Anti-Aging with Dr. Sandra Kaufmann: Rational Wellness Podcast 122

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Anti-Aging with Dr. Sandra Kaufmann: Rational Wellness Podcast 122

Dr. Sandra Kaufmann discusses Anti-aging strategies with Dr. Ben Weitz.

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Podcast Highlights

5:52  Dr. Kaufmann, in her book The Kaufmann Protocol, Why We Age, and How to Stop It,  breaks down the concept of aging into 7 different physiological pathways or tenets of why we age.  Dr. Kaufmann took the analysis of the aging process down to the cellular level. 1. Tenet one is DNA alterations. The ends of your chromosomes, referred to as telomeres tend to get shorter as you age and this is a major problem. Also, epigenetic modifications of your DNA tend to occur with aging. 2. Tenet two is your mitochondria and energy production. Important factors here include free radicals and nicotinamide deficiency3. Tenet three has to do with various pathways related to aging, including the AMP kinase pathway, which is activated by caloric restriction and fasting. These tell your body that you are starving and it puts yourself in a state of hibernation. And you can take agents that fool your body into telling you that you’re starving.  There are also 7 mammalian sirtuin systems. There is also the mTOR pathway that controls catabolism and metabolism, the breakdown and the building of tissues. 4. Tenet four is what she calls Quality Control, which refers to DNA and protein repair mechanisms, which also includes autophagy, which is the recycling of organelles.  5. Tenet five is security, which is your immune system, which can go waywire as you age. 6. Tenet six is individual cell needs. 7. Tenet seven is waste management, because glucose is an issue.  And you may get an accumulation of lipofuscin over time. Some anti-aging experts are obsessed with fasting and AMP kinase or with mTOR or with stem cells. But Dr. Kaufmann points out that if you don’t address all 7 categories of aging, you will fail. We need a more comprehensive program.

10:50  Dr. Kaufmann is involved with a project with Dr. Bill Andrews to sort through 400 different lab markers to figure out which ones are the most important to analyze where a person’s biological aging level is, to help target an anti-aging program.  On a previous episode of Rational Wellness, Dr. Russell Jaffe went through which predictive biomarkers he recommends to assess a person’s aging level in episode 100, Predictive Biomarkers with Dr. Russell Jaffe.  Dr. Kaufmann does think that the Telomere length test is one way to assess the level of our biological aging, though results may vary depending upon which company runs the test.  On average, we lose between 47 and 67 base pairs per year.

14:47  Dr. Kaufmann has a rating system for judging potential anti-aging compounds based on which ones affect which of the 7 tenets of aging, so each agent got a 7 digit rating. When we look at a given compound, we ask is it an epigenetic modifier, does it affect your genes, does it affect your mitochondria, etc. If it had no affect on that category, then a given agent got a 0 score. If it had a very significant effect on that category, then she gave it a 3.  Does it work in a test tube? Does it work in a small animal? Does it work in humans?  If it does all those things, then it gets a 3 in that category. Resveratrol is a very important anti-aging compound and it has a good rating number in most of the 7 categories and it activates most of the sirtuin pathways. Unfortunately, resveratrol has poor bioavailability because the half life is only one hour.  Dr. Kaufmann says that option one is to use Pterostilbene from blueberries, which is a cousin of resveratrol and it has better bioavailability.  However, resveratrol looks like its better if you have high cholesterol.  Dr. Kaufmann recommends that option two is to use a more bioavailable form of resveratrol, like a liposomal form with properly constructed nanomicelles.  Or you could take resveratrol in the morning and pterostilbene in the evening.

20:16  Astaxanthin is one of Dr. Kaufmann’s favorite anti-aging molecules.  It’s a carotenoid that comes from algae and its the strongest, naturally produced free radical scavenger we have.  She also recommends it to athletes, since they create so many free radicals, esp. if they are outside in the sun.  Astaxanthin will help protect your skin from the sun as well. 

25:50  Senescent cells are normal cells that accumulate DNA damage and go into shutdown mode.  One of three outcomes occur: 1. the cell is so damaged that it can’t fix itself and it commits cell suicide, 2. the DNA is fixed and the cell goes back to normal, or 3. we have these grumpy, senescent cells that are somewhat damaged but they start up again. These sensescent cells change shape and don’t function as well and produce evil cytokines. These grumpy, old cells accumulate over time and create more inflammation and pathology. There are xenomorphic agents that change how a cell acts and there are xenolytics that kill these cells and a lot of regenerative medicine can be focused around xenolytic therapy.

28:20  Dr. Kaufmann recommends taking nicotinamide riboside to stimulate NAD production.  She also pointed out that the seven sirtuins cannot function without nicotinamide, so NR is necessary to stimulate the sirtuins.  Nicotinamide is also necessary for DNA repair 

33:55  Curcumin is also an important anti-aging nutrient. Curcumin is a potent epigentic modifier, it helps mitochondria, it’s a free radical scavenger. It helps activate some of the pathways. It helps with DNA repair and it helps with lipofuscin accumulation. Over time, our mitochondria get beat up and when you make new mitochondria, your body squishes down the old mitochondria and extracts out the reusable pieces and what it can’t use, it squishes it in the back of the cell. Over time you get more and more accumulation of this gunk, which is lipofuscin.

36:47  Carnosine is also very important for anti-aging, which is a dipeptide of alanine and histidine.  It’s a acid buffer in our muscles and it’s a free radical scavenger. And its a transglycosylating agent, which means it plays a role in glucose control. When sugar combines with proteins and fats, they are referred to as advanced glycation end products.  You end up with sticky proteins and once a glob sticks to collagen you get destruction of anything that’s collagen-based in your body, which includes your skin, your heart, your blood vessels. This is one reason why caloric restriction and fasting are so beneficial. Dr. Kaufmann pointed out that in Europe there is an AGE reader that you place your arm in and it tells you how much glucose has been glycosylated into your arm.  This device which could be the future of tracking diabetes.  Dr. Kaufmann also recommends carnosine eye drops to reduce the risk of cataracts.

43:28  Dr. Kaufmann recommends taking Metformin, a drug prescribed for diabetes, for anti-aging purposes.  Metformin helps with controlling mTOR, which he calls the youthful pathway.  She does not recommend taking Rapamycin, which is an extreme blocker of mTOR, (which stands for the mammalian target of rapamycin), but it is a chemotherapy agent and has a lot of possible side effects.  The mTOR pathway is responsible for building tissue and turning over cells and if you block it, you put yourself in a state of preservation.  But if you block all growth and turnover, that can be problematic and you may become sarcopenic and if you don’t turn over your hippocampal cells, you will have trouble with memory.  There are many tissues that you want to turnover, like muscle, bone, and skin.  Dr. Kaufmann does not feel that berberine is a good substitute for metformin because while berberine helps with blood sugar regulation, it does not do a lot of the other things that metformin does, such as epigenetic modifications, it reduces the risk of cancer in diabetics, it reduces weight, it helps with menopause, it helps with PCOS, it stimulates AMP kinase, and it reduces inflammation.  Because metformin is a partial mTOR inhibitor and can result in muscle wasting, so she recommends that people also take leucine, one of the branch chain amino acids, or just take a branch chain amino supplement, and also take a B complex, since it reduces B vitamin absorption from the gut.

50:44  There is a product that is highly touted for anti-aging purposes, Astragalus TA-65, which is extremely expensive, but it can activate your telomerase to make your telomeres longer.




Dr. Sandra Kaufmann is an ND with a speciality in Pediatric Anesthesia. She is the Chief of Pediatric Anesthesia at the Joe DiMaggio Children’s Hospital. Dr. Kaufmann has an avid interest in Anti-Aging Medicine and has published an excellent book on Anti-Aging, The Kaufmann Protocol: Why We Age and How to Stop It  and her website is Kaufmann Protocol.com

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com.


Podcast Transcript

Dr. Weitz:                            This is Dr. Ben Weitz, with the Rational Wellness Podcast. Bringing you the cutting edge information on health and nutrition from the latest scientific research, and by interviewing the top experts in the field. Please subscribe to the Rational Wellness Podcast on iTunes and YouTube, and sign up for my free e-book on my website by going to drweitz.com. Let’s get started on your road to better health.  Hello, Rational Wellness Podcasters. Thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness Podcast, please go to Apple podcasts and give us ratings and review. That way more people can find out about our Rational Wellness Podcast. Also, you can watch the video version by going to YouTube. And if you go to my website, drweitz, D-R-W-E-I-T-Z.com, you can find detailed show notes and a complete transcript.

Our topic for today is anti-aging medicine, with Dr. Sandra Kaufmann. While there is a debate in the scientific community whether there is a limit to the human lifespan, it is generally thought to be 125 years, with only 48 people in recorded history making it to 110, and one recorded person making it to age 122.  In the US today, there are approximately 80,000 centenarians. Some anti-aging specialists distinguish between the lifespan and the health span, with the health span being the number of years the person is healthy. Others make a distinction between chronological age, which is the number of years you’ve been alive, and biological age, which is the measure of your physiological age of your functional and health status. And some experts feel that this can be measured with the telomere test or other tests. In the scientific community and the medical community, anti-aging refers to the slowing, preventing, and reversing of the aging process. Part of this means detecting, treating, and preventing the diseases associated with aging, like heart disease, cancer, and Alzheimer’s disease.

                                                But anti-aging medicine can mean different things to different anti-aging medical clinicians. For some anti-aging specialists the focus is on restoring the body’s hormones to the level of a 25-year-old, by taking bio identical versions of these hormones, like estrogen, progesterone, testosterone, thyroid, and even growth hormone in some cases. There’s been a lot of research in both animals and humans showing that caloric restriction may prolong life, 30 to 50% caloric restriction. But who wants to live longer and be miserable for most of that time? So, recent research has looked at fasting, and intermittent fasting, and even the fasting mimicking diet, all of which seem to promote some of the same anti-aging pathways as caloric restriction.   Others have explored the use of caloric mimetic substances, which might give us some of the benefits of caloric restriction without calorically restricting, including substances like resveratrol. For other anti-aging specialists, it means researching the reasons why aging occurs, and finding interventions, whether they be changes in diet, lifestyle, exercise, procedures like cryotherapy, infrared saunas, hyperbaric chambers, or the use of medications or nutritional supplements to positively impact these biological pathways and processes.

                                                Dr. Sandra Kaufmann is our special guest today. And she has a Master’s in tropical ecology and plant physiology, with a focus on cellular biology, and an M.D. degree with a specialty in pediatric anesthesia. She is the Chief of Pediatric Anesthesia at Joe DiMaggio Children’s Hospital, and also at Sheridan’s Health Corporation. She also has an avid interest in anti-aging medicine, and has published a book on anti-aging, The Kaufmann Protocol, Why We Age, and How to Stop It. It’s a very well-organized way of categorizing the most important molecular and physiological pathways of aging, and an analysis of some of the most efficacious, nutritional, and pharmaceutical compounds that can positively influence these pathways. She also has an app, and she constantly updates all of this information on her website, kaufmannprotocol.com. Dr. Kaufmann, thank you so much for joining me today. Dr. Kaufmann?

Dr. Kaufmann:                   Absolute pleasure. That was a fantastic introduction. Well done.

Dr. Weitz:                          Thank you, thank you. So, as a pediatric anesthesiologist, how did you find your way into the antiaging field?

Dr. Kaufmann:                   Well, people ask me that all the time, and the reality is, there’s absolutely zero correlation. I take care of kids every day. However, because I was a cell biologist and I spent a lot of time learning human physiology, and pharmacology, and all the -ologies having to do with medicine, I looked at myself, and I decided I didn’t want to age anymore. I decided that all of the information out in the literature when I started this project seemed like mumbo-jumbo. And I thought there had to be a way to look at it scientifically and clearly, and organize it and then make it practical. So, the reality is, it has nothing to do with being a pediatric anesthesiologist.

Dr. Weitz:                           Right. So, in your book, you break the concept of aging into seven different physiological pathways, or tenets of why we age. And then you talk about how we can slow down or reverse that aging process. Can you explain what these aging mechanisms, pathways are?

Dr. Kaufmann:                   Absolutely. And I know you’ve read the book, so feel free to stop me if I’m skipping anything that you found interesting or important.

Dr. Weitz:                          Okay.

Dr. Kaufmann:                   But to back up just a little bit, people, when they think about aging, they think about their skin, or their heart, or their organs. As a cell biologist, I took it down to the cellular level. And, whereas all cells are not identical, they generally function roughly, the same way. So, if you look at a cell … I looked at all the reasons that a cell ages, and separated them out. People argue that you can’t really separate them all out. If you think of a Venn Diagram, you’ve got seven overlapping circles. Sometimes you can pull things apart, and sometimes you can’t. So, some of my ideologies may be a bit of a stretch, but I think it simplifies it to make it easier to understand.

                                          So, that being said, so, tenet one, I call DNA alterations. People probably are already aware of this, but telomeres and such get shorter as you age, and that’s a huge problem. The other category in the DNA issues have to do with epigenetic modification. I don’t know if people are aware of that, but epigenetics changes. And that dictates what sort of DNA gets processed over time. The good news is, both epigenetic and telomere issues can be altered in a positive way if you know what you’re doing. So, that’s tenet one.

                                          Tenet two has to do with any energy production, which basically, boils down to your mitochondria. Rate limiting issues in this category are free radicals from the oxygen issue, as well as nicotinamide deficiency. Issue three is pathways. And I talk about innumerable aging pathways, and different people have their favorites. You referred to caloric restriction in your opening comments, and that’s basically activating your AMP kinase pathway. And that’s by telling your body that you’re starving, it puts yourself in the sort of state of hibernation. And that’s how caloric restriction works. And you’re absolutely right, we can take agents that fool your body into telling you that you’re starving, which essentially, just activate your AMP kinase. But there are also seven mammalian sirtuin systems. These are my particular favorites, because they do really cool things. And there is also the mTOR pathway, and that sort of controls catabolism and the opposite, which is building of tissues. Gosh, I’m losing my words today. I’m quite sorry.

Dr. Weitz:                          That’s okay.

Dr. Kaufmann:                   Let’s see, the next tenet I call quality control, which is DNA and protein repair mechanisms. Because over the course of time, things break, and we have to fix it. I throw autophagy into that category, which is the recycling of organelles. The fifth category is security, which is your immune system. Your immune system goes haywire over the course of time for several reasons. The sixth category, I think of as individual cell needs. What does a red cell need, versus a liver cell, versus a brain cell? And I also have recently thrown the senolytics in this, because it’s become a more active topic, and I just wrote a huge diatribe about that. So, we can talk about that more. And the last category is waste management, because glucose is an issue. And then you can get an accumulation of something called lipo fuscin over the course of time. And I know that’s a heck of a lot of stuff to swallow at one time, but those are the seven tenets of aging. I’m so sorry.

Dr. Weitz:                            No, that’s okay. There’s a ton of stuff in this book, really good stuff. And I know all we can do is hit some of the highlights. But interestingly, it seems like a lot of people are talking about number three. A lot of people are talking about the AMP kinase. We’ve had a number of discussions on the podcast about the ketogenic diet, which supposedly hits some of the same pathways as fasting does. And a lot of people are talking about mTOR, and how to block mTOR. And that’s, for some reason, seems to be where a lot of the recent discussion in anti-aging and the functional medicine world that I’ve been hearing.

Dr. Kaufmann:                   Oh, without a doubt. And I think what happens is people, especially the experts, focus on what they know. I call it the silo effect, of course. Some people are obsessed with, you’re right, the mTOR, they’re obsessed with rapamycin. Some people are obsessed with caloric restriction. Other people are obsessed with stem cells. And my take on the thing was, you’re going to age for seven categories. And if you don’t attack each of the categories, you’re pretty much spinning your wheels. And I don’t care if you starve yourself until the end of time, you’re still going to have issues with glucose, you’re still going to have sirtuin issues, your mitochondria are still going to fail. So, I like to think of it as the need to have a more comprehensive program.

Dr. Weitz:                            Right. So, is there a way to analyze sort of, where we’re at? How would a given person … Is there a series of tests that they could do? You talk about glucose, I’m thinking about hemoglobin, A1c.  Is there sort of a panel that you can do to sort of get an idea of where you are?

Dr. Kaufmann:                   That is a very excellent question, and we’ve been striving for that for many, many years. And if you go to readily available anti-aging clinics, they all have their favorite labs that they test.  What’s very interesting is, a lot of them mean absolutely nothing.  And I don’t want to pick on any one in particular, but what was very interesting is, I was recruited about a year ago.  I don’t know if you know who Bill Andrews is.  He is sort of, the telomere God. And I’m working on a project with him.  And one of the pieces of the project was to put together the most comprehensive list of anti-aging markers. So, between he, I, and a few other folks, we have a list of probably 400 markers.

Dr. Weitz:                          Wow.

Dr. Kaufmann:                   And we are initiating some studies to try to figure out which ones are the most efficacious.

Dr. Weitz:                          So, I was just asking you about, are there any tests so we can get a sense of where our level of biological aging is, and you were talking about the fact that you’ve been working on and looking at 400 different tests to sort of whittle down which are the most important ones. And I was just mentioning that I interviewed Dr. Russell Jaffe, and he felt that the eight most important ones were hemoglobin A1c, HsCRP, homocysteine, he had his lymphocyte response assay, which is his sensitivity test, and first-morning urine test for pH, vitamin D, omega-3, and 8 Deoxy-guanine.

Dr. Kaufmann:                   Well, that’s quite a nice list. I can tell you, I mean, everyone has their favorite list. And they’ll probably tell you exactly why. The reality is that no one knows quite yet. But I will tell you that based on my seven tenets of aging, and all the biochemical things I talk about in the book, I created a hierarchy of things to look for. So, it started at the cellular level. For example, we could measure DNA destruction rates, right?

Dr. Weitz:                          Wait, how do you measure that?

Dr. Kaufmann:                   So, there’s a chemical with an extremely long name, 8 OH, blah, blah, blah, blah, blah, blah, blah, blah, blah that I won’t bore you with, that you can actually measure DNA destruction rates.  So, the question would be, “Can you change that over the course of time?”  You can measure levels of sirtuins, you can measure mitochondrial rates, you can measure amazing things at a cellular level.  If you bump it up to an organismal level, right, what can we measure, in terms of GFR for your kidneys, for your lungs, for your heart.  We can measure all of those factors.  On a more systemic level, then you’re looking at CRP’s and that sort of thing.  And then, when you get to the higher level, you’re actually looking at full body function.  So, we have a huge unbelievably full list of labs. And as soon as we figure out what really is important, I will let you know.

Dr. Weitz:                          Okay. What do you think about the telomere test?

Dr. Kaufmann:                   I think the telomere test is fantastic. I think it depends on who does it. It’s not the same from the different companies, because we’ve tested a few different companies, and the answers sort of range from place to place. But I think it does give you a very good indication. As you know, we lose between 47 and 67 base pairs per year, which is horrifying. And so, it is an extremely important test. Is it absolutely linear as we age? No one really knows yet.

Dr. Weitz:                          Right. So, you have a rating system for judging potential anti-aging compounds. Can you explain what that is?

Dr. Kaufmann:                   Oh, gosh, yes. And I’m going to bore your audience to death, here. I am so sorry.

Dr. Weitz:                          No.

Dr. Kaufmann:                   This is called geeky science. No, so what I did is, I decided, for whatever reason, that these seven tenets should never change order. And after I figured out, or decided that this is what causes you to age, I started looking up every agent that anyone said had any anti-aging properties. Because everyone has their favorite. Uncle Schmo takes this. And what does it really do, right? Because this is the way people approach anti-aging. So, I would look up agent X, whatever it was, and I did a huge literature search in every category. Was it an epigenetic modifier? Did it affect your telomeres? What did it do to your mitochondria? etc. I mean, this took me an extremely long period of time.

                                          And it started out as a simple chart on my desk with pluses and minuses, and it got to be a little confusing. So, it turned into a numerical rating system. So, in any one given category, if an agent did nothing, for example, for your DNA, it got a 0. If it was amazing, it got a 3. And people say, “That’s kind of nonspecific.” And the way I sort of did this is, I call it the hierarchy of evidence. So, theoretically, does agent X work in a test tube? For example, a trans-glycosylating agent. Is there evidence that it works in a test tube? If there is no evidence, then it’s not going to do anything anywhere. If it works in a test tube, great. Does it work in a small animal model? Does it work in a culture? Those two things are backwards. And finally, does it work in humans? And if all of those things were true, it got a 3 in that category. Means it’s very efficacious, it’s awesome, right? Lots of evidence to support it.

                                          So, what happened, because there’s seven categories, each agent got a seven-digit rating number. So ultimately, these numbers became, I decided, additive, or synergistic, such that when you wanted to create a program for yourself, you would line up whatever agents you thought were reasonable, add up the numbers, and then it became clear that some categories would be over-represented and some would be under-represented. So, it serves as a good guideline to determine what each individual should be taking.

Dr. Weitz:                          Okay. So, let’s go through some of these more important compounds, starting with resveratrol.

Dr. Kaufmann:                   Okay. So, don’t expect me to have remembered all of the numbers for all of these, because there’s 30 or 40 of them…

Dr. Weitz:                          No, no. Forget about the numbers. So, for resveratrol, I remember regionally reading about it years ago, and I think David Sinclair found that it would mimic caloric restriction. And he was researching the sirtuin pathways, and it was going to be the big key to anti-aging.

Dr. Kaufmann:                   Oh, absolutely. And in fact, it is one of the keys of anti-aging, because it does many things. And the rating number is very good in each of the categories, for the most part. But the highlight is, in fact, what it does to your sirtuins. It activates most of the one through seven of the sirtuins, which is extraordinarily important. The issue with resveratrol, which is sort of unfortunate, is the bioavailability is very poor.

Dr. Weitz:                          Right.

Dr. Kaufmann:                   And this is what has baffled people for a long time. So, there are two options. Option one was to alter the plan and go to something called pterostilbene, which is, I call it a cousin. Very closely related, higher bioavailability, it’s in blueberries instead of wine. I always laugh that it’s way less sexy, because who wants to talk about blueberries. But it is more bioavailable. There are some information coming out lately that if you have high cholesterol, maybe you should stick with resveratrol, over pterostilbene. I think that’s still in the beginning stages of understanding all that.

Dr. Weitz:                          Interesting.

Dr. Kaufmann:                   But certainly, I’ll direct one or the other based on your cholesterol status. If you do, however, decide to take the resveratrol, I think you need to make sure you’re taking something that’s more bioavailable than the standard. Because the reality is, is the half-life is about an hour, and you need it way more than that in your system.

Dr. Weitz:                          So, what’s a more bioavailable form?

Dr. Kaufmann:                   So, they put things in nanomicelles, which is my favorite way of taking these. There are a few companies that do this. And I don’t want to cite any companies on a podcast, because then I get busted by other companies. But, if you’re looking for something, you look for something that says bioavailable. Nanomicelles, nanomicelles, there’s a variety of different ways to package it.

Dr. Weitz:                          Yeah. I mean, when I hear of nanomicelles, I usually think of Quicksilver.

Dr. Kaufmann:                   Yeah, but … Yeah, that’s very true. But Rev Genetics does it, a variety of companies do it. It makes it a whiff more expensive, but it’s worth it.

Dr. Weitz:                          And then, what’s the kind of dosage you need for resveratrol?

Dr. Kaufmann:                   Well, it’s sort of depends on which one you’re taking, right? If you’re taking a regular one, you’re going to need more. If you’re taking one that’s more bioavailable, you need less. The half-life is probably about six to eight hours. So, if you really want to get a jump start, you could take it twice a day. Because daily dosing is based on half-life of the drug. It works in regular drugs, and it works for this, as well

Dr. Weitz:                          Okay.

Dr. Kaufmann:                   Some people, covering their bases, they take resveratrol in the morning and pterostilbene in the afternoon.

Dr. Weitz:                          Right.

Dr. Kaufmann:                   It’s a little zealous, but it just depends on what people want to do.

Dr. Weitz:                          Right. And astaxanthin is one of those on your list.

Dr. Kaufmann:                   Oh, astaxanthin is my favorite. I love astaxanthin. It’s ridiculous. I have a love affair with the molecule. It’s really quite sad.

Dr. Weitz:                          Is basically, a carotenoid that comes from seaweed, right?

Dr. Kaufmann:                   It comes from algae, yeah.

Dr. Weitz:                          Algae, yeah.

Dr. Kaufmann:                   Algae. My kids like to call it angry algae. It’s silly, it’s the slime that you see in birdbaths. And when that slime gets stressed out in any way, as much as you can stress out algae, it makes this orangey-red substance. And the stuff is amazing. And basically, it helps the plant survive, or it helps the algae cells survive. And it helps us survive via the same mechanism. It’s the strongest free radical scavenger that we have at the moment, at least naturally produced.

Dr. Weitz:                          Right. And I saw in your book you also recommended it for athletes.

Dr. Kaufmann:                   Oh, 100%. So, athletes create more free radicals. Generally speaking, in your mitochondria, as you probably know, or as most people know, when you’re looking at the electron transport change, oxygen is the final receiver of the electron. So, that’s why you need oxygen. Unfortunately, for normal resting folks, 1 to 5% of that oxygen becomes radicalized. And that’s bad. In the world of good and bad, that’s bad. So, in athletes, you’re using more oxygen, so more oxygen gets radicalized. So, you’ve got more free radicals floating around. And experts that are lazy use this as a reason not to exercise, which is ridiculous. But athletes need more free radical scavenging, especially if you’re outside. Because it also protects your skin.

Dr. Weitz:                          On the other hand, some of the studies show if you take too many antioxidants, you may reduce the benefits of exercise.

Dr. Kaufmann:                   So, what people don’t understand as well, and Ben Greenfield, I love him dearly, but it’s hard to understand, exercise and aging are two very separate things. What’s good for one may not be good for the other, right? Some feedback of free radicals does, in fact, help your body work better. It does.

Dr. Weitz:                          Right.

Dr. Kaufmann:                   But there’s truly no way to get rid of all of the free radicals. So, I think that’s a little bit ridiculous. But the example sort of holds true, as well, when you’re talking about the mTOR system, right? To not age, we want to shut down the mTOR system. To be an athlete, we want to activate the mTOR system.  So, you need to know what you want to do before you plan how to get there.

Dr. Weitz:                          Yeah, when I work with athletes, we usually try to time the antioxidants and not have them, say, if they’re exercising in the morning, not have them take it right around the time they exercise, and say, have them take it in the evening.

Dr. Kaufmann:                   Right. That’s perfectly reasonable. Absolutely.

Dr. Weitz:                          Because there have been several studies seeming to show that when you take these antioxidants, they blunt some of the benefits of exercise.

Dr. Kaufmann:                   That’s absolutely true.  But you need to also keep track of what type of athlete it is, right?  Is it a resistance-type problem? Is it an aerobic-type problem?  For example, my daughter, and I talk about her frequently, is a tennis player.  She is out in the Florida sun all the time. She’s a redhead, and she burns.  When she takes her astaxanthin, she does not burn.

Dr. Weitz:                          Cool.

Dr. Kaufmann:                   You know of course she forgets all the time, and then she turns into a beet. So, we know that it works, because we’ve done this controlled study now. So, it just is sort of … Again, it depends on what your absolute goal is.

Dr. Weitz:                          Right. It’s interesting, a lot of the focus in anti-aging medicine these days is all about cleaning up dead older cells, and putting your body in this mode in which it thinks it’s starving to death, so it starts eating up the old dead cells, autophagy, which is something that exercise also does, whereas, a lot of the focus 20 years ago in anti-aging was about doing things that increase your potential for growth. And so, a lot of the focus was more on giving testosterone, and growth hormone, and various strategies sort of that increase  growth. Because, as we get older, our cells break down and need to be replaced. So, I think there’s this kind of yin and yang between having your body being in growth mode and being in the opposite mode.

Dr. Kaufmann:                   I think that’s completely true. I think you’re mixing a whole lot of subjects there, so I’m going to try to tease out what I think is important. And I don’t mean that in a bad way at all. I think before 15-ish years ago, we didn’t know a whole lot about not aging. I really don’t. I think we do now. But people do have various opinions. And when you talk about all of the hormones, I think it’s … and people are going to hate me for this … I think it’s a little crazy, to be perfectly honest with you. Our bodies work on feedback loops. So, if you’re a young man and you take testosterone, your body perceives that testosterone, especially if it’s bioidentical, and says, “Oh, I don’t need to make anymore because I have enough.” So, it shuts down. So, you’re not going to end up with any higher levels of testosterone. And in fact, you’re going to hurt yourself over the course of time.

Dr. Weitz:                          Sure.

Dr. Kaufmann:                   I generally tell men, “Get the levels tested. As you are getting older and they fall, it is not unreasonable to replace them.” But trying to jack yourself up when you don’t need it is, I think, horribly painful. I mean, I think it’s just a bad thing.

Dr. Weitz:                          Oh, absolutely.

Dr. Kaufmann:                   So, I don’t believe in any of that. The other thing that you mentioned is clearing out the bad cells. And now, this is a huge new topic. And what you’re talking about is senescent cells. And I just spent months, and months, and months digging into this, so I could bore you to tears. But in general, a senescent cell is a cell that was a normal acting cell, and it had some DNA damage, and it decides to go into a shutdown mode, right? And the shutdown mode does then … The outcome is one of three things. Either one, the DNA damage is absolutely horrible. The cell can’t fix itself. It commits cell suicide. Call it apoptosis. It just sort of disappears.

                                          Or, the DNA is fixed, and then the cell goes back to doing what it should do. But in the middle, we have these things called senescent cells, where the cell starts again, but it’s not exactly the same as it was before. The analogy that I like to use is the grumpy old employee at a factory, right? He used to be young and vivacious, and now he’s the fat guy in the corner, right? So, these senescent cells, they change shape. They become larger, their organelles change shape, their production change shape. And what they do is, they produce something called an SASP. Basically, they put out what I call evil cytokinins. It’s a senescent associated secretory phenotype, for those geeks out there.

Dr. Weitz:                          Okay.

Dr. Kaufmann:                   But it’s actually, essentially, they’re just bad, evil, grumpy cells. But they accumulate over time. And they create a localized inflammatory issue. We think originally, they did this to bring in immune cells to get rid of those cells, but it doesn’t exactly work that way. And as you get older, these cells accumulate. And they cause more pathology, and more inflammation, and more damage. I’m not completely sure of this, but I developed a graph, where while you are still young, you have some senescent cells, and the increase is very small. As you get older, the slope of that increases. And then beyond some point, sort of, when people just feel old, it becomes moderately exponential.

                                          So, the question is, how do you get rid of these cells? And so, we’ve been looking at drugs. There’s xenomorphics, which change how a cell acts. And the good news is that there are xenolytics, that actually kill these cells. And it’s been shown in animal models that if you can kill these cells, where the cell was gets replaced by normal new cells. So, a lot of regenerative medicine can be actually focused around xenolytic therapy. So, I think that’s a really cool thing.

Dr. Weitz:                          Absolutely. So, another substance that you highlight is nicotinamide riboside, to stimulate NAD production.

Dr. Kaufmann:                   Ah, another one of my favorite subjects.

Dr. Weitz:                          Yeah, a lot of people talk about this. And then there is some controversy over which of the various compounds that are available are best to take, whether you’re going to take nicotinamide riboside, or whether you’re going to take NMR, or whether you’re going to take NAD, etc., etc.

Dr. Kaufmann:                   Yes. So, first we’ll start off with what it is and why it’s important, and then I’ll tell you what I feel about the other stuff.

Dr. Weitz:                          Okay.

Dr. Kaufmann:                   So, nicotinamide is important, because number one, it is very active in the electron transport chain in the mitochondria. So, as you get older and you have less nicotinamide, and we’ll talk about why that happens in a sec, you make less energy. You just do. Your mitochondria just don’t function efficiently, which is why a lot of older people just don’t have the energy they should have. So, that’s problem number one. Problem number two is that it is a necessary co-factor for sirtuins. So, the aging, or not aging pathways, the seven mammalian sirtuins, do not function without nicotinamide. So, you can take as much resveratrol or pterostilbene as you want, but without nicotinamide, you’re not doing anything. So, that’s number two.

                                                Number three is that, when you have DNA damage, you’ve got a big glob missing in your DNA chain, your body takes the nicotinamide molecule, chops it into pieces, and puts part of it back into the DNA so it fixes it. So, again, if you don’t have enough nicotinamide, you don’t repair your DNA, then you get cancer. And then, lastly, and this one’s hard to sort of quantify, serves as a communication device between your nucleus and your mitochondria. So, four reasons that you need more, because you have more damage, you need more energy, blah, blah, blah.

                                          So, as you get older and you have less, you, by definition, need more. So, the supply/demand chain makes it very difficult to keep up, which, you can actually get your nicotinamide levels measured. But it’s extraordinarily hard to do. We have tried to do this. There is one company in LA, I believe. We measured a gentleman’s nicotinamide, and it had to be immediately spun down, put on dry ice, and hand-driven to their company to do it. So, at the moment, it’s not exactly commercially available.

Dr. Weitz:                            And niacin levels are no reflection of that?

Dr. Kaufmann:                   Not at all. Completely different, completely different. My kids always tell me that, why can’t you just smoke a cigarette, because isn’t that the same thing? And the answer is, gosh, I hope not. And I hope other people don’t think that, either.

Dr. Weitz:                          Because nicotine, being a similar compound?

Dr. Kaufmann:                   Well, the word sounds kind of the same.

Dr. Weitz:                          Right.

Dr. Kaufmann:                   And so, people think, “Oh, well, I smoke. I’ll be fine.” And the answer is, “Not exactly, actually not at all. And you’re making the problem way worse, because now you’ve got more DNA damage.”

Dr. Weitz:                          Right.

Dr. Kaufmann:                   Right. So, the question then goes back to, “How do you know that you’re short?” And the answer is, “Probably anyone over the age of 40.” People that say, “You know, I just don’t have the energy I used to,” that is probably nicotinamide deficiency. Do you really know? Not really. But it’s just likely. And then, of course, which one do you take, right? There’s no way of knowing, because there’s no way of measuring it. People are touting NAD infusions, and I think that’s kind of crazy, because I’ve worked in a hospital a really long time, but no one’s ever come in, in a stat nicotinamide deficiency. It just doesn’t happen, right? And giving something extremely quickly that’s going to get metabolized, and then it’s going to disappear, I’m not convinced that’s great for you, just from a pharmacological standpoint.  What I think you do need is slowly filling the deficiency, which you could do obviously, with oral supplementation, which then, boils down to, you’re right. Is it nicotinamide riboside or the NMN? And the answer is, we don’t know that either. There’s never been any head-to-head testing. There’s been a lot of studies that show that NR is very efficacious. They’re catching up on the other side. I think this is a war of companies. Because they both have their trademark compounds. We know that you need it in some form, and someone ultimately, is going to win. I wish they would do a head-to-head study, because people asked me all the time which is better. And the answer is, “I really don’t know. I wish I had an answer. But taking one of them, I think is crucial.”

Dr. Weitz:                          So, if you take nicotinamide riboside, what dosage do you like?

Dr. Kaufmann:                   That’s a good question. I think it depends on how old you are. I think it depends on how deficient you are. Just many, many things. For example, if you’re already 50, you’ve got some catching up to do. So, I recommend a higher dose. You probably would take maybe, two weeks to three weeks to catch up. When your energy levels sort of level off-

Dr. Weitz:                          What would would that higher dose be?

Dr. Kaufmann:                   I would say, it just depends on the bottle, too. I think it’s … They usually come in 250’s, I believe.

Dr. Weitz:                          Right, I think they do.

Dr. Kaufmann:                   So, I tell people, “Take two of them. Spread it out, one in the morning, one at night, for two to three weeks, until you feel like your energy levels are good. Back down to once a day. And if you still feel good after a month or so, take it every other day.” Because having too much isn’t good, either. This is not a, “who gets to have the most in their body wins” sort of thing. You need the right amount, but not too much. And the only way to do that is judge it by energy levels.

Dr. Weitz:                          Curcumin. That’s one of my favorite nutritional compounds. And I know that’s big on your list.

Dr. Kaufmann:                   Oh, I love it. Yes, absolutely.

Dr. Weitz:                          Yeah, we love curcumin as an anti-inflammatory, as an anti-everything, cardiovascular, cancer prevention, etc., etc.

Dr. Kaufmann:                   Absolutely. And I used to think that it was really crazy that one thing could do all of those things, but if you boil it down to the seven tenets, it does. It is a very potent epigenetic modifier, right? So, everyone should be on it. It helps your mitochondria, because it’s a free radical scavenger. It helps activate some of your pathways. It helps with DNA repair. It does everything it’s supposed to do. I won’t bore you with the details. Although, one of my absolute coolest favorite thing is, it’s the only thing that actually been demonstrated to help with lipofuscin accumulation.

Dr. Weitz:                          Okay.

Dr. Kaufmann:                   There’s a great rat study that looked at old rats, and medium old rats. And if they were on curcumin, not only did they not get a lot of, or get the same amount of lipofuscin accumulation, some of it was actually reduced, which I think is incredibly amazing. 

Dr. Weitz:                          Can you explain what lipofuscin is?

Dr. Kaufmann:                   Absolutely. I call it the kitchen drawer phenomenon. You probably read that in the book. It’s sort of a goofy analogy. So, when a long-acting cell responds to the environment, it changes the number and type of organelles it has. So, for example, over the course of time, your mitochondria get beat up, and your brain cell says, “You know what? I really need to make new mitochondria.” Squashes them down, extracts out the reusable pieces, and takes the rest that it can’t use, and squishes it in the back of the cell. And then over the course of however old you are, 90, 80, however old you are, every time you’ve recycled these organelles, you get more, and more, and more accumulations of just gunk sitting in the back of your cells that you can’t use.  And it really doesn’t do anything, it’s just a space occupying problem. And what I think is really cool is, you can age lobsters by lipofuscin accumulation. I mean, not that that’s really important to anyone, but it’s just really cool. It’s the most accurate way of measuring crustaceans. And the same with us, you cut open our brains when we are old, you can probably look at it and go, “Aha, 90- some years old, or 100, or however old we are.”

Dr. Weitz:                          Right. So, when you were talking about NAD, I believe a lot of people talk about it as a factor that affects mTOR, right? Is it a bio-blocker for mTOR?

Dr. Kaufmann:                   NAD should not be, no. Metformin is. That’s what you’re referring to.

Dr. Weitz:                          Oh, okay. Okay, we’ll get to that in a minute. Okay. So, next, we have carnosine.

Dr. Kaufmann:                   Aha, carnosine.

Dr. Weitz:                          Yeah.

Dr. Kaufmann:                   You’re hitting my top favorites here. This is great.

Dr. Weitz:                          Yeah, so, most people probably don’t know carnosine. They know carnitine, and carnosine is a little bit different.

Dr. Kaufmann:                   It is different. It is a dipeptide. It is alanine and histidine, So that’s a very simple peptide. The Russians are very, very fond of this. They gave it to all of their athletes behind the Iron Curtain, and honestly, they kicked our butts in the 80s. And I think it’s because of the carnosine. It does two major things. Number one, it’s a buffer in your muscles, and it’s a free radical scavenger, which is why athletes like it. But I’m in love with this because it’s a trans glycosylating agent. So, all of the glucose that we take in our system needs to get stripped, and it’s one of those things that can actually suck the sugar off of you, and you just excrete it, and you’re all the better for it.

Dr. Weitz:                            Okay. Yeah, we know that blood sugar, insulin resistance are major factors in antiaging. And we need to try to manage those. And I think that’s one of the benefits of caloric restriction, fasting, and probably of ketogenic diet, as well.

Dr. Kaufmann:                   Oh, without a doubt. Glucose control is extremely important. Obviously, we need glucose. It’s just like oxygen, we need some, but we all have far too much.

Dr. Weitz:                          Right.

Dr. Kaufmann:                   Glucose falls into my waste management category, just because it’s everywhere. I tell people, “It’s sticky on the outside, it’s sticky on the inside.” You get glycation everywhere. I talk about AGE’s in the book a lot. One of my favorite abbreviations, it’s advanced glycation end products.

Dr. Weitz:                          Right.

Dr. Kaufmann:                   Glucose sticks to protein, it sticks to DNA, it sticks to lipids. And it causes several problems. It causes the things that it sticks to, to lose function. And then the glob sticks to collagen. And once a glob sticks to collagen, you get basically, destruction of anything that’s collagen-based in your body. Your skin, your heart, your blood vessels. So, I think it’s one of the huge reasons that you age. So, by calorically restricting yourself, as well as taking less glucose, obviously, you’re causing fewer of those problems than you could normally.

Dr. Weitz:                          And when we measure hemoglobin A1c, we are measuring one of those glycosylated proteins, right?

Dr. Kaufmann:                   That is correct. So, basically, you’re measuring the amount of glucose stuck to a red cell. Red cells take about three months to turn over, so, it’s a transient snapshot of your glycation level. If you really want to know how coated you are, there’s a great machine, is called an AGE reader. They have it in Europe.

Dr. Weitz:                          Really?

Dr. Kaufmann:                   Absolutely. If I had a private clinic I would get one, but I don’t, so I haven’t.

Dr. Weitz:                          And AGE reader, wow.

Dr. Kaufmann:                   Is called an AGE reader. You stick your arm in it, and it tells you how much glucose has been glycosylated into your arm.

Dr. Weitz:                          Wow, fascinating.

Dr. Kaufmann:                   I think that’s the future of tracking diabetes. It just hasn’t made it to this country yet. It’s on our list of antiaging markers, so we’ll get to play with it. Is just not a popular item yet.

Dr. Weitz:                          You know, I’ve talked to some anti-aging doctors. I talked to Sarah Gottfreid recently and she likes to wear a continuous glucose monitor, just to continuously see where her glucose levels are. What do you think about using something like that so you can really fine-tune your glucose levels?

Dr. Kaufmann:                   I think it depends on your level of OCD. I know that sounds terrible. I mean, some people are very, very into this. And I applaud that. My whole plan of this whole thing was to live a normal life, and not to be too crazy. So, I think that would just drive me to drink, to be perfectly honest, which wouldn’t be good, either.

Dr. Weitz:                          Well, you’d get plenty of resveratrol, as long as you had red wine.

Dr. Kaufmann:                   Oh, absolutely. And there’s quercetin in white, so we’re covered either way. So that’s good.

Dr. Weitz:                          Oh, there you go.

Dr. Kaufmann:                   No, but … So, the way I approach it is, I block glucose going in, metformin. There are seven steps to glucose coming in AGE, and there are innumerable substances that serve as blocking agents. And then once you do have an AGE, there are several agents that can trans glycosylate to get rid of it. So, I don’t actually care what my momentary glucose is. I go on my Haritaki holidays, and I … Maybe I’m kidding myself, but I like to think that I’m sort of taking care of the problem.

Dr. Weitz:                          Cool.

Dr. Kaufmann:                   You’ve nothing to say to that, do you?

Dr. Weitz:                          Well, I just had something pop up on the screen that, Zoom sent me this note that, “We’ve just eliminated your 40-minute limit.” So-

Dr. Kaufmann:                   Oh, great.

Dr. Weitz:                          Yeah, there’s this weird thing, that if you have two people on a meeting, you get unlimited time. But if you get a third person, because you switch computers, it limits you to 40 minutes.

Dr. Kaufmann:                   Oh, no.

Dr. Weitz:                          And you didn’t see it, I guess. It said, “We eliminated that.” It’s like, “Thank you.” Okay.

Dr. Kaufmann:                   Oops.

Dr. Weitz:                          So, you mentioned carnosine eyedrops. I never heard of that. That sounds really fascinating, as a way to reduce risk of, I think you said cataracts?

Dr. Kaufmann:                   Right. So, again, this carnosine falls under the expertise of the Russians. And there’s some extremely zealous Russian dude with a ridiculously long name that I could never pronounce. And he loves carnosine. And he decided that cataracts, and I think by extension, presbyopia, had a lot to do with glycation in the lens. And interestingly enough, he formulated NAC, So, it’s N-acetylcarnosine. And he gave it to, I don’t know, 50,000 Russians. And they all said their vision got better.

Dr. Weitz:                          Wow.

Dr. Kaufmann:                   So, amazingly enough, it’s over-the-counter. There’s probably 17 versions of it on Amazon.

Dr. Weitz:                          I looked online, because I read about this on your website. But, what do you think is the best one to take?

Dr. Kaufmann:                   So, that’s a very … I tried a whole bunch of them, and I don’t know why some of them burn and some of them don’t. I get this one, and it’s … This is the most ridiculous ad ever. But it comes in a little metal bag. How about that? If you’re looking for it online, it comes in a little foil bag.

Dr. Weitz:                          Okay.

Dr. Kaufmann:                   I know that’s really silly. It says NAC. It’s a tiny bottle. I wish I could tell you exactly who made it. I can work on that, and I can send you a link.

Dr. Weitz:                          Okay. So now, in your list, most of your list of compounds are supplements, but yet metformin, which is a pharmaceutical drug, is-

Dr. Kaufmann:                   Wait, wait, wait. I have to interrupt you there, because this drives me absolutely nuts. Okay, so a supplement technically, is something that you already have in your body, and we are adding to it, right? And add you vent is something that your body’s never seen before, right? Then there’s vitamins, and then there’s minerals. So, I call them molecular agents, because everything falls into a different category.

Dr. Weitz:                          How about if we use the term nutraceuticals?

Dr. Kaufmann:                   That’s fine. We can use that.

Dr. Weitz:                          Okay.

Dr. Kaufmann:                   But see, metformin, the only difference of metformin is that somehow, it became controlled by pharmaceutical companies. As far as I’m concerned, it falls into the same categories.

Dr. Weitz:                          I’m sorry, that makes it evil.

Dr. Kaufmann:                   It does not make … well-

Dr. Weitz:                          I’m kidding.

Dr. Kaufmann:                   The only good news, it’s been around for a zillion years, so it’s extremely cheap.

Dr. Weitz:                          So, metformin helps with controlling mTOR. What about rapamycin? I’ve heard some anti-aging experts, I think Peter Attia, talk about, I think he’s been experimenting with taking rapamycin.

Dr. Kaufmann:                   Right. So, the mTOR pathway, I call it the youthful pathway. It’s about building.

Dr. Weitz:                          By the way, mTOR stands for mammalian target of rapamycin.

Dr. Kaufmann:                   Yes, yes it does. Yes it does. And I should’ve said that. In my world, that’s sort of a given, so I apologize. What the mTOR pathway does is, it builds. It builds muscle, it builds tissue, it turns over cells. It’s a very active system. It’s anabolic, right, versus other things that are catabolic.  As you get older, however, the system becomes obsolete.  And if you block it, you put yourself into a sort of state of not growing.  And that helps to preserve you, right?  Therefore, rapamycin is extremely potent, and it can do this, which is why we use it … It truly is a chemotherapy agent.  We use it and stents, so that you don’t regrow tissue in a coronary artery.  We use it to block issues after kidney transplant. It’s a heavy-duty medication.

                                        And if you block all tissue turnover, you may preserve yourself, however, I spent a ton of time looking into this. And the problem is that you block tissue that you need to turn over. For example, you tend to become sarcopenic, right? Because you’ve got muscle wasting, because you’re not turning over your muscle. And the other thing that’s a little bit worrisome is that you have to turn over your hippocampal cells to make memories. And, at least in experimental animals, if you block that ability, you’re not going to remember anything. So, I don’t necessarily agree with the rapamycin bandwagon.

Dr. Weitz:                          Right.

Dr. Kaufmann:                   And other people will say different things, but that’s sort of my take on the situation.

Dr. Weitz:                          So, just practically, how would … You’re an MD, I’m a chiropractor. I can’t recommend pharmaceutical drugs anyway, but even if I were to suggest a patient take Metformin for anti-aging, I mean, practically, what are they going to do, go to their primary care doctor and say, “Hey, Doc, I want to live a long time. Can you prescribe Metformin”?

Dr. Kaufmann:                   So, the answer is yes. A study came out many … Four or five years ago by now, and it looked retrospectively at three groups of people. They weren’t diabetics on metformin, diabetics on sulfa ureas, and non-diabetics on obviously, no diabetic drugs.

Dr. Weitz:                          Right.

Dr. Kaufmann:                   And retrospectively, the diabetics on metformin did extraordinarily better. The morbidity was lower, the mortality was lower. So, clearly, people realize that metformin was doing something to help with not aging. And it certainly was not just the glucose. So, a lot of money and time has been dumped into figuring out why metformin does this. It does many things. It’s a epigenetic modifier, it activates your AMP kinase, and helps with glucose issues, it’s an anti-inflammatory. We know it reduces the risk of cancer in diabetics. It reduces weight. It helps with menopause. It decreases issues with PCOS. It is an extremely potent useful drug. And people are realizing that in a risk-benefit ratio, it really is a great thing to take. And I’ve actually gotten calls from a lot of primary care specialist saying, “People are asking about this. What should I do?” And I say, “You know what? Give it to them. Absolutely give it to them.”

Dr. Weitz:                          Well, there are studies showing that a natural compound, berberine, has been shown to be equally effective to Metformin in some situations. Could we take berberine instead of metformin?

Dr. Kaufmann:                   So, the answer is sort of. That plant, or that chemical, does actually help with glucose reduction. But it doesn’t do a lot of the other things. So, what you would have to do in order to substitute that is go to my numerical chart and find agents that helped in the categories that you are now not using from the metformin. So, this goes back to my idea that you don’t have to be on everything, but you have to just make sure all of the categories are covered.  So, for example, if you’re going to use berberine for glucose management, you need to use something else for the AMP kinase, or the inflammatory issues.

Dr. Weitz:                          Okay. Interesting.

Dr. Kaufmann:                   The caveat, and I just like to say this, because people run out, and then they buy metformin, or they talk someone into it. Because it is a partial mTOR inhibitor, you can get muscle wasting over the course of time. So, I recommend that people take leucine, one of the branched-chain amino acids, to try to prevent it.  And then secondly, you get decrease in vitamin B absorption in the gut from it.  So, I suggest people take sort of a generalized B.  People love B-12 for some reason, but you really need all of the B’s.

Dr. Weitz:                          Interesting. So, leucine.

Dr. Kaufmann:                   Mm-hmm (affirmative).

Dr. Weitz:                          There is some controversy about amino acids playing a role in aging, and some specialists, anti-aging folks, feel that certain amino acids like methionine, in particular, are contrary to an anti-aging perspective. What do you think about that?

Dr. Kaufmann:                   I think it goes back to what we talked about before. You have to define what you really want to get to, right?

Dr. Weitz:                          Right.

Dr. Kaufmann:                   Absolutely, amino acids cause you to build muscle.

Dr. Weitz:                          It’s one of the arguments for a vegetarian diet, in say, having anti-cancer effects.

Dr. Kaufmann:                   Right. And I get that. But again, you have to pick your battles. If you’re going to protein starve yourself, you’re going to become extremely sarcopenic, right?  And if you’re an aging athlete, you don’t want to become sarcopenic.  So, I tell people not to take all of the amino acids that you see in those big giant bulk cans for the bodybuilders.  But if you want to maintain some lean muscle, so that you’re not frail as you get older, the only one that you really have to focus on is leucine.

Dr. Weitz:                          So, you take the branched-chain aminos?

Dr. Kaufmann:                   That’s exactly what I do.

Dr. Weitz:                          Right, okay. So, we can’t go through every one of your compounds, even though they’re all fascinating. But I wanted to mention that Astragalus TA-65 compound that I’ve seen at some conferences advertised. And I’ve read some of the literature on it. I know it’s an extremely expensive one. Can you talk about that, and how efficacious is that as an anti-aging compound?

Dr. Kaufmann:                   Right. So, it is extremely important to activate your telomerase to make your telomeres longer. And the question, of course, is how do we do that? The natural agent, astragalus, as you mentioned, has pretty potent powers. Compared to the ones that we’ve concocted in the lab, it’s pretty weak. TA-65 is pretty good. You can thank Bill Andrews for those, because he invents them at Sierra Sciences, and then passes them along. The 818 is even better. But again, these things are ridiculously expensive. So, for those billionaires out there that really don’t care about cost, it is a great thing to do. It really is. For a regular human that just wants to stop aging, it probably is not going to be very affordable. I personally, stick with astragalus. Do I expect phenomenal things to happen? No. But the other really cool thing about telomeres, and I actually just learned this recently from a very brilliant scientist from Spain, is that as you exercise and you become transiently hypoxic, you actually activate something called your-

Dr. Weitz:                            What was that?

Dr. Kaufmann:                   When you are exercising, right?

Dr. Weitz:                            Right.

Dr. Kaufmann:                   And you feel that acidotic burn.

Dr. Weitz:                            Okay.

Dr. Kaufmann:                   You’re getting transient hypoxia in those areas, okay?

Dr. Weitz:                            Okay.

Dr. Kaufmann:                   That activates the-

Dr. Weitz:                            So, not enough oxygen in those muscles.

Dr. Kaufmann:                   Right. Contrary to what a lot of people think, more oxygen is not good for you. Sitting in an oxygen chamber, unless you’re a diabetic, is not so good for not aging.

Dr. Weitz:                            Because it’s reactive oxygen species, right?

Dr. Kaufmann:                   Yeah, for innumerable reasons, yes. Our stem cells like [crosstalk 00:52:32]

Dr. Weitz:                            … what’s good is bad, too, right? So, that’s why people use hyperbaric oxygen and ozone, because it’s inflammatory, but then it stimulates the healing, right?

Dr. Kaufmann:                   Right. I mean, again, you have to figure out what your endgame is to figure out what your therapy’s going to be.

Dr. Weitz:                            Right.

Dr. Kaufmann:                   And what’s good for one person is not necessarily good for someone else.

Dr. Weitz:                            Right.

Dr. Kaufmann:                   That being said, when you transiently become low in oxygen in your muscles as you are exercising, it activates something called the HIF Alpha factor. It also gets activated when you’re climbing mountains and you’re hypoxic. And that, through a series of enzymatic reactions, actually activates telomeres. So, simply by exercising, you are actually activating your own telomeres. So, that’s probably the most important thing that normal, reasonable people can do.

Dr. Weitz:                            Now, I think that there’s been studies showing a whole series of things about lengthening your telomeres, including multivitamins, fish oil, on, and on, and on. And so, I think it’s why some people would be a little skeptical about you telling me your hypothesis.

Dr. Kaufmann:                   Well, I think it boils down to, telomeres are much like epigenetic modification. Whatever your mom said was good for you, probably is a positive epigenetic modifier, and it probably helps your telomeres, right? And the other thing you have to realize is that all of your telomeres in every cell of your body are not going to be identical all the time, right? So, if you looked at a telomere from your brain cell, it’s going to be different than a telomere from your white cell, or from your red cell, right? It’s not an absolutely homogenous population. So, it’s just, you have to realize that once you have your telomeres measured, it may be different if you took a different specimen, you know what I’m saying?

Dr. Weitz:                            Yeah. So, the telomeres in the bloodstream may not reflect the telomeres in the brain versus the telomeres in the liver or in the muscles.

Dr. Kaufmann:                   Right, right. But, going back to what your mom said, right, clearly she said, “Don’t eat Twinkies.” We all ate Twinkies as kids. Twinkies are clearly negative epigenetic modifiers, and they certainly cause a lot of stress on your body. Stress causes decreased telomeres. So, again, all of this is what I like to think of as a giant overlapping Venn Diagram, where you can’t necessarily say, “This does this, but it doesn’t do that.”

Dr. Weitz:                            So, how do we put together a list? How would I put together a list, let’s say, for myself or for one of my patients, using your system? Bam. What’s the list of six, eight compounds I would come up with?

Dr. Kaufmann:                   Ah, excellent question. So, the first thing I do is, how old is someone, how zealous do they want to be, what medical problems do they have, right? Someone says, “You know, I’m middle-age, don’t really have too many medical problems, my back hurts, I’ve got disc problems, and I don’t have any energy.” I immediately put them on the panacea. And conveniently, it’s the panacea, because I rearranged some letters at some point, and kind of misspelled panacea on purpose, and it kind of worked. But it works.

                                                So, for the P it’s pterostilbene. A is astaxanthin. N is nicotinamide. And then, you throw in two C’s, which is curcumin and carnosine. And then for some people, I throw in the EGCG’s from green tea, because it helps a lot, as well. So, to a basic program, that’s a great place to start.

Dr. Weitz:                            Cool.

Dr. Kaufmann:                   But if you want to be fancy, right? Some people go, “I have a lot of immune problems.” Then you add more agents that score well in that category. Or if you’re a diabetic, pre-diabetic, like to eat a lot of junk food, then I add up a lot of things that score well on the waste management category. So, there is actually an app, and unfortunately, people are angry at me right now. My developer is kind of … It gets stuck on the subscription page. So, please don’t have anyone do it until I absolutely get it fixed, because I’m getting tired of getting hate mail. But, what it does is, you put in all of your personal information, and then an algorithm, based on what I have done, sort of tells you what you should take, and then where to get it. Trying to make it easy for people.

Dr. Weitz:                            What about the role of … We’ve been talking about supplements, and … Not supplements. We’ve been talking about nutraceuticals.

Dr. Kaufmann:                   Oh, there you go.

Dr. Weitz:                            But what about the role of diet, exercise, sleep, stress reduction techniques like meditation, for antiaging benefits?

Dr. Kaufmann:                   All of those things are good, right? The question would be, why? Well, exercise is good, right? We talked about telomeres. It actually activates your sirtuins, increases your circulation. It does a variety of fantastic things, right? You need aerobic, you need anaerobic, everyone knows it’s good for you. And I actually rated it at one point, to figure out exactly what it did in each category. It scores pretty well. Scores pretty well. Foods are important, because they’re epigenetic modifiers. They really are. And what’s really interesting is, if you take twins and you watch them grow up, they get more and more different as they age. And the reason is, it’s all epigenetic modification.  It’s their diet, or are they around polluted areas? Do they smoke? What do they do? So, you could absolutely do great things, right? Meditation and all those things, they reduce stress levels. Stress level reduces stress on cells. Cells work better, i.e., you’re not aging as much. So, it all ties together. You just have to boil it down to what exactly it’s doing to your cells.

Dr. Weitz:                            Cool. Awesome. So, I think that’s all the questions I have. I thought that was a lot of really good information to help us with aging better, and hopefully living healthier. How can our listeners get a hold of your programs, and your information, and your book?

Dr. Kaufmann:                   Excellent question. So glad you asked. And so, we’ll start from the beginning. As you well said, I am not an antiaging specialist, per se. I don’t have an office. This is a hobby.

Dr. Weitz:                            When is that office opening?

Dr. Kaufmann:                   That’s a very good question. This is really starting to not help my day job. I run an operating room, and every now and then I’ll get a phone call and they’re looking for me. And I’m, “Can I help you with an anesthetic?” And they’re, “No, I don’t want to age.” And then I’m sort of moderately perplexed, because it’s hard … anyway, whatever. So, what I do do is, the book is available. It’s on a regular book, it’s on an e-book. So hopefully, people can sort of get through that. The app … Don’t get it yet. I’ll tell you when. There is a website, kaufmannprotocol.com. It explains all of these things that I’m talking about.   I will be sending out updates. I’m sending out my … So actually, Bill Andrews is reviewing my diatribe on senolytic cells right now. He’s on a trip back from Japan. Assuming I get has blessing, that’s going to go out on the websites. I’m on Facebook, it’s Sandra Kaufmann. I’m on Instagram @ Kaufmann Antiaging.

Dr. Weitz:                            Is that a book or a paper?

Dr. Kaufmann:                   You know what? It started to be a paragraph, and it turned into 30 pages.

Dr. Weitz:                            Okay.

Dr. Kaufmann:                   So, I don’t exactly know what it is. It was all the information that I thought was important. My next project, I actually have a playbook for athletes, a specifically anti-aging playbook, or anti-aging for athletes, which is sort of interesting. And I’m working on a book for skin, because your skin ages for nine reasons instead of seven reasons. So, hopefully that will be out shortly. [crosstalk 00:59:47]

Dr. Weitz:                            I was very excited to do that pinching thing, and my skin didn’t-

Dr. Kaufmann:                   Uh-oh.

Dr. Weitz:                            It went back immediately. I didn’t have any line at all.

Dr. Kaufmann:                   Oh, fantastic. Then you’re doing well. Doing great.

Dr. Weitz:                            And I’m 61, so-

Dr. Kaufmann:                   Fantastic, fantastic. So, the really big question here is, what do you take?

Dr. Weitz:                          Oh, I take about 30 different things, yeah. I take a lot of these. I’m big on … A multi, curcumin, fish oil, I take vitamin E, vitamin C. I take the gamma tocopherol, vitamin E, I take C, I take berberine. I use that as a natural blood sugar control agent. I take astaxanthin, I take nicotinamide riboside, I take [inaudible 01:00:44]. I alpha lipoic acid.

Dr. Kaufmann:                   Excellent.

Dr. Weitz:                          And that was before I read your book.

Dr. Kaufmann:                   Oh, good. So you’re probably then, agreeing with all this crazy stuff, thinking, “Yeah, that’s why I do it.”

Dr. Weitz:                          Yeah, when I get up in the morning, I add a green powder, red powder. I put fiber, I put probiotics, I put modified citrus pectin. So, yeah, I do a lot of stuff.

Dr. Kaufmann:                   Perfect. That’s awesome.

Dr. Weitz:                          I take way more stuff than I would ever ask a patient to take.

Dr. Kaufmann:                   Well, you and me both. If people looked at my list, they’d probably have a heart attack.

Dr. Weitz:                          Absolutely. Okay. Thank you so much, Dr. Kaufmann.

Dr. Kaufmann:                   It’s been a pleasure. Thank you.

Dr. Weitz:                          Okay.


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