So there are existing drugs that can target the markers of immune system that are really important for longevity and also for other diseases, because it's just a really important component. So that's one piece, and then the second piece that you're again, your viewers might be familiar with

Unknown Speaker 19:44
is, are there markers of

Unknown Speaker 19:49
of gut function? So we're looking so 70% of your immune cells are in your gut, and so anything that you eat, that's a high number. It's basically.

Unknown Speaker 20:00
Most of you, yeah, most of your immune system is in your gut, basically. So when we say something is wrong with the immune system, I wonder what happened. A lot of times it's gut, because that's where most cells are. And so when you think about immune system, responding and forming memory cells, again, a lot of those challenges come from the gut, because that's where most change challenges are, and so and so as we age, things happen. We lose our representation of microbiome. You sort of lose the, you know, gut permeability changes, the nutrient absorbent changes, and so all these changes affect immune system. And again, it affects the T cells. And you start your T cells become what we call terminally differentiated. So they sort of change the profile, and then once that happens, they create chronic inflammation. And that's where you start to feel like a lot of clinic a lot of clients that have these markers elevated, have what we would collectively call gut issues. They're not diagnosed diseases of intestinal tract. They're like, Oh, I feel bloated after I eat, or, you know, I feel fatigued, like it's, it's these sort of, you know, like little signs of, like, something's up with my gut. I want to take a break. I want to take a fast it's that kind of stuff. So, like, those symptoms are usually associated with higher levels of chronic inflammation that your gut is now starting to create. So that's sort of another, again, as you can imagine, really important part of the immune system that you do. And then the third piece is there's, sort of,

Unknown Speaker 21:29
there are multiple things in there, so it's stem cells, so ability of your immune system to use so instead of responding to infections I've seen before, it's responding to new infections. So you have stem cells that would respond to new infections and sort of, you know, inform, then you form new memory cells. So as you age, the number of stem cells doesn't necessarily change, but their ability to respond changes, and so therefore you cannot. That's why older people are more prone to getting sick from infections they've never seen before. But also those stem cells have mitochondria is essential for the function of stem cells. Mitochondria in general, so it's a powerhouse of the cell, and it's essential for your feeling better and feeling energy in any cell, but in the immune system, specifically, mitochondria is critical, and so when we measure these markers, so the ability of stem cells to function properly is correlating with 15 years of extended health stem so if your immune system, mitochondria and stem cells are functioning as well as they should Be, you just from that, you get 15 years extra of health span, which is, you know, if you think about, you know, is 10 years a big difference. 15 years is a big difference of health span. That means the, you know, disease 40 versus 55 it's a big difference. And that's looking at your stemness, of your stuff. It's looking at stemness Exactly. It's looking at the ability of CO stem cells to respond and again, in the space, there's sort of all sorts of mitochondrial things people can do, whether it's supplements or peptides or, you know, red light therapy or hyperbaric chamber. There's all sorts of things. But I think also, like one thing that is really important to know is there is a lot of things that exist, but if you don't know whether you need it, so if you think of it, if you're a person who exercises and eats really well and sleeps full eight hours and leaves completely stress free, like everything is perfect, stress free life, you have great genetics, you can take longevity treatments, you're not going to feel any difference because you already optimized, there's going to be zero difference, right? And so the more sort of, the more out, the more of the outlier you are, the better you're going to the more difference you're going to feel, right? And so when, when you're looking for longevity treatments, if you don't have a deficiency in the domain that this treatment is going to target, you're really just wasting your money because you're not really you're not going to feel any different. It's not going to do anything. So if you don't know whether you need it,

Unknown Speaker 24:09
it's the and then it's sort of the safety to efficacy ratio also changes, because you know, treatments have side effects. And if you don't know that you need a treatment and you're doing it anyway, then you're not just wasting money, you potentially, especially for drugs, you're potentially risking a side effect for something that you really don't need. And I think it's sort of like that's also what is really exciting about working with clinicians and being able to do this work, is we are able to help them think through the medical history of patients and kind of think about these questions of, what do therapies do? What does this person have?

Unknown Speaker 24:49
Is it a match? Right? Because it's, it's their field is growing so rapidly that nobody is going to do clinical trial on every indication, on every.

Unknown Speaker 25:00
Drug on every therapy for efficacy, it's just not going to happen. And so being able to have the safety efficacy analysis of these things as they come on the market is really important. And I think that's the piece that frequently is missing. Because, you know, new therapies are sexy and exciting, but it's not one like, there is a reason why personalized medicine is personalized, because it's not one size fits all, and none of us are average. And so if you're not average, then you might not benefit from it. But for the person who is feeling sluggish has, you know, adult fatigue, you just feel like something's off. Your patterns are don't feel right. It's a really valuable tool to be able to guide them down which path they need to work on, whether it's muscle strength or, you know, if you're like, exactly, you know, mitochondrial health and that, and that is exactly that, because it's if you have a disease, like, let's say you have heart disease, your lipids are high, and you can do a scan, and you can Look at it, and you have a drug, those things are diagnosable. You can treat them. But if somebody comes to a traditional doctor and says, I feel tired, right? And you're 50, they're going to be like, well, you're 50, you're tired. That's how you should feel when you're 50. Like, there. So the ability to find a doctor like you, for example, where somebody is going to look at your entire medical history and is going to look at, sort of, and then look into where the deficiencies are. Maybe it's hormone optimization, maybe it's mitochondrial function, like, what is it? And maybe it's just purely need to start more exercise, which, again, if you're fatigued, you know it's a tall order to start exercising, so you kind of still have to overcome that first before you can actually exercise. And that's where the advice of, like, you just exercise and sleep better. You know, sometimes it's not as easy, right? And so you kind of have to prioritize, like, whether you start first, right? You You know need to. Maybe it's chronic inflammation and you just don't feel well and you can't exercise. And so let's do that first, like it's being able to understand, yeah, if you're the average 50 year old there, like my joints are a little achy. I feel exactly. Why is my hair turning gray so quickly? Quicker than ever. Yep. I mean, that implies mitochondrial dysfunction, exactly these gut issues, exactly. Yeah. So, like, that is super helpful. So people will take your test as a blood work test. It's a blood work, yeah. And then what kind of things are we testing on that blood work? So you mentioned earlier, it's not DNA methylation, which shows already kind of so it's so, yeah, so it's a gene expression. So DNA methylation looks for specific tags on your genomic DNA. So our test so we isolate T cells, which is kind of basically what drives the aging of the immune system, and then we look for expression of specific genes. So we look at levels of these genes that are present in your sample, and the level in general will tell us, so how much is in there will a general will correlate with. So then we say, this is high level information, this is medium information. So sort of, there's so we have, we have a kind of a report, has a dashboard that kind of shows you an overview of your immune system. And then you individually go into each one and you see, what does a number look like? How is it different from optimal, where you are in the population? Sort of, you know, what are your goals, like, how far out of the population you are, right? So if you're 95 percentile versus in your let's say 55 percentile, right? So it's sort of, you can gage of how off you are from from the average, and the average, again, it's clients in longevity clinics. So they're, you know, somewhat healthy, like, at least it's a preventative medicine space, so they're not people with, you know, three different diseases. So in that sense, the average is more of a sort of healthy average, but still, like, you know, people don't like to be average. Like, if you want to do better, it shows you where the average is, and then you can kind of set the goal, yeah. I mean, should people be nervous or scared to get that testing done? Because I'm going to get it done, and I feel

Unknown Speaker 29:08
like a show like, Oh, wow. Well, so here, here's or red alert, I have time to reverse my trajectory, right? Exactly, exactly. And that's, I think that is a really, I mean, sort of, again, it's a really important point that this shows you early science. This is well before, like, you're not going to die tomorrow, or even in five years, at least not from this. Like it's, it's early signs, right? And I think so it depends, right? Sort of depends on people's mental, mental sort of setting. I in general, think that I would rather know that not know, because when it's that early, then you can do something about it. So before we went into longevity space, the last four years, I guess it's been almost five we've worked in the traditional disease space that you know, sort of, as you mentioned, the cardiovascular, cancer, Alzheimer's and all that, for like eight.

Unknown Speaker 30:00
Years before that, and when we were not going to go into longevity space, because we did not think that anything can be done about it. And so we did not want the report that somebody's senescence is a 95 percentile, and while there you go, now you have your number like we did not think it was ethical to do that, so we didn't want to do that. And so when first clinician approached us to try, wanted to do a pilot, we were very specific about it, that we can measure it, but we don't think, because we've never in a traditional medicine setting, we've never seen ours being able to change senescence, so we did not think it's possible. Yeah, and we start working with him and being able to stratify people in who needs a treatment, who doesn't, he could decrease senescence in almost 40% of his patients we've never seen, ever seen it before. That's what made us comfortable to say, hey, we're not just telling people their senescence is high. Like there is actually a path, right? That's, I think, like I take, I'm taking all these supplements Exactly. If I had an indicator of what was wrong, why it was exactly, and how exactly, but I would take them every single day, versus being very sporadic as I am. And this is same with exercise, same with sleep. Like, we all know what we need to do, like, Who has time? Like, it's just what you can do, everything for everything. Like, it's but seeing your own results and saying, Hey, you're getting away with your lifestyle on these metrics, but here you might need some help. It will help you focus on your interventions will help you focus. So I think it's really helpful because of that, because it helps you prioritize the things you already know, like you said, like, we all know what supplements are good for you. Like, we all know these things. It's just, we don't always take them. Yes, you know, it's just, it's just, it's, it's hard life, you know, like, gets ahead of you and it's interesting. So you brought up sort of being fatigued and tired. So we, like in the last few years, doing this with longevity clinics. What we what

Unknown Speaker 31:57
we realized is, so when people are either over exercising, they have sort of the immune system is breaking down, and they have really high cellars, in essence, and then, but they're seen as really healthy by physicians, by society,

Unknown Speaker 32:13
6% BMI, body fat, like that kind of stuff. So

Unknown Speaker 32:19
biologically, it's really not good for you. So being able to see that is important. But also what we've noticed is is the resilience piece, that some people have the same level of stress, and some people will have really high cellular sinuses, and some will be fine. And so being able again. We all know mindfulness is important. We all know sleep is important. But if report comes back and says, You Natalia, really need to pay attention to this, because look at your cellars. In essence, I would absolutely prioritize sleep and all that, versus like, you know, it's my job. I need to do this six more months is not going to kill me. I'm doing like, it's, it's sort of, it's it again, it allows you prioritize. And so we're putting out two new products. One is for athletes who exercise and want to try to sort of optimize their performance. And another one, so that's called superior X endurance. And another one, superiors resilience is going to be specifically for men and women in their sort of, you know, 40s and 50s, where they feel sluggish and they're trying to understand why, especially at that age where you know you still have children at home, you have parents, you're taking care of jobs, all these responsibilities, and you start to age, you start to feel it, and it's not, yeah, and nobody can help you, because it's not a traditional sort of aging, right? And so trying to understand, to see what your deficiencies are, so you can start taking better care of yourself, which you know, again, we know we should do, but we don't, right. We deprioritize that. It can be a very specific prescription, which I think that is the best Exactly, exactly. And so that's, I think, that's being able to launch products that clinicians tell us they need, and we see the need is really exciting, because you can help the actual people do this. And as somebody who's 54

Unknown Speaker 34:09
I know how it feels like I'm there, right? So it's, it's a very like, it's, it feels personal, and it's, it's really helpful, and it's, it makes me really excited, even with, sort of, you know, as hard as it is to run the company and launch products and sort of all the kind of, you know, busy things that come with it, being able to do this, being able to help people that way, is really impactful. It really is. I mean, do you think women age a bit differently, given that they go through so much childbearing and pregnancy, and they do wear and tear on the body. For sure, it's extra stress, I know, but I also feel like somehow we're more resilient exactly that is, you're you're right on the money. So women have, in general, a better immune system than men, like if you think on a scale.

Unknown Speaker 35:00
Of 02, 100, it's by about 10 points. So it's pretty significant. So women, in general have a better immune system, and they're in general, more resistant to resilient to stress. But childbearing, especially the more children you have, it changes your metabolism. It changes it's it definitely is more so in general, number of children correlates with mortality, for example, because it does, and it's, I mean, in those studies, it's hard to separate the capacity to provide for children from actual childbearing, but it's definitely sort of having that sort of strain on your body is definitely a risk. And I think again, women tend not to take care of themselves. You know that they take care of their family before they take care of themselves. And and it starts to show, it starts to show exactly you. And that's the thing. It's like, it's not, it's not sudden. It doesn't just happen. You're 45 and then you turn 46 and all of a sudden, there it is. It's not sudden. It's been coming. And so if you know it's been coming and you can see it, then you can start. You can you can convince yourself you need to take better care of us all, because you can see it. I know my dad passed away last year, and it was such a difficult year, and I felt like I got 10 years older in one year. Yeah, I can believe it literally. I see and I see that sometimes in patients who are struggling with grief or divorce or big life events, and like it does. It's interesting how much impact your psychology and stress and like all of that builds up to affecting the cells at the seventh level, but, but the good news is, then you have, hopefully the ability to change, or hopefully that's a motivation. I was reading this article that was on the microbiome theory of aging, which I thought was super fascinating, which kind of goes along with this concept.

Unknown Speaker 36:45
So is there a regimen you think is best to improve gut health, to improve the immune system health? So super controversial. And the answer is, it depends on where you are as a person. So everybody's microbiome is different. So again, there is an average, but everybody microbiome is different depending on your ethnicity, depending on your current sort of location, depending on and ethnicity. It's part of a genetics. And part of it, you know, what your parents cooked, and what do you cook, and what you eat, what kind of what kind of food. And it's also like, you know, like, whether you eat dairy or not, right? So in certain parts of the world, you don't need dairy, basically, like, past breastfeeding you like, you don't need dairy, so you cannot tolerate dairy because, and so you don't have bacteria that can process dairy, because that's not your genetic background. So it's sort of, so it's very different. But it's also the the

Unknown Speaker 37:41
ability to

Unknown Speaker 37:43
understand, and I think it's true for a lot of testing, the ability to understand the change is really way more important than just single measurement, because it's everybody is different in their different way. And so being able to measure and then measure something in two years. Or if you have symptoms, measure and see what changed, because that means that change is probably driving a symptom versus I measured mine, you measured yours. And look, you know, this bacteria is different. Well, maybe it's been different our whole life, and it has nothing to do with your health, right? So again, being able to kind of see what changed with every test. I mean, the same goes for cardiology. Same goes for diabetes. Like some people are more resilient than others, so this could be, just be your baseline, and that's where you are. Yeah, I wonder if we should all be doing gut biome testing, if that's going to be useful. I think, I think so, the the consumer. So there's sort of, again, controversy over the quality of consumer gut testing products. But I think as a general statement of knowing where your gut is in your 30s and your 40s and your 50s, I think is a really good idea, because as your barrier starts to like it's about in your 40s, like early 40s, where your gut health, like you start to become more sensitive to like fats. You're not processing fats as well dairy. You're kind of starting to have like food allergies, especially in women, they tend to be more predisposed to autoimmune diseases. So be so all of a sudden you have Woods food sensitivities you've never had before. It's that kind of stuff. So that usually starts in your mid 40s. And so to be able to see what happened, is really important, because then you can specifically, versus taking broad range of, you know, probiotics or whatnot, like you can actually target specific strain you need. Because, in reality, we still don't know what bacteria are good, what are bad. How much do you need? Even aside from ability to make live bacteria, manufacture properly and store it and all that, and like, actually give it in a supplement form that still is active, yeah, just even knowing what you need is really hard, because everybody's different.

Unknown Speaker 39:53
Have you Hans kirsted has his whole immuno, human immuno project and.

Unknown Speaker 40:00
Um, and that's so interesting. Can you talk a little bit about that those ideas and how they correlate with this immune aging concept? So it is, it is, there is a lot of, like I said, in the last two years, there was a lot of research done in the immune space for that specific reason, that immune system is so complicated that trying to so

Unknown Speaker 40:20
from a research standpoint, the most important task is to what we call mapping of immune system, right? So trying to understand what kind of cells exist, types, cell subtypes, what happens? What changes happen with age? Some changes can happen on the surface of a cell. Some changes can happen inside the cell. So trying to understand, like, what actually happens. The second is, what we call a clinical utility, is understand which changes actually cause a clinical phenotype. Just because something changed, it doesn't mean that matters and so, and also might not mean it matters to you, because you might have something else that is compensating for it. So that's so that's why immune system is really complicated, because we, we didn't even have a map yet. So that's where the mapping the immune norm is really important, because at least now we have a concept of what cell types exist, how abundant they are. You can look at population. The studies are super expensive, so there's only that many people you can test, but you can have general idea of, you know, what the 20 year olds look like, what the 30 year olds look like, and so you can kind of understand what changes happen globally as you age. The next step is actually going through and saying, you know, what sequences, what subtypes are important for aging or specific disease, or, you know, are they able to be reversed with drugs or vaccines or sort of other treatments, red light therapy, for that matter, or hyperbaric chamber? So they don't only have to be conventional for mythological inhibitors. It could just be things, exercise, diet, so understanding what, what can be moved by treatments, and whether it will matter clinically, that's still lacking, or at least lagging behind the mapping, but the mapping was, it's the same with with sequencing, the genome sequencing, until we had the genome, everybody was sequencing little pieces, and You really didn't have a full picture, and you were Kay, it's there is a famous kind of cartoon in the scientific community that you have an elephant and you have four blind scientists who are blindfolded, who are feeling different kinds of animal. And so one is person is feeling the trunk, one is feeling leg, one is feeling tail, and they think it's a completely different animal based on what they're feeling. And so until we have a map of the entire thing, we just know what individual pieces are, and it doesn't give you a full picture. So immune mapping is really critical to be able to see how these things come together, and technology, technology didn't exist before that to do that. So now that's where technology advancing is really important, because we're doing things that, you know, even five years we couldn't do. Go, yeah, super interesting. It is super interesting. And it's, it's, I mean, it's fascinating area, because, I mean, the immune system is really complex the body, because it's so critical for your aging. The body did a really good job. Nature did a really good job and making sure you're protected every which way. And they're all these different layers of resilience. And so to be able to understand how things break at which point, that's a breaking point, it's fascinating. Now you, I know you've looked at four or 5000 patient lives in terms of this testing and what pathway of aging that these people are going down. What kind of so you have all the knowledge.

Unknown Speaker 43:46
I wish. What? What interesting insights have you uncovered in terms of, like, noticing trends, or, you know, aging, inflammation pathways, or things that are very obvious for a 50 year old versus a six year old. It's, yeah, it's really like, it's, I mean, it's fascinating because, you know, as I mentioned, it didn't, this didn't exist before. So we basically just said, Let's measure things, and we'll ask clinician for what they think and what the medical history is, and then we're comparing of how they see the client when they first see them, sort of on the surface right, and then once they have this insight, and sort of, you direct them to look into specific things, is what they think about. And so the there were some really. So the one I mentioned is people who over exercise and see it as a very healthy activity. And it's, you know, you produce adrenaline that makes you feel good, and that you look good, and everybody compliments you. It's it absolutely is really important. Exercise is really important for longevity. But if you over exercise, you're breaking down your immune system, and so you're actually decreasing longevity by something you're trying to actually increase.

Unknown Speaker 45:00
And so being able to see, because when we started the pilot, we were completely blinded to patients, to human names, like following history. We had, like it was just a sample. And so we're routinely, before that, we've tested another, I don't know, 15,000 samples in different diseases. And so when we would look at these samples, and we would say, wow, look at this 40 year old. Maybe she has cancer, and she had multiple rounds of chemotherapy because look at how high Her levels are and how bad the immune system is. And we go back to clinician to discuss it, and they were like, Oh no, yeah, she's super healthy. She's great. And that's where we were like, Huh, well, so this is not due to something that obviously is damaging. This is due to this thing you think is healthy, but you're overdoing it. But then the opposite was also true, where clinicians would ask us, like, well, so what do you think about this particular patient? And we're like, it was also completely normal, like, I everything looks fine. And he'd be like, well, that's fascinating, because I think out of my entire practice, she would be, like, the most stressed, and she has the most stressful life and and yet, she's completely resilient to this, because she looks way better than somebody else who doesn't have, at least, clinician perceives doesn't have that stress. So this sort of this, like, I've always dismissed stress as a really serious stressor. Like, I mean, we all know stress is bad, but I didn't appreciate how big of a magnitude the stress can change things like, it's sort of it just I until you see it like, you don't appreciate how bad is it for you and you like, I can like, I'm somebody who considers myself resilient to stress just based on kind of how I handle things, but I don't know, right? So until I start testing, and I was like, Yes, I do seem to be resilient, but until you start testing, you actually don't know where your molecular molecular aging is, because everybody's like, we've seen that everybody's different. So that was one really interesting thing. And another thing is

Unknown Speaker 47:06
we've noticed is that you

Unknown Speaker 47:10
there is a when it comes to inflammation. So inflammation is the most complicated thing to unravel, because inflammation can come from from anywhere, right? And so what we are measuring is we're measuring molecular footprint of inflammation. We're telling you you have a lot of inflammation in your body, but we don't know where it's coming from, because it's just general inflammation, right? And so to be able to have calls with physicians where we look at traditional things, right? Do you have heart disease? Do you have diabetes? Do you have liver disease? Do you have kidney disease, like, sort of all the typical things you think about, right? But a lot of cases, you would have inflammation coming from sources that you wouldn't think about, for example, like iron. High iron is bad for you. And especially men tend to accumulate iron as they age. But the problem with that is, even if you decrease your iron and in the plasma, you think that your iron is okay, your tissue tends to over absorb iron, so that still causes inflammation, but now you don't see it, and you think you're fine. And so finding things like that, like like we can see there is inflammation because we actually measure it. Where is it coming from? It allows clinician to pay more attention and be more systematic, if you wish, or more persistent, I guess, looking for these sources. Because sometimes it's not obvious. Sometimes they think they fixed it, because the lab results say they are and it's fine things like that. So it's really, it's in, I mean, it's really,

Unknown Speaker 48:41
it. I mean, it's humbling to think that people trust us so much, to say that I know your markers are real, therefore we need to find a source and not like it can't possibly be true. This person is healthy. So it is really humbling that they believe our results so much, that they are willing to sort of look further. For sure, that's a privilege. But I think in general, if you think about it, being able to have a tool that tells you no continue looking

Unknown Speaker 49:08
is really valuable, because how else would you know, right? Like, you can't possibly look at everything all the time? Very interesting. How often should someone do this type of testing? Once a year? Yeah. In general, we kind of have two groups of people. So if your results come back normal, everything looks or at least normal to you, like you think it's fine. Then once a year, is what people do. If it's if results come back and you want to do something about it, then you should retest once you're done with whatever it is you're doing. So if you decided to take some supplement. Then, you know, you take a supplement, let's say for six weeks. You take a supplement, you give it a month or so, then you can retest. So some people test once a year, about 50% I would say, twist once a year. And some people test, you know, twice, three times, four times a year, depending on what they're doing. So it really depends on your goal. It really depends on what you're trying to.

Unknown Speaker 50:00
Accomplish. But in general, these markers are really stable. So if you're just living your life and not really changing anything, it's not going to change. So there's really, it's not there's no need to change, like you don't need to do anything. You know, there's no fasting. You don't need to do anything before you test, because they're really stable. So now that's sensitive to lifestyle, unless you dramatically change something. Well, speaking of fasting, are there some habits that you've adopted based on all this knowledge of immunity? Yes, not fasting. My habit is not fasting. Fasting. Well, so again, it depends on sort of everybody's preposition, right? So if you're over consuming calories, then doing fasts is a good idea in general, fasting is really hard on your immune system, and that's why, sometimes when people fast, they get colds. And so it is, in general, pretty hard on the immune system, and but it turns on your, you know, your mTOR, it does. It turns autophagy Exactly. But so in the immune system, autophagy is actually independent of what we call nutrient sensing. So when you eat your your T cells, your immune cells don't really care about that. So the autophagy is so critical for their process that they cannot depend on external stimuli. So they're not induced by nutrients. They're induced by things in the body. And so you're not really reversing autophagy in the immune system. You're reversing the tissues, but not an immune system. So therefore immune system now is starving,

Unknown Speaker 51:24
but it's, it's, I mean, again, it's sort of, so I adopted the sort of the intermediate fasting, if you wish. So I don't eat after, like, six, seven o'clock, but that's because I then I don't sleep well, like I it's just I feel better if I don't. And I also tend to exercise later at night than I do in the morning, which, again, works for my body. In the morning I cannot like, I'm just not capable of, physically capable of exercising as well as I do like, that's how my body works. And so I think it's really, it's really important to know your body and listen to your body, because it's, again, not one size fits all, but I think in general, trying to going into it with these things might be good for me, and let me see if I can work them. Making anything a habit is really important. The fed diets, the Fed treatments, the Fed like, if it's a habit, it will stay, and that's even if it's a little bit. If it's a habit, it's really important. Are there supplements that you favor? We talked about mitochondrial health, and I'm in general, generally, like, in useful for all humans in general. So, so that's yeah. So I'm, in general, a big proponent of take what you need. So I in general, I'm low on vitamin D. I sort of, I'm I grow up in Russia, so and I'm very white, so therefore I don't get enough vitamin D. So vitamin D, I was like, below detection, essentially. So vitamin D for me, I had to fix and then I have a problem in my methylation pathway. So to be able to keep homostein homocysteine low, I need to take folates and vitamin B, and sort of that kind of feed that pathway so that again, because I know I have deficiency because I tested it, so I take that, and then I know my omega threes are low because I don't like fish. Like, I will eat seafood, but I don't like fish. And so I take that. That's pretty much it. So there is really, like, I take things that I I needed one thing I started so creatine is really good for your cognitive health, not just for muscle building. And so I start taking that, and I do feel better. I think in general, people can benefit from fiber like usually, it's better to eat the fiber than just take the fiber, soluble or insoluble. But you know, if you don't like vegetables, or don't like most vegetables, then at least take some fiber, like fiber, you know, so it's again, if you cannot get through lifestyle, then you should supplement, but you should know whether you need it or not, because too much fiber is also problem. Like you don't want to too much vitamin D is a problem. Too much vitamin B will give a neuropathy. Like it's you need to know that you need it, yeah, supplement. So I supplement as needed. That's, that's a good way of approach, I mean, and that will end up the level. Like, my vitamin D is normal now. Now I take it once a week and not every day. Like it's sort of,

Unknown Speaker 54:15
you know, like you do it as needed, so then you're not giving yourself side effects. Well, this has been absolutely fascinating. I definitely am going to do a Sapir test. I want to know everything about my immune system, my immune aging process. And I will do that with our Instagram audience so that, hopefully that can inspire some people to also look at their own health. And we'd love to start doing this test in our office. It's, I think, going to be game changing. I think it's like you guys have such a scientific approach to esthetic space. It's really impressive how you're on this cutting line of understanding how these treatments and therapies and creams and injections work. Because, I mean, again, you're doing it if.

Unknown Speaker 55:00
Individually for each person. And I think if you do it that way, then everybody gets the most benefit our treatments, and not just because, you know, my neighbor did it. And I think that is, I think that's the future. I think that's the future of longevity, and that's the future of health span. To be able to have treatments that you need to make you feel better and look better and live better, but it is, it is very personal. And so to be able to have a doctor that spends time and takes time to understand what you need, and not just this is my expertise, and this is what I do all day, like it is really critical. I think that's that's really critical. That's so important. Because people come in all the time and they say, like, I look so tired, and I don't feel like myself, and they want me to make them look better, but I also want to figure out what's actually going on internally, and all the senescence that we see on the skin surface, the brown spots, the fine lines, wrinkles, that's fibroblasts, in essence. So these cells are already getting attacked by body muscle, the body's immune well, and even then, even healing after procedures, like, your immune system is critical for everything. Like, it's not just, you know, when we have covid, like, it's critical for everything. So if you're not taking care of your body on the inside, you're not going to look better. Like, you know, I mean, it's so true. Well, this has been absolutely fascinating. Where can people find you? Dr Minton. So we have wiki, very low profile, but our website is sapirx.com where we're launching couple new products. So we're launching your website in the next couple days, so you can learn more about that. But in general, if you send us an email, we can point you to a clinic, so maybe not far from you, that is using our testing, and in general, we encourage people to think about that and to think about what you need and what sort of you know, prioritize your health and prioritize your wellness and prioritize taking care of yourself in a scientific way, where you're, you Know, you're actually sort of science guiding these decisions, because the tools are here, like we can do these things today, so being able to understand what you need, you can take advantage of these things if you can just take that extra step. I love it. It's scientific backed guidance to to change your aging trajectory. Right? That Exactly, exactly. Yeah, before, before, sort of it becomes irreversible. Yeah. Well, that's it for now, guys, I hope you learned so much. I know I did, and I hope it motivates you to take time to think about your longevity, pathways and trajectory of aging, and how are you, or are you even taking care of yourself correctly? That's it for now. Don't forget to find me on my instagram. It's Beauty by Dr Kay, D, R, K, a, y, doing amazing things with people's faces and health and longevity. And our website is the same as beauty by Dr kay.com and that's where you can find our new skin longevity launch, which is a wonderful set of products that have peptides that stimulate collagen growth and lasting growth, as well as GHK copper and glutathione and NAD precursors. So this is a whole new sector of skin care, and I'm really excited to hopefully teach you guys how to change the trajectory of your skin aging. That's it for now, guys, stay beautiful. You

Unknown Speaker 58:20
you.