 Well, hello everybody. You are in for a treat today. You're back for another episode of Dr. Jill Live. You can find all of our previous podcasts on YouTube, Stitcher, iTunes, wherever you listen or watch podcasts, and please go there, support us, give us reviews, and share with your friends. Today, I have a special guest who I was so fortunate to meet in his office in Los Angeles, Dr. Ryan McLean, and I'm going to introduce him, and then we'll dive into, today our topic is the science of living longer and better, because one of the things I know, Dr. Ryan, you see this as well, but it used to be that we'd all go until like 1995 would be skiing or surfing or doing something amazing, and then just dive a heart attack or die in our sleep. Nowadays, the health trajectory has changed. So many, many people are experiencing either themselves or their loved ones in their 60s, starting to have health decline. I think one of the biggest industries now is, you know, old folks' homes, and that's not a very PC way of saying it, but it's like, what do we do when we could no longer walk upstairs or take care of ourselves or feed ourselves? And we're, you know, our elderly population is losing their ability to take care of themselves, and it's really a sad thing. And so one of the things we want to talk about today is how do we not only live a lot of years, because that's great, but it's not great if you're disabled and unable to care for yourself. How do you live a lot of years with life and longevity and happiness and joy and purpose and meaning and vitality? And I think that's the core of what you do every day and what I want to talk to you about today. Great. Well, I'm glad to be here. Thanks for having me. And let's dive in because that was the purpose of the book. Yes. Yes. Yes. So we're going to talk about your book. It's called Cheating Death. And before I do, let me just formally introduce you. Dr. Rand McLean is a dedicated regenerative and sports medicine specialist who enjoys helping patients with their complex medical care and providing insightful patient education at his clinic in Santa Monica, California. He has worked with some of the best health innovators in sports and regenerative medicine, as well as aesthetic and family medicine. He is passionate about therapy counseling. With each patient, he always listens to their unique medical concerns and works hard to provide them with wonderful education. So often that's our job, right? We're educators. Pretty much all the time, right? Yeah. As a dedicated osteopathic physician, Dr. McLean enjoys studying nutrition, exercise, herbs, supplements, acupuncture, traditional Chinese medicine in his professional as well as personal life, and from the latest in stem cells to hormone therapies to IV drips that reduce trauma, anxiety, and promote longevity in human performance, he believes that your past health mistakes don't project into your future. I love this framework, Dr. Rand. And before we dive in, yeah, I've got a million questions for you. Before we dive in, though, I always like to know story of how did you get into medicine? How did you kind of get to where you're at now? What's your backstory? Yeah, that's the classic, right? It is story of inspiration and desperation, right? This is really my ninth career as I count them. I came out of school and tried to follow in dad's footsteps as an accountant. I didn't try to. I kind of fell into it because I didn't really didn't care that much. I was involved in athletics at the time and just having fun, was happy to just get out of school and then realize that being a CPA was not the most fun thing on the planet with all due respect to other CPAs. But I always had a pension for medicine started with nutrition. You remember Adele Davis? Yeah, wrote books on nutrition. And I was fascinated at 11. I remember by being able to control your health with what we eat. And I just thought that was the coolest thing. I don't know if it was genetics or just, fate, because you hear so many stories about what triggered that. But I just struck me and then, anyway, smash cut nine or eight, eight careers later, I was expecting my daughter's arrival. And I said, you know what, I'm 37 years old. I've got to choose a career I like now for the rest of my life because it's going to be hard to do what I've been doing, which is bopping around and switching. So I was on a trip across country on I-10. And I thought, what do I really want to do? And I was honest, I really love medicine. I'd always been scared to do medicine because, you know, it's a daunting task and everyone talks about how daunting it is at school and all the studies. But I don't know, I made the decision and you know what happens when we decide we cut off all the other options. And I just said, I'm going for it. And that's where I am now. It's the best, it's my last career for sure. And I really am glad I did it because as you know, following your passion, as Joseph Campbell said, is the way to go, right? Yes. Well, what a story. So it was really a little bit later in life compared to the 21 year old, right? The classical like right out of college or whatever that goes into medicine. How amazing though that you went ahead because so many people are overwhelmed by the amount of time or effort that it takes and it does. But that is amazing. I did not know that. And then where did you start with, did you start to sell family medicine on your bio? Was it like family internal medicine or what was your start of your career training? Yeah, well, started having to go back to school and do my pre-rex all over again. Actually, if you don't know the truth, because it had been too long. And then, yeah, I went over to the USC program. They had a hospital, USC Kelecoma Hospital there and studied family practice on purpose, actually, because I don't know if it was the ADHD or just I thought, you know, I want to learn everything. And then I could decide from there. I originally wanted to be a surgeon. But, you know, as I said, I was expecting my first child. And there's a lot more involved to do medicine at age 37 that I had planned on, even though I planned on a lot. So anyway, that was kind of short. But yeah, with family practice or internal medicine, you get to learn a lot about very many topics. And then, you know, I mean, you know, once you get out, you've got this ticket to play. And so I chose sports medicine through another physician I knew prior to going to medical school. And then I think it just dovetails, you know, whether it's sports, optimization of health, whatever you want to call it, there's no regenerative medicine specialty per se. But if you're interested in just optimizing health, I mean, what better way to go? And, you know, it's just, look, you and I are both doing it for ourselves anyway, right? So why not share the wealth? And it just seemed like a natural course. Yeah, no, that makes so much sense. And I'm with you family medicine trained. And I love that you said I chose that because what people listening may not know is there's this hierarchical you know, system and medicine and like, you know, the there's often like, I don't know, maybe a idea that the best docs go into surgery or orthopedics or, you know, and brain surgery, right? Yeah, right. Neurosurgery. You know, that's not true. I mean, there's some amazing don't get me wrong. All specialties are amazing. But family medicine is sometimes in medical school, at least at the university setting, kind of on the low end of the totem pole. But I like you felt like I was given such a great foundation of all ages, all of the I delivered babies, I treated newborns and just like you. And really, when you know the spectrum now here today, we're talking about how to live longer and better and thrive on that half the spectrum. But you have to know, you know, are we born with chemicals? How do we have healthy pregnancies? Like it's the whole spectrum, right? And in our family medical training, we really get the whole spectrum and the whole thing with ages. And even I always enjoy treating people of the same family, because whether it's genetics or exposures, or even their own, you know, dopamine pathways or whatever, it's fun to see those patterns within families and actually treat a family as well, right? Yeah, no, I couldn't agree more. I can add to that. That's, that's, yeah, a perfect synopsis. It makes a lot more fun. And I argue that, particularly the latter part of what you said, it can help to know everyone in the family and what's going on. And, you know, without even having to get a genome mapping, it's just you can get a feel for the entire family. And I think if I'm not mistaken, that's why they used to do it, you know, going back to the Chinese medicine background where, you know, the families would have doctors for the entire family or, you know, extended families, right? And I think that was probably part of the reason why it works so well. Exactly. And they'd like treat, you know, the daughter and then they deliver the daughter's baby later in life in this whole. So onto what you're doing now. One thing I saw on your bio, as I read it, was the traditional Chinese medicine acupuncture and some of that. Tell us where that came in, because that's kind of a unique thing that's really powerful. And how did you get interested? Did you do additional training? I did. I was pretty frustrated with Western medicine because I had some bad experiences. The first one was when I was really, really small and they took out my tonsils and I best I can assume because I was really tiny is, you know, they put the mask on incorrectly with the anesthesia and I couldn't breathe. And I thought, gee whiz, this is what it is. And it left a mark, not physically but mentally. And then, you know, all the way up through college, you know, when I broke my neck, they gave me an option of basically what amounted to a door hinge or a fusion. And I'm like, okay, well, that's not going to work for me. I'm still young. I still got stuff to do. And you heard all the stories about, you know, okay, you're going to be a kind of a cripple the rest of your life. And that's not a PC term either. But that's the way it was looked at. So anyway, it was born out of frustration with Western medicine. So well, there's got to be a better way. Let's try apply to a school in Florida where I was at the time went two weeks and said, okay, this is not the best. I want to go to the Harvard. And back then, arguably, it was a school called Yosan University. And I went through the whole process there, you know, not the, in other words, not the, was it 400 hours, or maybe it's even less than that, to get a acupuncturist license once you're an MD. No, I did the whole enchiladas, they say. And, or the whole Sichuan, maybe it's in Chinese language, but it was great because, you know, a lot of the things that we learned in Western medicine are the kind of hit you over the head things. And, you know, God forbid if you got into a car accident, I wouldn't direct you toward the local Chinese medicine doctor, right? Emergency medicine, you know, that's where we've got an upper hand in Western medicine. But a lot of the chronic diseases where we kind of throw up our hand to go, gee, I don't know, whether it's, you know, menopausal symptoms or allergies. I think the Chinese medicine has a lot of better solutions, oftentimes, or at least equally good solutions. And without as many side effects, oftentimes, that Western medicine does, and it focuses on a lot of the subtleties that we ignore. I mean, one was last time, you're probably too young. But when I was a kid, every time he went to the doctor, the doctor would say, stick out your tongue and say, ah, did they do that anymore? Rarely, right? And that was a major part of diagnosis in Chinese medicine, as was, you know, listening to your polls and other things that we tend to ignore. And look, I'm not, I'm not being too pejorative toward Western medicine because, granted, we have other techniques by which we practice that arguably are improvement. But not necessarily all of them. But anyway, answering, how'd I get into Chinese medicine? It was frustration for Western medicine, and I did it the old fashioned way. For you. Amazing, because what I find is these philosophies that have been around for hundreds and thousands of years, are you going to traditional Chinese medicine? They have some wisdom, and it's even like, whether it's body typing or pulse or, you know, the physicality of our bodies and how they present in the world. And so many times, like you said, more gentle. What I really love hearing too is because of your life experience, you went into medicine, not completely. I think a lot of young people go in and think, oh, I want to be a doctor and everything that solved the world's problems. And you and I both kind of went in knowing that there's some amazing things we learned. And there's some amazing things about our Western system, like you said, heart attack stroke, whatever. But there's limitations. And I know I went in the same way growing up on a farm with a mother who was a nurse, we did, you know, lots of more natural things first, we still went to the doctor still did all the conventional stuff. But same as you, I had some experiences like that where it was like, oh, wait, this isn't the answer, the panacea to everything, right? So then you look outside. And I think you and I both now, we have a larger toolbox. So we still use great diagnostic tests and, you know, great Western medicine principles prescribed drugs at times. But it's like the toolbox of what else is possible is bigger, right? Yeah. And I think, you know, we're never going to get away from the art of medicine too, just to add a little bit more flavor to what you said, because we just don't have that down yet. You know, the whole Star Trekian thing where you just go whoop, and you get all the answers hasn't been invented yet and arguably may never get invented. So there is some art that comes with, again, interpretation of the tongue is scalloped or, you know, it's puffy or it has a code on it, which means something. Yeah. It's just we go digging into the laboratory assays and other things that also means something, but sometimes miss the overall picture when taken all together. So anyway, there's my take on it. I'd say something exactly similar to what you're saying. But yeah, I think it definitely has value some of these other methods that we seem to have passed over to some degree. I'm certainly glad I took the coursework because I think I definitely use it every day, even if it's just paying attention to detail. Hey, everybody, I just stopped by to let you know that my new book, Unexpected, Finding Resilience through Functional Medicine, Science and Faith is now available for order wherever you purchase books. In this book, I share my own journey of overcoming life-threatening illness and the tools and tips and tricks and hope and resilience I found along the way. This book includes practical advice for things like cancer and Crohn's disease and other autoimmune conditions, infections like Lyme or Epstein Bar and mold and biotoxin related illness. What I really hope is that as you read this book, you find transformational wisdom for health and healing. If you want to get your own copy, stop by readunexpected.com. There you can also collect your free bonuses. So grab your copy today and begin your own transformational journey through Functional Medicine in Finding Resilience. Attention to detail. Yeah, it really is like it's a story, right? And if we're good listeners, that's the heart of where things start. So what do you nowadays mostly what kind of people are coming to see you? I'm assuming it's like high performers and people who really want to live their best life, but describe kind of a day in the life of the kind of people you see. And then I want to talk about some of the interesting things that you do that are maybe not typical of most doctors. Because when I visited, I got to jump into your human freezer, which is like a cryotherapy, right? Where it's what's the degrees there in the cryotherapy? It's usually at least 150 below. Yeah, so I was three minutes in there. It was one of the funnest experiences. And of course, I've done it since, but that was one of the things that's in your clinic. So tell us a little about like day in the life of what you do typically and what kinds of other tools do you have to enhance longevity and performance? Well, I like to say I really don't see sick people, you know, in the sense of people that are on 26 meds and, you know, not doing very well. Although I did have one of my really good friends, mother come in at just that state. And that's a whole other story. But I see people who want to optimize their health. So they're already in pretty decent shape. But they say, hey, I don't want to live like we were describing at the very beginning, that life where I'm spiraling downward into my old age, which, you know, who wants to do that? I mean, it's a privilege, obviously to be alive, but you'd like it to be without pain. And you like to be able to do as many things as you could up until the last moment, right? So I see a lot of people like that. But I also see, you know, you said high performers or high end people, you know, what the biggest group of people I see in my office by far as a group is law enforcement officers. Part of that's because I'm a reserve officer. So I have, you know, a certain regard for law enforcement on its own. But, you know, the point being that these are guys that are in gals that are in the trenches, so to speak, of everyday life. They're not necessarily, you know, the professional basketball players or baseball players or bicycle riders or anything like that. They're elite and pro athletes, which, you know, those are fun to work with too. So it's really the whole gamut of anyone who's interested in better performance, not only performance, but just better health in general, optimizing health. So we like to provide as much as we can that cryotherapy you mentioned, which is a lot of fun. And actually there's a lot of science behind why that's good for you and why it makes you feel so much better. But we do things from what we call IV nutrition, where we're giving typically vitamins and minerals through intravenous administration to now that we had the recent decision in Southern California, the Central District, where it's no longer an FDA banned substance, you know, stem cells, otologous stem cells are now available. And that, I hope, is an area that's going to blossom because there are so many things we can do from lowering inflammation to regenerating tissue with these substances and what comes with them, that that's a really exciting part of medicine coming up. And then we have lots of new peptides that are available that we find, you know, look, we've been working with peptides since, I mean insulin, right? And we kind of passed over peptides because they were short acting. We had some trouble working with them and there were other opportunities. This happens so often you go, why did we skip over that? Well, we just changed our focus over here. But yeah, but we had all this good stuff over here. Peptides to me are very exciting too. And we offer that because you've got, I refer to as like the tinker toys of old, you know, where you can have so many different arrangements and a slight change to each arrangement can change the entire way it works in the body. So there's an unlimited number of things that you can do with the peptides. Not necessarily in my office, we have a limitation, but in the course of medicine down the road here, I'm expecting a lot because if you combine that with AI, we can extrapolate with the knowledge we have and come up with more likely guesses as to what's going to work well with additional peptides. And you know, back to what we do in the office, I'd say probably the mainstay is hormone replacement because if you last long enough on this earth, you know, we're not designed to do what we were when we were 20. I mean, there's all kinds of arguments that have to do with procreation and whatnot. But the fact of the matter is we start to run low on certain of these hormones and we can replace them now just like you could thyroid hormone, testosterone, estrogen, progesterone, and it can make a real difference in people's lives for what we were saying about just enjoying them. And it's not robbing Peter to pay Paul, which is an important point. You know, you're not saying, Oh, well, I'll trade 20 off the back end for some quality. Now, if you think about it, you're improving your health, your quality of life, which by extension, you would no pun intended, you will be extending your lifespan, right? So it's a win-win and just getting the word out there is part of what you and I are both doing. I know you're doing it too, right? I see your book in the background there and you know, that's part of the fun of what we do. And that's just a smattering of what I do. I try and keep in touch as do you. I know with the latest and greatest, you know, the expression you never want to be the first one I get, but and that might apply to another thing that's coming down the pike that we don't do in my office, but that we're looking forward to gene editing. You know, we don't have that perfected yet, but we've got a lot of new advances, some of which are working to cure some formerly incurable diseases. So anyway, I'm going off topic when I say, you know, other things we're doing, but I get excited about what what the opportunities are, which things I hope to be doing in my office down the road, right? No, I love this. And I want to like ask you a few specific questions about, we'll just kind of do popcorn. I'm going to talk about cryo, some of the benefits, NAD, if you do it, the pet, like you said, because you just said on so many great topics, I'm all in like you on all of these topics. I don't have the cryo in my office, but I certainly recommend it for people. But what I wanted to say here too is you just pointed out something really important. The typical medical literature takes about say there's a study today and then there's two studies and then 10 and 20. It's about 20 to 30 years till that becomes standard and fair, right? So it's a vitamin A beneficial for night blindness. Well, it took 30 years for that to become like a standard. So what you and I are doing is we're looking at that, we're not, it's not that we're not doing great research or not doing it, but reading the great literature because there are literally exponentially growing amount of research on the topics you just brought up cryotherapy for increasing nitric oxide and performance and right and all these things and norepinephrine, epinephrine and we could go on and on. But what happens is we have the studies, we have the data and then you and I have to decide as physicians with patient safety, okay, what things are probably safe and potentially very beneficial. And I'm always on that curve. I'm sure you are too of like, okay, peptides likely safe. These are amino acids, right? Like they're not drugs even in the sense of a chemical, it's an amino acid sequence. And then the likelihood of them benefiting our patients is so great that I'm willing to be on that cutting edge, maybe even bleeding edge sometimes to try these new things. As long as you know, you have the informed consent, you say, hey, this is new. This is what we're seeing. This is what I'd like to do. Are you interested? The patient gets to decide, but at least we give them the option and being on the edge, I'm sure like you, I see things that are almost considered miracles. They're not, but they're like really extraordinary outcomes because we're pushing the envelope on what we're willing to do. Well, you bring up two topics really. The first, you started, you know, one of the problems with the culmination of all these studies to eventually, you know, 20 and 30 years down the road, becoming standard of cares, the quality of the studies. And that's something we forget. And which comes up and bites us in the rear end, so to speak, because, oh, we put all our eggs in this basket and we find out. But if you think about it, this study wasn't done properly. There's too much, too many biases. And then you got to go back and say, well, okay, that wasn't such a good idea after all. And that relates also to the long term goal of first, you know, harm, which arguably when we're dealing with this, especially what used to be called anti-aging medicine or regenerative medicine now, we don't have the time, the luxury of several generations of saying, oh, see, it's absolutely without risk, which I think is to your point. But if we can show that at least in the short term, there's no harm done. And theoretically, it appears that there would not be a reason for any long term damage. I think, as you said, as long as there's informed consent, it's worth a risk. And you find that, you know, with a lot of the physicians who are in this field, one of the things we haven't mentioned yet is rapamycin. That's a drug that, again, will need several generations to show. See, we did the gold standard to work here. And even then, you know, to the exclusion of some of the other things that could be contributed to longevity, et cetera, will never have an exact answer or 100%. That's science. But you still have people that are, like you and I, I would say, that have a certain base knowledge. And the art tells them, you know what, I think we should do this anyway, as long as there's no harm. And I think that's where we are in some fun place to be, don't you think? Oh, I love it. And it's funny, I think you probably do the same, my experiment on myself. So often, I'm the first one to try something. And I take risk on myself that I would never take on my patients. But I also learned such a deep knowledge. We were just talking before we came on about our oar rings. And I know you have one, too. So often, I'll do an intervention, and then I'll track my deep sleep and my heart rate variability, and my bio rhythms, because I can say, okay, for this intervention, for this end of one, this day, or this week, or this month, didn't have a physiological objective effect on my outcome. And again, that's just me. But often, I learned through that. And then again, talking to the patient, giving them informed consent, especially with something, you know, fairly benign, like a PMF mat or a cryotherapy session, you can actually have them help us track the data as well to give them feedback or give us feedback. Well, you are one that I'm really excited about, too, because these things that we talk about, like the oar ring, even just, you know, things I only say just, but the Apple iWatch, which has got a lot of features to it, or the latest Fitbit or Garmin, to have patients be able to track their own data, something we've never had available to us before, except in a hospital setting, right? And granted, there's some issues with precision and therefore accuracy, etc. But I had a patient recently in Aspen, for example, who unfortunately was going through some chemotherapy, and or you could argue, fortunately, because it seems to be moving in the right direction. But what was interesting is we saw, when I saw him, we had a very low hemoglobin hematocrit, so we had anemia, clearly. And we were trying to track when it happened, and we had limited resources, but we had this oar ring. And you watched as his heart rate increased over time. And we could trace it back to exactly when we started a particular chemotherapy agent that had not been added before, that we think affected his kidneys and the ability to create erythropoietin, etc. But isn't that neat? I mean, you know, people who aren't physicians are probably going, what in the heck is he talking about? But to be able to track that without having the standard that we normally expect, like we need serial blood work to show, oh, right there is where the hemoglobin started to change. We didn't have that, but we could track it and sort of help verify our theory using a wearable. I mean, to me, that's so cool. And when we can start tying all that together, I think we can get people, I hope, excited about other things like being able to track how exercise affects our health too, not just because they tell us to whoever they is, grandpa and grandma and doctor, of course, all the time. So I think that's a great prospect for the future too. And we were talking about how stingy the oar ring is when it comes to sleep. Just to be able to gauge your sleep is something that, again, unless you're part of a sleep study or in the hospital, but a special wing of the hospital where you're wearing something that tracks your eegee, we wouldn't have this otherwise. So again, not to be the dead horse, but very exciting what we have available to us to help optimize our health. It really is. And I use it all the time. And like you said, I love that you said, it's not perfect. These data points aren't, but they're enough of an ed to give us data. Like for me, when I do an intervention, I often see how did it affect my deep sleep? How did it affect my restfulness, energy levels, these things? So I want to mention the IVs because you do a lot with IVs. Do you do NAD or PC or I'm sure you do like Myers? What's your top offerings for IVs for patients in the realm of? I'm going to be remiss in not remembering this doctor's name because he deserves credit. He's an environmental medicine doctor. I believe he's based out of Arizona or was. I think he might be retired now. But to me, he wrote the book on what would be considered IV nutrition. It used to have a yellow cover. And I am so apologetic. I don't remember his name because again, he deserves credit. But he has developed a great list of different cocktails as it were. And obviously, the Myers is one of the most popular and one that he suggests everyone should start with to see your tolerance for it. But yeah, we add different amino acids depending upon what the patient is looking for. And I'd say it's really open to just what's your goal and what we can add to it and what degree. When it comes to, I mean, there's so many things you can address with IV nutrition from. I mean, we just mentioned cancer. There's a pro-oxidant dose of vitamin C that you can use and combine that with hyperbaric oxygen. And there's, I wouldn't say there's tons of studies, but there are plenty of of sufficiently designed studies that show that will help. At least as an adjunct, I know we can't say it cures cancer, but at least as an adjunct to cancer treatments. And so there's plenty there. And then as far as NAD, there's a lot of controversy and the jury's still out because we don't have a lot of science behind it. But there's, and I'm going to blow it again, there's a doctor in Springfield, Missouri, who's great. He's the guy when it comes to NAD, at least in my mind. And he can rattle off a huge number of patients that are helped considerably by NAD, particularly those that have certain addictions. I have seen, using the URA by the way, if I did an NAD, like a gram intravenously, you can watch that night. Your rhythms, your sleep rhythms go back to what you had when you were much younger. Every 90 minutes, you'll see an up and down through the stages. That's classic, right? And that can't, that has to reflect that it's doing more than just accumulating the liver. Like you would, very possible that when you take it orally, that's as far as it goes. Who knows? But I have seen a difference with it. I'm a proponent of it if you have the time, because it is typically a long procedure to tolerate because it can make you feel a little weird. But I should hasten to add that, as you know, the best way to increase your NAD levels is to exercise, right? So this is great. Because again, a lot of you are out there and they've done an NAD or they're interested in it and among all the other things you're doing. What would you say? So do you have the cryotherapy? Do you have the hyperbaric as well in the office? We do. But you know, with COVID, we just, for obvious reasons, people said, I'm not going in there. We hope to pick that business up again. And I say, we don't. I see in our office in Santa Monica, no. But believe it or not, in Aspen, we've got like three there at a place called The Fix. We're working together with that group. And it's still a very, very useful tool. There's so much science behind it. I would say the biggest drawback, if there is one, is the time necessary for what we call a dive. But you know, everything from releasing stem cells from within the bone marrow to getting drugs or nutrients to where it needs to go, including oxygen, because it's under pressure so it can go farther down into the capillaries and whatnot. It's a great tool. Fantastic. It's interesting to have been preparing a talk on nitric oxide and the importance and how we diminish as we age. And the things that have evidence for nitric oxide are cryo, hyperbaric, infrared sauna, red light therapy, probably all these things that were, you know, and so I wonder if some of this of we're seeing on all these kinds of therapies is really just increasing nitric oxide because that affects everything, right? So I have a question I want to kind of pick your brain about because my audience is men and women, professionals, doctors, but also patients. But probably the most common type that's out there listening is a woman 35 to 60, maybe perimenopausal, maybe menopausal, some, maybe some autoimmunity, maybe some fatigue. With this prototype, that classical kind of woman, I'm sure you've seen some of these as well, come in. Where would you start? What would you, if you had top three things to offer this woman? Again, let's say 47 years old, menopausal or perimenopausal, fatigue is a main complaint, otherwise do an okay and decent shape. What would you do with that kind of person? Well, of course, I'm going to get accused of being a hammer that's always been looked for a nail, right? Because I said earlier, hormonal replacement is one of the big things we do. It's really because it's just so prevalent. When you see a hoof print, you look for a horse before you look for a zebra in a unicorn. As you well know, environmental issues can cause fatigue, definitely on the list. But typically, 47-year-old with no other reason for fatigue, except, hey, I'm 47, I'm out of gas, I'm getting proper sleep even, or at least I try. But yeah, the short of it is, and we do a pretty comprehensive panel actually, so we can pick up as much as we can, but it definitely includes measurements of the steroid hormones from the word cholesterol for, again, those who are think, what's steroid? No, not anabolic steroids, the naturally occurring steroidal hormones. And typically, we'll find that just like men, women also use testosterone and have a deficiency in it. And that's the energy hormone. That's the nature's antidepressant hormone. That's the one also that potentiates muscle creation. I say it leverages all these good things that without which, I spoke earlier about professional athletes and whatnot coming off as they're the last ones to come in because they're the ones that know all the tricks and don't come in till they're like 55 and say, okay, I'm waving the flag. I don't know why I can't do all this. Well, because you lost the leverage you had, and all you got to do is put that leverage back and all the good things you have always done and know how to do will start producing for you again. So that's an easy one, the one you mentioned. And of course, with auto-immunity, if we want to go a little bit to the side, but still hormones, oftentimes it involves the thyroid hormone, which testosterone I referenced to the horsepower in the engine and the thyroid more to the the idle speed. But either one of those can make you feel like a dragon. You just don't have the get up and go, right? No, I love that you said that. And there's studies with the differences between I think that's four to six times more prevalent auto-immunity in women. And part of that is because the lower levels of testosterone. So in certain cases, I've actually used DHA and testosterone as part of a protocol to reverse auto-immunity in women. And you know what, people and I say people, the average person shouldn't know this, but the average physician should. And again, we I'll take the blame can point the finger at physicians because it's part of our profession. But it's a little known fact, but a fact, nevertheless, what you just said, when you replace testosterone, almost invariably, it's very rare. It doesn't happen. Your body will make more thyroid hormone. Hello, just like you said, the two go hand in hand. And if you're anything but euthyroid or if you're certainly deficient, you oftentimes kill two of us one stone, your body will make use of that new newly formed thyroid. So yeah, really shift to another category. Say the 65 year old male, and you know, they've kind of taken decent care of themselves. Maybe they actually have testosterone replacement, you know, if they're low, but there's also a same thing kind of fatigue, stamina, they're losing a little bit of muscle. Where would you take this kind of a guy? Where would you start with that without much more history than that? What kind of things would you know, if they're already on testosterone replacement therapy, then we have to look for the things that testosterone would leverage but aren't there. Is this male getting enough simple stuff? Is he giving enough sleep? Is he getting enough rest? Because without that, you can't do it. You know, you use I say you write the prescription by working out and eating properly, but you fill it at night when you're when you're asleep. Speaking of which, are you getting proper nutrition? I mean, you're talking about somebody my age who didn't necessarily get the best nutritional advice, even in med school, if 20 minutes, that would be a lot, right? So I always say they try to not eat, to not sleep, to not pee, to not take care of ourselves. That was part of the training, yes, including all they just wanted us to know how bad it feels when you don't do all the right stuff, right? Yeah, but you know, there's other things too, where just to add another hormone in there just so I can formally be accused of being a hammer looking for a nail. If you're not producing enough growth hormone, which then eventually is responsible for initiating production of IGF1 in the liver, that can have a toll. It's not one of those like testosterone where it's, you know, thought by and spinach for you go, wow, that made all the difference, but it often can make a difference, particularly for someone who is not producing. And I think that's part and parcel of at least a little of what happens when people don't get enough sleep because people don't realize most of the growth hormone you're producing is when you're asleep and during, you know, deep sleep, which oftentimes does not occur if, well, and actually this would probably be the best answer to your question. Quite frankly, now that I think about it, I'm looking for sleep apnea in a 65 year old that otherwise is doing well, right? Brilliant. Because if you're not getting enough sleep, no matter what hormones you're on and what other things you're doing to the maximum that's available to you, you're not going to be doing your best and you're probably going to be tired, right? I love these of that because you just demonstrated the best of conventional medicine and the best of all of these other things. And that's what hopefully you and I bring to the table is like really good clinicians, but also opening our toolbox to add some things for our patients. Gosh, I could talk to you for hours. This is so fun. Last thing before we talk about your book and where people can get that and find more about you is what's the future? What one or two things do you see there on the horizon that you think, hey, this has some potential, even if we're not yet doing it? I gotta pick two, huh? One is fine, two is great. No, I was gonna say it's hard to narrow them down. There's so many cool things going forward, but I would have to go back to the example that I already touched on a bit where we can use artificial intelligence. And I'd say this is probably the coolest because we're still very chemistry based, I realized. We could also apply it to the physical medicine, but that's not where we have a good foothold, but we can change that. But if you take the best we have in terms of stem cells and genetic engineering, okay, so now I'm combining a bunch, but I think this is where we have a pretty big future in the US, you combine that with artificial intelligence and we will be growing tissue now and design how we want to design that tissue. And it's not Frankenstein stuff. I'm just talking about tissue so that we can test whether it's peptides or various drugs and see, okay, based upon what artificial intelligence extrapolates from what we, the current knowledge is, well, let's take this tinker toy, for example, the peptide and jigger it this way. What is the promise of that? It looks really good. We put it in the petri dish as it were with this grown tissue. We can get so much further ahead than what we do starting with, you know, animal trials, which doesn't cross over more often than not. And then finally, human trials, which you got to be very careful because we're dealing with a live human instead of something that a petri is. So if I had to pick one, and I'm just riffing here because there's a bunch to look forward to, I think that's a big one because it's going to lead to the development of so many new substances that we can use to manipulate our health the better. Love that. It makes so much sense. And we're so close because really, and you throw in the genetics into that, right? Can't you just see like taking that and then you have the SOD mutation. And so you do this or the exciting. And we're already doing that to some degree in the sense that, you know, through the genome mapping, which is under $1,000 now, I mean, you can get it done for almost nothing. When I first did it, my wife and I, it was each like 10 grand going down to San Diego and Illumina. And now for, I want to say, it's closer to $700 maybe you can get the entire genome map, have it looked at through the lens of what we currently know about the SNPs through AI intelligence to be redundant AI software, I should say. And you can find out, well, this drug, from what we now know, doesn't work for someone with a SOD mutation, for example, just riffing. And that's pretty cool, too, because you don't waste time treating a patient with a drug that never going to work because their genes are different. We're already there in some degree. Yeah, we are. And you and I know the test if we just, you know, have this centralized. So exciting. And, you know, I just want to reiterate one thing you said over and over. And I think it's so important. One core thing is sleep. And that's so like not sexy, right? But honestly, I love that you mentioned that because really truly sleep is a foundation. I always say, like, if you're not sleeping, none of this other fancy stuff is going to work. So actually size that as a core because everybody has access to that, you know, as far as the sleep habits and sleep. So, so where can people find you you have the new book cheating death, the new science of living longer and better available, I'm sure on all platforms, but where can people find you? Where can they get your book? Tell us more about that. Well, we have this website called cheating death.com. So that makes it pretty easy. And then from there, you know, branches off to our main website, which is PSR med papasierromomed.com. And yeah, I mean, Amazon has the book Barnes and Noble, although the major outlets and whatnot. So, yeah, if you want more information, I did my best to, to incorporate a lot of what we talked about in the book so that people could get this was truly the purpose of the book, more information about the tools that are available to us. And we just didn't know about it. And I tell a little bit about my personal story of, you know, if only I had known because as I said earlier, I was disenchanted with Western medicine because I had so many bad experiences. But in advance, it's such a rapid rate. And we are still that it's worth at least looking to see, well, is there an option I'm going to cotton to I don't want surgery, but I want this. Oh, yeah. And, you know, and with resources to dig further. So sorry, I gave you a too long win in an answer. And I have a copy. It is a fantastic menu. You've done an amazing job. So you guys want to know where I go out and get yourself a copy. And Dr. Rand, thank you so much. I hope to come visit you one day and play in your playground office. I'll keep the cryotherapy running. Awesome. Thank you so much. No, no, thank you very much.