#31 - The Don't Die Network State | Bryan Johnson

15 Jan 2026 · 1 h 1 min · 31 chapters

Ask about this episode

Ask anything about it. ChatGPT or Claude reads this page and answers with the times it was said.

Connect VO and ask about every podcast you hear, including the moments you saved. Add to ChatGPT · Add to Claude

In short

Podcast Notes: The Network State Podcast - Episode #31: The Don't Die Network State | Bryan Johnson

Overview In this episode, Balaji Srinivasan interviews Bryan Johnson, a pioneer in the field of biotechnology and health innovation. They discuss the evolution of Johnson's work with his "Don't Die Network State," the implications of new advancements in gene therapy and biomedicine, and the potential for a new approach to health and longevity.

Key Themes The Evolution of the Don't Die Network State

  • Initial Reception: Johnson discusses the progression of the Don't Die Network from initial skepticism and backlash to a recognized movement, especially after a Netflix documentary brought it to a wider audience.
  • Current Trajectory: Johnson highlights how he now collaborates with influential figures in health and wellness, marking a significant shift in credibility and acceptance.

Barriers to Longevity

  • Regulatory Challenges: The American healthcare system is described as a primary barrier, focusing on treating sickness rather than promoting longevity.
  • Underreporting of Advances: Many breakthroughs in biomedicine, especially relating to aging and health, remain underreported in mainstream media.

Visual Evidence in Science

  • Importance of Aesthetics: Both Johnson and Balaji agree that visual evidence (e.g., changes in appearance or health markers) is crucial for public perception and acceptance of longevity treatments.
  • Examples of Successful Interventions: They discuss various treatments, particularly those showing significant visual results, such as hyperbaric oxygen therapy, caloric restriction, and gene therapies.

The Future of Biotechnology

  • Gene Therapy and Cell Therapy: They delve into promising areas of gene therapy, focusing on gene modification techniques like FOXO3 overexpression and their potential effects on aging and health.
  • Potential Treatments: Johnson mentions several specific genes and treatments, including those that could enhance cognition, muscle mass, and even aesthetic improvements.

Discussion Points Creating a Million Dollar Longevity Prize

  • Johnson proposes a prize to incentivize the development of visible, safe, and effective longevity therapies that could bypass regulatory hurdles.

Experimental Approaches

  • The conversation touches on using willing participants for experimental therapies, particularly for those facing terminal conditions, to allow for a wider exploration of possible treatments.

Health and Safety Regulations

  • Critique of the current regulatory frameworks for drugs and therapies, noting that while designed for safety, they may hinder innovation and patient autonomy.

Societal Attitudes

  • Johnson and Balaji highlight the contradiction in societal attitudes toward risk in health versus other areas of life, suggesting a need for a cultural shift to embrace experimentation in self-improvement and longevity.

Key Takeaways

  • The Don't Die Network State is gaining credibility and momentum, transitioning from skepticism to recognition as a legitimate movement in health and wellness.
  • The American regulatory environment poses significant challenges to innovations in longevity and health treatments.
  • Visual results are critical in gaining public interest and acceptance for longevity therapies.
  • Gene and cell therapies hold potential for transformative impacts on aging and health but face hurdles in acceptance and regulatory approval.
  • There is an opportunity for pioneering approaches to health care that focus on characterization, diagnostics, and patient participation in their own health journeys.

Future Directions

  • The discussion concludes with a vision for a Longitudinal Network State that incorporates extensive health characterization and allows for the iterative testing of therapies, potentially revolutionizing personal health management and longevity research.

Conclusion This episode provides a comprehensive look at the intersection of biotechnology, health innovation, and societal attitudes towards aging and self-improvement, emphasizing the need for a shift in regulatory approaches to facilitate advancements in human health.

Written by AI. May contain mistakes. Listen to the episode to check what was said.

Chapters

Tap a time to open that second in VO

Progress of Network School

0:45 to 2:00

Discussion on the developments and achievements of Network School over the past year.

“When this went viral a couple years ago, it was kind of like, what is happening?”

The Don't Die Movement

2:00 to 3:00

Conversation about the progress and acceptance of the Don't Die movement and its impact.

“And also, we get almost no news about the incredible developments that have happened in academic biomedicine in terms of reverse engaging in mice or even in humans.”

Challenges of Longevity

3:00 to 5:00

Exploration of the barriers to longevity posed by the American regulatory state.

“You can read them out, or you can visually see them.”

Visual Evidence in Longevity

5:00 to 8:00

Discussion on the importance of visible results in promoting longevity therapies.

“What are your top ones that have like a visual phenotype that you think is really impressive?”

Animal Studies and Longevity

8:00 to 10:00

Exploration of animal studies and their implications for human longevity treatments.

“They don't need to squint and be like, did it work or not?”

The Future of Longevity Drugs

10:00 to 12:00

Conversation on potential future drugs for longevity and the challenges in development.

“and what we can do with human lifespan, healthspan ability.”

Regulatory Challenges in Biomedicine

12:00 to 14:00

Discussion on the impact of regulatory challenges on innovation in biomedicine.

“And so you could see what your dose was before taking the drug.”

The Risks of Safety Regulations in Medicine

14:01 to 15:10

Discusses the paradox of safety regulations that hinder beneficial medical experimentation.

“away of some condition during this period and say, well, did you know that six years later, a drug was approved that would have saved them?”

The Case for Self-Experimentation

15:11 to 17:43

Explores the idea of self-experimentation and how regulations limit personal health choices.

“It's not the case that people are gonna make good decisions.”

Promising Treatments: Gene and Cell Therapy

17:44 to 19:32

Identifies gene therapy and cell therapy as the leading treatments for significant health improvements.

“And now, so let's say there's three treatments, which assume you had a friendly regulator.”
Show all 31 chapters

Exploring Innovative Gene Therapy Approaches

19:33 to 21:56

Investigates potential gene therapies that could enhance human capabilities and health.

“Gene therapy, which genes, what looks interesting?”

The Intersection of Genetics and Biochemistry

21:57 to 23:53

Discusses how gene therapy merges with biochemistry and the public perception of genetic solutions.

“You know, a lot of the skin stuff, like wrinkles and so on and so forth.”

Challenges and Potential of Cell Therapy

23:54 to 25:53

Analyzes the challenges faced in advancing cell therapies and their potential benefits.

“And that protein will then bind to the genome and unlock mRNA that'll do other things.”

End-of-Life Treatments and Ethical Considerations

25:54 to 28:00

Considers the ethical implications of offering advanced treatments to terminally ill patients.

“For example, let's say you've got a car and you hit the brakes and you hit them hard enough and it doesn't crash into the wall, right?”

Exploring Age Reversal Technologies

28:00 to 29:10

Discussion on the potential of using biomarker technology for age reversal and longevity.

“It's a case-by-case kind of thing to figure out.”

The Importance of Governance in Longevity Research

29:10 to 30:20

Examination of the governance challenges in pursuing longevity and how they affect progress.

“And this is why I think your sentiment is correct.”

Wealth, Health, and the Concept of Life Force

30:20 to 31:40

Exploring the connection between wealth accumulation and the essence of life energy.

“and that's a whole change in your way of thinking.”

Ideological Shifts and Health

31:40 to 32:50

Discussion on the need for a paradigm shift in our approach to health and aging.

“I guess as a side tangent on this theology, I just finished this book, Passion, the Western Mind by Richard Tarnas.”

The Future of Genomic Resurrection

32:50 to 35:00

Concept of genomic resurrection and its implications for the future of health and identity.

“it's about feeling great and being great.”

The Evolution of Medical Experimentation

35:00 to 37:10

Highlighting the historical context of medical experimentation and how it has evolved.

“you could if somebody was well behaved you could write their genome to a blockchain or something like that.”

The Role of Adaptive Trials in Health Innovation

37:10 to 42:00

Exploring the future of adaptive clinical trials and their potential impact on healthcare.

“And so that was a time when pharma moved at the speed of software, where you went from idea to execution and via iteration in like two years.”

Exploring Metabolomics and Gene Therapy

42:00 to 43:32

Learn about the advancements in metabolomics and how gene therapy can be enhanced through detailed biological data.

“You did something like the Mike Snyder integrome while you're giving people this gene therapy or cell therapy.”

Characterizing Human Biology vs. Technology

43:32 to 45:25

Discover the challenges in characterizing human biology compared to technological advancements and its implications for health.

“Like my cholesterol or my liver enzymes.”

The Need for Risk Tolerance in Biotech

45:25 to 48:21

Understand the cultural and historical factors influencing risk tolerance in biotech development and innovation.

“I think just the diagnostic zone, right, where you can just get genome sequence without a prescription from your doctor.”

The Future of Personal Genomics

48:21 to 51:08

Explore the potential of personal genomics and the future of at-home genetic testing with new technologies.

“AI is very good at expanding suggestion lists.”

The Importance of Characterization in Diagnostics

51:08 to 54:03

Learn why characterization is crucial in diagnostics and how it leads to better-informed therapeutic interventions.

“And so if we could bring that down to$10 a day or even$1 ,000 a month.”

Building a Longitudinal Diagnostic Network

54:03 to 56:03

Discuss the idea of establishing a longitudinal diagnostic network to enhance health monitoring and treatment personalization.

“company was in diagnostics because also diagnostics has a lot of advantages first is it's half computer science, because after you do the assay, then you can analyze everything on the computer, right?”

Characterization and Longevity Therapies

56:03 to 56:58

Discussion about the importance of characterization in new therapies for longevity.

“because they have done good characterization, better than a non-characterized peptide.”

Exploring the Longitudinal Network State

56:58 to 57:40

The hosts explore concepts of a longitudinal network state and its potential impact on health.

“But we could have the exemplary for aging would be that moment.”

Innovative Healthcare Models

57:40 to 58:57

Exploration of new models for healthcare that involve immersive experiences.

“which is these end people for this period of time.”

Bridging Health and Ideology

58:57 to 1:00:18

Discussion on connecting health, ideology, and governance within new frameworks.

“back when savings was good, residential education.”
Hear the part that matters, and keep it.Open this episode in VO. Double tap your headphones to save a moment as you listen.
Get VO free

Transcript

Automatic transcript. May contain errors.

0:00Brian, thanks for speaking at the University Conference. Paul G., it's my pleasure. I love being here. Awesome. All right. So last year you came by at the opening of Network School on the very first day. Thank you for coming to the ribbon cutting and grand opening. This year we've moved very far. We've built a lot of stuff. We've had, you know, more than a thousand people have come and really on our way towards building Network School and startup societies. And you've also come a long way. Blueprint has come very far. It's become a global movement. Don't Die and Blueprint. We actually have Blueprint bars, as you know, at NS and all the Blueprint kind of stuff.

0:40What's the summary of the last year, few years? Give Brian O 'Brien, and then I want to talk about the longevity network state. It was initially an intrigue. When this went viral a couple years ago, it was kind of like, what is happening? There was this tsunami of hate, and then it went into this quasi-curiosity mode of, what is this? Is this real? Is this sketch? And then there's been this gradual acceptance, like actually it's legitimate and it's interesting. The hate has tapered off substantially. And now it's really gone into a movement. I'd say then the Netflix documentary was out in January that had a deep global impact.

1:15And so now over the past, I'd say maybe five to six months, I'm now with some of the most powerful and influential people in the entire world. It's just been this really remarkable trajectory towards credibility where, I mean, yesterday I was with, well, I won't say who I was with, but like some of the most powerful people in the world working on health and wellness protocols and whatnot. So it's just been interesting to go from what is this to now like deeply engaged in in the world order. So that's been it's a fun been a fun trajectory. Very unexpected. That's amazing. So, you know, what I would say and I will propose this to you and maybe maybe you agree, maybe you won't.

1:56But let's discuss. I actually think the don't die network state is actually the key to both. And the reason I say that is I think the primary barrier to longevity and more generally transformative biomedicine is the American regulatory state and more generally the American health care apparatus and how it only treats people when sick and acknowledges that death is or thinks death is inevitable. And also, we get almost no news about the incredible developments that have happened in academic biomedicine in terms of reverse engaging in mice or even in humans. And there's some amazing phenotypes like, you know, I can put this one on screen which shows two mice of the same age, and the first one is balding and older, and the second one is clearly younger.

2:47Or here is like a side effect I could put on screen of a couple of men who had a cancer drug and it caused, as a good side effect, their hair to reverse color and to go from gray to less gray. And you've probably seen, actually, are there other examples you've seen that are like that, that have these amazing visual undeniable effects within humans or animals? Yeah, I mean, many. There was a study out in June from a bunch of Chinese researchers who put the overexpression of FOXO3, and they packaged it up in a mesenchymal stem cell, that people are doing interesting experiments that have measurable impacts.

3:21You can read them out, or you can visually see them. And I agree with your framework that seeing is believing. that a lot of people, I mean, biology, I think your point is correct, that when I started doing this years ago, I tried to achieve the best biomarkers of anyone in the world. Like that was like a way to say there's a healthiest person in the world, there's a richest, fastest, can there be a healthiest? And what I really learned is nobody cares about biomarkers. They just wanted to look at skin and face. And, you know, and so I had been on this deeply caloric restriction diet and I'd lost so much fat in my face.

3:54I hadn't really paid attention to aesthetics and people could not see the project when my face was gaunt. And so it's remarkable that I agree that people understand longevity basically through the face. And so what they see, they can believe, or hair. But that really is, I think, the entry point for most people in understanding what is aging, do therapies work, and if you can't see it there, they don't believe it. That's right. And I think there is some sort of meta-logic to that because for many people, longevity is about aesthetics and, you know, people wanting to look younger. And, you know, if they had the trade-off between looking younger and actually, in a sense, biologically being younger, some fraction would actually even take the first over the second or what have you, right?

4:37But I think it's almost like the entry point. It's a little bit like, you know, with cryptocurrency, people seeing was believing because it generated transformative wealth and then they paid attention to the theory underneath. And so if with longevity, we can generate transformative health, then we'll get people to pay attention to the theory underneath. So what are the top three or five? You mentioned the FOXO overexpression, FOXO3 overexpression, right? Was it FOXO or FOXP? FOXO3. Okay, give me like three, four, five. What are your top ones that have like a visual phenotype that you think is really impressive?

5:13Yeah, I mean, sadly, I would say there's probably, honestly, there's skin therapies. I'd say hyperbaric oxygen therapy and then just the cumulative effects of good sleep, exercise, and nutrition. Those are the ones that aesthetically work the best. Of course, you can... Go ahead. Go ahead. That's on humans. So what about on mice? What about on animals where we can do a lot more in terms of eugenic manipulation? Yeah, I mean, on mice, I guess I've seen enough of these studies where it seems like you can generate really compelling effects on mice in many different ways. And this is seen with caloric restriction.

5:48It's seen with rapamycin. It's seen with metformin. So in some regards, the bar is lower on mice visual outcomes because there's a lot of them. With humans, I think it's much harder. So why do you think that is? Do you think that the effect is there in humans, but it's not as visible? Or do you think it doesn't translate from musmusculus to homo sapiens? Yeah, it's a good question. It reminds me of anyone who's selling the skin cream basically shows the same 4-, 8-, 12-week transformation of a light wrinkle line to a smooth wrinkle line or something like that. It's kind of the same with my studies.

6:31If you see enough of these, you kind of have a general pattern of roughly what you show in the mice, whether it's a biopsy or whether it's hair growth or something like that. So I guess I do – there is credibility to it, but I also take it with a bit of a grain of salt. of, you know, there's translation issues from mice to humans. But yeah, really, I mean, I think mice are compelling. Humans ultimately respond most strongly to other human faces. Interesting. Yeah. So, I mean, some of the large effect size things that have been done in mice, obviously there's the GFP mouse, where you can make a mouse glow in the dark by taking green fluorescent protein.

7:06You can, you have like a myostatin null mouse, where you can make them like incredibly muscular. And there's various treatments that can do that. and there are all kinds of knockout mice and genetically altered mice that do crazy things. And my view is it should be possible. There's also like the Doogie Mouse. I don't know if you know this by Joe Shen more than 20 years ago, where they made the mice smarter and they seem to be able to run mazes faster, right? So my view is that we are finally, after more than 80 years, exiting the FDA era where the focus was on minimizing side effect size and finally reentering the era of large effect size drugs that may actually have more side effects, but also have larger effects like Ozempic, which you don't need to.

7:56I mean, of course, they needed to do studies to determine whether Ozempic worked, but people don't need to see whether Ozempic works. They don't need to squint and be like, did it work or not? It's just such a visible effect that it's like caffeine, does it wake you up? You can take it and it's like N of one, you know, it works, right? So all the GLP-1s, that's the new era. We're back to the era of the wonder drugs, potentially. So why don't we have a Zempic for cognition? Why don't we have a Zempic for longevity? A Zempic for muscle mass? We should, we will, we could, maybe, right? If we take all of these things that we think work in humans or like mice or human adjacent mammals, or perhaps like, for example, Alzheimer's drugs have a neuroprotective effect, but they also have a neuroenhancing effect, many of them, right?

8:50Like drug repurposing. And so my thought is, A, we have all of these interventions on this side, which have these amazing visual phenotypes. And then B, we have all these jurisdictions on this side. And so what I want to do is offer a million dollar longevity prize for the people who take these visual interventions and carry it all the way through to actually have them legal in these jurisdictions. And when I say legal and functional, they should have a paper, at least on archive, that documents everything, all data, open source, open state. And they should have a law there that allows them to do it.

9:25Ideally, there's some government official who's even welcoming it in the area. And there's 190 countries, and a lot of them are doing interesting things in crypto, and now they can do interesting things in bio. Let me know your thoughts. I agree with you entirely. The thing that will get people most excited is when they see visual effects by far. And when you do a comparison and contrast to when we talk about machine intelligence, we talk about orders of magnitude, of scaling, of efficiency. when you talk about human effects, you're saying 10%, 15%, 20%. It's such a disparity between the capabilities we have in improving our machines and intelligence and what we can do with human lifespan, healthspan ability.

10:05And so the question is, and I think what you're getting at the heart of it is, what is the system to create larger effect sizes? Yes. And so we see, for example, like with the GLP-1s, that is potentially the first mainstream longevity drug, where now it's characterized well enough where you're seeing cognition benefits. You're seeing all sorts of benefits out, I mean, in addition to weight loss. And most people, I mean, I am microdosing that now myself, even though I have no need to lose weight. I can basically try to achieve a dose where I can achieve some of the health benefits. But that has very compelling.

10:41It's a very compelling offering. It's a very simple drug. And so I think you're right, is if we can train people's attention to jurisdictions where you can actually move this thing forward, because it's very, very hard to innovate in the United States. It's burdensome. It's complicated. And of course, it's not without reason, right? Like they are trying to make things safe, but just over time, the bureaucracy owns the situation. It just becomes a paralysis state. So it's the same situation we have with China, where China is racing forward on energy and AI and a bunch of other things. And the U.S.

11:13is having a difficult time because we have this large regulatory state that slows things down. So I think it's on point. So I want to discuss whether they make people safe or not. But let's say we do a million-dollar longevity prize, and let's say we get it to work. will you come with me and talk to the people there and maybe try it out if it's real? Yes, absolutely. I mean, we are looking for safe, efficacious therapies that have large effect sizes. And that's just, it's really limiting right now in the field. Amazing. And the thing is, type one, meaning just testing safety, is actually very inexpensive.

11:52It's type two, which is testing, quote, efficacy, that's much more expensive. and just determining whether something is safe um you could have a totally different drug regime that just tested for safety and there's a lot of things you can do by the way like potentially patient derived organoids where you've got like a proxy for the human that you're testing the drug on beforehand you could do much more with pharmacogenomics you know farm gkb and various kinds of resources if everybody had a genome sequence you could at least see whether you know For example, your warfarin dose is dependent on VKRC1 and CYP2A9.

12:26And so you could see what your dose was before taking the drug. You could look at relatives and what their dosage was. You could look at people who are distant familial relatives if you had genomic databases and what their response was. So much we can do with technology in terms of just quickly checking whether something is safe. And then willing buyer, willing seller, right? Like a minimal necessary regulation, right? Right. And, you know, this brings me, you know, when you said whether or not they care about safety, it's a little bit like saying the TSA cares about safety. Do they really? You know, because it's I mean, that's that's the benign way of looking at it.

13:02Right. And the other way of looking at it, they just care about optics. And so they're not optimizing, for example, type one versus type two errors and the sensitivity and specificity, the false positive, false negative. trade-off. Alex Tabarrok and others at Marginal Revolution have written about drug lag, which is if you have a drug that was approved, but it was delayed by six years by the FDA, then all of the incremental morbidity and mortality over that window is directly attributable to FDA because the biomedicine was the same at the time that that new drug application that NDA was submitted.

13:40It's not like the biomedicine changed. The approval time was so long that it slowed it down. It was literally just pure information in a sense that they were getting over that time period. And so that is the unseen. One of the things I thought about is running a Google ad campaign at some point to find somebody who had a sibling or a relative or parent that had passed away of some condition during this period and say, well, did you know that six years later, a drug was approved that would have saved them? And then talk to them. And that's a way that you could actually make drug lag visible, you know, on the screen, right?

14:17That's like one example of how quote, safety often is actually unsafe, because it's so risk averse, that it's reward averse. Let me know your thoughts. Yeah, I mean, yes, and that statement, if you think about the the way we do things in actually globally, I was gonna say the US, but people we allow people to experiment with fast food, and a lot of sugar and right, like you, you are, you have the freedom to kill yourself and to experiment. Does fried food cause me to age and potentially develop disease and lead to my life? So you have the freedom to do that. But if you want to try to experiment to do something good for yourself, you can't.

14:53It's against the law. And so it's really backwards in that if you try to step on anyone's ability to sell anything that causes someone to die, people are upset. But yet we can't get the system to move. so that we can self experiment on things that can help us now clearly, there's gonna be complicated outcomes. It's not the case that people are gonna make good decisions. But that's just humans. So it really is backwards that and I think it's really a stifling factor on our ability to make any progress. Whereas like, when you look at computation, it's just like anything that produces a better compute or intelligence, go like very little guardrails.

15:31So it's really a constraining thing for us humans. That's right. I mean, the thing is, as I said before, and you probably also observed, you can go bungee jumping, you can go skydiving, euthanasia is even legal in many states, right? Like you could join the military. There's many different contexts in which you're allowed to take a very serious risk of dying, right? And with essentially no upside when it's bungee jumping or skydiving, it's just pure thrills. I mean, fine, right? So why can't you take a risk of taking a new drug or device or something like that that could improve your life, right?

16:03Why is human self-improvement of all things, the thing which has stopped, right? And it's always framed as protecting you from yourself. But what if you had better information? You know, for example, the FDA doesn't really, like it's a so-called phase four, you know, like post-market surveillance. It doesn't include real-time reviews from hundreds of countries or like, you know, hundreds of jurisdictions. Like, whereas even like Reddit reviews do. The upvotes on Reddit or whatever are drawn from around the world. So you can like crowdsource all of this data from around the world because biology remains the same.

16:40And that kind of, you know, because it's locked at the level of the state rather than the level of the network, you know, like an Uber rider, they're rating, sourcing information from New York City. I mean, they take a ride in London and so on and so forth. But drug responses aren't for people of similar biology around the world. They're not centrally pulled together. And they could be. Yeah, yeah. Yeah, I mean, some of the risks, like the GLP-1s, for example, like blindness. I think there's like 3 ,000 plus lawsuits against the GLP-1 manufacturers right now. But you can take precautions by getting your genome sequenced and see if you are at risk for those kinds of conditions.

17:16So like you're saying, you can do really basic, inexpensive tests to see if you are a responder, non-responder, or a higher risk for these outcomes. And now that our testing is getting so cheap, this is a really great path where if the regulatory structure says, hey, this is... too complicated and too high risk. I mean, you could even offset that and say you can characterize yourself much better to lower that risk. So I mean, it really is, it's very hard to justify the argument that we should be as limited as we are. That's right. And now, so let's say there's three treatments, which assume you had a friendly regulator.

17:54Okay. Somebody who, and crucially, by the way, people would sign something that's similar to like being a test pilot, because no plane crashes, no planes. No train crashes, no trains, right? If there weren't people who are willing to take the risk of a plane crash, you'd never have transatlantic flight. You'd never have flight at all in the first place, right? And there were a lot of plane crashes early on because people were figuring it out, right? And we could think of those people as heroes. So let's assume there was some jurisdiction where it had a crypto-like attitude, like, you know, where if it's willing buyer, you're signing all your stuff away, you recognize you're taking a risk, you're an adult and blah, blah, blah.

18:32You're being appropriately informed, compensated, whatever the thing is. What are the three most promising treatments that we should look at that will have large visual effect size? I mean, if you look at the evidence on what has worked, it's been gene therapy, cell therapy, you know, at the very top. And then, you know, lifestyle thing. So probably gene therapy, cell therapy. What about parabiosis, for example? I'm not sure it's going to have the effect size that would be big enough. Because I've seen varying studies on that. You've probably looked at it more closely. Yeah. I mean, so I did this with my father.

19:08I also did several other treatments. Now you can do the phoresis without a donor and just replacing all of your plasma with albumin. People are now generating the synthetic plasma for the replacement. So I think it has some problems, but I don't think it's ever going to have the effect size that a cell therapy or gene therapy would have. Okay. We'll see where the data comes out. But my guess is that gene therapy, cell therapy, will be the biggest ones. Okay. And also the OSK stuff. Okay. All right. So gene therapy, cell therapy, OSK. All right. So let's go in order. Gene therapy, which genes, what looks interesting?

19:42I mean, the ones that people have been playing with, like telomerase or Clotho, FOXO3, folostatin. I mean, those are the ones that mostly have been top of charts, but people are working on several others. I mean, now that it's really a fascinating field where it is emergent in that we're looking at much more underappreciated genes than we have been before. So, yeah, there's just like probably endless. And it's just the case we haven't been able to characterize these things very well to line them up and say, I mean, like, for example, when you look at what the new limit. So Brian Armstrong and Blake Byers built startup new limit.

20:18when you look at what they've done with the transcription factors, basically saying what changes things inside the body, they turned it into a computational problem. Whereas before when you're screening, what are the combinations, it's a very hard problem because the combinatorial set is so large. And so now they took a tech approach to a biological problem. For transcription factor binding sites. Exactly. And they've been doing so much progress in making it a computational problem versus what people were doing before, a much slower academic level approach. So I think - Yeah, I think some combination can work.

20:55The problem is that what you do in silico, and to be clear, I like New Limit and it's great, but some compliment of those because the in silico approach will also have often false positives and false negatives. It depends on how specific that social structure factor binding site kind of thing is. But I think there's definitely promise to combining both. Go ahead. Yeah, I'm imagining that it's probably just an intuition building process that even if there is some false positives and you have some degree of accuracy where you can't entirely get there. Still, it's just this, like, how do you take this insanely large problem, make it somewhat approachable, and have a more sophisticated iteration speed?

21:31So I think if you look at their progress over the past couple years, that's what I think is probably the potential for gene therapy. You know, people are looking at things like, can we do the four-hour sleep gene, for example, right, which is, like, very appealing. You get more time in life. So I think there's a pretty long list of things people start trying to knock off so let's let's go through so let's just talk about that for a second for less sleep right less fat you know or less weight okay like ozempic but gene therapy ozempic um more muscle right uh maybe faster healing perhaps for a lot of things that's that's helpful um uh perhaps uh you know like uh reversing graying of hair i mean i i actually i actually think it Looks a little distinguished, but that's fine.

22:14You know, a lot of the skin stuff, like wrinkles and so on and so forth. What are the other upgrades that you think are interesting? Go ahead. Cognition, right? Intelligence. Cognition, of course. Right. Yeah. And that could take several forms because there's like spatial rotation, there's musical ability. Right. Also, I think sight, hearing. Yeah. You know? Yeah. Yeah. I mean, I recently discovered, I mean, over the past couple of years, I've got mild to moderate hearing loss from listening to music too loud as a kid and also shooting guns. And that leads to dementia. You're a gun guy? I would never have thought that, honestly.

22:51Yeah. Yeah. I mean, we grew up with guns. Like, it was like an omnipresent thing in our lives. Huh. We just, everyone had guns and we were all shooting them all the time. But yeah, so we, yeah, basically I have, I discovered this. I didn't realize I had any deficiencies until I got the test. And so now I'm going to get a hearing aid because there's evidence that it can lead to dementia. I'm guessing most Americans, most people in the world probably have hearing loss. Our modern day world was not built for our ears. Like concerts, like 120 decibels. Damage starts happening over about 90. So we just, we have way too many loud noises, ambulances, et cetera.

23:25So, but yeah, hearing gene therapy. We've been wanting to find a gene therapy because I would love to be able to fix my hearing. There's a few groups who've tried it, who've been playing around, but there's nothing even close. So that's what I'm saying. This is so promising is once you, if we actually can figure out how to efficiently do gene therapies and do them in a state that allows rapid iteration and we can try these things and we can pass some safety threshold, then I think it really could be this like, this new era of how we think about ourselves entirely. That's right. Because I think gene therapy, what's interesting about it is it blurs the difference between, I mean, biochemistry and genetics are very closely related, as you know, you know, because, You'll have a compound and then there's like some small molecule and it will trigger like a protein will bind to it.

24:12And that protein will then bind to the genome and unlock mRNA that'll do other things. So biochemistry and genetics are tightly related. And one of the things I've observed is that many of these things, people are fine with solving them at the biochemical level. Like, for example, caffeine does make you smarter, right? or people are okay with chemistry to dye their hair blonde, for example. They're like, oh my God, you can't solve it at the genetic level. Or actually another example is they're okay with solving at the surgical level. So for example, height, it's okay to take HGH, which is a biochemical solution.

24:46And it's okay, people do a very painful thing of limb lengthening, which is a surgical solution. But the genetic solution, oh my God, right? And because they just have this weird hangups, they don't actually understand the distinction or the relationship between biochemistry and genetics and how close they are. And you can do that for all kinds of traits. Surgical and biochemical are okay. And genetic is, oh my God, right? But gene therapy is actually something that's more like biochemistry because it's an injection or whether it's an injection or something similar to that depends on the modality of it.

Read the full transcript

25:17But it feels to people like a drug because it's on somebody who's already living, but it changes them in an upgraded way, right? And it's actually been started to work for people who had sickle cell and other things. We can put that on screen. So, okay, so there's gene therapy, right? And then let's talk about cell therapy. What should we look at? I mean, there's a, we've been trying to get access to cell therapies for years, and it's never been possible because they're just too high risk. So there's some attempts at doing this with mesenchymal stem cell therapies, you know stem cell therapies um we have not yet seen a lot of success with these we don't see a lot of good evidence you know as as one approach whether it's from your body or someone else's body um but there's some of the more advanced things to to change more uh sophisticated biopathways in the body that just don't have good pathways like it's a very hard drug to get approved and there hasn't been good ones too like it's a very hard development path you know an interesting question that occurs to me is, depending on what age these treatments would be effective.

26:30For example, let's say you've got a car and you hit the brakes and you hit them hard enough and it doesn't crash into the wall, right? There's a point of no return by which if you hit the brakes, it doesn't matter. You're still smashing into the wall, right? But as just a thought experiment, you might actually, from the ranks of older people or people who for whatever reason are pursuing euthanasia, especially the people who are pursuing euthanasia in places like Canada or whatever, right? You might say to them, why not try one of these treatments? Because if you're going to die, right? Like can't, like can't, like heart T therapies for cancer.

27:14Exactly. That's right. Just like, you know, for example, with this novel argument that strikes me that's similar to the ACT UP argument that was made in the late 80s, early 90s that finally liberalized the FDA after many decades. Basically, a lot of people who had HIV said, we're going to die. So why don't you approve AZT and these other things? So at least we've got a fighting shot. Dallas Buyers Club documented that, right? So it strikes me that a potential extension of that would be, given that there's millions of millions of senior citizens out there, right? Those who were like, you know what, might as well give it a shot towards the end.

27:55Now, the tricky part about that is in that car analogy, they might be close enough to the wall that even if the treatment worked, it couldn't reverse it. But maybe it could. I don't know. It's a case-by-case kind of thing to figure out. Maybe it's a powerful enough thing that just rewinds it. One of the things, I know you know this, but like that's always struck me and many others who have written about this is a relatively older couple can have a child that is a newborn that you know clearly there's something regenerative in our in our bodies that can birth again right like and so maybe that can be triggered even much later in life than we think yeah this is like yamanaka factors take get an adult stem cell, you go back to a pluripotent.

28:41So you make a seven-year-old liver young again. And of course, like now people are... Go ahead. Yeah. So with your biomarker thing, you could gauge someone's life expectancy. And if they've got only five years to live, give them what... Obviously they have to opt in, sign up all this stuff. They've only got a few years to live. Try it. What's lost? Exactly. I mean, that's the thing is the exciting thing is the technology is here. Like we actually know we can turn an adult stem adult cell into a pluripotent cell like legit age reversal of course now there's complications with you know can you avoid it being cancerous cancerous yes of course right can you avoid uh you know the other off-target uh outcomes uh so like there's things we need to sort through but the the cool thing is in 2025 we now know we can legitimately reverse age in a stunning way.

29:34And this is why I think your sentiment is correct. Topology where we're too damn slow, right? Like I don't, I don't know why we are not pursuing longevity. Like we're pursuing artificial general intelligence. You know, when I look at 2025 and I try to zoom out to the perspective of the year 2 ,500, either you're, you're working on AGI or you're building don't die. Like everything ultimately builds up to like your existence or your shared existence with AGI. And so I just don't know why it doesn't have a similar level of fever pitch build around it. I think a big part of it is the stuff that I think about a lot, which is the governance part, because you need risk tolerant jurisdictions since, and that's a whole change in your way of thinking.

30:23It's like, as we've talked before, the traditional financial system assumes you have some degree of inflation every year, and you lose some of your health, one, 2 % inflation, lose some of your health every year. And the traditional medical system assumes you lose some of your health every year. So you lose some of your wealth and you lose some of your health. And so it's a paradigmatic change. Even if crypto has bar charts and graphs that look like the traditional financial system, its moral premises are fundamentally different. Even if you or I will publish graphs that look like traditional biomedical papers, the moral premises are totally different because it says, maybe we don't have to die, right?

31:02Yeah. That was our first phone call. I think you called me, hey, Brian, I think we have the same philosophy. I reject inflation and you reject death. Yes, exactly. I congratulate that. So we're after the same concepts. That's right. Because actually, and the thing is that wealth, in a sense, is a cumulated life force, right? Because you're spending hours of your conscious, highly productive time on accumulating wealth. And so it's diluted from you. It's like you're spending, they're taking away your life. You know, there's this movie called In Time by Andrew Nichols that actually makes that metaphor.

31:34It's like, you know, sci-fi drama, but the concept is like the currency is ours, right? Like hours of your life or whatever, right? Yeah. I guess as a side tangent on this theology, I just finished this book, Passion, the Western Mind by Richard Tarnas. And he tries to go through the major epochs of ideology. And he starts with Plato and Aristotle going through the Renaissance, going through Christianity. medieval times, Renaissance, Enlightenment, modern-day scientific era. And if you look at it from that perspective, like a Ray Dalio principles perspective, where you zoom out, you say, hey, there's these big economic cycles, reserve currency, that they go through the same stuff every time.

32:12We're really due for a major ideological shift right now. And I think you're on this, I'm on this, that it's not some slight tweaks to the continuum. it is like a wholesale change on scale with other major ideological shifts. And I think what we're talking about today is basically a part of that. It is like this unleashed want for health. This is not about living forever. It's not about transhumanism. It's about we all appreciate waking up in the morning feeling good. We don't like aches and pains. We don't want to be diseased. We don't want to see our loved ones die. it's about feeling great and being great.

32:52And that, that ideology is not part of our zeitgeist. Like we just accept this slow decay, death and decline. And it's like almost something where you celebrate. It's like, I'm living life by slowly killing myself. Yeah. Well, human self-improvement is, I think the way that I think about it, where that's a continuum from simply eating right and doing better to hitting your genetic limits and then surpassing them. Right. And, you know, Now, towards that end, by the way, I think the influence of, let's call it, dharmic and sinic thought on the world. So, you know, for centuries, India and China, like Marco Polo sought out China and Columbus sought out India.

33:34That's actually how the Americas discovered, why Native Americans are called Indians, because India was a large enough economic power. It wasn't unified, but it was worth sailing to and for Columbus to do it. And so for the last few hundred years, India and China have basically been through their equivalent of the Dark Ages, and now they're coming back. And those two schools of thought have a different view on the human body, and they're less... The Abrahamic school of thought has kind of weird hang-ups in certain ways that the Chinese and Indian schools of thought or more generally the Sinic and Dharmic schools of thought don't.

34:10And so, like, for example, something I've thought a lot about, I may have mentioned this to you, the concept of genomic resurrection or reincarnation. Did we talk about that? We did, yeah. Yeah. Yeah, but explain it. You could get your DNA sequenced and stored on disk. And we already can do chromosome synthesis for eukaryotes. Like, you know, we could do it for actually, you could synthesize an entire prokaryotic chromosome from disk and actually have that thing swim around in a test tube. and as our abilities of chromosome synthesis get better you could imagine just projecting out to be able to do it for full complex human chromosomes and it's just it's like a technological direction it's kind of like if sequencing got better synthesis will probably get better it might take you know a few decades but it'll get there which means that if you have a file you could if somebody was well behaved you could write their genome to a blockchain or something like that.

35:07And if they had good karma, then the community would reincarnate them 50 or 100 years hence or whenever chromosome synthesis becomes feasible because they have the data there. And, you know, people argue the genome isn't everything, but it's a lot. It'll get you a lot. And then you could replay all their past life experiences for them if you recorded it. And they would just be born with all this amazing knowledge of everything that happened, you know? And that's something where if someone was going in on one of these, missions where they're trying out this experimental drug, you could sequence their genome and say, if it doesn't work out, you'll be reincarnated with the knowledge that you had in life and so on and so forth, and we'll look after you in the next life, right?

35:50And so that's like a dharmic inspired way of thinking about it. And then the psychic inspiration among other things is just extreme pragmatism and just experimenting with things. This is actually, you know, the Western mindset used to also be like this Banting and Best. Do you know that story? I don't. So Banting and Best, this is an important story for, you know, like 19, if I get the dates right, I think 1921, they started experimentation on insulin supplementation, said a hypothesis could treat diabetes. And they tested it on first like dogs, then, and it worked. And then they treated, you know, they tried self-experimentation and they went for patient volunteers.

36:29and those patients just like stood up in bed like this. It was like the canonical bench to bedside concept, like a bubbling beaker, you know, it was brought there. And they iterated on formulation and so on. And I think, you know, right now it's so hard to go from like pill to oral to an injection to a patch. There's a whole process. Whereas in some ways it's kind of like going from web to a mobile client to like a command line client. It's kind of the same drug, but in different formats or whatever. So they just did all of that. It wasn't case control studies. It was just iteration, quick iteration and seeing it.

37:03And it was a large fact. And by 1923, they had Eli Lilly doing scale production of insulin for the entire North American continent. And they'd won the Nobel Prize. And so that was a time when pharma moved at the speed of software, where you went from idea to execution and via iteration in like two years. And one of the issues I think a lot about is there's no case control studies on case control studies. There's no regulatory science on the regulator themselves. Why don't we have a jurisdiction where you can just iterate your way to, you know, to something? Where crucially, by the way, the patients aren't simply patients, they're participants in their own health.

37:40They're not like a row in a table, like a very 20th century study like Framingham or something like that. That's just like a row in a table, right? Whereas if it's a human being there and they've got a mobile app and they can send you back what their experience of the treatment is and they're an act to participate in their own health, that's a totally different paradigm. It's bidirectional. And the very simplest version of that is adaptive clinical trials, which show you can converge on an endpoint faster if you're not simply doing a really dumb open loop trial. where you're basically taking information from the trial as it's going to adjust things very shortly in adaptive clinical trials.

38:17But I think you can do much better than that. No software is designed with case control studies. SpaceX wasn't designed with case control studies. I'm not saying that there isn't some utility to them, but they're really for teasing apart small effect sizes rather than large effect sizes that are so manifest that they just jump out at you. Yeah. This probably goes back to the beginning of our conversation where if you have a large visual effect size, that gets everyone involved. And if you can do so in a jurisdiction to be like, hey, you can go from idea in gene therapy, cell therapy, or something else.

38:52And I mean, I guess that's why people are so interested in peptides is peptides are drugs, right? Peptides give you a drug like effect sizes. The problem is they're poorly characterized. There's questions about how they're manufactured and the quality of those things. And then also you have a lot of off-target effects. So, I mean, peptides are inherently a risky path when you're not doing a well-characterized path. But, yeah, I mean, if we could demonstrate some, like, one or two wins of a process from a talented drug developer to an actual thing that works, that has a low safety profile, large effect.

39:29Now, I guess it's TBD whether we can see that because, I mean, biology is complicated. Maybe that's too big of an ask. Maybe, you know, the GLP ones, they kind of hit that sweet spot where it's the immediate visual effect of fat loss. And it has all these follow-on health benefits where even if you're not obese or if you're not having an eating problem, they, you know, it gives you power, gives you discipline. Yeah, exactly. Yeah. Yeah. That reminds me of like in the future, like we talk about, like you and I have imagined what gene therapies, we say hair, skin, you know, muscles, et cetera. But it might be fun to a thought experiment of like, what would gene therapy be like in 30 years?

40:04Like what kind of nuanced, expansive concepts would, what do we think about? Now we think about like designer babies of like, we're going to choose height and eye color, but like how would you think about the human experience? Mini circle is interesting because they have the concept of a plasma that's reversible. You can turn it on, turn it off, right? So almost like, you know, I have some caffeine and I don't, right? You could, or you change your, you know, put on your contact lenses or not. But, you know, biology is complicated. There's all kinds of off-target stuff. It's not trivial to get it right.

40:35People's biology is different. All that's true. But there's something cool to the idea of a very specific target that can flip on and off a protein that can add or delete a function, right? And Patrick Friedman, I think, had that therapy. And he showed his mini circle, you know, which is doing the plasmid. So Patrick Friedman and Farb Nevy both had the therapy. and patrie said that he was just crushing it with his vo2 max farb also said the same thing right and um that's something where it's n of one but they know their own bobby better than anybody else it's n of one but it's over it's it's a lot of variables which are n1 you know mike snyder's thing on this from many years ago the didn't talk about mike snyder's prophet staford and he yeah no my yeah the integrum right he just took every possible thing from expression to the rest and just ran on himself.

41:29And he's able to, for example, see himself getting sick in the gene expression data, like a few days before he actually got sick, right? Exactly. And so we could, with better metrics, that's another piece of this actually, diagnostics are non-invasive, right? So if you had constant whole, like all 30 ,000 odd or 22 ,500, or whatever, you know, a human gene expression panel, and you track that and maybe, you know, metabolomics and so on. You did something like the Mike Snyder integrome while you're giving people this gene therapy or cell therapy. You just got a much richer readout, you know, from them, right?

42:10Now you're not just relying on self-report. You know, it is, it's like your biomarker stuff, obviously, but it's just like, you know, we're getting tens of thousands of them. Yeah. That seems like, you know, something that is very feasible because costs are coming down of all that sequencing and so on. That'd be a very good thing to do, like an intagram-like thing that's like a time series intagram. First you get whatever data points on them to determine healthy, then you impose a stimulus, and then you look in state space and you see, is it actually changing anything or not? And what's it changing?

42:36Yeah, that's exactly what I'm doing at Blueprint. So we are going to try to do, I guess we've done that for myself. Because when you build an ASIC, if you have not built an ASIC, it's really cool that if you get a picture and zoom in, zoom in, zoom in, zoom in, zoom in, you find that it's like down to the nano level of like granularity. It's beautiful. It's amazing we can design these structures. It's crazy, yes. It's crazy. And the thing is you can characterize this at every level, every circuit design you can characterize. You can say, what happens when I do this? And so like we can characterize our machines and our intelligent machines so well from the circuit all the way up to the application layer.

43:20We can characterize the entire stack, the servers they run on, the energy. Whereas in human biology, we can't characterize. You can get like a really high level of like, what does my blood draw say? Right? Like my cholesterol or my liver enzymes. But you can't get down and characterize these smaller molecular interactions, which like you're saying, they read out really important data. Am I getting sick? Am I showing signs of disease? Am I responsive to this drug or not? And in what ways? And so if we can pair the characterization with these jurisdictions with good drug developers, that's your path.

43:57And then we can open up. And once people get a few successes, we'll say, huh, this is a thing. We can actually do it. I was talking to Jason Kelly the other day. He's founder of Ginkgo Bioworks. Yeah, exactly. I was first money in. And they really led the charge for biotech in industrial applications. It was a really great moment. They've run into some roadblocks and doing it, which breaks my heart because there's nothing I want to see more than biotech in the industrial world, like really smart biotech designs. And we were saying the other day, we're talking about doing something together. And we were both just like, why can't we build human with the same fever pitch we build tech?

44:39Like, why? Like, why can't we chase this thing? It's so frustrating. I think it boils down to risk tolerance. And the reason is with tech, we can have crashes. Because there are crashes and the computer crashes and it crashes all the time. It's like acceptable to fail. Right. With humans, people get really mad if there's a failure. Right. They are, you know, but but they didn't used to. With Banting and Best in that era, people were more reward seeking and less risk averse. Right. And I think we're kind of coming back to that era gradually where risk tolerance has radically increased over society over the last few decades, I think.

45:24And, you know, one thing on this is an intermediate between, though maybe we can just go to the full thing. I think just the diagnostic zone, right, where you can just get genome sequence without a prescription from your doctor. It's so stupid, the entire FDA, you know, CDRH thing where it's like requiring a prescription to look at the mirror. Like, why should you need a, why should that be bottlenecked through the medical system to get your genome sequence? When the AI models are smarter than my doctor, like, why do I have to go ask them? Exactly. That's right. So I think there is definitely room for something where you get your genome sequenced by, for example, Nucleus or some at-home kind of device, you know, like as Oxford Nanopore or something like that gets smaller and smaller, eventually it'll get there.

46:13Or you just do it in a lab and you just get the file back. And you have it interpreted by something like an open source version of Prometheus, but it's an AI-enabled thing. And it's all done locally. And so I've got some companies that I'm looking at that do some combination of these things. But, you know, I think the second generation of truly personal genomics could be another big thing that we do. And maybe that's the intermediate step that then people have enough data and enough time series on themselves that then that opens up. Basically, the reason that's interesting is now you're not flying blind.

46:46Every treatment, you have a sense of your own dashboard and your own metrics. Like you're one of the very first on this. Actually, there's that guy, the measured man. There's an article in The Atlantic many years ago on this guy. He's a prof. I forget his name. You should maybe meet him if you haven't. It was back when The Atlantic was good. But the, so the, this guy also is measuring all kinds of time points on himself. And he found, he was like an early quantified self kind of person, right? So if you have that dashboard, now you have a sense of kind of what's a speed bump, what's a real major thing.

47:25And then you're kind of better able to process what an intervention is doing. Is it messing you up? Is it just moving these genes? That kind of thing, like these expression levels, et cetera. Do you actually, in all your Biomecker stuff, have you done gene expression time series on yourself? By the way, his name is Larry Smarr. That's him. Yeah, that's the guy. I've never met him. When was his son? Do you know him? I don't know him. I just know him from the, I think Larry Smarr, Mike Snyder, and you. Yeah. should do, if you want, we should all do a podcast together or something. That's a good idea.

47:59Those two people are very aligned with our way of thinking. Yeah. So he's a founder of the National Center for Supercomputing Applications at NASA, born in 1948. So he's just - Yeah. So he's 80 or something. I'm not sure what health he's in, but him and Mike Snyder are both pioneers in this space. Mike Snyder with the Intergrom, Larry Smarr, right? And I think it's worth - I bet, by the way, if you put that into AI, AI is very good at expanding suggestion lists. So if you put both of those there and say, who else is like that, you'll come up, but maybe others will come up too. Yeah, he found early Crohn's disease in himself before he was clinically diagnosed.

48:34I mean, this is like, so I have kernel on my desk here. This is the brain interface I built. I measure my brain every day now. Ah, I'll show you. Yeah, so this is like characterization of the brain. You can start, you can see the inside here, maybe. Yeah. So this is like, we spent seven years building this technology. It's basically wearable fMRI using light, using light. And this is the problem is we've never had the ability to characterize our brains. It's like, if you want a brain scan, you do fMRI or you can MRI. FMRI is a functional side. MRI is a structural side, but just like go to facility, sit in an environment that's claustrophobic.

49:10But now I can basically characterize my brain every day, looking at the functional networks. You know, I have a, my intuition, by the way, does that need to be, can you walk around with that? Or is it having to plug into the wall? Yeah, yeah, it's stationary. It's stationary. You know, a fun test would be, what does it look like when someone is just scrolling versus what does it look like when they're on the treadmill? Yes, exactly. And like, I didn't do this, but my colleague did. He drank alcohol for science, and he saw an immediate aging of his brain, I think it was two to three years the following day.

49:50It's been cool to just see basic correlations. What happens when you're sleep deprived? What happens when you exercise? What happens when you eat well? But you can run all these experiments now where I couldn't before. But this is like the characterization thing. The characterization thing is what we've been missing is people run to do therapies, and even when they do therapies, it's poorly characterized. It's very poorly characterized. let alone before, like having some, like you're saying, some time series, longitudinal data, looking at these things, which is I've, you know, I've become the most characterized person, human in history.

50:21There's no human that has this more characterized than myself. And so we have, it's enabled us to find so many insights that we just haven't been able to find in the literature or through other observations through doctors. It's just like, it's all about measurement. And what is the cost per day of your characterization, by the way? Like what, what asses are you running? Honestly, it's not that expensive. These are like, I mean, blood draws, saliva, stool, mitochondria, fitness tests, imaging, methylation, proteomics. You're like, I don't know. She's like, not honestly, probably, I'm guessing without thinking about this more robustly, but something like 50 ,000, 100 ,000 a year.

51:06Like it's not that much. It's like$1 ,000 a day. And so if we could bring that down to$10 a day or even$1 ,000 a month. Yes, exactly. Right. Actually, it's less than$1 ,000 a day. If you're saying$100K a year, right, then it's somewhere between$200,$300 a day, right? It's already not too bad for what it is, right? Right. So, um, it's like, you know, the thousand dollar genome. Yeah. There's, there's obviously, I mean, I've run a clinical lab. There's definitely returns on scale with clinical lab for all kinds of stuff with instrumentation to reagents to everything. So I've thought about a residential clinical lab where we just build it into network school.

51:53Yeah. And cause it's a pain to go in, you know, you want is a phlebotomist to come to you, right? You want mobile phlebotomy you want saliva you want ideally even in your apartment or something like that you can just leave your toothbrush or something like that and then it can just you spend a cup or something and then uh there's various ways of probably streamlining if not fully automating yeah making it easier to get samples i have a sensor in my toilet yeah exactly that kind of Just automatically. Yeah. Bill Gates was interested in this 20 years ago. And you could, you know, like you're in colorimetry and so on and so forth.

52:34There's a lot you can do with that. And you just have it there and maybe, you know, you just image it and so on and so forth. I think the Chinese could do a lot here because they can innovate on hardware. And there's something to be done here because they're building a lot of cities so they could actually install these smart toilets. some kind of Chinese Japanese companies because the Japanese also do a lot of toilets. Yeah, I just watched that South Park episode where they got the Japanese toilet. Anyways, yeah. This is also the characterization thing is really cool because when I started Blueprint, I was trying to solve my own problem.

53:09Like, how do I actually find nutritious food that's third-party tested and low on toxins? And then friends and family were like, hey, can I have access? I'm like, sure, here we go. And it just like accidentally became a business. But the problem with that is like, Even though I'm trying to solve a real problem in life, people have such a negative connotation towards therapies, towards things you actually... It's complicated. And characterization is much more friendly. If you're helping someone measure themselves, there's much less blowback. And so I'm moving very hard in that direction where I'm going to help people characterize themselves.

53:39Not drugs and devices. Yeah, just characterize yourself like me. Let's just get this baseline measurement. it's a much safer path to build because then people somehow they don't have suspicions like they do with me now when i'm like really i'm like i don't need i don't want to be doing this like i there's so many like if i were out to make money there's like a thousand other ways i want to do to make money so anyway yeah so the thing is actually you know years ago that's why you know my first company was in diagnostics because also diagnostics has a lot of advantages first is it's half computer science, because after you do the assay, then you can analyze everything on the computer, right?

54:20And you can make all the dashboards and so on. So it's like at least half within our bailiwick. It can't hurt the person usually. So the risk is way, way, way lower. So you can move much faster. You know, the worst thing you can do is you can give them a wrong result, but you can move close to speed of computer science. And then most interestingly, it means that the intervention is informed. So arguably diagnostics creates a room for therapeutics. So perhaps we start with the universal longitudinal diagnostic network state first. Longitudinal network state, then longevity network state. Okay, cool.

54:58Balja, I like this. So basically, we get a cohort of people together. We say, we are going to invest the capital to do high fidelity characterization. I love this. We don't know why, right? We don't know to what end. Myosand or integrome for 100 or 1 ,000 people. Yeah. Now, and it may not be useful to be this characterized for five years, 10 years. Like we don't know, but like we want this longitudinal characterization so that when we find things to trial, we have this time series, longitudinal data that we can, yeah, that gives us a better shot identifying what therapies are going to, what we will be responsive to, what we won't be, and then see the off-target effects.

55:40And so probably a much better way. Whereas right now, even when you look at the clinical trials, they are so poorly characterized. Absolutely. I read this one scalar variable on a very complicated human. I read these studies. I'm just like, this is not reliable data. Like when you're telling me it does blank and blank and it has these side effects, like sure, but nothing close to what I would think it'd be. So even as like, that's why like the GLP ones are a good one because they have done good characterization, better than a non-characterized peptide. But that said, we don't know a lot, which is why all this stuff is coming out, like blindness and stuff like that.

56:17So yeah, really, I guess this conversation has landed us on characterization as the key input, but then we need to go to these jurisdictions and figure out with that, how we'd leverage fast track, safe, high effect size therapies. Because we need a moment for longevity. We need something. Yeah. Go ahead. Say what you're saying. Yeah. No, just like, it could be the case that it's like, you know, the history book says, you know, from like 2025 to the 2035, these new therapies came out and I had this like starting this cumulative effect. Or there's like a moment where something happens. Maybe the GLP ones are that story of like people got familiar with doing these.

56:57They're important. They are. But we could have the exemplary for aging would be that moment. Yeah. Yeah, like something pretty, but the effect size is big enough where everybody turns their head and they're like, I understand reality differently now because of that. Yes, that's right. And I do think that's possible simply because we're seeing it in mice and so on. We just got to figure out what buttons to press within humans. But I really like the idea of the longitudinal network state and then the longevity network state or the longitudinal special economics zone, longitudinal diagnostics. And we can cost that out.

57:32And we could do something as a DSI thing. You know DSI? Yeah, yeah. Or we could do it at a traditional raise, but it's just a very scoped thing, which is these end people for this period of time. And frankly, they could even pay for it where it's something where it's not that expensive. It's just expensive enough to be within like a, you know, sort of pro-Zoomer budget, like a crypto person, right? Yeah. And they could maybe live at network school and be part of the study. Yeah. I like this. So you have the list of all the instruments that you do for your measurements. Do you have that in a public spreadsheet or do you have that internally?

58:12I need to put it together. Yeah. Basically, what would a high fidelity characterization look like? What tests would you need? What machines would you need? What labs would you need? Because some of the assays we want done are just not available off the shelf labs. So even if we had some people who could spin up some nice, so it could accommodate some of the unique things we want to measure. That'd be great. Yeah, I think, and we do it in participation with NUS or somebody like, you know, some sort of local university or hospital. And I think we could do something here. I think there's something very, very cool.

58:48If anything, it's like a new model of, even it's a new model of healthcare, really. The key is, you know, like at Stanford, there was this concept called, back again, back when savings was good, residential education. And the idea was that the education didn't stop when you were, it wasn't one hour in class, you were 23 hours outside of class. And so education happened to the dorm rooms and so on and so forth. So it was like, you know, immersive in that sense. So this is residential health. Yeah, yeah. I mean, this is kind of like, you and I have been spinning around this idea, I mean, since we first met of like, how we bridge the worlds of ideology health, governance, nation state.

59:32Like, what is this moment? And I like this as a path because it does, it brings together the things people care about. Yeah, and there won't be that much resistances because we could start with the lunch tool measurements. No one gets hurt, right? Exactly. And you have enough data to show what normal looks like, what interventions look like, what fitness looks like, what bad foods look like. You've got all their nutrigenomics. you got their pharmacogenomics. It's a whole thing. There's a whole stack of actually open source software that you develop in doing this. Yeah. I like this a lot. And then we can also, if we, okay, this is probably too much, but then we add some organelles, right?

1:00:10So now you start doing therapy trials against your organelles. So then you've got the patient-rived organoids. Exactly. Yeah. Exactly. So now you start doing the experimentation, high throughput experimentation on your organelles. Yep. And they're your proxies. Exactly. Yeah, that'd be badass. I mean, that'd be amazing if we actually set this up. All right. Yeah, okay. Good outcome. All right. So we've got a plan for the longitudinal network state towards the longevity network state. Make a progress. Okay. Well, thank you very much, Brian. Thanks for having me. I really enjoyed this. Awesome. Talk soon.

1:00:43Okay. Bye.

From the publisher

Bryan Johnson is the most biologically characterized human in history. We cover the transition from the FDA era to large effect sizes, the potential of gene therapies, real-time brain measurement, and the roadmap for the Don't Die Network State. If you're interested in ideas like the Don't Die Network State, come to Network School. Apply online at https://ns.com.

More from The Network State Podcast

All 27 episodes
#31 - The Don't Die Network StateThe Network State Podcast · 1 h 1 min
Listen in VO