Toxins are everywhere in the news and they can significantly affect our health and longevity. Today we get to speak to Dr. Wendy Trubow. An expert in the area who has learned from personal experience how devastating these poisons can be.

After completing medical school in residence, she’s CS she and her husband, Dr. Ed Levitan have made it their passion to help patients with visions health care, which became the largest functional medicine practice in the country. During their eight year tenure, they had the privilege of serving over 20,000 patients. They also formed five journeys, a membership based wellness organization that incorporates Functional Medicine and their unique approach to what they consider to be the five core aspects of health, physical, chemical, emotional, social, and spiritual. They are also authors of a new book, dirty girl how to ditch the toxins look great and feel freaking amazing. Dr. Trubow completed medical school and residency in obstetrics and gynecology at Tufts University. She is currently serves as the president of the National celiac Association.



  • 00:13 – Introduction to the speakers
  • 01:42 – Dirty Girl book
  • 04:58 – Perimenopause
  • 09:07 – Foundations of Health
  • 10:37 – Medicare
  • 12:30 – Notre-Dame Lead Exposure
  • 13:53 – Toxicity
  • 17:07 – Mercury Fillings
  • 22:10 – Ability to Detoxify
  • 24:42 – MTHFR
  • 28:10 – Celiac Disease
  • 32:22 – Lymphocystic Cancer
  • 36:38 – Infrared  Sauna
  • 38:37 – Five Journeys
  • 49:47 – Mitochondrial Dysfunction
  • 56:30 – Senescence Cells
  • 1:04:18 – Inflammatory Markers


#senescene #metformin #toxins #fasting #celiac #gut #aging #rapamycin #homocysteine #gluten #functionalmedicine #lifestyleintervention
#robertlufkinmd #drlufkin #robertlufkin #healthlongevitysecrets




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Robert Lufkin  00:00

Welcome back to the health longevity Secret show and I’m your host, Dr. Robert Lufkin. Toxins are everywhere in the news and they can significantly affect our health and longevity. Today we get to speak to Dr. Wendy Trubow. An expert in the area who has learned from personal experience how devastating these poisons can be. After completing medical school in residence, she’s CS she and her husband, Dr. Ed Levitan have made it their passion to help patients with visions health care, which became the largest functional medicine practice in the country. During their eight year tenure, they had the privilege of serving over 20,000 patients. They also formed five journeys, a membership based wellness organization that incorporates Functional Medicine and their unique approach to what they consider to be the five core aspects of health, physical, chemical, emotional, social, and spiritual. They are also authors of a new book, dirty girl how to ditch the toxins look great and feel freaking amazing. Dr. Trubow completed medical school and residency in obstetrics and gynecology at Tufts University. She is currently serves as the president of the National celiac Association. And now, please enjoy this interview with Dr. Wendy Truffaut. Hi, Wendy, welcome to the show.


Wendie Trubow  01:34

Thanks, Robert. Great to be here.


Robert Lufkin  01:37

I’m so excited to be able to talk today about Well, first of all, your your your book that you wrote with your husband, which is dirty girl, and we’ll talk you can see it in your picture there. I have my copy. I really enjoyed it. And but But before we dive into that, maybe let’s take a moment. And you could just tell us a little bit about your story and how you and your husband came to came to work in this space.


Wendie Trubow  02:09

Sure. So those are two completely different things. So let me answer the second one. First. My, my husband was into functional medicine long before I was and got trained. And right when I was about to have my second kid, he said while we’re insurances changing, he was working with a functional medicine doc, he was mentoring with him. He said, Why don’t you see my mentor? And so I saw his mentor when I was like, an hour postpartum, you know, schlepped my newborn in nursing, of course, it was like nursing everywhere. And he did all this tests on me. And at the end of it, he said, Oh, well, you have celiac. And I was like, oh, so that way, I can barely get out of bed. Like I feel terrible, head to toe issues. And so he diagnosed me with celiac. And that was my opening into functional medicine because it was that moment where I went, you know, all those things that I just brushed under the rug, the hair loss, brain fog, anxiety, thyroid, heart palpitations, asthma, everything wrong with my gut, bloating, gas, diarrhea, constipation, the world’s worst gas in the world, the worst one, that one. And then fertility issues, which I had recently made up for, because we had four kids, and I was wasting and nutritional deficiencies. So that was like my list of things. And all those things were things that typically I was brought short of just blowing off. So I learned about functional medicine because I was a patient, and I was really sick. And that opened my eyes. And then I’ve always been the person who wanted to do it, right. So I’m like, I want to do it. My mom said my first statement, my first full sentence was I want to do it. So that’s kind of been my motto in life, I want to do it. So when my husband opened up our first Functional Medicine Center, back in 2008, it really irked me that I couldn’t take care of the patients the way he was, I was sending them to him. That was very irksome. So finally I was like, Well, I kind of could do that. I want to do it. So I left obstetrics and gynecology in 2009. And we went into practice together. So we’ve been working together since 2009. And then back to the other. So that was like part one of the story. And then part two was in 2019. I really went off the cliff again, and it couldn’t figure it out. Because since I got diagnosed with celiac in 2005 I have walked the talk or talk walk the talk yet right. I have lived the life of someone I don’t drink alcohol. I avoid processed carbs. I don’t eat sugar. I don’t stay up all night any longer. I try not to be a stress ball. I exercise a we like mostly organic food. And so why am I having a health challenge against human thing? We’re all humans, right? So I chalked it up to well, I’m pre menopausal. But then things got really bad and I could no longer just say oh, it’s normal to be like I was because perimenopause doesn’t cause you to gain almost 10 pounds or in the course of a month, and it doesn’t cause your hair to fall out the way mine was. And it doesn’t cause a rash to erupt seemingly overnight on your face. It doesn’t really cause those things. So I could no longer say, Oh, it’s just perimenopause. So I started to dive a little deeper, and I couldn’t figure it out. And about four months after I went off the cliff, I heard this report on NPR. And here’s the part of the story I can tell you. We went to Paris right after notre DOM burned. And notre DOM when it burned, released 500 tons of lead into the air. And the closer you were to Notre Dom, the more lead you got, in these concentric circles out, you got less and less, but we spent a week right there. And the month after we came home was when I went off the cliff. And so when I heard this report on NPR months later, I mean, we’re not talking weeks, months later, I heard the report and I said, I got a lead exposure. And it was enough to send me off the cliff. And so I did the testing, and I had, my lead levels have gone up by 25%. And so then I started to treat, and that was really the entry into this passion for toxins work, because it got really personal, you know, my hair started to grow back, I lost the weight, again, the rash got better, all those things that weren’t working, improved, and I started to see the impact and then do it with my patients. I’ve done a little bit, but it really got personal at that point.


Robert Lufkin  06:25

Now that this, this is such an important message for for our audience in particular, I mean, we we pay a lot of attention to diet nutrition, like you say, you know, the, the message finally is getting out there about avoiding processed carbs and sugars and seed oils and things like that. And people take care, their sleep, they they take care of, you know, their exercise, but sometimes things still aren’t right. They’re they’re still symptoms, they’re their labs are out of whack and toxins are can be really the overlooked solution to that. And it’s it’s great that your your message is so important. They’re now wondering, should should everyone be be tested for toxins? Or is there a certain? Are there certain you should wait for certain symptoms? And then go for it? Or Should everyone just as part of their wellness be screened for certain toxins? Or is it a case by case? basis?


Wendie Trubow  07:29

Well, I think it depends on what your philosophy is. So if your philosophy is, let’s wait until things get bad, then you should not test. And by bad what I mean is heart disease, diabetes, obesity, cancer, dementia, Parkinson’s, all the bad stuff. If you want to wait for them to develop and then react, no, you should not test if your philosophy is let’s nip things in the bud before they get worse. Or oh, geez, I don’t want to get any of those than 100%. Yes, you should test. I’m rarely ever that like yes, but that’s really you should test. The ignorance is bliss Knowledge is power. Pick pick where you fall, right? I’ve tended to fall on the knowledge is power, because then I can choose if I’m going to react or not, but not knowing doesn’t give me the ability to choose my trajectory. Yeah, and I think for our audience, certainly we’re leaning towards the knowledge is power, because people are curious about this. And they’re listening to this. So as far as tests, obviously, you mentioned the in your in your book, The Enescu the multiple symptom questionnaire, is that a good place to start? I think it’s great. And I mean, we have it on our website, it’s at five We have it right up in quizzes. So I think it’s fantastic. And basically if you have anything that you’re just living with, you’re suffering with, then it’s a place to start, not everything funnels to toxins, because it’s funny, this is what I’m talking about in my upcoming talk at a forum is that you have to deal with the foundations of health, your food, your gut health, your excretion, your sleep, your stress your your relationships to yourself and others, you have to deal with the foundations of health, but let’s just say for for purposes of ease that everyone listening eats ideally, their gut optimize, they have great relationships, they sleep enough for their bodies, they’re not overly stressed, which is hard to say when we’re on the verge of a world war and we’re, you know, we’re gonna end the end of a pandemic, but set that all aside, right, say, Okay, we’ve done all that. If you’ve done all that, and you don’t feel amazing. Yes, it’s a toxins issue. You know, so it is a really useful place to start for people who’ve already done the foundations. And are there any are there any go to tested that you’d recommend for for toxins so you so you, maybe you’ve done the MS. Q And you’ve you’ve


Robert Lufkin  10:00

that the symptoms are abnormal, or are you just not feeling well? Are there some basic screening tests that that people can do? Or is it again a case by case basis?


Wendie Trubow  10:10

No, I have my favorite. So this so I always do toxins in round two, because because like I mentioned, if your guts dysfunctional, you’re not going to be able to excrete the toxins, you’re going to actually make yourself sicker. So people are always like, why aren’t you doing my toxins? First, I want to lose my weight. I’m like, I know. But we gotta get your gut and your adrenals sort of pacified first. So okay, set those aside, pretend we’ve done them. My favorite tests depend on how old you are and what insurance you have. So if you have Medicare, then there’s a test from real time labs that tests for mycotoxins, and that’s covered by Medicare. So that’s, that’s my first choice for anyone with Medicare. And then if you don’t have Medicare, then my first choice is Great Plains lab, because it’s about half the cost. Because the the real time is about $799, which is it’s it gets people’s attention, right. And so the mycotoxins testing is 299. And then if you bundle it, you save about $60. And you can also bundle on the environmental toxins, testing and glyphosate. So that’s a really useful test. And it’s all urine, so people can do it at home. And then my favorite testing for metals, these aren’t covered by insurance. So it’s reasonably inexpensive, and it’s a doctor’s data. It’s like 69 bucks for the test. And you do a baseline test to make sure that people don’t have an acute exposure that we’ve missed. And then we do a provoked test that pulls the metals out, binds to them, puts it in the urine, and we measure it. So it’s a whole bunch of pee going on, basically.


Robert Lufkin  11:42

Good. Well, back to jumping back to your your Notre Dame exposure, exposure over there. That’s, that’s fascinating in, in your book, you bring up an important point, a concept about lead toxicity versus lead poisoning. Can you share a little bit of that with our listeners?


Wendie Trubow  12:06

Yeah, definitely. So the kids in Flint, Michigan are getting poisoned. They are just completely overloaded. And the system, it’s like the funnel is full and stop it up, and they can’t get rid of it. That’s toxicity or poisoning, toxicity. It’s more subtle, right? So it’s, I by the way, Robert, I didn’t tell you that about eight months before I got that Notre DOM LED exposure, my neighbor took his postwar house down, that we knew had lead paint in it, because we took ours down and it had lead paint in it. And he, I mean, where we live, the houses are pretty close together. So it’s not like there’s two acres between us, there’s about 15 feet, and the winds blowing. And so we got a lead exposure then, and then eight months later got another lead exposure. So it’s this slow drip of exposures on top of how do I language this, if we were just talking about lead, that’s one thing. But we’re talking about lead in the setting of living in America, being exposed to highway driving, gasoline fumes, new furniture, construction, clothing, house cleaners, air quality, water quality, all of these things are playing a role. So it’s this, this sort of slow drip of torture, as opposed to flooding the system. So you get poisoned when the system is flooded, you get toxic when the system is overloaded and just can’t deal with it. So I’m particularly bad at dealing with toxins and lead and mycotoxins. So when I get an exposure, maybe I could deal with it if I didn’t have all these other things going on. But in the setting of living on the earth, I can’t handle it and it just builds up. So I the excretion is shut down.


Robert Lufkin  13:52

So it may be possible to have a toxicity from a thing like lead or some of these other factors that will manifest as a variety of symptoms or a variety of other chronic diseases, without necessarily being classic lead poisoning, like we see in medical school may


Wendie Trubow  14:10

be right, right, very few people will have lead poisoning, but what they have is this ongoing slow drip of toxicity that manifests as inflammation. So when your doctor says to you, you have metabolic syndrome, meaning you’re pre diabetic or insulin, your insulin and glucose are rising, but you haven’t crossed the line. That to me is a toxicity issue, because it’s an inflammatory cause and if you’ve taken away the inflammatory food and you’ve still got it, toxins are the number one reason that you’re going to have leftover inflammation, you know, optimize everything you still got inflammation you have toxins.


Robert Lufkin  14:45

Yeah. And and just the effect like you say with the gasoline, even the lead the lead fuels that are still leftover it’s been removed in many in many states but the the history of it And then the lead paint in the houses. And I think you pointed out your book, it was news to me, it’s not like, oh, people eating, you know, chips have led paint, like babies just accidentally putting it in their mouth. But actually, they’re microparticles, that dust that just comes off normally off paid as a as a normal wear and tear that then we’ll have this dust that we can inhale or ingest, or otherwise be exposed to it right.


Wendie Trubow  15:30

And don’t forget the weekend warriors who were like, I remodeled my bathroom this weekend, they ripped all the walls down. I’m like, Oh, I suppose for how she got a lead exposure. So the DIY things that you do on a weekend, which are so proud of her amazing. However, if you live in a postwar home, you’re likely exposing yourself to lead particles and lead dust. And then there’s mercury in the environment that gets released like with wildfires. So that’s another layer of exposure that is happening, particularly out in your neck of the woods. Yeah. So a lot of ways.


Robert Lufkin  16:04

Yes. Speaking of lead, and mercury, some of our some of our listeners have asked, asked specifically to ask you about dental amalgam, what your position is on that. They’re not being put in that much anymore. But and so obviously, no one would no one would have it done today. But I guess the question is, many of us, beyond a certain age have dental amalgams in our in our teeth. And what what’s the best way to handle that? Or is there a consensus really on that?


Wendie Trubow  16:37

Yeah. So there’s a couple of layers to this, Robert. And it’s pretty horrifying. I actually just learned that, in certain cases, if you have state sponsored dental insurance, they might require the silver amalgams because they’re cheaper. But if we set that aside, and say, if you have if you are getting a cavity filled, then you should not be opting for silver fillings, because they’re 50% Mercury by weight. And here’s what’s crazy. And I will acknowledge that I was very reluctant to take out my mercury fillings, because I felt like, well, they’ve been there for 40 years. What difference is this making? Right? And so I went to a biologic dentist, and I said, straight out, I’m really reluctant to have these done. And she was very kind. She’s much more PC than I am. And she basically very kindly in a PC way said, that is the dumbest thing I’ve ever heard. Now, she didn’t say that to me, but that, but she said, Well, let me tell you the facts. And I’m like, oh, so she said, Okay, they’re 50% Mercury by weight. The Mercury never stopped off gassing. It never goes away. And every time you eat, drink, brush, your teeth, put anything warm in your mouth, you are causing that mercury to get released. So it is a constant source of exposure. She said, in fact, when we take these out, we have to put them in biohazard. We can’t put them in the trash, even though they came out of your mouth. And you’re living with it. It’s biohazard. And I went, Oh, well, that’s a pretty good argument. So I got my mercury fillings taken out. Recently, actually, it because I was very resistant. And so what I’ll say to people who are who might have them is if you have them, I would recommend going to a biologic dentist and getting them taken out. And the reason I stressed biologic dentist is that I felt like I was in a hazmat unit. So I had oxygen on, I was fully draped. I had a practice my deep breathing because I felt a little claustrophobic under the mask and the sunglasses and the end the drape. I mean, she put a drape over my face, my whole body. And then what she did was she protected the tooth with a dental plastic barrier so that nothing could go down my throat. And every three seconds, she’s irrigating. And she’s and I had oxygen on so that my exposure was little and her exposure might the whole team she had was wearing the rebreathers so that they weren’t exposed to anything. So I would recommend getting them taken out. And we did it in two settings. I have sittings I had three fillings, and it was hard. I mean, I felt I did it on Friday and took the weekend off because I found that it was very stressful. Maybe that’s just me, you know, some people fly through it. I didn’t I didn’t feel that good when I did it. And I also did do DMSA which is a binder and I did charcoal so that I could bind anything that was coming and I I fasted so that I was quieting the system down. So I would recommend getting them out.


Robert Lufkin  19:33

Were there were there any? And of course Mercury is notoriously difficult to test for in our bodies that you know, it can be difficult to find a level are there any levels that you would use as an indicator that obviously someone has cognitive impairment? Of course you get them out but is there any any markers that you followed or anything you noticed in yourself that changed after you had the map or anything you were following about that?


Wendie Trubow  20:02

Yeah, I’ve been following this actually. So so when we tested the lead in myself, it was a whole panel that looked at all of the heavy metals. So I’ve been watching thallium, mercury, cadmium, arsenic. I’ve been watching these for a couple of years. My Mercury initially was not positive. And here’s the really interesting thing. I promise you. I’ll answer your question in a second. But the really interesting thing is that if you’re someone who has been exposed, and your detox system starts to shut down, when you initially get this data, usually it’s it’s not that interesting. It’s like, well, your lead levels nine, we trade over eight, and sometimes lower if someone’s really sick, but over eight is like, definitely treat. But if it’s nine, my lead level was nine. I was like, nine, you know, nine, okay, maybe I won’t do it. But what’s really interesting is for people who have very impaired detox, that’s not the real level, that’s actually only what your body is able to excrete. And it’s only after you go through the detox, ramp up the livers ability to get rid of it, improve face to digest digestion in the liver, that you actually see, oh, these levels are much higher than I thought. So the highest my lead got was about 21. But my Mercury went from negative to 41. So again, back to this crappy, crappy detox pathway and genetics. So when people when you say to me who should get their mercury fillings out? My response is, unless you’re healthy as a horse, I get it out. I would, it’s not in your favor, because it’s a huge risk. Fat toxins is a tremendous category of risk for cancer and for degenerative disease, meaning Alzheimer’s, Parkinson’s, cognitive impairment. So it’s worth getting these out, because they put you at risk for nasty stuff long term.


Robert Lufkin  21:52

Yeah, yeah. And it’s speaking about detox mechanisms. And since you mentioned that on the many of our listeners that have asked about any, any genetic testing that will monitor our ability to detoxify, you know, like the methylene, tetrahydrofolate, reductase, that famous snip there is, is that a good one? Or maybe you could just speak a little bit anything about anything about genetic testing? Is it worthwhile and how it can help?


Wendie Trubow  22:30

Yeah, I think it’s really worthwhile and it depends what level you want to go to, right. So you can go pretty easily and go to your doctor and even get MTHFR tested, that’s methyl tetrahydrofolate reductase. And what that indicates is your ability to methylate. And methylene is a critical part of Phase Two detox. So it’s one way that you get rid of toxins, and especially your hormones, a lot of hormones get methylated, that makes them water soluble, you put them in your gut, and you poop them out. However, if you’re not methylating them, what’s happening is, in phase one, you take this hormone that your body knows it needs to get rid of, you make it more toxic into this intermediate thing. And then your body’s like, I can’t get to phase two right now. Hang out in the fat till I get to Yeah, so these women, especially women, who say, everything I do, I can’t lose any weight. I’m like, Oh, you got a toxins issue. It’s sitting in your fat, preventing you from losing weight. So quite easily, you can go to your doctor and test for MTHFR to see if you have impaired methylation. That also impacts your risk for cardiovascular disease, depression, heart attack, stroke, homocysteine issues, so it’s all tied in together. So that’s a really useful one to get. And then you can do another dive where you can do like 23andme, where you look at all the genes that that look at detox and feed it into some interpretive mechanisms, and that’ll tell you a little bit more information. And then there’s some even more information that you can get from things like DNA life, where it’ll look at specific snips something nucleotide particles, it’s deletions in the in the genes that will put you at risk for disease and that will even drill into what’s happening in phase two in your Cytochrome P 450. Do you have snips that are going to make you not digest caffeine or not digest alcohol or not digest Tylenol is going to look at all of those. So it depends how how deep you want to go with it, but you can definitely do it is pretty easily.


Robert Lufkin  24:36

You mentioned homocysteine, we have several questions on that assuming people check their MTHFR for mutation. They don’t have a mutation there, but they have elevated homocysteine, they’ve taken the B vitamins, the methylated B vitamins, not the regular ones, and it’s still elevated. Is there anything else they should do as far as looking for toxins are any other strategies to get the homocysteine down?


Wendie Trubow  25:04

Yeah, definitely I mean TMG tri methyl glycine can be helpful with homocysteine. And then if you’re really giving the body exactly what it needs and the homocysteine is elevated, then I would look at toxins because it creates this toxins. Toxins are amazing for what they do in a negative way, amazingly negative for what they do for cardiac health and metabolic health for cardio metabolic. So anything cardiac and anything metabolic is amazing for how it tracks back to toxins. By the way, we didn’t say I’m the bad news bear, right? I’m like the bad news bear. Except you, you have control over it, and you can impact this.


Robert Lufkin  25:41

Yeah. And hopefully, by knowing the bad news, you’ll be able to convert it to Good News and being aware of like you say, I just want to underscore what you said. It’s so fascinating that that all these all these health pathways are linked at like a fundamental metabolically level like, like homocysteine, like you said, it’s roots related risk for heart disease, it’s, it’s the one of the number one risk factors for Alzheimer’s disease, elevated homocysteine, and just so many other metabolic factors like that across the way. I wanted to be sure and touch on gluten a little bit. And you mentioned gut health, you’re obviously the President of the National celiac Association. And you mentioned your your own personal history with with the disease. Can you talk about that a little bit? And actually, specifically for people who are don’t have celiac disease? What is their risk and inflammation in the gut? What’s your position on that?


Wendie Trubow  26:52

Oh, this is so cool. I have to say the glute gluten and the gut and tight junctions is one of the coolest things I ever studied. So let’s back up 10 steps, about 40% of the population has one or both or, or one of the other of the genes that put you at risk for celiac disease, and that’s DQ two or DQ eight. Now, you can have the genes and not ever get celiac. Okay, let’s back up even a step further. What celiac, celiac is the diagnosis of the autoimmune disease that’s caused this full blunting of your villi in your gut that are responsible for absorbing your medulla, your nutrients and minerals, what are villi They’re these little hairlike things in the gut, that are their job is to reach out and grab the minerals and nutrients. So if you were to look at your gut under high high, high micro microscope, you would see these beautiful flowing, flowing fronds. And as celiac developed, the frond start to shorten and blunt. So at the end of it, instead of having this flowing thing, you have these blunted almost like knuckles. And obviously, if you decrease your surface area by 99%, you’re gonna absorb a lot less. So Celiac disease is the end result of this process. So imagine celiac diseases at the at the final end of the spectrum. And the very other end of the spectrum is no genetic problems. No gluten sensitivity, no nothing. It’s a spectrum. You don’t develop it overnight. And when you have celiac disease, you have antibodies that your body is producing against these gluten particles. Okay. Now, what’s really even cooler is that when you have these genetics, and by the way, Robert, something you said was so poignant, because you said, people who don’t have celiac, have the people who do have celiac, only one, one to 5% are diagnosed. So the other like 95% of people who have celiac don’t know they have it. So it’s just really crazy to think there’s this epidemic of people who don’t know they have it and have it anyway. If you have one or both of the genes, you have more copies of this receptor called CX CR three. I don’t know why they named it that but they did. It’s a terrible name. So when you eat gluten, you have all these copies of CX CR three, it binds to gluten and it up regulates this thing. That Alessio Fasano discovered in 2000, called zonula. Ins. I think he’s gonna get the Nobel Prize for this discovery because it impacts gut permeability. Now, what Zonulin is do Zonulin then go to the go to the lining of your gut, which is really tightly packed, it doesn’t let anything through. It’s your protective mechanism. And it opens up Zonulin say to the tight junctions. Okay, guys, open up. So the tight junctions open up, and now your bloodstream is exposed to everything that’s in your GI tract. If you don’t have the genes, whenever you eat gluten, you expose that it happens also for like 15 minutes. If you do have that Genes and you eat gluten, you have this upregulation. And that process lasts for four hours. So a lot more stuff can get through the lining into your bloodstream and for hours and 15 minutes. So what you frequently see alongside people with celiac is before you get to celiac, you have food sensitivities, you have seasonal allergies, you have issues with other toxins, because your bloodstream is essentially open to the rest of the world for a lot of time now, layer on a standard American diet. What do you have for breakfast cereal or a bagel or a wrap? Okay, it had it had tomatoes and cheese in it Good job. Or it was with milk. When Jeff for lunch, a sandwich around? I had my veggies. I’m like, okay, cool. What Jeff for dinner, chicken and pasta. So three times during the day, most people are getting gluten. If you’re if you’re in that 40% of people, I mean, that’s a lot. Four out of 10 people have it. They’re opening their entire bloodstream to the world for essentially 12 hours a day. So it you can have problems with gluten and not have celiac because it’s a progression. You can you can interrupt the process before you get to celiac. Celiac is just you’ve made it to the end autoimmune issue. Congratulations, you’ve gotten bad enough, right? But you can interrupt it way before that.


Robert Lufkin  31:20

So so it sounds like we have almost a 5050 chance of being harmed by gluten in their diet. Are there? Are there easy ways to test for this? Or is it is it best just to just to avoid gluten and grains altogether? And for everybody and make that a policy? Or? Or what approach do you think?


Wendie Trubow  31:42

Alright, so So before you and I get egg egg by people who are like, Well, wait, wait, why would you do that? So I think that there’s a there’s a role for grains, except it’s a much smaller role than what we’ve given it. The other issue that we want to layer on with gluten, especially is that it’s all contaminated with glyphosate, which is Roundup, which is a most commonly used herbicide in the world. I forgotten the number I was looking it up, I just can’t remember the number. It’s something like 500 million pounds were used in 2014 in 2014, right? So a ridiculous amount of it is being used. And it’s a microbiome disrupter, so it disrupts the gut. And it’s an independent risk factor for multiple forms of lymphocytic cancer. This is nasty stuff. And you really can’t get gluten without the glyphosate. So I would say, as a broad brushstroke, when you look at eating food, Michael Pollan said it best eat food, real food, not too much. And so it should look like itself in life, you shouldn’t, if it’s a piece of bread that doesn’t look like itself, it’s been processed beyond belief. And when you grind it down, you make it easier to digest, which means it turns to sugar faster, so and then it’s contaminated with glyphosate. So I would say the carbs that are processed are probably not in your favor. And then when you’re looking at grains, you want to look for organic grains. However, keep in mind, because of drift with glyphosate, a lot of organic grains are even contaminated. So they’re not they’re not your best source for food. On the other hand, they have fiber, and a lot of people need more fiber, which helps with digestion to so it’s like this sort of push me pull me. So I don’t think that I would say everyone should stop eating it. But I would say if you have any chronic issue, if you don’t feel amazing, it’s worth looking into. And then you say, okay, test for celiac, that’s an easy blood test. And then then the question is, are you on the spectrum, but not celiac? Are you somewhere on that path? And that you’re going to need a functional medicine provider to do gluten specific testing for for you. That’s not celiac. It’s like, hitting you before you get the disease. How do we diagnose you? So that’s functional medicine doctor?


Robert Lufkin  33:56

Wow. Yeah, that’s very challenging. Let me let me back up one step. You said something very interesting about inflammation of being inflammation, the root of most of our chronic disease today, that’s accepted. And the fact that these tight junctions and just food itself triggers inflammation in our bodies, if you think about it, inflammation is a protection against foreign things and food entering our bodies is foreign. It’s a natural foreign process, but the process of eating and food in our gut will increase inflammation. So is that an argument for fasting and decreasing the frequency of the B inflammation triggered by the food?


Wendie Trubow  34:41

Kindness that does that work? I mean, you have to break your fast eventually, right? So you always have to eat at some point. Men tend to do a little bit better with fasting than women do. Although I will say like I’ve been intermittent fasting since before it was a thing like I don’t eat after dinner and I didn’t eat my breakfast or lunch until my breakfast until like, I don’t know Somewhere between nine and 11 in the morning. So if you’re fasting overnight that is fasting. So men tend to do better with longer periods than women do. But you do eventually have to break your fast. So what you’re talking about is resting the gut. And certainly, if you have any gut dysfunction, it’s worth resting it. You know, I always say to people, do you wake up bloated? If you wake up bloated, that’s a much different process than if you don’t wake up bloated. And then you eat and get bloated. That’s very different processes that we want to look at. And so because eating and getting bloated implies a digestive issue, and waking uploaded implies an imbalance in your microbiome that we need to address. So it’s, it’s useful to figure that out, but I think it’s useful to rest the gut, but the question is for how long? And what are you breaking it with?


Robert Lufkin  35:50

Yeah, yeah, it’s just we always hear about fasting as a detoxification or thing like that. One other one other thing about that for detoxification, saunas, jacuzzis, are those all that helps with cleansing also, you live on in that?


Wendie Trubow  36:10

Yeah. It’s so funny. I was listening to a lecture. We got an infrared sauna last year, actually, more than a year ago, we got an infrared sauna. And it was so pristine that I didn’t want to sit directly in the woods. So I made everyone put towels down. And I was listening to this lecture that said, you know, if you’re sweating directly on the wood, all the toxins are going into the woods. It’s not good, because then you’re sitting on it, you’re reabsorbing him, I was like, well, sort of counter intuitively, just because I didn’t want it to be dirty. We did that anyway. But yeah, infrared sauna near mid far is best in class. And then regular sauna would be the next level. And then on a separate separate pathway, jacuzzi, Epsom salt, bath, Steam, anything that gets your lymph moving, and you sweating because your skin’s a huge detox organ. Anything that does that is meaningful, dry brushing, exercise. Again, anything that gets you get you sweating.


Robert Lufkin  37:06

One other one other thing in your book, you mentioned that, for me as a sort of a child of white working class parents was very foreign. But since my wife was born and raised in Shanghai, China, it was sort of we’ve adopted this ourselves. And one health tip you mentioned was taking your shoes off in the house. I never really thought of it that way. But do you recommend that for your patients?


Wendie Trubow  37:32

I do. I recommend it for everyone as the so I gave up cleaning my house because I was just too stinkin busy, but it still bugs me to see dirty floors. So it’s a it makes the floors dirtier but be you are tracking everything that you’ve come in contact with, into your home, and then you take your shoes off at some point and you’re absorbing that. So if you’ve come in contact with pesticides, mycotoxins, you’re absorbing that all into your skin, because our skin it the skin works both ways, right? It can absorb, and it can release. So we want to focus it on releasing as opposed to absorbing but yeah, 100% I would take your shoes off. It’s an easy way to decrease exposure to lots of things.


Robert Lufkin  38:15

Yeah, that’s, that’s, that’s great. Well, let’s talk about five journeys. You You and your husband have put together this amazing program. I mean, in addition to the book, which hopefully people will will enjoy and read it. Yeah, it goes into a lot more detail than the things we’ve been talking about and covers a lot of things we haven’t had time to even get into. But five journeys is a program that you have now to help patients specifically with with these issues. Yeah,


Wendie Trubow  38:45

so five, five journeys was really the name was my brainchild, the philosophy was my husband’s brainchild. So, looking sip, you know, it’s all connected, we can’t really pull it off. But putting it all together to say your combined health is the sum total of your body’s ability to manage your physical body so that your bones, your muscles, your ligaments, that’s your posture, that’s your exercise, how you hold your structure impacts the hormones that your body puts out. So it really is important to have good posture, if you’re hunched, you’re gonna have less testosterone. And if you’re open, you’re gonna have more testosterone. Go figure. It’s as easy as that, right? So your physical body, then your chemistry that’s really where the functional medicine doctors often play, which is your digestion, your absorption, your hormones, your minerals, your nutrients, your toxins, that’s, that’s all your chemistry, optimizing that. And then there’s your emotional balance because we’re so cruel to ourselves. And being unkind to yourself can actually set off a whole cascade of unhealthy chemical reactions that impact your adrenals your liver and your gut which can shut down digestion shut down absorption Shut Down detox. So balancing people’s emotional health, and then their social health because if you’re isolated, that is a key factor for for lack of health. So making sure that your community that you’re connected to your community, and then making sure you have a purpose in life, right? Like, that’s the spiritual part. Because if you don’t have a purpose and aren’t moving towards something that inspires you, what’s the purpose of working so hard on your body? Why avoid the cake, if you don’t have a bigger purpose, right. So we put that together and work with people usually, usually three of them, three areas people need to work on. Now, sometimes the chemistry is so out of whack, and people are like, that’s all I can do. Oh, and super overwhelming. So we will remind people where they are. But that’s really our clinic. And that’s where we work with people on. Let’s take the next step. We say you’re meant to be vital and vibrant and healthy, alive, interested in intimacy and able to do it until you’re at least 100. So if you’re moving towards that, cool, let’s keep it up. But if you’re not, let’s figure it out, get you back on track.


Robert Lufkin  41:04

And five journeys is your practice is based in New England in the United States. But I understand people can join and participate in the practice from anywhere in the world, right, from an online type of program, then, yeah, great. And, and that information is available on the website, they can sign up, is it like a membership thing, sort of an ongoing experience? Or is it more like a clinical practice where you address certain things and treat them or combination thereof,


Wendie Trubow  41:37

it’s a membership practice. So you join the practice. And then ongoingly, what we’re working on is how do we level up and level up and level up so that when you look back over the last two, three years, you know, I’m so much better now than I was three years ago, and continue to level up?


Robert Lufkin  41:53

Yeah, and it when they, when they read your book, they can see how you’ve done that with your own life and turn your own life around. It’s really a remarkable, remarkable journey and all and, and any other things that you want to share as an expert in this area and toxicity you shared a lot in your book about the things you do for your own personal life choices for the choices you make in your lifestyle in your health for for this area. Anything you you think would be a value for our audience. Yeah,


Wendie Trubow  42:28

I think that listening to me at the, at the 80% done part of the story can feel kind of intimidating, because there’s a lot of things to address. So what I’ll say is, you know, I’ve been in this for three years already. And at the beginning of it, and by the way, I’m still tripped up by stuff, I’m like, Oh, I never looked that up, I just assumed it was, you know, really a great product. So it’s easy to feel overwhelmed in the process. And what I would say is just pick something in your life that you’re running out of, and go to Environmental Working Group. I think that Amazon and environmental Environmental Working Group now have an agreement where they’ll show if something’s ew G certified, which is so easy, so much easier. So start to buy products that are are not giving you toxins, at least stop filling up the pump with toxins, right, and then a truss the thing that’s easiest, have a when don’t fit, you know, it feels overwhelming. It’s okay, go slowly. Rome wasn’t built in a day. I didn’t do this in a day. And I’m still in the process, and will be indefinitely here because we live on the earth. So we’re continuing to clean it up.


Robert Lufkin  43:36

Yeah, yeah. And we’re learning so much. Now, it’s such an exciting time to be in this space, because we’re figuring out stuff that, you know, when I went to medical school, we didn’t even think about, you know, which are so significant now, and, and I’m sure you know, 10 years from now, we’ll be looking back at this time and saying, Wow, how could we have missed that? So for people who were for people who are listening, we’re gonna put the links to all your websites, and we’ll put eat the Environmental Working Group as well, and the things you’ve mentioned in the show notes, but for people who are listening, could you tell them how they can reach you? And also you mentioned it was a free gift available to our listeners if they want?


Wendie Trubow  44:22

Yeah, definitely. So I’m reachable through all the social media channels Wendy Truffaut, MD It’s an I’m assuming you’ll put it in the show notes, but it’s W E and D iy. Tru Bo W M D, and that’s on Instagram, Facebook, LinkedIn, and Twitter. And then our company website is five And then the free gift because if you’re reading the book, and you’re like now psyched to go clean up your life, now you don’t know where to go. So we put together this companion guide that is the guide to non toxic living. Nope. It’s sort of a misnomer, right? No, no life is non toxic, but lower toxic, I would say. So that’s all about What’s the right beauty product? And what’s the best pan to use? And where do you get your furniture from and which to clean your house with all of those things we put into one guide, because we really spent so many hours researching this. And then we said, well, let’s put that to good use. So that’s on our website. Also, at FYI, VJO. You are any forward slash promo, and that just put your email in, we’ll send you the PDF of the non toxic Guide to Healthy Living.


Robert Lufkin  45:28

Oh, that’s, that’s, that’s great. I that that will be a great follow up to this to the book, which, again, is showing up very well. We just see


Wendie Trubow  45:37

my face. It’s got face recognition.


Robert Lufkin  45:43

There it is. Yeah. Well, thanks so much, Wendy for spending an hour with us and sharing the knowledge you have you and your husband have put together in this great book and and the great and the great practice you have and I look forward to catching up with you again soon. Yeah,


Wendie Trubow  46:00

definitely. Robert, this has been great. Thank you so much for having me on.


Robert Lufkin  46:05

Welcome back to the health longevity Secret show and I’m your host, Dr. Robert Lufkin. rapamycin, Metformin, and phi Sciton are all associated with improvements in markers associated with aging. We are now beginning to see the news by healthy individuals interested in promoting longevity. Daniel Tawfik is the founder, developer and CEO of health span. health span optimizes human performance through interventions that target cellular senescence. healthspan was created to empower patients to regain control over the levers of aging that are at the foundation of most age related diseases. Daniel holds a BS degree from UCLA in Molecular Cellular and Developmental Biology and Physics Daniel did his graduate research at UCLA is protein expec expression Technology Center where he studied neuro metabolic disorders. Before we start the episode, if you like what you hear, please consider supporting the work we do as well as joining us on your personal health longevity journey. You can do both by becoming a member of our community. The benefits include a private messaging area, live QA sessions, weekly premier videos, product discounts, free giveaways, and much more. You can join for as little as $1 per month, and the first month is free. See the link in the show notes for more information. And now please enjoy this conversation with Daniel topic. Hey, Daniel, welcome to the show.


Daniel Tawfik  47:52

Hi, Rob. Are you doing?


Robert Lufkin  47:54

I’m so excited to have you on the program today and hear about the fascinating things you’re doing with healthspan. And these these interesting longevity drugs. But maybe before we before we dive into that, could you take a moment and just share with us how you came to be interested in in this area?


Daniel Tawfik  48:19

Yeah, you know, there’s so there’s multiple dimensions of, of curiosity, frankly, that brought me to wanting to understand the underlying mechanisms of aging. When I was an undergrad at UCLA, I took a biology of aging course. And we learned from it like evolutionary biology perspective, or looking at salmon. And after they reproduce, they just rapidly degrade. They die. And I was curious, I was like, well, that’s just not wear and tear, right? We’re kind of taught that we have wear and tear, we have DNA damage and that ultimately, tissues become dysfunctional. It’s this is this is what he has been, it seems like it’s based off of this example. It’s usually there’s some self programming here. And I was curious to see what what are the underlying mechanisms of this? When I was in college, I worked in a lab where we’re looking kind of at metabolic pathways that progress, chronic age related chronic diseases we’re looking at neuro degeneration specifically. And what I learned from that experience or looking at kind of mitochondrial dysfunction in that context is that human beings have much more power over health outcomes, then the luck of the draw kind of paradigm, we we think about the stuff, of course, there’s genetic factors that play into health outcomes. But ultimately, it’s very empowering to know that there are interventions or lifestyle changes we can make, that can bend the curve in our favor. And so I love to geek out on the interventions that, that do that, right. So ultimately, the, the thing that made me want to make this kind of a career thing is my wife’s health complications. So my wife, you know, this is someone who was the captain of the water polo team, she’s a, like, super high achiever type, highly active. She had lymphoma, and she, she went through one bout of it, and three years of treatment, getting chemotherapy for for lymphoma, she’s at a, she, it’s, she’s in the clear for about five years, then it relapses and then she has to do a stem cell transplant. And, ultimately, you know, I had, taking kind of a break from the life sciences browse the software development kind of entrepreneurial activities, I thought, well, I know all this stuff now about metabolic pathways, and in this specific case, cancer, how kind of there’s, there’s a component of metabolic ecology that can, we can kind of use to bend the curve in our favor against having getting cancer at some point in our lives. I think this is a good way to just kind of sublimate the, if I can bring something to market that allows patients to optimize healthspan through these lifecycle lifestyle interventions, and pharmaceutical interventions, and help someone avoid the health outcome that my wife had, it would be a worthwhile pursuit. And ultimately, that was kind of the inspiration to kind of get off the sidelines and be kind of like a hobbyist, if you will, to, to make this kind of like the cause of of my life. So I it’s, you know, started with curiosity, kind of wanting to geek out on underlying mechanisms of aging. And then there’s a very practical reason why we, you know, put our time and attention into building a telemedicine practice around cellular senescence. So hopefully, that gives you some idea of all the the decision making process on my end.


Robert Lufkin  53:11

Yeah, I totally get the motivation there. And it’s very, it’s very admirable what you’re doing in it, it’s a great area, and the progress that’s being made, the discoveries in this area is is changing so fast. So So you’re back to your concept of aging, I guess it’s, I get from the IT, in your opinion, it’s not really an accumulation of errors, but it’s a program process. So what maybe you could just share with us a little bit, what are some of the mechanisms then of the of these programs? How what can we do and what what’s happening that, that controls this programming?


Daniel Tawfik  53:55

So the there’s multiple, you know, with current diseases, there’s, there’s just multiple, it’s very complex, right? So you can kind of you have to pick and choose what what’s your area of focus, right. And what I’m acutely focused on the cellular senescence and to give the listeners some background on what cellular senescence is. A cell undergoes damage, you know, UV radiation, some kind of DNA damage that, that makes it such that the body needs a way to the organism as a whole needs a way to make it such that this cell doesn’t proliferate, right. So we have cell programming to deal with damaged cells. So a cell can either go through apoptosis, which is like cell suicide. It has a cell had built in program and say, Hey, there’s damage here. Let’s eradicate this cell. Before it encourages more damage, there’s a second kind of evolutionary response to to cell damage, which is senescence. And that’s the arrest of proliferation of a cell. The cell still exists, but it can’t replicate. It can say in kind of like a zombie state, right where it, it can grow, it can exist, but it can proliferate into what would be the third outcome and the worst outcome of cell damage, which is tumorigenesis. If the cell damage cells actually replicate. So cellular senescence, the second outcome that I talked about, is a way as a protective mechanism to guard against kind of the growth of bad tissue, if you will, but cellular net senescence cells have a they have some defining kind of factors about them, that make them something that as we, as we age, when we accumulate more and more of them, they can cause a lot of tissue dysfunction. And that is, they can’t proliferate. They can’t, they can’t replicate at all, but they can grow, they can. So there’s three kinds of traits of us senescence cells, they exhibit Hyper Growth hypertrophy, so they can, when they’re exposed to growth factor, unlike regular cells that can’t replicate, they just enlarge, they exhibit hyperplasia, meaning they release, they can release mitogenic factors that cause adjacent cells to grow disproportionately in a way that’s not healthy for the tissue as a whole. And then lastly, they exhibit hyper functionality be over express certain molecules in this case, senescent cells have this, this defining characteristic of something we called the SAS. And that’s the senescence associated secretory phenotype, which is kind of a witch’s brew of kind of very harmful molecules. So this is these are things like inflammatory molecules that cause damage to adjacent cells, mitogenic molecules that cause proliferation of adjacent cells. And so these cells, they’re, they’re growing, they’re excessively active in in producing molecules that are causing damage to the tissue as a whole, and they don’t carry out their original function, right. So you get this tissue degradation over time. And if you look at across the board of age related chronic diseases, you see senescence as a foundation, kind of theoretically as a foundation for everything. So if you look at osteoporosis, you see hyperactivity of osteoclast reabsorbing born bone and if you look at Corrado and cites the overexpression of parents in leading term wrinkles, and we had a someone come to healthspan the other day interested in taking these class of drugs called mTOR inhibitors for male pattern baldness. The The reason why is the overexpression of androgens leading to hair loss. The and then neurodegeneration is probably the easiest to explain. It’s the overexpression of these immune molecules that cause a autoimmune issue and neuronal cells. So the overexpression of tau proteins linked to Alzheimer’s, it’s like a very glaring example of this. So senescence, as we’re young, we’re young we’re able to get rid of senescence cells or dispose of senescence cells at a rate that matches the rate of accumulation. But as we get older, there’s a Critical Mass Effect of where senescent cells accumulate accumulate accumulate at a rate that outpaces our ability to to dispose of and so as we get older, you see tissue degradation and dysfunction across you know, the entire organism. And that, to me, is kind of a universal theory that we could I can kind of dig into and look into the interventions that kind of specifically target that. That says, Hey, let’s put some more time into kind of thinking about how do we target senescence as kind of this kind of umbrella. deleterious dysfunctional state?


Robert Lufkin  1:00:34

Yeah, before we dive too much into senescence, I, I backing up just a little bit I often hear Leonard Hayflick, as work in the 60s, I think it was about it, famously, the generational limit for cell division, you know, the Hayflick limit at all, as a as a trigger for senescence and and these things, but what you’re seeing is it also accumulated damage, in a sense also.


Daniel Tawfik  1:01:10

It’s, it’s, it’s so yeah, there’s there’s a kind of a normal course that leads to a senescence it, but in the exposure to damage the cell can go and these three routes, right, but we’re from an evolutionary perspective, we’re really hyper protected against that third tumorigenesis state. So there’s either we apoptosis to, like cell dead date the cell, this kind of suicide state, or there’s let’s just arresting the cell cells capacity to replicate entirely. And that’s in essence as a protective mechanism against tumorigenesis. So no more proliferation. It can the problem with a senescence cell is it still exposed to growth factor. So we see when it’s exposed to growth factor, when core which we’ll talk about it’s switched on, to kind of get in these anabolic states and grow or grow, it just gets it has the defining characteristics of hyper growth, hyper over expression of molecules, and then causing adjacent cells to just overly proliferate you get kind of a tumor genesis state as well. So it’s a protective mechanism in one set when we have the cell damage, but as with many things in excess, it becomes the driver of cellular tip cellular dysfunction and tissue dysfunction which we which we can see as we get older right. So our tissues not being able to do its original function.


Robert Lufkin  1:03:10

Now, you mentioned these the effects from the senescence the SASP and and this other hyper functionality, hyperplasia ik etc. are there are there ways we can follow that in a patient? There are there easy markers we can use like CRP for C reactive protein or anything or what are the best senescence markers if we had to pick something to follow senescent activity in a patient? I think these are


Daniel Tawfik  1:03:43

kind of inflammatory. You would see the difference if you took it, if you took a biopsy like a young person and an elderly person who be fairly easy to detect, which is which because the biopsy the older person, which is have more signs of inflammation, right? So this the SAS, we can kind of measure through proxies of inflammatory markers, right. So, you know, we have a solution or with healthspan, what we produce is Yoast speak to one of our doctors is focused entirely on cellular senescence, and they’ll send a panel based off of their discussion with you and kind of measuring these markers of inflammation. So, ultimately something you’ll you’ll talk through with your physician.


Robert Lufkin  1:04:47

So, first in essence, now there what are the what are the main drugs and Will Will, Will Will I want to get into healthspan in a little bit, but just generally, what are the main Any drugs that that you look for, for for combating senescence and what are their mechanisms of how they work?


Daniel Tawfik  1:05:09

Sure. So through mechanistic perspective, it’s helpful to understand Tor. So it’s targeted rapa myosin to Tor is this switch within the cell that directs the cell to either kind of go, you have, the best way to describe it would be the easiest way to describe it would be an anabolic state, a growth state versus a catabolic state, which is a word we need to stop growing, we need to conserve energy. Oftentimes, in this catabolic state, we go through a process called a top algae, which we use cellular debris to utilize for energy. So you have this accumulation of these this Sass, or these toxic proteins, let’s use that as an energy source. Right. So Tor is this switch within the cell, that is really its stimuli or lack of stimuli, it’s look, it’s detecting states of nutrients within the cell. So it’s primarily looking at the amount of amino acids available in the cell, and then through the rate through kind of media to the mitochondria, ATP to MP levels. So in a state where you’re low on nutrients, and you are fasting all day, tours going to, you know, the simplest term sourcing to get a signal saying, Hey, we’re low on energy right now, let’s not proliferate, let’s not grow, right? Conversely, if we’re getting a lot of stimuli that says, hey, there’s a lot of amino acids, there’s a lot of ATP right? Now, it’s a good time to grow, right? Like, it’s like let’s both be bullish on growing right now, then it Torre will signal to the cell like like, let’s let’s it might be a good time to replicate, it might be a good time to grow. It might be a good time to overt to express kind of these aggregate proteins that we talked about. So what would that being said, there’s there’s a lot of implications to that. So one thing, before we go into the medication itself, the implications for metabolic pathways are significant, right? So on the standard American diet, if we’re constantly over feeding ourselves, we’re constantly exposing ourselves to carbohydrates, and, you know, very calorie rich diet all the time, you’re in an anabolic state all the time. And you’re, you’re overexpressing tore continually and that has a lot of negative effects. Right? So that’s a lifestyle intervention to need to think about. What ways can we turn Tor on in certain seasons of life and what what ways can we Kukui inhibit Tor to get into a catabolic state to do some kind of spring cleaning. So in terms of lifestyle, lifestyle, interventions, fasting is a way to to signal to kind of play the the nutrient deprivation state as a lever to stop the the Tor anabolic state from from being flipped on. Right. And so fasting is a great way to understand how how Tor inhibition works. When you’re in a fasted state, you there’s the cell is basically producing less ATP and ATP is kind of the currency of the cell to do work, essentially. And when we’re low nutrients, we produce more of the form of energy. It’s not a triphosphate, so three phosphate groups but a single phosphate group, which has each phosphate group is kind of the energy source that allows the cell to do work. So we’re in a fasted state you’re producing more a&p kinase, producing more the ratio ANP the lower energy version of of this energy currency to ATP, there’s more ANP the A tore through a signaling pathway says, oh, there’s a lot of Andy kinase here today, let’s turn off this proliferative hypergrowth state. Right? So fasting exercise is another example of this trait. These are lifestyle interventions. So that leads us into the prescription molecules that shouldn’t take. So Metformin is a fasting mimetic, right. I’m gonna say this just to illustrate a concept, it’s, it doesn’t really do the, I’m gonna use the word clamp. I think of it as like Metformin is a clamp on the mitochondria, it’s not a clamp on the bioeconomy. But it reduces the output of ATP. And it signals to the to increases the output of a MP, which then mediates this inhibition of Tor and Tor. And it does this for very practical purposes, when a MP levels are are low. It there’s a cascade of effects here. But one of the things it’s going to do from kind of a very practical perspective, it’s going to trans look translocate blue transport channels to get more glucose into the cell, hey, we’re deprived on energy. Let’s get some more glucose into the cell. All right. So Metformin is a way that we can induce this, this catabolic state, this a tapa G, state, that kind of the spring cleaning state. So but forming mediates a cascade of effects from a metabolic. It’s going to a metabolic perspective, it’s going to lower the overall release of IGF one which is a growth factor that causes cell growth and cellular proliferation. And it’s going to do this cellular deep cleaning through instigating a toffee G. So Metformin will be top of the list, it has a an incredible safety profile. The reason why we know mechanistically, anything about Metformin is we’ve there’s tons of observational research on Metformin, with people with us an assortment of comorbidities, whether it’s diabetes or cancer, their health outcomes turn out to be better than in some cases, that kind of helping populations. Be looking at his observational data. Folks like NIR Barzilai folks who really put a lot of time studying Metformin, wanting to look at the mechanistic mode of action for Metformin. Everything I just spoke about is kind of like speaks to how the form of those first seeing that the health outcomes and that form in patients were surprisingly good even in an unhealthy patients on Metformin is kind of the, the medication that targets senescence through kind of triggering this fasting mimetic state. The second medication that also kind of mitigates the deleterious effects against senescence cells is rapamycin to make both fall into this category of kind of a Senate morphic, they they kind of tamper the mitigate against those hyper functional kind of states that I was talking about. But Foreman does this through nutrient sensing, kind of mimicking the nutrient sensing pathways that the mitochondria randomizing directly inhibits portion of the tour that controls this proliferative growth state as well. And that’s the medication that in the longevity space has the most interest because of its direct binding, so towards the target of rat myosin, and the art of course, the raffle is in part, so So rapamycin seems to kind of be the rapamycin and its analogs, the the the new versions that that pharmaceutical companies are working on, seem to be having the most interests there. It’s a kind of a novel approach to targeting the mitigating the deleterious effects of senescence cells. So there’s the Those, those two drugs which are kind of most interest in they really they’re really trying to mitigate the the kind of proliferation of senescence cells and the deleterious effects of senescence cells. There’s another group of medications that it’s a little kind of it’s it’s kind of a brave new world a little bit. It’s senolytics, which is compounds that kind of push, push the senescence cells into apoptosis state, right. So it’s basically trek triggering us in essence, self self detonation kind of programming. And so like the SAT nib, which is actually chemo medication, I’ve never taken this additive and abductor green prescribes it five to 10 courses and as a combination has our interests and kind of miss analytic space to basically lead to the eradication of senescence cells, rapamycin, Metformin, are kind of limiting the harmful effects of HIV and AIDS and stopping the proliferation of senescence. Cells on Linux or our phones are targeted towards the eradication of senescence cells.


Robert Lufkin  1:16:31

I see. So yeah, a combination of both rapamycin and metformin to decrease senescence and then the Pfizer tend to be actually say analytic to, to destroy the cells that already are senescent, in a sense there. So maybe so we have these drugs. Now, I want to hear about about healthspan, about your company that makes these makes these medications available in a supervised medical setting for for patients that are curious about that. Yeah. How did that get started? And tell me more about that?


Daniel Tawfik  1:17:07

Yeah. So it goes back to this experience I had with, with my wife and kind of trying to figure out what to do with that kind of energy and frustration. And also the curiosity component. So prior to my wife relapsed I was I was like, fully, but I was a geek on on these these different compounds. And these lifestyle intervention, so I would, you know, fast. over the weekends, I would do a 24 hour fast every Saturday, and sometimes I would do a three day fat, once a month. But I ultimately was very curious about taking Metformin from myself, and I want to go talk to my primary care physician about taking Metformin. And so we know that Metformin is a drug that patients with diabetes take, right? And so I’m healthy 35 year old, and my PCP looks at me and says, like, why would you take Metformin? Your view of No, there’s no indication that you need to take Metformin at all. And then I know I said, Well, you got other studies and kind of it was clear to me that one of the one of the features of our medical system is that, you know, physicians are bogged down with the day to day dealing with putting out fires. My brother’s a physician in my wife’s position. I’m surrounded by physician, my life all my friends from molecular biology days are physicians, right? And when I talk to them about Tor, and metformin, their eyes glaze over, like, Oh, you’re talking about this stuff, again. It was clear the pipeline from the research community to the clinical community, just there’s, there’s a huge chasm because of kind of everything we talked about, about the constraints on doctors right now and all that they’re responsible for, in their practices. And so, I thought to myself, Okay, it’s kind of an interesting idea. There’s really not a clinical home. For these folks like myself who are interested in cellular senescence, some might call it kind of like bio hacker types. There’s, there’s not a place you can go to, or it’s very hard at least to find a physician that’s super knowledgeable about these things. And then there’s this kind of like, overlap with At the wellness community too, so you might be like a functional medicine doctor, which is awesome. But there’s also a kind of like, overlap with kind of holistic medicine, that is less data kind of driven. And so you might, if you’re kind of a biohacker type, you might see kind of a wellness person. So our thought my thought at the time was, like, it’d be interesting to see if we can create a medical clinic that is doesn’t matter analysis of kind of what’s happening in the research community, but make it a specific focus, because I truly believe in this theory, this hyper functionality, theory of aging, just targeting one thing, cellular senescence, and so I sat on the idea for quite a bit of time. I because these are starting a company, it’s you know, it’s like, it’s, it’s a lot of work. And it’s a it can be you know, it’s it can be quite challenging, you’re really kind of going to, you’re going to be dedicating a lot of time and energy into something I sat on, I was like, I wasn’t sure how many people there are in the world, like, we don’t want this thing. Ultimately, my wife’s cancer relapse. And we were at City of hospital. And I had been reading Peter T ‘s article on Metformin as kind of manipulating the quirkiness of cancer cells and their kind of ravenous consumption of glucose. And, yeah, this is stuff that I knew back from my college days, but I was like, you know, if this can help one person, if we lost this clinic, it can help one person, it would be a worthwhile endeavor. And so I said, okay, like, it was at her city of hope. hospital room was like, Okay, let’s do this. And I, that’s when we put into play kind of developing the software and kind of mixing and matching the vendors and all this stuff and recruiting doctors who are interested in cellular senescence as a driver of aging. That same day, it was released healthspan.


Robert Lufkin  1:22:29

And just to be clear, this, this service is for it’s for normal, healthy people. It’s for people who want to look at longevity and anti aging. And also, you mentioned before the lifestyle things like let’s say, I’m a patient, I’m already I’m already low carb, I’m in ketosis all the time. And I’m fast and one meal a day. So I’m, you know, I’m intermittent feeding, it can still benefit me above and beyond even when I maximize my lifestyle thinks potentially, is that not correct? Yeah. And


Daniel Tawfik  1:23:06

so we’re this type of patient, right? Like, we’re doing all the lifestyle intervention sets, but we’re intrigued by the benefit of some of these Sena morphic drugs. And so we’re providing a home for folks like us who are kind of willing to kind of expect we’re in a healthy state, we want to talk to a doctor. We want to take these medications under a doctor’s supervision and kind of put, adhere to a protocol that we had talked about this prior to the to be podcast of, you know, putting together a protocol that’s least somewhat data driven. And we can talk into the challenges around some of these off label repurpose drugs when putting protocols together, but it is a doctor supervise clinic where you patients from all over the country can have a telemedicine consult with a physician in their state that can ultimately discuss lifestyle interventions and if it’s appropriate, prescribe some of these mTOR inhibitors to target the deleterious effects of senescence cells.


Robert Lufkin  1:24:25

Okay, so for patients who want to come to healthspan, just to be clear, they can come they don’t have to physically come to Santa Monica, California, they can it can be done remotely through telemedicine, is that correct?


Daniel Tawfik  1:24:38

Yeah, it’s patients across the country. Right now we’re just in the United States and with the exclusion of Alaska, which has its own kind of telemedicine rules. So, if you’re a patient that is intrigued by some of these, these interventions, you can talk to Doctor No matter from your own home, from your computer or your your iPhone or your mobile device, and start kind of pursuing some of these, these senescent targeting protocols.


Robert Lufkin  1:25:18

And the service for the patients is this, in addition is this, they, these, your your service specifically manages the application of these drugs for longevity, it’s not like they would still go to their primary care doctor. So this would be in addition to that, right? So it’s not a full primary care services specifically for these drugs, correct?


Daniel Tawfik  1:25:47

That’s exactly right. That’s exactly right. Thank you for clarifying that, too. Yeah, this is not your sort of, you’re gonna see your PCP. When you have your strep throat, this is for kind of the healthspan promoting kind of interventions. When you have an acute problem, you’re gonna go to your local doctor, who, who will help you kind of put out that fire. This is for people that are specifically looking for healthspan promoting interventions.


Robert Lufkin  1:26:20

And with that, I assume it’s not covered by insurance, because aging is not a disease according to Yeah.


Daniel Tawfik  1:26:32

The new problem in our in our field, it’s, I mean, so it’s all cash pay. But this kind of opened up a conversation about I talked about rap blogs, these new these new medications that are being produced by pharmaceutical companies. They essentially kind of mimic what rapamycin is doing. And it’s, it’s, if you look at kind of the incentive structure of, so we’ve met for at least take a step back, metformin and rapamycin have existed for decades, right? And when we look at rapamycin and metformin, conferring kind of a prophylactic benefit against these senescence driven age related chronic diseases, that’s not a that’s not there’s no clinical trial that can be done against aging there SBS specific malady that the clinical trial is kind of targeting. So it becomes very challenging to kind of make the claim that Metformin has these healthspan promoting benefits. And when I say healthspan, I’m not talking about the name of our company, I’m talking about the the amount of time in your life that you’re in a kind of a good health state, you’re not dealing with chronic chronic disease age related chronic disease. It’s just very hard to bill insurance to for taking Metformin arap mice. And so this has gotten into cash pay service where Yeah, it’s kind of an elective thing for the folks who are who are coming to our clinic. I shouldn’t say our patient base are super knowledgeable about these medications. They’re probably more knowledgeable than any of us. They they should face. They send us the papers on all the applications of it. They’re very interesting people. But yeah, it’s a kind of like, we have our tribe of folks that are very interested in senescence as a as a as a pathway of aging. And it’s those folks that we’re seeing in our in our practice.


Robert Lufkin  1:29:03

Yeah, just just one mentioned to you mentioned near bars ally, who’s his one trial, I guess he’s doing the team trial with metformin. It’s, he’s trying to get trying to advance it as a disease and get the FDA recognizing it and all but it’s, it’s a long process and very, very expensive. And like you say, there’s very little incentive for drug companies to work with at least the primary rapamycin or Metformin, which are which essentially are off patent now and and it’s, it’s both good and bad, but it’s a disincentive for them to move things forward. There.


Daniel Tawfik  1:29:44

Absolutely. I think there’s a lot of challenges we face as a community. And it’s one of them, it’s kind of off label repurposing of these medications that we have to figure out. Well, then if, if there’s not an incentive to do real time Testing, how do we collectively test this stuff out? And maybe it is incentivizing it through the creation of these rapid log base rep, biasing kind of analogs. But I think collectively there’s the onus is on us to figure out how to prove safety profile and efficacy. And I think your work in the myosin registry does a lot to promote that. But yeah, it’s this is kind of what were the pressures that we’re faced with?


Robert Lufkin  1:30:33

Yeah, tremendous challenges, but but a lot of a lot of opportunities. What as an expert in this space, we always like to ask, what, what personal choices if you made in your, your lifestyle, and and the drugs or supplements you take to knowing what you know about longevity?


Daniel Tawfik  1:30:59

Yeah, so yeah, I would say for everyone start off with lifestyle intervention. So like, the easy deal with the basics first, right. And so that is, for me, I like one of the the important pieces here is to understand the levers of aging. It’s kind of the tools at your disposal to, to, you can manipulate it different seasons of life, if you will. So what I will do is, I know that I can kind of inhibit, tore through fasting, I know that if I can restrict carbohydrates, and some cases, amino acids, like leucine, for periods of time, I can get into that autophagy state more regularly. Now, there’s certain points in life where I want to be more anabolic, like I’m from weightlifting, or, like I do CrossFit regularly. And sometimes I don’t want to be a more anabolic state, I want to be in a pro growth state. So I will stop taking Metformin or fast or I will, you know, sufficiently provide nutrients, right. So then kind of leading in, I will take Metformin on days that I don’t work out. And then lastly, I take medicine once a week, at three milligrams a week. So it’s very conservative dosage. But those are the four primary things that I do with my life.


Robert Lufkin  1:32:36

And five certain also, do you take that? I have,


Daniel Tawfik  1:32:40

I am not currently taking it. I was taking Pfizer 10. And once a month at a heavy dose for like, three, three days, I’ll ingredients protocol for doing it, but I haven’t taken it in a while. And for no good reason. It just kind of fell off my my habit kind of like routine.


Robert Lufkin  1:33:07

Yeah, I think the challenge is that all of this space in in the longevity space. And and for all the drugs you’ve mentioned, are biomarkers for for successful positive outcomes we can we can always look for side effects. You know, certainly there, there’s side effects with these strokes. But what is your approach? You were with? healthspan? In other words, what do you monitor on the positive side? Or is or is it just increasing the dose to get side effects and then then pull back? Or is this


Daniel Tawfik  1:33:43

to be completely honest, it’s something we’re still putting together kind of the laboratory kind of protocol that we have. So we will send a phlebotomist to, to your home. This is part of the service, but we’re putting together a panel right now. But we also kind of lesson, the problem that we have in this community is that we don’t have a real good panel for to measure autophagy. And so if there’s any kind of researcher, you know, we’re working on at once a wants to work on this project of like, measuring artifact zones, like that would be really interesting. Everything else we just have proxies for. And then we’re also managing, we’re monitoring for side effects of hormone levels, etc. But we also more on the metabolic side and we’ll send you a continuous glucose monitor too. That’s something that she mentioned why.


Robert Lufkin  1:34:53

Yeah. Oh, this is great. Well, how can people follow you on social media Dan You know, we’ll have we’ll have links down below in the show notes. But for people who are listening to this as an audio version, maybe you could just tell us, tell them the links that they can find you.


Daniel Tawfik  1:35:11

Okay, cool. So I’m, I’m active on Twitter. I think that’s how we met. I’m at Dan Tawfik. That’s ta W F phi k. That’s primarily my social. Most of my social activities there, but you can go to my website, it’s Dan And if you’re interested in kind of our clinical telemedicine practice, it’s get


Robert Lufkin  1:35:41

Great, well, thanks so much for spending an hour with us today. It was it was it was wonderful getting to know you and also hearing about the exciting work you’re doing it healthspan and the possibilities for for dealing with senescence for with all these these new, amazing drugs you’re using.


Daniel Tawfik  1:36:01

This has been a lot of fun. Dr. Lufkin, I really appreciate it.


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