Dr. Patrick: Hello, friends. This episode has two amazing, amazing guests who need no introduction, Dr. Peter Diamandis and Tony Robbins. Neither of them really do need an intro. So I'm going to keep it really, really brief. Dr. Peter Diamandis is a serial entrepreneur, founder of XPRIZE, which designs and operates global competitions to incentivize the development of technological breakthroughs that can accelerate humanity toward a better future. Tony Robbins is a serial entrepreneur. He's a number one "New York Times" best-selling author, he's a philanthropist, and he's the nation's number one life and business strategist. And both of them are so much more.

I kind of wanted to kick this off because I'm personally curious. Peter, you're really well known for being perhaps uniquely motivated in finding systems and organizational level approaches to creatively solving big problems, XPRIZE being one such example. On the other hand, Tony your work focuses more on the individual and in helping people solve their own internal problems, whatever they are for, you know, whatever's holding them back. So there's definitely some potential overlap here, but maybe you could tell us a little bit about how you both connected to form such a strong, lasting friendship and collaboration over the years.

Tony Robbins: Well, we've been friends for a long time, but this book came together with us together because I had an accident that they told me was going to end my career. I was being an idiot chasing a 22 year old professional snowboarder down a mountain, and I couldn't make the moves they were making, and it ended in disaster. I thought I literally broke my neck. In the end, I tore my rotator cuff severely, and the pain was nine-nine pain, because it was nerve pain. I couldn't sleep. What do you do? You go to your doctor's. I went to four doctors, all of them saying surgery, surgery, surgery. Well, what's the prognosis? Well, I'll be honest with you, you may not be able to lift your arm above your shoulder again. It could tear again. Four to six months of recovery, I asked them about stem cells because I worked with some of the greatest athletes in history. You know, someone like Cristiano Ronaldo was supposed to be out for three months, it was two and a half weeks, and he's back on because of stem cells. And so, no, no, no, they're worthless.

And then the final doctor looked me straight in the face and said, "I want to show you something. Life as you know it is over." These were literally his words to me. And I said, "You clearly didn't go to my communication seminar." But he showed me my spine, and he said, "This is no laughing matter." He said, "One good hit," and he said, "You won't be able to walk again. No more running, no more jumping, you know, no more snowboarding, that's for sure." And, you know, if you're ready for a punch in the gut, you might handle it. I didn't handle it so well, I got to be honest, for a few hours, and then my normal brain kicked in and said, "There's got to be better solutions." So, Peter and I have been different for years and partners in business. So I called the genius over here and said, "Listen, you know, who's the best person on stem cells? I've heard good, bad, and between." And he said, "You got to reach out to Bob Hariri." Why don't you share with him a little bit about that, peter?

Dr. Diamandis: Yeah, sure. So, like you said Rhonda, I've been focused on large-scale solutions, and for probably the last 15-20 years, it's been around how to use exponential technologies to solve the world's biggest problems, you know, AI, robotics, 3D printing, synthetic biology, quantum computing, all of these areas. And I became enamored about eight years ago on the idea of using those exponential technologies, focusing it on health and longevity. You know, as you get older, you know, space is taking a long time, I wanted to live as long as I can. And I met Bob Hariri years ago, these were both pilots, he's passionate about space, and became just fascinated by what Bob was doing. Bob had been one of the very first people ever to isolate stem cells from placentas.

In fact, he said, you know, "The placenta is the richest source of stem cells out there, and these are like, you know, day zero old stem cells." And I had helped him spin the company, a company called Cellularity, out of Celgene where he was the head of cellular medicine, and we formed this company to have stem cells from the placenta being able to be used eventually for repairing the body. And so when Tony reached out, I said, "Tony, listen, you've got to talk with Bob Hariri. He's like the world's expert in stem cells. He's my go-to guy in this field." And stem cells are how you can rejuvenate the different systems and tissues of the body. So, Tony, back to you.

Tony Robbins: Yeah. So, little I know, it's like saying I want to learn about basketball, and he goes, "Let me introduce my friend, LeBron James, you know." So, I talked to Bob, and Bob said, "Listen, you know, using your own stem cells is a waste of time after 40, they dropped through the floor." He said, "If you're doing an elbow or an ankle or something, maybe," but he said, "This is really extensive. You need four day old stem cells." And I said, "Fetal tissue? I don't have fetal." He said, "No, not fetal tissue," and he explained, you know, the power of placenta and the power obviously of cords. And he said, "I'll tell you where to go." He said, "You can always go back for surgery." So, I went for it, and I did three days of treatment. It was just 20 minutes a day of an IV and a shot. And, you know, the first day, I felt tired, the second day, I had a cytokine response.

I knew what it was, so it didn't scare me, but, you know, shaking, freezing, about 20-25 minutes of that. And then my body had a very strong reaction. I went to sleep, and I woke up, not only was my shoulder perfect, I have done the MRI, I'm totally fine. That was almost five years ago...four and a half years ago. But for the first time in 14 years, I stood up with no pain in my spine. So, it turned me into an obsessive one, I want to know everything about stem cells, what's the greatest breakthroughs in this area. And then what I began to find out is not just stem cells, there's this incredible revolution in regenerative and precision medicine. And then, you know, every two years, the Vatican, the Pope actually throws a conference, probably the biggest in the world, with doctors from all over the earth because he believes this is a breakthrough for humanity, and he wants the answers for humanity.

And so Peter was going, and then all of a sudden, I got a call, and they said, you know, "We'd like you to be the cleanup speaker," and I said, "Wonderful, but I want to attend the whole thing." And so I attended the conference, and I met some of the greatest scientists alive in rehabilitative medicine and regenerative medicine and precision medicine. I met patients, more than a dozen, that were sent home to die because the cancer wasn't treatable, but they found somebody like Dr. June with CAR T cells. And here they were six years later totally healthy. I met, you know, Jack Nicklaus, one of the greatest golfers of all time. He couldn't stand for more than 10 minutes, his pain was so severe. They were going to, you know, lock up...you know, give him a spinal fusion, which, as I'm sure you know, doesn't usually work at least half the time, and if it does, gives you limited mobility. He did stem cells instead, and here he was 82 years old now playing golf and tennis.

So, I just said, "I want to do like what I did with money. I want to go to the very best, but instead of 50, you know, the Warren Buffett, the [inaudible 00:06:33], the Carl Icahn, let's find the top 150 Nobel laureates, scientists, medical doctors. Let's interview them and bring the very best on how to increase your energy and your strength and your vitality, but also what's the best in diagnostics to prevent it, and what's the best if you're running into real challenges. And so that's how this was created. And I went to Peter and said, "Why don't you join me on this, you genius?" I went to Bob who helped me. And so the three of us worked on this project together. It's been a three year project. And by the way, we're donating 100% of the profits as I did in my last three books. We're feeding 20 million meals for feeding America. I'm up to 850 million meals. I committed to a billion meals seven years ago, and we're ahead of schedule. And the balance is going to Alzheimer's cancer and heart disease research with some of the best researchers out there.

So, we've tried to create something that people could enter and use as much or as little simple lifestyle changes, are things you and I have talked about in the past, to what are some of the most high-tech solutions that are available.

Dr. Patrick: Awesome. We're going to dive into all that hopefully. On the stem cell front...on the placenta front, Peter and I were chatting about this a little bit before off camera. I banked my placenta in 2017 with LifebankUSA. This was mind-blowing to me. You know, I didn't even know about the source. You know, the stem cells in the placenta being people hear the word stem cell, and, you know, it's like, "Okay, a stem cell, what is that?" It's a cell that has the capacity to replenish the different cell types within an organ. But there are stem cells that can form many different types of cells in different organs, and so you can have what's called a pluripotent stem cell, which can form a cell in your heart, or your liver, or your brain. And the placenta is actually a rich source of that. And I didn't [crosstalk 00:08:21]

Dr. Diamandis: In fact, Rhonda, I would say, and for anybody listening, if you're pregnant or someone you know is pregnant, it's something you should consider to bank, not only the cord blood, and the cord blood is the hematopoietic stem cells, it's the stem cells that lead to red cells, white cells, you know, immune cells, but if you bank a placenta, it's rich in these pluripotent stem cells. In fact, I think that the placenta is a 3D printer that manufactures the baby, all of the cells that make up the baby come from that placenta. And the placenta is also rich in natural killer cells and T cells, all these immune cells. And what LifebankUSA does is it decellularizes the placenta, it saves those cells. And it's like saving...you know, for those of us who remember a boot disk from your earliest computers, it's like saving the original software before it gets corrupted.

And another thing is that the cells from the placenta haven't developed...they haven't been thymonized yet, they haven't developed a us versus them characteristics. So you can give placental cells to anybody, you know, because the placenta doesn't generate an immune reaction against cells and you...don't generate immune reaction against placental cells.

Tony Robbins: Rhonda, there's also, you know, one of the people that we met originally, Peter and I both met, at the Vatican, became good friends with, and investors in this company, is a company that's called Biosplice. And they're in the third stage of FDA trials right now, you know but just so your listeners know, phase one safety, of course, phase two is efficacy, phase three's efficacy at scale. So, in the third phase, they think they'll get approval sometime in the late fall or the beginning spring of next year. And literally, they've discovered the Wnt pathway has been known about, it's the signaling system that tells your system, "Okay, make this many stem cells for the brain, this many from the heart." And as you age, sometimes that signaling system becomes corrupted or less effective.

Well, they figured out how to upregulate or downregulate, whether it's cancer we want to downregulate growth or upregulate, like you want to get osteoarthritis and you want to regrow tendons. And so the one they're getting approval for first is for osteoarthritis. It's a single injection, and in 11 months, you regrow all your tendons, but based on the boot disk as was just described, they're like 16 year old, tendons, even if you're 40, 50, 60, or 70 years old, that's the world that we're entering to right now. So it's like there are things you can do today, there's things you can do in 12 to 36 months, and that's what this is focused on, not 10, 20 years from now, what you can do right now to change your life.

Dr. Patrick: So, Tony, you're all about applied health promoting habits. You know, I know you're a big time fitness enthusiast, you're a cold plunger. What are some of your favorite lifestyle habits that you practice and are most excited about when it comes to living healthier?

Tony Robbins: I'll tell you what I was least excited about but have become excited about, and I give Peter partially credit for this, but I'd also give Dr. Walker from...you know, neuroscientists from UC Berkeley, who's kind of the sleep expert. My whole thing was, "I'll sleep when I die." You know, it's like my wife loves eight hours of sleep. I was like four or five hours is more than enough, I gotta live this life. And the way He convinced me, Dr. Walker, was he said, "Tony, we did a study. I think it'll convince you, 1.6 billion people." I said, "Dr. Walker, you couldn't have coordinated that" because they didn't have to. He said, "It's called 70 countries that all have daylight savings time." And he said, "Here's what we found, an alarming statistic, when we spring forward and we lose just one hour of sleep, in those 70 countries, over the next three days, heart attacks increase like clockwork, on average, 24%. When we fall back and get just one more hour of sleep in all those countries, heart attacks dropped 21%."

He also does correlations to traffic accidents. He also showed me that a man who sleeps four to five hours a night usually has testosterone levels of a person 10 years older than they are, that got my attention. So, you know, he taught us and he's taught all of us some really simple hacks that I now use, one of those is having a consistent time to fall asleep and wake up. And I got to be honest, that one is not perfect for me by any stretch.

But the other is, you know, I was working on the sleep chapter for the first time at 6:15 having to be up at 9:30 in the morning. So, I knew something was wrong. But now I really work to get eight hours, which I've never done before. I wear a Whoop and I measure it. I use an eye mask, I keep the temperature about 65 degrees, which allows you to go deeper, and so I stay away from those blue lights that... you know, you can wear the little goggles if you want, kind of a rose-colored glasses so your brain can go to sleep easily, so some really simple things. But for me, I love cryotherapy, as you know, I love cold therapy. You were the one that got me into saunas. I obviously knew about saunas and used them, but I had no idea the research that showed four to seven times a week could change completely the profile of you having a heart attack or a stroke, to changing a blood pressure. I'm quite religious on both sides, the cold and the hot, I find that to be invaluable. I also do hyperbaric oxygen. I'm a big believer in pulsed electronic-magnetic frequency, PMF.

I use that as a kind of a biocharger for my body because, you know, I'm a biohacker, I got to get up and do 12 to 13 hours with 15 or 20,000 people in a stadium who won't sit for a three hour movie for four straight days or seven straight days. And these days, I just finished a seminar with 800,000 people for six straight days. Now I've got to do it through a screen, and I keep people like...you know, I got a seminar coming up next week or two weeks from now, it's 25,000 people in 195 countries. And so we start here at 10 a.m, my friends in Australia start at midnight, and we go 12 and a half hours a day, so they start at midnight and they finish like 1:30 in the afternoon. My, you know, friends in, let's say, London are five hours ahead of us, so they're starting their, you know... Literally, every time zone in the world, I got to hold them together, so the level of energy this demand is through the roof.

And then, of course, there's the understanding of how do you really impact those mitochondria through things like understanding NMN, NAD and what the impact of that is, which, as I'm sure you know, is quite powerful to say the least, especially after you turn 40 or 50 years old where that drops off the cliff.

Dr. Patrick: I want to ask Peter sort of similar question, but before I go there since you mentioned it like...I mean, anyone that's seen you in action, whether live or virtual or on television, Tony, I mean, you've got incredible mental and physical stamina. Like what's the secret sauce? Are you disciplined with these...with your lifestyle factors? Tell us.

Tony Robbins: I'm extremely disciplined with my lifestyle factors, but some of them backfired. So I was a vegan for 12 years, and then, you know, when you're burning 11,300 calories...that's my average calorie burn. I have a group that works with Olympic athletes, and they traveled with me for three years. They tested me. I wore a 70,000-dollar device that measured everything, heart rate variability, they took my saliva, they took my blood, over 11,300 calories on an average day on stage 12-hour day. Actually, the device only lasted nine hours, the battery died, and I kept going another three hours in perspective, right? I jump 1000 times, Rhonda, to give you an idea, in an average day, and they explain to me, I'm 282 pounds, so every time I come down, it's four times your body weight. So imagine 1000 pounds times 1000 jumps, a million pounds of pressure in one day. If you saw my bone density, you always said, these are humans, these are Olympic athletes, this is something we've never seen, I have 99.9% higher bone density than anything they've ever measured, to give you an idea. I have 15 pounds more of lean muscle mass than the average lineman.

If you're running with a friend, and you can't talk anymore, your lactic acid's about 4. I'm at 18 and still speaking. So, I went from being a vegan at one stage because it's just burning so many calories to having fish, but the fish I chose unfortunately was salad fish with swordfish and tuna. And there's one thing Peter and I both teach people now. You've got to do a blood test around metals because, unbeknownst to me, those are older fish, they eat the younger fish, they absorb all their mercury, plus my DNA did not enough slat[]e as well just the way I was operated. On a zero to 5 scale, I was 123, highest they'd ever measured in the state of New York. The Florida Health Department was notified by New York. They came out and investigated, talked to my staff, they thought my wife was trying to kill me because I have a large life insurance policy. Was not true, it was the fish. So, sometimes you're trying to be really disciplined.

So I've been very disciplined. I'm very disciplined with my body and my workouts. But I think there's also the psychological emotional part, which we do talk about in the last two chapters of the book, I think they're the most important pieces because you can do everything right with your body, and your mind and your emotions can mess it all up. So we all know about placebos, obviously, and most people don't know, they actually only discovered in World War II, a doctor who was treating people ran out of morphine, and as you know, they go into shock without that, not to mention the pain. It was actually a nurse that changed the world. She handed him saline solution and said, "Oh, we got some more morphine." Since he believed it, he told these patients with total certainty, "You'll be out of pain in the next minute or two, and you're going to be fine." Well, none of them went into shock. 90% of them were out of pain with no drugs. It was just...

And so when he came back to Harvard after World War II, he basically started the standard we now have for almost all drugs, you're comparing, you know, to a placebo. But what most people don't know is you can make yourself sick or well. Now, first of all, the size of the placebo, the size of the invention changes everything, a little pill, certain reaction, a big pill, more, an injection, even more. But in the book we gave you also an example of the veteran's administration for knee surgeries. They decided to do a third of the surgeries as sham surgeries, placebo surgeries, they just put a mark, sewed the person up, but did nothing to the knee. A year later, the patients that had no treatment but thought they had had no pain, talked about how mobile they were compared to the ones that were. They don't even fund it anymore. And it's more than that. I'm sure you know Harvard's done studies where they take someone and give them a real drug, not a placebo, a barbiturate, it's going to knock you on the ground and slow you down. And they go, "Big, giant red pill, this is amphetamine, you're going to be prepared what's going to do for you." To a man or a woman, their bodies speed up.

So, understanding the power of your mind to shift things and also your emotions to have the quality of your life to me is most important. So, my energy comes from discipline and training. It's very intense. I do everything biohacking, you can imagine. But it's also fulfillment, and I think success without fulfillment is the biggest failure in life for anyone. And so, for me, it's a virtuous circle, I believe I'm made for this, I'm here to serve, it doesn't matter the hours, I'll go until we'll make this thing happen. And I pour so much into the people, and that energy comes back, and so it becomes like a turbocharger, and so it gives me an enormous level of energy. And I'm doing things at 62 that I wasn't able to do when I was 29, to give you a [inaudible 00:19:09]. So a lot of that is some of these tools that we talk about, but you can't leave out the psychology and the emotion of your life as well.

Dr. Patrick: Peter, similar question, tell me a little bit about the lived Peter Diamandis's longevity routine. Do you have a protocol you follow? Do you have a comprehensive approach? I know you're a co-founder of Human Longevity. I'm curious to know about your... [Crosstalk 00:19:37].

Dr. Diamandis: I do, and I value it more and more every year because I think the better care I take of myself, the more likely I am to intercept all of the new biotech solutions that are coming our way. We can talk a little about idea of longevity escape velocity later, which is an idea that we're going to be scientifically extending our life significantly, we have to get there. One of my missions, Rhonda, is making 100 years old [inaudible 00:20:05] 60, right, have you had 30 or 40 healthy years on our lives. So, for me, it's the fundamentals, sleep. I'm religious about getting eight hours of sleep. We talked about that a little bit. On a diet side, I have, to the maximum degree possible, I'm not perfect, but gotten rid of sugar, right? It's like sugar equals poison, it's a neuroinflammatory, it causes cardiac disease, it feeds cancer, there are so many reasons. And so minimizing sugar and focusing on whole plant, more of a Mediterranean diet for me given my genetics exercise.

Now, you know, Tony's probably a lot more on exercise, but I lift twice a week and I try and get 10,000 steps a day. And I do some, you know, lighter exercise, but it's every day, it's keeping the body in motion. One of the things I do, Rhonda, that I think it's so critically important is every year, I go for a digital upload. What does that mean? Most of us are optimists about our body. We think we're fine, don't feel anything, you're fine, keep going, you know, you don't want to go to the doctor, you don't want to know. But what we have built...and, you know, full disclosure, Tony and I are co-founders of this company, we talk about it in the book, because I think it's so important people to know about a company called Fountain Life and similar company called Human Longevity and Health Nucleus. Once a year I go and get digitally uploaded. I happen to have done it yesterday.

So, I went to the facility in Naples, Florida, I did a full body MRI, brain MRI, brain vasculature MRI. And those MRIs now have very low false positives, but I'm looking for any aneurysms, I'm looking for cancers. And it turns out, historically, for people in my age group, 2% have a cancer they don't know about, 2.5% have an aneurysm they don't know about, and 14.4% have something that's found that you need to take action on. And so my goal is to find it at the very beginning at stage zero, right? I'm going to find something eventually, and I'm going to say thank you, and I'm going to take action immediately to try and get it.

Besides the full body MRI, which is looking for cancers, we do a Grail, you know, liquid biopsy, which can find 50 different cancers in your bloodstream. It turns out as cancer cells are growing and dividing very rapidly, some of the cells rupture, and you get free floating DNA in the bloodstream. Well, Grail, which is now part of Illumina started by Jeff Huber, we can tell his story, they were able to determine and find from a blood draw any number of 50 different cancer DNA sequences, and tell you you've got cancer someplace in your body then the MRI can help you localize and find it. Then we do another thing called a Cleerly coronary CT, right?

So, the company's called Cleerly. It's a coronary CT, is part of this Fountain Life procedure. And it's an extraordinary AI-driven CT that is looking for soft plaque. So, you hear about a calcium score, and people go, "Oh, my God, I've got 1000 calcium score." Well, that's okay because a high calcium score means that the plaque in your coronary arteries have been calcified and they're unlikely to rupture. What really is a concern is soft plaque, and you've seen people with a zero calcium score having a heart attack where the plaque in the side of the coronary arteries can rupture and then go and block the coronary artery, starve it from oxygen, your heart from oxygen, give you a heart attack.

But what this AI algorithm does is it's able to find the soft plaque and then you're able to monitor it and able to stabilize it. And there's a whole set of meds that I take. Besides that, there's a DEXA scan, there's your genome, your gut biology, all of your blood tests, 150 gigabytes of data. And so I do that every year, and I feel antsy until I get it done. And now, you know, there's an amazing sense of relief. So, I do that. There's a whole bunch of supplements, we could talk about those as well. But, you know, it's still the basics, right? It's still the basics.

Tony Robbins: Rhonda, you know, I'd love to amplify that for a second for you. So, you know, the National Cancer Society did a study on 100,000 people, and they found that if you get something at stage three or stage four, you have an 80% chance of dying, I like it like a 20% chance of living on what to do. But their point is well made, it's really hard to turn around. If you get a stage one or two, you have an 80% to 99.9% chance of survival. And the problem is we have certain tests, mammograms colonoscopies, but the ones that usually get us are the ones that we're not able to find. So, this Grail test is life-changing in this area. And again, the gentleman who created it, lost his wife to cancer because they found it too late. And most of the heroes in the book have something in common, they lost a husband, a wife, a son, or a daughter, and it pushed them to find answers that were beyond the standards of care for 20 or 30 years.

And on the CCTA test, the Cleerly test, you know, one of our partners, you know, he built 12 hospitals, owns 12 hospitals, he's so tired of sick care. That's why he partnered with us to open these Fountain Life Centers. And he calls me, he's a very understated guy, because we have this new breakthrough, and he said, "We've got first access," and he said, "Tony..." He understates everything, he's talking real gentle, and he goes, "I really think it's one of the greatest breakthroughs in cardiology in 10 years." So him saying that, you listen. So, he explained to me how it opens up the arteries and how you get this score and they can predict the heart attack five years in advance and show you what to do.

So I was with my 80 year old stepfather happened to be visiting, a great man, built his own company, lumber company, was always pretty strong and built, but, you know, got older and people around him saying, "You're 80, you got to get your will, you got to get things together." I could see these last two or three years just the energy dropping, again, psychology as much as physiology. And so I said, "Hey, dad," I said, "I'm going to go do this test." I explained it. And I said, "Look, we're both at a stage of life where we probably have some soft plaques, but they'll show us where they are and what to do to clear it up." I said, "Why don't you come?" He said, "All right." And my father does the test, and he's clear, I mean, it's like he has no soft plaques at all, zero, and his entire mindset changed, "I was better than I was five years ago. I'm doing really great," but he literally had nothing. And then while we're there...

You know, there's some brand new techniques that are amazing, we've worked some of the world-class athletes, I've had it done. You know, when you injure yourself, connective tissue can harden up, and you don't get the fluid, you don't get the oxygenization or if it traps a nerve. I had an ankle that for 15, 16 years has bothered me, you couldn't touch it without their nerves firing off. And they go in and they use ultrasound, and they show exactly what's going on. They open it with this fluid, you know, often they'll use something, you know, that will help heal that process to me in which process they use. But I had it done, and it was two years ago, my ankle's perfect. So I said to my dad, what makes him feel old is pain and not able to walk so well, your hip problem. So he now knows his heart's perfect. So I said, "Dad, why don't you let these guys look at you here? And you know what I did to my ankle."

So they looked and found two locations where it was all being locked down, open it up with some of this fluid, about a half hour later, he's walking perfectly, I mean, smoothly zero pain. So we get on the plane, he crosses his arms, and he goes, "You know, these people talk about living 110, 120. I don't know if I buy that because, you know, Tony, my heart's perfect, you know, I'm walking perfect. I could live another 20 years. I could live to 100, and you've only known my daughter for 22 years," he goes, "like another lifetime." It completely changes psychology.

So it's not just about, "Oh, my God, I need to do this." It's like ignorance is poverty, ignorance is pain, ignorance can be death. And today, there are some tools there that can change it all, and they're very fundamental.

One more, hormones, every woman, you know, especially women in their 30s or 40s, knows about hormones because of menopause, but hormone replacement therapy is usually at the point where there's a problem. And now, as you know, there's precision, there's hormone optimization therapy. And even for men. Like we had a gentleman come in, and he was 36 pounds overweight, listless, frustrated with his life, working out hard, nothing working, said, "We looked at your hormones." He goes, "Oh, yeah, they're fine...they're just fine." We look up and do the hormone test, and his testosterone thing was like 225. Well, most doctors won't intervene until it's like 175. Most men don't feel alive if they're not in the 700, 800, 900 range. So, small change in his life, in three months, he loses 36 pounds, he feels 10 years younger, your life changes. So, it isn't just about avoid disease, it's about optimization, it's about what do you do right now that can give you the quality of life that maybe you had earlier or you maybe never had because things weren't in balance.

Dr. Patrick: Let's shift gears and talk about more big picture. Let's talk about the aging process in general. And, Peter, I know you have some interesting opinions on this.

Dr. Diamandis: I do. Yeah. So, I mean, one of the questions to ask yourself is why do we age. I mean, you've got the same genome when you're born as you do when you're 20 and 40 and 60 and 80, and you live to 100, same genome at 100, right, 3.2 billion letters from your mom, 3.2 billion letters from your dad. Why don't you look like you look when you're in your 20s? Well, it turns out it isn't your genes, it's which genes are on and which genes are off, it's the regulation of your genes which we call the epigenome from the Greek word for above, you know, the regulation above the genome. And it's a challenge to understand this. You know, the breakthrough is in the last decade, and Dr. David Sinclair, who wrote an incredible book "Lifespan" that talks about this, does a great job there. But your epigenome, the analogy I used in the book is that your genes, which are not your destiny, they are part of your destiny but not your destiny, your genes are sort of the keys of a piano, and your epigenome is the piano player.

Now, it turns out that the control of your epigenome in part is handled by seven sirtuin genes and seven sirtuin enzymes, and those sirtuins have two primary functions in life. Number one, they control your epigenome, they control which of your genes are on and which of your genes are off. The other thing it does, which is massively significant for your life, is they facilitate DNA repair, and so as we're getting older and we're exposed to radiation, you know, flying in airplanes, or smoke, or, you know, chemicals in the environment, and we start getting...accumulating more and more DNA damage, your sirtuins are spending more and more time repairing your DNA instead of controlling which genes are on and which genes are off. And there's just this constant struggle back and forth. And as you get older because the function of DNA repair is so critical, they're basically distracted from their epigenome.

And then, you know, Tony talked about this concept of NAD as sort of a fuel in the cell that powers these sirtuins. And we can talk more in detail here. But the NAD in your mitochondria inside your cells, you know, is pretty good in your teens, 20s, and 30s, but then in your 40s into your 50s, it falls off rapidly. So just when you need more active sirtuins as the DNA damage is increasing, the fuel supply for the sirtuins starts plummeting, and then all of a sudden, you're not able to, you know, control your epigenome, and we get aging, we get aging significantly. And so, that's just fundamental right now, and the question is, how do you change it? How do you fix it? How do you upregulate the NAD in your cells? And how do you, you know, really focus your sirtuins and give them the ability to focus on both the DNA repair and the epigenome control?

Tony Robbins: And one of the pieces that NAD does that I'm sure you probably know is it also affects the mitochondria directly, the ability to build energy in the cell. The sirtuins need the NAD for fuel, but NAD needs NMN as I know you know as the precursor to make all that possible. Well, you can go get NMN, but with Dr. Sinclair, we studied six companies, we took their products, see how much NMN are you really getting, and there was none in any of the products. Some were $30 a month, some were $120 a month. Last, the lab guy said, "I mean, are these people just cheats? A lot of it comes from China." And he said, "Well, they could be, some do," but he said, "It breaks down in 30 to 45 days, so by the time somebody gets this product, it's usually inert." I said, "That's insane."

So David has come up with his own products, but he's also done something even more amazing. He's partnered up with a group called EdenRoc, and this group... Well, let me first tell you, NMN, if you take an old mouse, meaning like a 70 year old equivalent as a human is about a 24 month mouse, as I'm sure you know, and you put them on, you know, a running platform, they can go maximum of a quarter of a kilometer. But a young, powerful mouse can do four times as much, a full kilometer. Well, 14 days on NMN, and now the NAD gets in because the absorption is about 30%. And that same animal that's equivalent of seven year old animal will run two to three kilometers, 200 to 300% more than the younger, strongest animals. But then the question you got to ask yourself is, "Well, mice studies are nice, but do they really translate to humans?"

So, EdenRoc put together 100 of some of the people we all know, some of the greatest researchers out there, and unlike some of these other companies, they have really focused on developing a product. And the product was, "Okay, how do we create an NMN that can sustain and be more absorbable?" And they came up with a synthetic crystallized form. It's called MIB-626, and unbeknownst to the rest of the world, but it's now out. As of about two weeks ago, the "Daily Mail" talked about it. It got out. They've been working with our special forces for two years. They proved its safety, then they proved its efficacy. And the FDA is now doing a parallel study. But this commander got so excited that he let the beans spill. I can't tell you the specifics because I'm an investor in the company, but I can tell you what he said so you know.

He acknowledged the fact that what they saw happening with mice happen with the strongest men and women that we know. They don't have that much more to get better, they're so strong. But he said their endurance exploded, their muscle development from the same stimulus increased significantly, but the most powerful thing was cognition because when you're out there under stress and you're exhausted, can you keep your brain together? The studies I have been doing now because I'm sure you know, with COVID, it goes into your mitochondria and basically steals some of the energy, that's part of the problem with fatigue.

So there's a phase three trial going on right now to prevent COVID and for long-term COVID. There's one on kidneys because the impact it has with COVID, and then they have these endurance ones. So their projection right now is they believe they'll get approval in the next 24 months, perhaps as early as 18, but more likely 24 months. It will not be a nutraceutical, it will be a sustained crystallized form that you can get from your doctor. So imagine there's a natural substance in your body that is dropped by more than 50%, and now you can supplement it with something that has 300% absorption more than you would have had before that now turns on and off the right genes, reduces inflammation in the body, we all know is the basis of it, and helps your mitochondria have more energy while simultaneously helping those sirtuins to clean up your DNA damage all at one time. So these are some of the things that...there's things you can do right now like NMN, but those are the things that are coming in the next 12 to 36 months that are truly life changing. That's one of them that excites us.

Dr. Patrick: Wow. Well, I look forward to seeing that data. It's interesting. I've had sort of mixed feelings with...not mixed feeling, I mean, my excitement. I've been holding my excitement back a little bit. I had, you know, David on the podcast a couple of years back, and we talked about a lot of this research. And there was some evidence that taking either NMN or [nicotinamide] ribonucleotide...

Dr. Diamandis: NR.

Dr. Patrick: ... NR, you know, can increase NAD levels in humans in the blood. But there was a study, I think it was the Rabinowitz Lab published that this was in animals, you know, that even really, really high doses of both of these precursors, NAD precursors...both NR and NMN were unable to raise NAD levels in other tissues outside of the liver. So, muscle brain, for example, there was no change. And there's a lot of mechanisms involved in that. But like, you know, I'm wondering if some of the effects you were talking about also may be indirect from raising it in the blood perhaps, maybe that's signaling each other [crosstalk 00:37:12].

Tony Robbins: It very possible, but they've just got the blood back two weeks ago, including what's in the muscles, and again, I can't reveal because I'm not at liberty to do that. But what I can tell you is they're very excited about what they've seen, it's greater response than they had hoped for.

Dr. Patrick: Awesome, super cool. In addition to the sirtuins, which are one very important and interesting piece to the aging puzzle, I know that you are aware of some of the technology and research that have come out of Juan Carlos Belmonte's lab at the Salk Institute where he has shown that you can take phenotype for a mouse, which is an accelerated aging phenotype, and add these four...

Tony Robbins: Yamanaka factors.

Dr. Patrick: ...the Yamanaka factors, which for people, you know, listening, these are four different transcription factors that were discovered by Dr. Shinya Yamanaka. Was it 2006? I [crosstalk 00:38:12]

Dr. Diamandis: Got the Nobel Prize.

Tony Robbins: Yeah, got the Nobel Prize.

Dr. Patrick: For figuring out that these transcription factors if you add them to an adult cell, a cell that's perhaps a skin cell or a kidney cell, you can completely reprogram that cell into a pluripotent stem cell that can become any type of cell like we were talking about, you know, the placenta being a source of. And so it sort of reprograms that epigenome that, Peter, you were talking about into a clean slate and allows it to then become a new cell type. But what, you know, Juan Carlos Belmonte's lab, and there's some others that have done this in vitro, but he was really the first to show this in an animal, it's called interrupted cellular reprogramming, where you don't want to make an adult cell lose its identity, you want it to just basically wipe the program free but still be the same cell. So you want it to become, you know, younger, so to speak.

So, he showed this proof of principle study that adding these Yamanaka factors but pulsing them throughout the life of these animals that have an accelerated aging phenotype, he could essentially reverse aging. And it was, to me... I mean, I got chills when I read this study. It's like, this is it. This is what I've been looking for, you know.

Tony Robbins: You know about Dr. Sinclair's work, with restoring the mice's vision, using the three of the four Yamanaka factors? [Crosstalk 00:39:43]. Tell her about that, just to make sure the audience knows.

Dr. Diamandis: I mean, it was the cover of "Science" in December of 2020. It was, like, you know, landmark work, where instead of using all four Yamanaka factors, David took in a mouse that had aged out, it'd become blind with glaucoma and lost its sight. And he gave it three of the four Yamanaka factors without retaining not one of them that causes cancer. And lo and behold, the visual system of the mice became young again, to the point where they regained their vision. And it's since been repeated in the cardiac system of mice. And, you know, George Church, another Harvard genomicist who you know, is now working on doing this in dogs. And when you ask David and George when they think these Yamanaka transcription factors, is effectively a gene therapy, to create this youthfulness. When we might see that in humans, you know, in early trials, it blows me away when they say it's gonna be this decade. Right? That is amazing.

Dr. Patrick: Totally amazing. I have a sort of tangent question. And just out of my own curiosity, Peter, want to know your thoughts on this, because I know...you know that there's a company forming that's recruiting some of the top aging researchers and recruiting them out of academia. In some cases, they're, you know, luring them with... And academia doesn't pay scientists glamorous salaries, unless, you know, they discover...start a company, a biotech company and get lucky, whatever. But, you know, in some cases, they're being offered salaries 10 times more than what their university salary would be. And so, you know, this company's getting the biggest names in aging and putting them all together. And I'm super excited because one of the, you know, big areas they're going to explore is this interrupted cellular reprogramming. I'm just interested what your thoughts are, like, the pros and cons of [crosstalk 00:42:15].

Dr. Diamandis: Well, I got excited about it, too. And I know, you know, Yuri Milner and Jeff Bezos, who funded this. And a friend of mine, Morgan Levine, who was at Yale, got sucked up into this, and she's now a founding principal moving to where you are, down in San Diego. So, it's very cool. I mean, this is in the context of probably $5 billion to $10 billion a year, going into age reversal, longevity, health span expanding research. Right? So, that's Altos Labs. We just saw Brian Armstrong, Co-Founder of Coinbase, start a new company called NewLimit, to go after this, you know, using gene therapy to extend a healthy human lifespan. We've seen the Kingdom of Saudi Arabia and the Crown Prince in Dubai co-fund something called Hevolution to billions of dollars. Where it's a nonprofit, but they're investing in extending the healthy human lifespan. I mean, you know, Tony and I talk about this, is that, health is the new wealth. And I don't think there's a bigger marketplace on the planet, right?

It's like, you still can't take it with you. And if you could spend your money to extend your lifespan, it's massively valuable. Now, the question I think you're asking is, is that going to make people less hungry to do this, having a fat checkbook? I mean, I remember we were talking about this before, you know, Google created Calico, which stands for California Longevity Company, or something like that. And, you know, invested billions of dollars. They're hired Art Levinson, who is also the chairman of Apple and was the CEO of Genentech, to run Calico. And, you know, the question is, are we seeing revolutionary research and breakthroughs coming out of these kinds of companies? Or do we need this to be in the university world? I'm a libertarian capitalist. I always think companies are going to go faster, and take more risk, and do stronger work. So, my bent is to be more excited than less excited. But then again, you know, I'm also doing an age reversal XPRIZE because I want to get as many labs and companies around the world competing to solve this problem. Because, you know, every day I'm getting older.

Tony Robbins: Well, you know, EdenRoc, one of the reasons I invested in them, they have a different approach. They have an incentivized approach for all of them. So it's all based on rewards and performance. It's not a fat check. And personally, I prefer that strategy. I think the competitive strategy, having to produce a result to be rewarded is very different than somebody getting comfortable and taking their time to do the research without being tied to an outcome or a measurable result. So, I'm really impressed, what I've seen come out of there, but I'm thrilled that everybody's doing it. And I think Peter's XPRIZE is a great gift because get all these people competing... You know, at least historically, as we all know, that usually brings the greatest result. But listen, having this much capital, this many brilliant minds, all being driven to try to resolve the riddle of aging. It looks really damn good for us. You know, you might want to come back to, Peter, I don't know, mentioning, you know, escape velocity and what that really means in terms of time.

Dr. Diamandis: Yeah. So, it's interesting, there's a concept called longevity escape velocity. Rhonda, I know you know this, but your viewers and listeners, I think it's important. Today, we're seeing this massive investment in biotech and health tech. And it's lengthening our lifespan, right? So, 100 years ago, the average lifespan was, you know, under 40. Today, it's in the upper 70s. Hopefully, soon, it will be in the 90s and 100s. But on the average, every year that you live, science extends your life by about a quarter of a year. So for every four years, you're adding an additional year. Well, there's a concept called longevity escape velocity that Ray Kurzweil talks about. Ray wrote our opening intro for the book. And the concept is that, there's going to be a point, as science continues to advance, that for every year you're alive, scientists extend your life for greater than a year.

And all of a sudden, it's a departure where you're living long enough to live forever. And so the question I asked Ray was, when do you expect we're going to see longevity escape velocity? And I was sort of shocked by his answer. He said, "Probably in about a dozen years." But then what I was even more excited about was, you know, I said, Ray's an optimist about technology. He's got 30 years of predictions that have an 86% accuracy rate, if you go and Google Ray Kurzweil's predictions. So, he's pretty good at predicting things. And I went on to George Church at Harvard Medical School, I was interviewing him for this book, and I just threw it. I said, "George, you know, you're talking about longevity escape velocity, when do you think we're going to hit it?" And he said, "Probably within 15 years." And I'm, like...you know, it just blew my mind. That idea that if we're able to stay healthy enough to really be in reasonable shape 15 years from now, that we're going to intercept technologies that can add additional decades onto our life.

And then by the way, during those additional decades, science isn't stopping, it's accelerating. So you're going to intercept even more technologies that add decades to your life. So this is a magical time to be alive. And as I tell everybody, and my family and friends, and in this book, you know, you just don't want to die from something stupid in the interim. Wear your helmet when you're skiing, wear your seatbelt, do your uploads, find cancer, if you're gonna have it, you know, at the very beginning.

Dr. Patrick: We've talked a lot about, you know, cellular rejuvenation, about the Yamanaka factors, epigenetic clock reversals, sirtuins, all these really exciting aspects and technologies in the field of aging. And it's really striking in some ways that the mechanism for some of these facets of biological age, they already seem to be here, in us, and yet evolution seems to have mostly withheld it from us. Have you given any thought, Peter, as to...

Dr. Diamandis: Yeah. We're, like, what up? Why? Why? You know, first of all, you have to realize that there are species on this planet, the bowhead whale lives 200 years old, the Greenland shark can live 500-plus years old. I remember when I was in medical school, I was watching this TV show on long-lived sea life. And I was saying, "Well, if they can live, like, hundreds of years, why can't we?" And I remember in that moment in time, I said, "It's either a hardware problem or a software problem, and we're going to be able to fix it." Well, that time I believe, is now, it's the next few decades. And it turns out that we were never engineered to live past age 30. You know, we would go into puberty at age 12 or 13. Before birth control, we'd be pregnant by age 13 or 14. And then by the time you were 27, 28, 29 years old, your baby was having a baby.

And if you wanted to perpetuate the human species, the worst thing you could do was to eat the food that was going to go to your grandchildren, because they died. And, you know, ultimately, we were not intended to live past age 30. We would die, give the food supplied to our next generation. And so, none of the factors that we're seeing, in terms of dysregulation, loss of optimization of our hormones, growth factors, all of these things. You know, we dysregulate after the age of 30, we see this plummeting of the stem cell population...you know, stem cell exhaustion in the body because it was never selected against. And what we're trying to do now instead of, you know, Darwinism, this is evolution by human intelligence. We're trying to, like, change the clocks, and change the factors, and add them back in, and get us back to optimal state of what we were like in our 20s and 30s. And we're doing it by supplementation. Soon, we'll be doing it using gene therapies and CRISPR. But the idea that, you know, there's some magic limitation that we can't overcome, I don't believe it. I do believe we're going to be able to add many decades, perhaps centuries on to our life.

Tony Robbins: And that brings up a different question, which is, most people do not have a full life living to age 65 or 70, in terms of fulfillment. And so the real question is, what do you do when life is no longer scarce? Because scarcity does create some sense of value, right? I want to take advantage of what's here. And, you know, there's an old Twilight Zone piece that actually Ray Kurzweil told me about decades ago. And it goes like this. It's a man who dies and he goes to have intercourse. He's a gambler, so heaven is Vegas. And where does he find himself? The top of the number one hotel. He's in the presidential suite. He opens up the drawers and the cupboards and everything, and he has brand new suits and jewelry, he puts it on. There's credit cards and cash. He goes down and he starts to gamble. And sure enough, he gambles playing 21, 21, 21, 21, blackjack, blackjack. He wins continuously. Suddenly, there's a group of women around him.

Now he goes and rolls the dice, he's playing craps, he wins, he wins, he wins, he wins. He's out of his mind. He goes home that night. He's not alone. He's quite happy with the people that are joining him, and the situation that he's going in. He wakes up the next morning, and he starts the whole thing all over again. After three weeks of doing this, he starts to get pissed. He gets angry. And at one point, you win, you win, you win, And he says, "I always win." And he says, "I want to talk to the head angel. I want to talk to the head angel." And they bring this man who looks like Guy Lombardi in a tuxedo. And he walks up and he says, "Sir, is there a problem?" He said, "Yes." He said, "I'm constantly winning. I win every time." He said, "Listen, I wasn't that good a person. I don't like this." He said, "I'm not supposed to be in heaven." And the angel said, "Who said you're in heaven?"

And the idea is that, if we just got everything we wanted, if there was no limitation on everything, would we find the meaning? And I think that's gonna be the next lesson for humanity, is finding how we use this additional time and these additional resources for something greater than ourselves. Because what fulfills people is not just hanging out and living. When you look at it, it's one primary emotion, it's progress. It's feeling like you're growing. And because you're growing, you have something to give. If you don't grow, it doesn't matter how much money you have, it doesn't matter how many people acknowledge you, how many stars on your chart, it doesn't matter. You will not be fulfilled because what makes us alive is growing. You look at people who achieve a goal, and they have one or two reactions. "Oh my, God, this is amazing," for a moment. Then, "Is this all there is?" Or a goal where they're like, "I can't even believe I achieved this after all this." And they're thrilled, but for how long? A year of happiness? Nine months? Six months? Three months? Three weeks? Three days? Three hours?

Most people are somewhere between three hours and three months. Because we're not made to sit at the table of success too long. We get fat and we get bored. We need progress. We need to grow because when we grow, we have something to give. And that's what makes life meaningful. So when Peter and I were together and talking to all these experts who are doing regenerative medicine. And Peter, you know, with his passion, says, "How many want to live to be 120 years old?" Two thirds of people did not raise their hands because... And Peter was, I remember, crestfallen. I said, "Peter, you can predict this." I said, "You could predict this because most people's idea of 120 is, you know, I lost my memory, I don't look so good, I don't act so good." But it's like, there has to be a deeper meaning, and we have to be able to shift that. And I think that is the newest opportunity that humanity will have in the coming decades.

Dr. Patrick: You bring up a... First of all, what are you going to do, Tony, when you're like 150? I mean, have you thought about it?

Tony Robbins: I don't know. Listen, I got a 10-month-old daughter. I got five kids and five grandkids. I got a 48-year-old daughter, I got a 10-month-old daughter. So, I'm happy to hit 100 and be vibrant and alive. I don't have to be older than that. But if I am, trust me, there's always something to learn and grow, right? That's not something that's ever gonna go away.

Dr. Patrick: But you brought up another really important point, was the happiness and the fulfillment. You know, there was a PNAS study published back in 2019, that found a direct association between happiness and longevity. And people that had the highest levels of happiness, lived the longest. They were more likely... And this was true for both men and women. They were more likely to [crosstalk 00:55:07].

Dr. Diamandis: That's right. And optimists live longer too.

Dr. Patrick: Optimists, yes. This was the study. Optimists, and I guess their kind of optimism and happiness.

Dr. Diamandis: And whether or not you're right about your optimism. Just having that mindset is a positive indicator.

Tony Robbins: Because people need a compelling future. Anyone can deal with a tough today, if there's a compelling tomorrow. If you have energy and health, it makes it a lot easier. If you have a psychology that's optimistic, it makes you find a deeper or a greater meaning.

Dr. Patrick: Do you think something [crosstalk 00:55:37]. Sorry, go ahead.

Dr. Diamandis: One of the things we talk about in the book is, you know, if you're in pain, the last thing you want to do is add a decade to your life. Right? And it's really about giving yourself a life where you've got the vitality, you're pain free. And if you have those two things, plus your cognition and your mobility, you know, everything is possible. Your next career, right? Your next startup, your next moonshot, whatever it might be. But that's fundamental. You know, when I talk to people who are youthful, independent of their age, that's the characterization. They love life, they're excited to see what happens next. When people are in pain, you know, the idea of another decade of life is just miserable for them.

Dr. Patrick: Yeah. I mean, I think the pain definitely can blunt some of that. You know, but there's also, as Tony was mentioning, that learning aspect, that drive, that passion, that thing that you feel like you have a purpose in life. You know, and of course, pain can...it can affect that as well. But getting that drive...

Tony Robbins: But there are people with immense pain who live a very long life, because they have a meaningful life, they have something to live for. I there's any common denominator, in my experience, of people who have a great experience of life, there's gratitude as a base somewhere inside them. But it's also that they're living for something more than themselves. Because it doesn't take that much to meet your own needs. But if there's something you love more than yourself, your children, your family, your community, something you want to serve humanity, there's just a different burst of energy and aliveness that seems to sustain people.

That sense of purpose, I believe, is the single most important component. Because a lot of people don't take care of their body, and they're crimpled up, but they still make things happen, because they have that internal drive. That's why the last two chapters of the book are on how you ignite that, how you take control of that is the most important part.

Dr. Patrick: Peter, I want to, just for a second, shift gears and ask you a question, again, out of my own curiosity. Anyone that knows anything about you knows you're very passionate about human space travel. And, you know, there have been a variety of studies that have sort of been on my radar over the years, that have looked at astronauts that have gone on the International Space Station, and then stayed there for six months to a year, and how they're being exposed to cosmic radiation and other types of solar things. And, you know, essentially being in space is causing accelerated DNA damage, there's chromosomal instability. You know, it's affecting the aging process. And so if there's any hope that humans not only are going to spend time, you know, on the International Space Station or in space, but habit other planets, or get to that point where we're traveling to other planets. We need to, like, get this aging thing figured out, because, you know, that's going to be an important component.

Dr. Diamandis: It is. You know, actually, it's funny because space has always been one of my higher purpose drivers for longevity. It's like, I really want to go and live on the moon for a while, go and mine asteroids, want to go and build space colonies. I truly do. It's like the nine year old in me, right, that got its vitality and energy from that scientific documentary called "Star Trek." The end of the day, those things will be happening in the next few decades. So I want to see them and participate in them. And longevity, you know, the idea of longevity and health span is driven, for me, in part to see this future. Plus, I have two 10-year-old boys, which I want to see their next 50 years, 100 years. What gives me hope in this, Rhonda, is another friend, Buzz Aldrin, who's now 92 years old. Right? The first Apollo 11 mission. He's had numerous missions into space. He's been outside of the Van Allen belts walking on the moon, you know, at least nine days outside the Van Allen belts, going there, landing, coming back.

So he's had very high exposure to radiation. And of course, we talked about earlier that what drives aging, not totally, but to a large degree, is this competition between the sirtuins repairing DNA, as we get more and more damage over the years, and controlling your epigenome. So, DNA damage does cause aging of all tissues in the body. So, yeah, we're gonna have to deal with it. Maybe we're going to deal with it by getting decent shielding. Maybe we're going to deal with it by actually adding better radiation repair genes and, you know, by genetically engineering a new generation of humans, versus just assuming we're going to keep what we've evolved here on this planet to get to the stars.

Dr. Patrick: You guys mentioned this in your book, the gene therapy, and probably one of the best ones that we have available today is the CRISPR gene therapy. What are your thoughts... I mean, first of all, what's your favorite success story for CRISPR in humans?

Tony Robbins: Can I interject for one moment? I'm so sorry, but I have a live broadcast I've got to go to. So I've got to sign off, so I'll leave you with Peter.

Dr. Patrick: Likewise. Thanks, Tony.

Dr. Diamandis: See you brother. So to pick up on that, you know, CRISPR is extraordinary, right? It won the Nobel Prize in 2020, two incredible women, Jennifer Doudna, here from the UC California system as part of the Gladstone Institute. You know, the conversation on CRISPR, which is life changing, is that, we can use this technology to not treat disease, but cure diseases. So we're seeing CRISPR treatments and CRISPR cures for sickle cell anemia, for thalassemia, which I think is extraordinary. We're seeing CRISPR now being used in a trial to cure someone who's got HIV, who's got an HIV infection, who's got AIDS. We just saw CRISPR being used to edit the PCSK9 enzyme in the liver. It's being done in monkeys, not to humans yet. But it has the demonstrated ability to reduce your LDL levels by 60%, which means you're knocking out a lot of heart disease, both cardiovascular disease and stroke. We've seen CRISPR being used with an injection in the back of the eye to cure a specific form of congenital blindness. I mean, I think we're going to see, in the next decade, at most, 15 years, CRISPR being used to basically treat and get rid of, in individuals, almost every genetic disease. We're going to put genetic disease behind us. And that's just incredible.

Dr. Patrick: What do you think about using CRISPR gene therapy for tuning up our longevity genes? I mean, curing disease is one thing, right?

Dr. Diamandis: Yeah. I'm much more experimental than most. It's funny, Tony and I both are experimental in our lives, and we sort of call each other our code, you know, [inaudible 01:03:26] guinea pigs. And what I've been working to do is try and find the smartest positions I can, bring them into sort of an advisory board. There are things today like senolytic medicines, right? Rapamycin, and dasatinib, quercetin. There's other treatments like total plasma exchange, that are being experimented with. One of my other favorite gene therapies to go back to that is some work that was done by Deepak Srivastava. We talk about him in the book. He's the president of the Gladstone Institute. And when you have a heart attack, and your heart muscle dies because of a lack of oxygen, what grows back is fibrotic tissue, fibroblasts.

And what Dr. Srivastava has done is use gene therapy, and I call it sort of cellular alchemy, to go and convert those fibroblasts into myocytes. So if you have a heart that has a very poor ejection fraction, because it's not able to really contract and pump the blood out, because there's not enough myocytes cardiac muscle tissue there. The idea of going to the fibroblast tissue, which is just connective tissue, and then basically taking them back to a level of pluripotency and then converting them back to myocytes, for me, sounds, you know, magical. This is the kind of stuff that's going on that I think we're just at the beginning of it.

Dr. Patrick: Fascinating. You mentioned plasma exchange. What's the latest on that? I mean, I've been following the research, a lot of it, coming out of the Conboy's Lab at UC Berkeley, out of Harvard. I know Amy Wagers had done some work a while ago. But, you know, this idea of taking, you know, factors in the blood, either factors in young blood and helping to reverse aging in older blood. Or opposite, you know, older blood has factors that can accelerate aging. And so getting rid of the factors.

Dr. Diamandis: So, you know, I mean, we talk about... I was in a different part of total plasma exchange, but I'll go into what you're saying, which is the early parabiosis experiments. And this was done years ago. And Bob Hariri, who I mentioned earlier, did a lot of this early work as well. Amy Wager's lab, as you mentioned at Harvard, has done a lot of the pioneering work. If you take the circulatory system of a young mouse and an old mouse, you put them together, the old mouse gets younger, and the young mouse gets older. And there was, you know, a great parody of this in the television series, "Silicon Valley," which I'm sure you've seen. Where the billionaire person has his blood boy, who's, you know, 20 years old, and they're exchanging blood. Well, it's not that easy, or safe, or doable.

But what Amy found in her lab was a certain factor called GDF11, that goes down as you age. And it appears that maybe there are factors that pull the GDF11 out of circulation, maybe there are antibodies made for them, the factors. And if you give GDF11 to older mice, it seems to have all the benefits that this blood exchange has, this young blood has. And so there is a company today, spun out of Harvard, that is called Elevian, that is actually developing GDF11, and taking it into clinical trials against a number of different chronic diseases. And, you know, the idea that we can isolate that factor that makes the old mice young again, and just give that factor by itself is fascinating.

Dr. Patrick: Exciting. I think...

Dr. Diamandis: I mean, it's all of these things, right? It's not just one approach. And again, billions of dollars going in, the biggest marketplace in the world. And there's nothing more valuable than a person's health. You know, the old saying, which I love, the person who has their health has 100o dreams, and the man or a woman who does not has one dream, is so true.

Dr. Patrick: There's one other area I wanted to kind of talk to you about when I was skimming through your book, you and Tony's book, "Life Force." There is the organ regeneration. And I was excited because Dr. Anthony Atala, who my husband sort of a few months ago, probably like a year, maybe a year ago, six months or a year ago, he sent me this YouTube link. He goes, "You've got to see this guy. You got to see what he's doing. You got to get him on the podcast. This is amazing." And I watched this YouTube video, and I was like, holy crap, this guy is, like, growing organs and transplanting them into people now. Like, he's been doing this for years. Can you talk a little bit about it for people that aren't aware of it?

Dr. Diamandis: Yeah. So, Dr. Anthony Atala, who's a brilliant researcher at Wake Forest, for over a decade, has been using stem cells, and basically differentiating those and building organs. Now, they're simple organs. It's like the bladder, it's like a urethra, it's like an esophagus. They're mostly tubular or containment. They're not complex organs. But he's been able to do this as well as basically creating skin that can be, you know, sort of create full dermis thickness and then used for transplantation. And that's amazing. But what we feature in the book, in addition to Dr. Atala's work, are two incredible heroes. And one of the things we are always trying to do is highlight the heroes. There are two people I'll mention, it's Martine Rothblatt and Dean Kamen.

Martine is extraordinary. I've known Martine for 40 years now. And she's known earlier in her life, for being the creator of XM Radio and Sirius Radio. She was trained as a lawyer, was in the regulatory realm working on satellites. And when Martine was probably in her early 30s, her daughter, Genesis, developed something called pulmonary fibrosis. And Martine learns that this is a fatal disease. And Genesis has, you know, single digit years to live. Martine being the extraordinary entrepreneur and action taker that she is, basically quits her job, takes all the capital from her companies going public, and says, "I'm going to cure my daughter's disease." Which is, you know, an extraordinary moonshot vision. Well, Martine has zero background in biology and medicine. She starts with a high school biology book, goes to the medical library, starts researching pulmonary fibrosis. Every time she finds a word she doesn't understand, she looks it up, she looks at the references, and she starts to build a body of knowledge.

Eventually, she finds a potential drug in one of the pharma companies. I don't remember which one. And she goes, and after many months of pleading, and begging and getting advisors in, is able to pry this drug out of the pharma. It's a orphan drug, they had no desire to go forward with it. And when she bought the rights to it, she got a little packet of white powder. Long story short, she took the drug through clinical trial. And ultimately, she was able to cure her daughter's disease. Not cured her daughter's disease, but treat her disease to the point where she was able to survive longer. But then she said, "I need a cure. I need to be able to create lungs for people with pulmonary fibrosis, because just treating them with a drug along the way is not going to be sufficient." So she follows up on a number of different approaches, including, like Anthony Atala, 3D printing organs. But the one that's most amazingly talked about in the book is, she partners with Craig Venter, on the notion that pig organs are the same size as human organs.

A pig heart, liver, lung, kidney, is roughly the size for an adult man. And she said, "What if we can humanize those pig organs? Change the surface antigens, go in there and get rid of the endogenous retroviruses that are in there." And so she set on this mission, probably about six, seven years ago, and just recently demonstrated transplanting a modified pig heart into the first human recipient. And so this is the potential for an infinite supply of organs. The second hero is a guy named Dean Kamen, who I love. He's one of the most brilliant scientists on the planet. Of course, Dean Kamen and Martine both know each other very well. Dean is the most brilliant engineer on the planet, 1500 patents, the creator of the robotic Luke arm, the Segway, the insulin infusion pump. He, about two years ago, gets a contract from the government to build a machine that can manufacture any organ, right?

So I want you to imagine this. He gets about $150 million worth of capital, he puts together 150 or so partner organizations, universities, companies, and they set out on the vision and the notion that what if you could take induced pluripotent stem cells, IPS cells, right? Converting your skin cells, we talked about earlier in the show, into induced pluripotent stem cells. Put that in one end of the machine, the machine then expands the stem cell line, it then differentiates those stem cells into particular types of tissues, and then begins to 3D print an organ. And the idea is, well, what Dean has done already is actually go from these pluripotent stem cells to a bone ligament and bone construct that can be used for knee or ankle replacement. And what he's working on next with Doris Taylor, who's one of the dominant thinkers in this area, is to generate pediatric hearts. To go from a pluripotent stem cell on one end, you know, two and a half, three months later, a beating pediatric heart at the other end, that can be then transplanted to a child who needs it. I mean, this is miraculous stuff.

Dr. Patrick: Absolutely, exciting, miraculous story. I mean, I didn't read the whole, like, chapter, so I was just kind of skimming through. So, super, super interesting stuff. What do you think, like, if all this stuff that we've been talking about pans out, you know, we start to get these technologies and they're safe in humans, and we can help extend their health span, extend their lifespan. Have you given any thought to how the incentives might be aligned between insurance companies, governments, health care, to provide these types of longevity treatments once they're available?

Dr. Diamandis: Yeah. I think that's a really important...one of the societal implications. Who gets it, is it only for the wealthy, and so forth. So, here's a stat. There was, about six months ago, a study done out of London School of Business, Harvard and Oxford. That said, adding just one year of healthy lifespan to every human on the planet is worth $38 trillion of the global economy, just one year of healthy lifespan. Add to that the idea that today, we're seeing the ability to hire people is getting more difficult than ever before. The great resignation, and so forth. We need people to be in the game longer. Right? I was interviewing Elon Musk about, I don't know, nine months ago. We were announcing $100 million carbon extraction XPRIZE, that he's funded, to pull Giga tons of carbon out of the atmosphere. And I asked him the question, which I thought was important for people to hear about, because I know his opinion on this, which I agree with.

I said, you know, "Are you concerned about overpopulation in the planet?" And his answer was, "No, I'm concerned about the exact opposite, which is, we're going to have a massive population drop off, that will probably peak at nine and a half billion or thereabouts, and have a very rapid decline on the other side." Because people are not having babies. Back 50 years ago, the average number of children per family was like 5.4 children per family. Today, globally, it's at about 2.4. In the United States, in Japan, in many parts of Europe and China, we're below the replacement level. And in the pandemic, it even dropped even more. So, ultimately, we're going to need people to stay in the game, to provide the labor, that, plus robotics and AI. Now, the question is, is this going to be only available for the wealthy, right? Are these treatments? So if I had to guess, and what kind of a treatment is going to give us a age reversal kind of treatment. And this is...I'm working on $101 million age reversal XPRIZE right now.

The primary funder for it, Chip Wilson, the Founder of Lululemon, wanted it to be larger than Elon's Prize, so it's $101 million versus $100 million, which I love. I'm expecting it's probably going to be won by a gene therapy approach, very similar to what David Sinclair did with rejuvenating the vision systems of mice. And so the question is, in volume, how much could a gene therapy cost? Because today, a gene therapy for rare diseases can be a half a million dollars to a couple million dollars. But it turns out that if you look at what Moderna and Pfizer did, it effectively is a type of gene therapy. It's microsomal lipid capsules, with mRNA in them. And what we've seen is that if you do it at a high enough scale, the gene therapy gets down to 20 bucks. So, that's the cost of a Pfizer or a Moderna vaccine, which is, you know, not exactly gene therapy, but it's at the same complication levels of gene therapy.

Dr. Patrick: It's funny because I've often thought about, you know, the silver lining of the pandemic. And to me, one of the silver linings is that, this whole field of the mRNA vaccines, it's just being catapulted, and so much research is going on. And there's this thing, you know, these mRNA vaccines have been shown in many studies, over the years, I mean, to treat things like, you know, muscular dystrophy in animals. Like, you're basically, you know, improving the dystrophin protein, right? So this is more...again, it's kind of a type of "gene therapy," but it's really at the protein level. But that's fascinating because I hadn't thought about that before.

Dr. Diamandis: Right. If you think about the scale that we realize when we're treating with these complex treatments at the billion person scale, the cost per treatment gets de minimusly low, right? It's the scaling of exponential technologies. I'll give you another example. You know, vaccines, which have had a mixed public opinion in history, I think people have gotten a lot more respect for vaccines over the last two years. We're gonna see these vaccines being used in a wide range of things. Stéphane Bancel is a friend, the CEO Moderna. And talking to him about where he's going next. You know, besides stem cell exhaustion, one of the things that occurs as we get older is we have immunoexhaustion. Our immune system, which is dealing with all of these viruses that you've gotten over the course of decades, starts to get exhausted because it's trying to suppress those viruses. And what happens is, if your immune system isn't up to snuff, that's when cancer sneaks in, and you develop cancers.

So one of the things Moderna wants to do is really go after all of the, you know, CMV, and herpes, and HIV, and create vaccines against all these viruses to really knock them out of your system. One of the companies I had a chance to co-found and I serve as Vice Chairman of a company called Vaxxinity, went public earlier this year. I'm blown away by what the team is doing. Vaxxinity, we have our own COVID-19 vaccine, which, fingers crossed, we'll... I'm not sure what I can say about it. But besides vaccines against those infectious diseases, the vaccines we've been building are against endogenous proteins in the body. It's a multitope peptide vaccine. What we've been able to do with this vaccine is train your immune system to go after targets in the body, like beta amyloid. We have a vaccine against Alzheimer's, a vaccine against Parkinson's, a vaccine against migraine. I take today... I have hypercholesterolaemia. I take a monoclonal antibody called Repatha. This antibody is manufactured in a vat in New York. And I get it in an injector.

And every two weeks, I inject about five MLs of these antibodies into my leg. And those antibodies go to my liver, and they block a protein called PCSK9, which is the protein that produces LDL, the bad type of cholesterol in your bloodstream. And this Repatha reduces my cholesterol, my LDL levels, by a half. And it's great. You know, I'm in fantastic shape when I'm taking that. The problem is it costs me like $14,000 a year for this. And it's not a first line of defense, it's the last line of defense. You know, everyone's on statins instead, which have their own problems. So what we've been working on at Vaxxinity is...we're just entering the beginning of trials now, is a vaccine against the PCSK9 protein. So instead of me buying these monoclonal antibodies that are manufactured very expensively, someplace else, what if instead, I give myself a vaccine that trains my immune system to manufacture the same exact antibodies against PCSK9. And instead of doing an injection every two weeks, it's, you know, twice a year. And instead of 14,000 bucks, what if it's 100 bucks, right?

Now, all of a sudden, we can vaccinate people against heart disease, against stroke, and cardiovascular disease because they don't have the buildup in their arteries. And then it becomes massively preventative. And so, this is the future of healthcare, where today, healthcare is about treating chronic disease, and just keeping it in this state of...your body in a state of disrepair. In the future, it's going to be, no, we're going to use CRISPR and gene therapy to cure... You know, one injection and you're cured. You know, or vaccinate you, so you never develop the disease in the long run. And that's the potential that we talk about. So, you know, in "Life Force," it goes from everything from the basics of sleep, food, exercise, two liters of water a day minimum, to the extreme of gene therapies, and CRISPR, and vaccines. And it's just an extraordinary time to be alive.

Dr. Patrick: The Vaxxinity stuff is super cool and exciting. Thank you so much for sharing all that. And it's funny, I'm not a medical doctor, and I certainly can't give any medical advice, but I've reviewed a lot of the literature on statins versus these PCSK9 inhibitors and it's just, to me, I'm like, "Why is this not the first line of defense?" I mean, the first [crosstalk 01:25:00]. And it's like, oh, it's price. That's what it is. It's just cost. And it's really unfortunate. It's really unfortunate. So that would be a pretty big breakthrough if you guys were able to do that. I don't know how far along you are, I'm not.

Dr. Diamandis: I have great hope and expectations. It's not a matter of if, it's gonna be a matter of when.

Dr. Patrick: And for Parkinson's, is it alpha-synuclein or what?

Dr. Diamandis: Exactly. It's alpha-synuclein. It's exactly what we're targeting. And so we're entering phase two in that. Alzheimer's is entering phase three, Parkinson's is entering phase two. It's backed by the Michael J. Fox Foundation as well.

Dr. Patrick: How's it looking? How's Parkinson's? Is it looking promising?

Dr. Diamandis: Great. We just opened our phase two trial now. So, you know, fingers crossed, the data from phase one is fantastic. You know, the thing we talk about in the book is, it's not like there's only one approach to each of these chronic diseases, there's dozens. And, you know, I remember when the pandemic first hit us, and you remember this as well. And everybody's just scared out of their minds. It's like, "Oh, my God, this is crazy. What's gonna happen?" You know, you couldn't go find masks any place or even just sanitizer. It was insane. Right? In those early days. And people were getting more and more scared. It was a pandemic of fear. And what folks didn't realize was that this was a clarion call, and it mobilized tens of millions, hundreds of millions of scientists, engineers, physicians, nurses, researchers around the world to attack this thing. And we did it in record speed, right?

You know, the sequence gets emailed over from Wuhan to our labs. I know, from talking to Stéphane, there was a vaccine designed within 24 hours. And then within a year, manufacturing is ramped up, and everybody's getting their emergency use authorization. And all of a sudden, we're beginning to vaccinate the world 10 times faster than ever before. And so this kind of speed is possible. And I think we're going to start to see this against cancer, and dementia, and cardiovascular disease. And then, you know, it's like, what do you want to do with the extra decade or two?

Dr. Patrick: Right. Well, I think this is a great place to end this episode. Thank you so much, Peter, for coming on. And Tony, as well. As you mentioned, the book is "Life Force." You're on Twitter...

Dr. Diamandis: Yeah, @PeterDiamandis, on Twitter and Instagram. And I put out a couple of blogs a week on these topics, just go to diamandis.com. Also, one other thing I'll just mention, something I created for myself, because it's so difficult to keep up with all of this information. I built an AI engine that searches the world's news, journal articles, tweets, magazine, newspapers, looking for breakthroughs in health and longevity. And it screens it for validity. And then it generates a summary of the top 15 articles a day for me. And it's a short summary that I can read. I can click back in, I get... I call it...it's longevityinsider.org. It's free. Check it out. It makes me so optimistic about the future because just the stuff that I'm seeing every day just blows me away continuously. And then there's lots of resources at lifeforce.com as well.

Dr. Patrick: I'm gonna check that out, for sure, the...

Dr. Diamandis: longevityinsider.org.

Dr. Patrick: Yeah, Longevity Insider. And Tony is also on Twitter, @TonyRobbins. He's on Instagram.

Dr. Diamandis: Absolutely. Yes.

Dr. Patrick: All right. Thank you so much to you both, and hopefully we'll get together again soon.

Dr. Diamandis: I look forward to it, Rhonda. Be well. Thank you.