Stem Cells & Peptides: The Secret to Reversing Chronic Pain and Aging? with Dr. Adeel Khan

Mark Hyman, MD

Full Transcript

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Dr. Mark Hyman
Coming up on this episode of Ths Doctor's Farmacy.

Dr. Adeel Khan
These things should be called committed progenitor cells, which is a fancy word for just saying that they can't turn into new tissue, that they can reduce inflammation, which is still which can still be useful in some conditions, but it's just misleading because a lot of patients are like, oh, yeah. I got stem cell injections. It's like, well, it wasn't really a stem cell per se. It was more of just something to reduce inflammation.

Dr. Mark Hyman
Before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice, there's simply not enough time for me to do this at this scale. And that's why I've been busy building several passion projects to help you better understand, well, you. If you're looking for data about your biology, check out function health for real time lab insights. If you're in need of deepening your knowledge around your health journey, check out my membership community, Hyman Hive. And if you're looking for curated and trusted supplements and health products for your routine, visit my website, supplement store, for a summary of my favorite and tested products.

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Every week, I bring on interesting guests to discuss the latest topics in the field of functional medicine and do a deep dive on how these topics pertain to your health. In today's episode, I have some interesting discussions with other experts in the field. So let's just jump right in. Adia, welcome to the Doctor. Sarnoji podcast.

It's great to have you here. Last time I saw you was in Cabo when you're about to inject me with a bunch of interesting compounds that are biological compounds they use in regenerative medicine for my disc issues, which helped tremendously. And I think, you know, you've, you've been in the leading edge of this whole field of regenerative medicine. And I think most people don't really understand what is regenerative medicine. So why don't we start by talking about your own story or how you kind of went through your medical training, you know, where your frustrations were, and how you ended up in this place where you're practicing a medicine that most people probably have never heard of and don't know what it is.

And we're going to describe today in detail, but is I think in many ways, the future of repair, healing, renewal, longevity, managing orthopedic issues, which I've certainly used for my own body. So so tell us about your journey, how you got here, and then what the heck is regenerative medicine?

Dr. Adeel Khan
Yeah. Yeah. No. Actually, it's it's funny because I watched your TED talk when I was in medical school, and I remember you talking about depression and how you have to look at micronutrient deficiencies, the gut health, neuroinflammation, and that just the whole concept just made so much sense to me. So you were definitely a part of the inspiration for me to pursue this.

So thank you for that.

Dr. Mark Hyman
And Oh, you knew that.

Dr. Adeel Khan
In terms of yeah. I read new books. I I read obviously, Jason Bland, functional medicine book, like his textbook.

Dr. Mark Hyman
Jeff Bland. Yeah.

Dr. Adeel Khan
Jeff Bland. Yeah. So and, and, you know, integrative medicine textbooks. Luckily, medical school was fairly easy and so I had lots of extra time and I could read I had a lot of time to read other things. But the reason I got into it was partly because I I saw patients not always getting better, and even my old mom had some medical illnesses.

And it was kind of frustrating when the doctors were just like, well, there's nothing else you can do. And and then I started digging deeper, and obviously, I came across functional medicine and and all this kind of root cause work. And then I'm like, wait a minute. There is stuff you can do. We're just not learning about it.

So then it was kind of like, why aren't we learning about it? And then you realize it's just because doctors don't know what they don't know, and that's just how medical school is. You're being taught by specialists who might be the best cardiologist at their in that center, and they're amazing they do amazing work, but they don't know much beyond what they do. And that's just the limitations of their knowledge and so oftentimes we're only being given one perspective which is allopathic medicine, but there it turns out there's a lot more than just allopathic medicine out there and when you look at the totality of the research you realize there's a lot of stuff out there that can be quite beneficial with less harm. And that's really what drew me to this field was just because, hey, if I can do less harm for my patient and have the same benefit, why wouldn't I do that first?

And and that's kinda what got me into regenerative medicine because regenerative medicine is just a playoff of functional medicine, which is, you know, you're trying to restore tissue or restore dysfunction of the cell back to normal. And now you can do that using cell therapy, gene therapy, or tissue engineering, or the combination of those 3 is kind of what we label as regenerative medicine.

Dr. Mark Hyman
Yeah. It's it's really interesting because, you know, as I, you know, think about functional medicine. It's really about how do you restore optimal function using compounds that support and enhance the body's function as as opposed to interrupt, block, or interfere somehow. And most traditional drugs are antidrugs. Right?

They're antibiotics. They're inhibitors, like ACE inhibitors. They're, you know, blockers, like beta blockers. So they're anti bay inhibitors or blockers. Right?

And and and that's fine for some pathways in some medical therapies. But there's an incredible healing system built into our biology that most people are not even aware of. And when you cut your skin, how does it know what to do to repair your skin? Or when you break a bone, how does your body know what to do? Well, you have a you have a built in healing regenerative repair renewal system.

We just don't know how to activate it. And that's a lot of what functional medicine is. But regenerative medicine, you know, my understanding of it is that it actually uses the body's own repair and healing systems to actually help facilitate repair by extracting them from biological sources and then repurposing them and putting them back into the body so they can go and do the repair and healing work without a lot of the side effects and consequences. Is that right?

Dr. Adeel Khan
Yeah, exactly. Our slogan is empowering the body's natural healing abilities. So that's what we live by but to your point it's not just limited to biological substances. You can even use something like bioelectricity or shockwave electrical signals that can manipulate the body's at a cellular level to help it to heal. So essentially it's anything really signaling wise that can facilitate healing or regeneration in your own body and that's why even peptides in my opinion fall into this category of regenerative medicine because a lot of them are just sending signals, especially obviously there are some peptides that are more regenerative in nature.

They're just sending signals to help your body to heal better. And and of course there's biological substances which we'll go into too, but at a very high level we're just giving your body the right tools and the right signals so it can heal on itself.

Dr. Mark Hyman
Yeah. That's exactly right and it's it's really quite amazing and and I it's it's unfortunately not accessible through traditional medicine. You know, I've had back issues for the last 30 years because I ruptured a disc and really damaged a nerve when I was 32, and that left me with sort of chronic, limp and then chronic back pain as a result of changed biomechanics. And I sort of managed it with yoga and stretching and massage and sort of managed my way through. But as I've gotten older, it's gotten more degenerative and there's been more issues.

And I was in a place where I just was really a mess. And and I looked toward regenerative medicine as a way to solve it. And I'd had, you know, steroid injections. I'd had radiofrequency ablation, which I didn't know. And when at the time, it would cause secondary consequences of damage to my back through damaging the muscles in my back.

And so, basically, I've I've really struggled. And the only thing that's helped me take away my back pain are, these compounds that are from this toolkit of regenerative medicine. So so maybe we can sort of talk about, you know, the the the there's 2 parts in my mind to regenerative medicine. 1 is orthopedics, basically healing, repairing, you know, trauma, injury, stuff that hurts. Right?

And pain management. And the other is sort of renewed rejuvenation around various chronic illnesses or longevity that's more systemic. So there's like, you know, injecting a knee with something or they're just putting something in your veins. And then we're going to talk about both those things. But in the in the in the before we start sort of getting into the details of it, I would love to sort of run through at a high level.

What are the sort of tools in the toolkit of regenerative medicine? What are the kinds of things that are included in that bucket? You mentioned peptides, which are things that all of us have tens of thousands of these running around our biology that are the communication superhighway regulating all of our biological processes. You might have heard of Ozempic. That's a peptide.

Insulin's a peptide. You know, they're very powerful, but there are things that the body makes that we can then synthesize or extract, and then we inject back into the body to help accelerate the healing. But that's just one component. So maybe you can take us through, you know, what are the kinds of tools in our toolkit that that are considered regenerative medicine?

Dr. Adeel Khan
Yeah. And I think that's really the key. The tools that we have now are much better than they were even 5 years ago. So regenerative medicine is moving at an accelerated rate and that's to your point a lot of physicians don't understand that there's so much innovation happening in regenerative medicine and so they still have this concept that they were taught in medical school or maybe they learned you know or 10 years ago when you know stem cells had all this hype and they don't actually end up doing anything and so in their mind that's what they still think. And of course stem cells is the first one I have to talk about just because I think that's the one people always think about was regenerative medicine.

And so stem cells is a very broad term number 1. Number 1 what that means is that it's it's not specific to any type of nomenclature. So if if you go to a stem cell clinic is they're not specifying like what does that mean right? Like does that mean does that mean you're getting a stem cell from like the fat, the bone marrow, and even if you get the stem cell is it culture expanded? How is it being engineered?

How is it being isolated?

Dr. Mark Hyman
Is it yours or is it somebody else's, right?

Dr. Adeel Khan
And there's so many questions there's so many questions that just don't go answered when you ask these clinics that and that's a problem still to this date with a lot of the offshore clinics too is you know the there's all this excitement around stem cells but at the end of the day stem cells have 2 functions. 1 is to self renew and others to differentiate and turn into other types of tissue. So the analogy I like is it's kind of think of it like a you know like a master key and that master key can replicate itself and then it can, you know, open up like different doors or it can divide and clone itself and and then open up other doors that way. And so if if that's a function of a stem cell in theory, then it should be able to repair tissue and fix things in your body when we put them there. But it turns out when we take stem cells in the test tube and then we and versus when we put them in your body, they behave differently.

So it's not as simple as we thought and and there's very and there's a lot of different types of stem cells. So

Dr. Mark Hyman
So stem cells are one of the big categories of regenerative medicine. That's that's one of the right. And so so keep keep going around that. I'm just sort of contextualize because there's a lot of other compounds that are used besides stem cells.

Dr. Adeel Khan
There's so many and and even but even in stem cells, I mean, you can just do a whole podcast just literally about that because stem cells are such an in-depth concept. But, at a very high level, what people need to understand is just when you take when you take something from your own body like for example if you go to the US right now there's a lot of stem cell clinics but they're not actually true stem cells because if you're just taking your bone marrow or your fat and then you're just isolating that and injecting it it doesn't actually have the ability to turn into new tissue but it does have an ability to reduce inflammation. And so a better term for it that Arnold Kaplan who's a guy who coined the term mesenchymal stem cells in 1992, He's a he's the guy who coined it he wrote a paper about this but basically he said that they you know these things should be called committed progenitor cells which is a fancy word for just saying that they can't turn into new tissue but they can reduce inflammation. Which is still which can still be useful in some conditions, but it's just misleading because a lot of patients are like, oh yeah, I got stem cell injections.

It's like, well, it wasn't really a stem cell per se, it was more just something to reduce inflammation because it's not because whenever because remember the definition of a stem cell is something that can actually regenerate new tissue. And if you're just taking your fat or your bone marrow and injecting it, that's not regenerating new tissue, through the mechanism of that stem cell. It may send signals to your own body stem cells to help with some regeneration, but for the most part it's an anti inflammatory product. And so that's that's the number one thing to understand about these. And this is we're talking about the broader category of mesenchymal stem cells, which is just you know an embryological term, but essentially what it means is this is from you know these the reason we use mesenchymal stem cells was because they're the easiest to source.

Because they're in the fat, they're in the bone marrow, they're from umbilical cord tissue, or dental pulp. There's so many different sources now but that's the reason why MSCs or mesenchymal stem cells are so popular and the other reason is because mesenchymal stem cells only have a finite ability to differentiate which means they can they won't cause tumors or cancer. Of course, that's always been a concern with like embryonic stem cells which if you're taking them from aborted fetuses which some clinics still do and obviously during the Bush era there was a lot of controversy around that and that's why stem cells kind of got categorized into this unethical thing. But that's not how we're sourcing our stem cells. We're we're sourcing them, you know, obviously we're not we're not harming any babies and they're being sourced from c section births after, you know, and and some instead of being thrown away, they're donated.

So it's a very simple collection process, but the problem with the mesenchymal stem cells, as we said, is first of all, there's a lot of clinics saying that they're taking your fat and bone marrow and cleaning their stem cells, which are not. But let's say let's say you go offshore somewhere and they can isolate them and then they can do what's called culture expansion, which means they can grow them and they can replicate them. So then they can actually have some sort of dose that can be a therapeutic and potentially regenerate tissue in theory. But then what happened, it turns out when you take these stem cells whether from any of these sources, when you put them in the body, most of them don't survive. And and when you do them intravenously, most of them get trapped in the lungs or die.

And that's why the results have been very inconsistent and that's why stem cells have been taken off the way we thought they would, you know, 10, 15 years ago. And that's why the clinical trials have been so mixed. And so unfortunately there's still a lot of clinics claiming that, you know, we can regenerate tissue. You can do yeah. And it's just it's just misleading because and even I thought this, you know, which is that I thought IV stem cells were great, but it turns out a lot of them just get trapped in the lungs and most of them die.

And that even with that, you still get some people who get benefits, And and that's and that's and that's the old generation technology. But now we can isolate we can isolate the best stem cell population and use that one. So it turns out that when you take a stem cell, a mesenchymal stem cell, there's actually 17 subtypes, which is kinda crazy if you think about it. So it's like they they there's something called single cell RNA sequencing, which is basically to look at gene expression of individual cell profiles. So that way you can see how different cells behave, and then you can see that, hey, there's actually these 17 different cliques that they hang out together and they behave differently.

And some of them are more useless and some of them are more useful. So we don't necessarily want all 17 subtypes, which is what most stem cell types do. That's what we were doing up until a year ago. But as you know, I spent the summer in Japan. And in Japan, they won the Nobel Prize for regenerative medicine, professor Yamanaka for cellular reprogramming, in which we can talk about those stem cells.

But there was another professor, professor Mary Dezawa, who discovered something called MUSE cells, which stands for multi lineage differentiating stress enduring cells. So it's a mouthful. All you need to remember for people is that these are cells.

Dr. Mark Hyman
The muse.

Dr. Adeel Khan
That are muse. Exactly. The muse. The muse is the cool stuff. And they're they're able to they're pluripotent, which means they can differentiate into all 200, you know, and 20 cell types in our body or 2 over 200 cell types, and and they are stress enduring which means they can survive harsh environments.

So that's really the key so they don't die when they go in the body. So we can isolate these using cell sorting technology and filter them out so that we're injecting primarily new stem cells instead of just injecting all the different type of stem cells. And so that's now what we've moved on to and of course you talked earlier about your back and that's what we use for you and that's what we're using exclusively just because the results are so much more consistent and the science makes a lot of sense. And you know I'm I'm in the process of doing some clinical work with professor Dazawa as well and we we want to investigate these new cells for a lot of different conditions but in Japan they've already published trials for ALS, for heart attacks, for stroke, and these are not easy to treat conditions. And and with intravenous new cells you you do see benefits and of course we're seeing that in the real world, treating patients with all sorts of degenerative conditions and actually seeing a real meaningful difference.

And that's just because these cells are actually surviving and doing what they are meant to do, which is reduce inflammation, repair cellular function, reduce oxidative stress. We know one of the biggest mechanisms by which they work is through mitochondrial DNA transfer and mitophagy, which is repairing damaged mitochondria. And I think everyone now knows that mitochondria is so important, not just for energy, but for regulating cellular metabolism and aging. So that's why there's so much interest in this space for longevity and not just orthopedic conditions. And so those are mesenchymal stem cells and then there's also induced pluripotent stem cells, iPSCs.

And that's the Yamanaka stem cells where you can take any old cell and you can make it young again. So, of course, when you think about that, you're like, boy, well, that's great. So shouldn't everyone be doing this? But it turns out when you make that old cell young again, it often makes it almost embryonic in nature, which means it can cause cancer or tumors. So iPSCs, as they're called, or Yamanaka stem cells to honor professor Yamanaka, they're great, but the problem is they're they have the risk of tumorigenicity, and so we don't actually use them clinically yet.

There's a lot of work being done on it but it's still I think a few years away from clinical translation. So that's why the new cells because we know they don't cause cancer and we know they're naturally occurring in our body so they they have a lot more clinical translation than the Yamuna concept.

Dr. Mark Hyman
So these are basically these these different kinds of stem cells and and and the most of the kind in the 1st generation seems like they were getting, you know, an inflammatory effect, but they might not be doing the full effect we had thought they might and why there was variable results. And they get trapped in the lungs. The immune cells seem to be stress resistant, so they hang out more. They have time to do their job more, and they they have the ability to actually, work in a different way because they're they're not, sort of chewed up so fast. And these don't get also trapped in the lungs.

They they are are resistant to that?

Dr. Adeel Khan
Yeah, they so about 10 to 15 times more are able to go into circulation. So there is still some that get trapped in lungs but Professor Jazawa has shown work showing that it's you know, it's not like 2 times more we're talking an order of magnitude, like 10 times more are able to go in circulation. So it is still a big difference compared to standard MSC.

Dr. Mark Hyman
And and, you know, there's there's, 2 kind of uses as you mentioned. The one is injecting it into a joint or a back or some damaged traumatic tissue or injecting them intravenously for systemic effects around really things like ALS or stroke. Those are really, like you said, almost impossible to treat problems. And what kinds of results are they seeing when they do these systemic treatments? And what are the kinds of conditions where it might be applicable for?

Dr. Adeel Khan
Yeah. Look, I just had an ALS patient I treated a couple weeks ago and I was blown away because it was my first ALS patient. I treated with new cells and she couldn't swallow because of the bulbous symptoms, you know? And, now she can swallow, she can speak clearly, she couldn't she was barely able to speak before, and that was just one IV and I mean it was pretty incredible to see. Obviously that's anecdotal but the clinical trial that was done also showed you know some slowing of progression and we all know how devastating ALS is and if if you can for something that can slow down even I think we just don't know the exact dosing for ALS yet but I think for now we I think we can certainly say it can be helpful and it's not harmful and then for stroke we can be much more much more kind of certain that they are gonna have positive results because in stroke, for example, she showed that 30% of patients in the clinical trial were able to go back to full time work when they were disabled.

Like, we're talking patients who are disabled and so imagine you're

Dr. Mark Hyman
So are you saying if someone's in a wheelchair and can't move the side of their arm or leg?

Dr. Adeel Khan
Exactly. Exactly. They're able to go back. Yeah. Exactly.

And they go back to full time work. So that was 30% of people and the other 70% had still had significant clinical benefits and were able to get off, you know, where they weren't necessarily able to return to work. A lot of them were able to get back to like normal functioning of ADLs and IADLs and stuff like that, which is very

Dr. Mark Hyman
good deal. Living. Yeah.

Dr. Adeel Khan
And you know what the the most interesting part was, 25% of the patients in the clinical trial had reversal of gray hair and that was just like an accidental finding.

Dr. Mark Hyman
That's amazing. That's wild. So so what other kinds of conditions might this be up for autoimmune diseases, longevity? Yeah.

Dr. Adeel Khan
I mean, I know it sounds you almost sound like a, you know, like a used car something when you're like this can treat everything you know but it but once you understand the physiology of chronic disease as as you do, you understand that there's certain hallmarks of aging and there's hallmarks of chronic disease that overlap. So I'm not gonna list all 12 of them because I'll bore people but there's basically 12 hallmarks of aging. We've listed a few of them mitochondrial dysfunction, you know stem cell exhaustion, yeah chronic inflammation which is related to immunosenescence and and you know there's lots of protein like protein just there's so many protein misfolding there's so many other ones and so basically these 12 let's call them the 12 hallmarks they they actually underlie not just aging which is you know arguably the most complex chronic disease, they underlie all chronic diseases from from heart disease to asthma to dementia to cancer even, and just components of that that are overlying. And a lot of them are metabolic in nature. And so that's why these stem cells have this ability to restore metabolic health because of that mitochondrial DNA transfer and helping to repair the mitochondria through autophagy.

And then, of course, the mitochondria are the ones that help you regulate metabolism. Right? That's where they have that's where your when you eat food and your body has to process it, it has to go through your mitochondria to produce energy. And if your mitochondria aren't working properly, which is what happens to everyone with aging and chronic disease, then guess what? Your metabolism is messed up, and that's why metabolic disease is really the root cause of so many different problems.

And that's why they call, you know, dementia type 3 diabetes and all this other stuff. Right? Because a lot of them are metabolic in nature, and if you can restore metabolic health, which stem cells can do, then that's why you can treat so many chronic diseases. And that's number 1. And number 2, the other beauty of these stem cells is their ability to regulate your immune system.

So this is called immunomodulation. That's the medical term but that just basically means we're shifting your body from a pro inflammatory state to an anti inflammatory state. So this is called immunomodulation which is reprogramming your immune cells, specifically your macrophages, and if if there's one cell that you need to understand, it's your macrophages. They're probably the they're my favorite cell in the body.

Dr. Mark Hyman
They're like little Pac Man. They like go and chew up all the stuff that shouldn't be there. Right?

Dr. Adeel Khan
Exactly. So they're like your little they're like your little Pac Man controlling and surveilling and making sure the bad guys don't get in and they eat the bad guys when they're around. They they take them away, and they'll they'll dispose of them. But what happens to a lot of Pac Man or police officers that they like to call them is they get fat and tired at with And and then they start eating too many donuts, and they can't do their job anymore. And this is actually called lipid associated macrophages or LANS.

And so they accumulate fat and lipid perioxydation inside of the macrophage, and then they can't do their job anymore and which and their job is so important, and then they start releasing the wrong signals. They start saying so the macrophages start releasing pro inflammatory signals, and then that causes the cycle of chronic inflammation. And that's really the root, as we know of so many disease processes. And that's why if you can treat chronic inflammation, you can treat so many different chronic diseases. And that's why these IV new cells have so much potential.

And I mean, even with IV, let's call it the 1st generation, even with the IV, you know, 1st generation stem cells, there are clinical trials that are published showing that inflammatory bowel disease can get into remission, that rheumatoid arthritis can get into remission, it's just the dosing is quite high and people need a lot of frequency of those, but with the new cells you can get obviously you can get a lot better results but it's the same principle which is you're just regulating the immune system.

Dr. Mark Hyman
That's it's incredible, yeah. So for autoimmune disease and for chronic inflammatory age related diseases for just rejuvenation longevity itself these can seem to be helpful. Well, you know, one of the things I'd love you to explain is, you know, how does stem cells work? Because you kind of alluded to the fact that they don't actually work as we thought they did, which is you inject them and then they go, if you have a liver problem, they become a liver cell, or if you have a kidney problem, become a kidney cell. They just they just have certain compounds inside of them that go out and kind of are in

Dr. Adeel Khan
all these chemical things. So mesenchymal stem cells primarily work through I

Dr. Mark Hyman
mean, just before you kind of go into that, mesem for everybody listening, that's a big word. It means just your body's tissue. What the other kind of stem cells come from umbilical cords or from embryos. We're not doing embryos at all. We're talking mostly about umbilical cord blood, blood that actually has basically baby stem cells as opposed to mine, which are, like, almost 65.

Right? So they're and they're not as antigenic. In other words, they don't tend to cause this foreign reaction. Like, if you were to take I was taking your stem cells. I'd have a rejection of those stem cells as part of my biology because we don't like foreign stuff.

But with these kind of umbilical cord cells, it's not like that. So you can use these umbilical cord muse stem cells to actually kind of bypass that of thing, but actually have the the benefit of these younger stem cells. Right?

Dr. Adeel Khan
Yeah. Exactly. Unfortunately, using your own stem cells, there's many reasons not not to, but the biggest one is definitely they've gone through a lot of replicative stress because they've gone through their own aging process and so they can they can actually have markers of senescence and other even cancer markers as you get older. So you don't want to take your own stem cells and put them in your body especially if you're over age 40. But but anyway yeah back to yeah back to the point about you know what these stem cells are doing inside of your body the mesenchymal stem cells are primarily producing inflammation via this what's called the secretome.

So the secretome is kind of the soup that the stem cells grow in or release and there's signals. So there's micro RNAs, there's what are called cytokines, which are these proteins that that help to reduce inflammation, there's growth factors. So this is all what's called the secretome and depending on what type of sacrotome the stem cells are releasing dictates their ability to change the microenvironment and help with these different cellular processes. So for example, the secretome of a stem cell from your own body isn't gonna be as good as a secretome from umbilical cord tissue. And you can probably understand that intuitively because it's like, oh, yeah, it makes sense.

This my cells are old. They've gone through x amount of cell damage, versus umbilical cord tissue which doesn't and that's why exosomes are such a hot topic because if the most of the benefits of mesenchymal stem cells are due to the signaling process then why not just isolate those signals and inject those and that's what the exosomes are.

Dr. Mark Hyman
Okay. So hold hold there hold there for a sec. The the there's stuff that the stem cells secrete. Right? That's why it's called the secretome or secretome, which is I hate to pronounce it right.

So there's stuff that it squirts out basically in its environment that goes out and does all these good things. And what you're saying is that these inside of the stem cells, there are these little vesicles, these little packets of healing factors called exosomes. And they're maybe where most of the benefit comes from from the stem cells. So you can actually take the exosomes out of the stem cells. You grow the stems all in the lab.

You remove the exosomes. You can concentrate them. They They don't have any DNA material. They're they're much safer. They're less expensive.

And then you can use them also. So so now explain to us what are exosomes? Because that's another part of this whole field of regenerative medicine. We've kind of sort of basically skirted the surface of stem cells. I hope you got a good sense of that, but I want to get into a few other things.

So exosomes are the next topic and and let's kind of explore what are exosomes, how do we use them, and why do they work?

Dr. Adeel Khan
Yeah. I mean, you you kind of just said the definition which is they're a type of extracellular vesicle, which are just packages by which your cell communicates with other cells so they help with cell to cell communication and there's different type of extracellular vesicles so there's something called apoptotic bodies, there's something called mbbs which are microvesicle bundles, and then there's exosomes which are the smallest type of extracellular vesicle. So extracellular vesicle or EVs is kind of the class and then there's different types of EVs and exosomes are the smallest type of EVs And they're basically to help facilitate cell to cell communication which interestingly changes as you age. So exosomes are also becoming a hot topic in diagnostics because it turns out the exosome profile of your cells as they become cancerous or as they become chronic diseases, you can detect certain exosome products because we did have this technology, right, like 5 years ago and now now we do and now we can figure out, hey, the signals your cells are sending are changing. This means that you might be developing this problem.

So that's so that's why exosomes are becoming a hot topic in diagnostics too and then of course in intervention or therapeutics then it makes sense because like you said it's all about the signals that they're that are being sent by the stem cells that dictate their ability to modulate or change the cells in a favorable way. And now the exosomes can be isolated in a lot of different ways that previously it can only be done through you know ultracentrifugation of cells that are replicating. So you have to have cells that are replicating, but now that technology is improving so that you can actually get exosomes from terminally differentiated cells. So meaning even if they're not replicating, you you can you can basically it's called homogenization, which is basically like, you know, you're blending, you know, how you, you know, you blend like fruit to get like the the pulp out and the the juice. It's like taking the juice basically and of tissue and that's the exosome.

So you can do that now with any tissue. So for example, there's people working on natural killer exosomes, dendritic cell exosomes, exosomes from liver, from muscle. So there's so many interesting exosome products being worked on. There's 290 or 281 patents or something like that on exosomes in the last like couple years. So that can tell you that tells you the scale.

Yeah.

Dr. Mark Hyman
There's different kinds of exosomes.

Dr. Adeel Khan
Oh, yeah. So that tells you the scale though. 2 over 200 patents on just exosomes alone in the last couple years. So that tells you the scale and the magnitude of research that's happening right now in this.

Dr. Mark Hyman
Yeah. You know, interesting. I I actually, you know, there's we're gonna talk about some of them in the music's homes, but I I had COVID like many of us out there in the world. And and, after one course of COVID, I got seriously depressed, and I I don't have that as a thing I deal with. And I I felt like it was a physiological depression of inflammation in the brain because we know that depression is inflammation in the brain.

And I felt my cognition was off. I had severe brain fog. I kinda couldn't understand why people would kill themselves. It was a really strange experience. And I had, you know, my higher self was there knowing, hey.

This is just your COVID talking. And, I was able to get some exosomes and inject them intravenously. Almost like instantaneously, it went away. It was quite striking. I was like, wow.

You know? Like, this is quite an interesting tool. And I also had back surgery 4 years ago that went badly, and I had bleeding into my spine and had severe just pain afterwards for months. And I saw a regenerative medicine doctor before before I knew you, and I and I had Matt Cook, and I had exosomes injected right up into the spinal canal through the bottom of my my, spine. It's called a caudal epidural, essentially, of exosomes.

And, it just within, you know, really almost minutes, I was feeling dramatically better. And so I began to kind of understand by using some of my own body with my own degenerative arthritis, with all the messed up things that are going in my back with the discs, with the the the inflammation that these products actually really help relieve this chronic pain that I've had for so long. And it was really striking to me because I I, you know, I didn't know that this was possible just with with these simple therapies. And and, yes, it's anecdotal. And the the problem with stem cells is that they they've been a neglected area of research in America.

There are people doing it in academic centers, but it's it's kind of on the margins. Traditional medicine hasn't recognized it. You have to go to other countries like Mexico or Costa Rica or Panama or Dubai or Japan or wherever. Yeah. You get all

Dr. Adeel Khan
the places I work or Lithuania is other place we work now.

Dr. Mark Hyman
Yeah. Albania, whatever.

Dr. Adeel Khan
Yeah. Seriously.

Dr. Mark Hyman
So and it's and and so we're often sort of trying to find solutions for people. People and I have to send them other places if they want to try these things. And it is it's still sort of, I would say, in the experimental phase. There's there's concerns about certain risks of it. There's more data needed, but I would say, you know, when you're in pain, you don't really care about what the randomized control trial says.

You just wanna be out of pain. And if something can help, you could try it. And a lot of athletes use it. A lot of people in professional sports use it. I know you work with a lot of professional athletes.

And these regenerative compounds, whether it's, stem cells or exosomes or peptides or other even compounds like placental matrix, which is kind of mashed up placenta, which I found incredibly helpful for pain relief. All are available, and there's there's other kinds of things that are also being used systemically under part of regenerative medicine, including cord blood plasma, which is the fluid the cells run-in. There's gene therapies that are available to help improve muscle, for example, like fulvestatin. There'll be clothogene therapy, which is another sort of longevity gene that's there that some people have, some don't, but you can actually provide it into people through different vectors that actually then can activate it and turn on these longevity factors. So it's a really extraordinary field, the medicine.

That is, I think, going to be the future. And I I think it's not really available widely because it's it's hard to get to. It's expensive. Where do where what other tools besides sort of the exosome, which you can use, by the way, systemically or you can use them, you know, directly into a injured area. What what are the other kinds of things you're seeing are being effective?

And and talk a little bit about the Muse exosomes because I think these are special sort of like special forces. I think of these like these special forces and the, you know, the, Navy SEALs and the Army Rangers, the great braze of stem cells. Right?

Dr. Adeel Khan
Exactly. Yeah. There so, yeah, a few things. First thing I would say just because you touched on a little bit was there's a lot of politics limiting regenerative medicine's ability to really get mainstream in US. And interestingly, Japan has the opposite politics, which is that because of Professor Yamanaka, they they spent $8,000,000,000 of taxpayer money on regenerative medicine and they have lobby they have lobbyists for regenerative medicine.

So it's very different environment that's actually favorable for regenerative medicine And unfortunately, the US has taken a really archaic stance to the point where they regulate exosomes, which is an acellular product, meaning it doesn't have any cells like you said, no DNA material and therefore we know it's very safe. They're just signals that stay in the body for minutes to hours and then you know they're they're more or less they're gone and then but they help to change the microenvironment and help to change the functioning of cells. And so the safety is so high of exosomes but FDA has decided to regulate it like a drug And so therefore, an FDA has still not approved any any drug or any exosome product. So technically, you know, I mean, obviously, there's so many clinics offering it, which is very interesting, but technically none of them are FDA approved. So it's just something to understand the regulatory environment.

I don't agree with it, but that's the world we live in and that's why people have to travel offshore unfortunately, and that's I I think that's gonna that's gonna be the way it is for the next few years. It'll take a while before, you know, even if someone like us gets FDA approval for the MUSE exosomes, it takes it takes 7 years, you know, 5 to 7 years. You just gotta you have to go through the phase 1, the phase 2, the phase 3, the post market, like you have to go through all that. And even then you may not get FDA approval and so they they've really made it difficult for regenerative medicine which doesn't make sense but

Dr. Mark Hyman
but yeah. Other countries are other countries are moving forward, right?

Dr. Adeel Khan
Oh yeah, exactly. US is being left behind US is being left behind basically and so Now

Dr. Mark Hyman
the data is and how strong is the data around these things? Are there

Dr. Adeel Khan
other clinical trials Well, it's always about safety. Safety is always number 1. Exosomes are so safe, and even, you know, mesenchymal stem cells have so much safety data around them too. It's always about first do no harm and this stuff does not have harm and so why not try it as an alternative to opioids or to surgery for chronic pain especially right? Like it doesn't to me it baffles my mind but it's very clear unfortunately do you know what the most profitable drug now is?

Dr. Mark Hyman
Ozempic?

Dr. Adeel Khan
No. It's actually methotrexate. It made it made something like $26,000,000,000 last year. So it surpassed it surpassed statins. So Methotrexate

Dr. Mark Hyman
which is a chemo drug but it's used for autoimmune disease. So you're saying it's the autoimmune rise of autoimmune disease?

Dr. Adeel Khan
It's an epidemic of autoimmune conditions probably related to toxins in the environment probably COVID maybe you know everything else that's going on in the modern world and so it's just an epidemic and you and I both know you can treat many of these to suit nutrition and lifestyle, but most doctors don't know anything about that. So so of course, they're just prescribing medications and we know these things. Wouldn't you rather be on something that's gonna regulate your immune system and fix it than just suppress it which may cause cancer, right? Like it doesn't the risk benefit, it just makes no sense, you know? And and I think you always have to look at what's called number needed to treat versus number needed to harm and that's essentially just a fancy fancy way of just saying benefit versus harm and if you look at that for a lot of the pharmaceuticals it's not that great.

You know it's like for statin medications the number needed to treat is not it's not one to one meaning not every person who gets their life is going to be safe from a heart attack. It's something like 1 in 200.

Dr. Mark Hyman
Yeah. You have to treat for for people for preventing a heart attack, you have to treat, 89 people to just prevent one heart attack and death. But, you know, it's it's quite it's quite amazing. It's not really good data on how effective these are. It's like so talk more about why why you brought that up.

Dr. Adeel Khan
Yeah. Because to me, then you have these interventions that we're seeing that are reducing inflammation, oxidative stress, that are helping with so many different chronic diseases, and they don't have harm. So why not have them as a first line as opposed to going straight to a lot of these pharmaceuticals that have risk? And and and that that to me is kind of the logic and on your note of muse exosomes the reason they're superior to standard exosomes is simply because they're from that muse cell lineage. So when muse cells are replicating and when they're growing the soup that they're growing in we're that's what we're isolating which has the signaling profile meaning that secretome which we talked about earlier is superior than just a standard mesenchymal stem cell.

So it has a better profile number 1 and number 2 because it is from a stress enduring lineage too meaning the exosomes can stick around longer than a standard exosomes which it cleared up pretty quickly.

Dr. Mark Hyman
So so like what is the difference between stem cell use and exosome use? Like some people say, oh, you can use to use exosomes. You don't need the stem cells because it's actually the exosomes that are doing all the work. So why bother with the stem cells? It's more of a hassle, more expensive.

Dr. Adeel Khan
Yeah. That was that was my take. Until I had the new cells, that was my take more or less. I would only use the stem cells in very specific situations, but now that's changed because the mu stem cells are actually pluripotent, which means they and they mu stem cells are very interesting because they act kind of like macrophages. So they actually eat, they gobble up damaged cells and then they turn into the new tissue.

So they'll, for example, in the heart, they'll go to the heart, they'll each, they'll eat the damaged cardiomyocytes, so like damaged heart cells, and then they'll actually regenerate new cardiomyocytes. So it's they're actually pluripotent right and that's the key difference because they're not just reducing inflammation and that's why new stem cells are of course more powerful than used exosomes because they're actually going to regenerate new tissue versus just reducing inflammation which is what the old generation stem cells used to do and that's why when I was using the old generation stem cells I was kind of just using exosomes for the most part because I didn't see the point because I'm like you're just really reducing inflammation. But now that we have something that's pluripotent, if I'm injecting it for something degenerative and I actually want to regenerate something new then I'm going to use the stem cell. So for example with advanced osteoarthritis, if we want to actually stimulate cartilage regeneration using the new stem cells makes a lot more sense, but if you just want to reduce inflammation then you can just use the exosomes.

Dr. Mark Hyman
So so you kind of have to you use both of them in practice and there's different uses for different people depending on what the issues are they're struggling with.

Dr. Adeel Khan
Yeah. And there's studies out there showing that the exosomes can create a micro can create a favorable microenvironment for stem cell differentiation and for stem cells to do their job basically. So that's why I tend to just combine them because the exosomes are only there for like minutes to hours you know like we said like they're cured up pretty quickly But then they what they do is they go in there, they reduce inflammation, they make it a better microenvironment so that the stem cells can do their job more effectively.

Dr. Mark Hyman
And and there's other kinds of tools out there with regenerative medicine, that I think are really emerging and interesting. And in terms of the orthopedic part, you know, you can inject peptides, you can inject stem cells, you can inject exosomes, you can inject placental tissue. We call it placentamatrix. You know, what are all the kind of things that you tend to use and inject to help with these these kind of orthopedic chronic injuries and how and what kind of results are you seeing?

Dr. Adeel Khan
So the results since the new stuff has been honestly incredible and as a physician you always want your patients to get better and now we have much more consistent results. With the with the older stuff the results are a bit more inconsistent meaning some people would get better you know some people wouldn't and whereas this stuff just tends to be reproducible. And the way we do it is it's still very specialized. Right? And this is the problem too.

There's so many stem cell clinics that they don't know how to inject properly. I'm you have to you have to have a very high skill level. You can't just yes. There is a certain homing mechanism, but at the end of the day, the the the treatments are gonna work better if you get them to where they need to go. So for example, if you have a rotator cuff in your shoulder and you don't get the right spot, your results aren't gonna be as good as getting it right in the right spot.

So, and that takes a skilled, that takes a very skilled, you know how it's skilled, you have to be very skilled at ultrasound and you have to have a high level of proficiency to be able to do that image guided injection. And so that takes years of training and and then on top of that, you have to know which products to use. So I I think people don't realize this is a very specialized field. It's not like anyone can just do it, despite a lot of people just offering stem cells. You know what I mean?

A lot of people are like, yeah, I do stem cells. It's like, well, you can't it's not it's not just like you can't just like do that. It's like doing to me it's like almost doing surgery. It's like I don't just do surgery just for the sake of it,

Dr. Mark Hyman
you know. And you can do intravenously anybody can do that but when you're trying to direct it to specific tissues or injuries or spots Exactly. To hit that spot.

Dr. Adeel Khan
Yeah. And so the image guidance is very key to it. And the results for musculoskeletal conditions, chronic pain, even neuropathic pain, has been it has it's very consistent. Meaning, the only patients that I find that don't get better usually just need a second treatment or sometimes a third in very rare cases. So it's just a dosing thing.

We don't know the perfect dosing for everyone, but we're starting to learn that more and more now.

Dr. Mark Hyman
The dosing of the stem cells or the exosomes?

Dr. Adeel Khan
Yes because some people respond great to one treatment and some people need 2 treatments and we don't really know why.

Dr. Mark Hyman
Now, can you talk a little bit about, gene therapy? Because this is an emerging area of of treatment. Most people have probably never heard of it, but I mentioned them a little bit before, like frolostatin gene therapy or clotho gene therapy. What what are these therapies? How do they work?

You know, what is the science behind them? And, you know, what are the risks? And and what are we seeing in terms of the benefits?

Dr. Adeel Khan
Yeah, so I work with a company called Mini Circle and Mini Circle has the world's first reversible plasma gene therapy. So what that means is it's basically a way for us to transmit any gene of interest up to a certain size to your body. So for example, if there's a gene like follistatin, which is a bio identical peptide hormone in your body, and we want your body to produce more of that, we can put it onto this mini circle vector. We call it mini circle because literally it's like a circular grand strand of DNA, and you insert that follistatin gene onto there, and then you can inject it and then that will transmit it to your cell and tell your cell, hey, your cell will now read that instructions and then it'll say, hey, I need to produce more follistatin. And then follistatin goes into the blood and you raise your follistatin levels.

And that has all these downstream benefits, which we can talk about in a second. But the vector is what people need to obviously is, you know, probably being like, holy, what what was what is he talking about? Right? The vector It's kind

Dr. Mark Hyman
of scary. You're like, what are you doing, like Yeah.

Dr. Adeel Khan
Exactly. Are you modifying are you modifying my DNA? Are you

Dr. Mark Hyman
a g are you a GMO human?

Dr. Adeel Khan
Yeah. Exactly. Yeah. So it's not it's not as it's not as, you know, advanced as CRISPR, you know, which is kind of the gene editing technology where you're actually like cutting out different strands of DNA and kind of putting them back together. This isn't as complicated as that.

It's not as powerful as that either, but it it it is still a form of genetic modification because we are inserting a foreign DNA into your body. Where does that foreign DNA come from? It comes from E. Coli. So we're not injecting bacteria into your body, but we're injecting something called plasmid.

The plasmid is kind of think of it like exchanging cards with people. It's how bacteria exchange information. So we're isolating that plasmid from the E. Coli and then we're using that as a vector. So plasmids have been around in microbiology for you know 2, 3 decades.

They're not new but the new breakthrough was just getting the plasmid to not shut off because normally when you put a plasmid in the human body your cell it does something called transgene silencing which is just says hey this doesn't belong here I'm gonna shut you off and then it just shuts it off and then but we figured out a way for it to keep remain on, specifically to express whatever gene of interest we want, which obviously are longevity genes. We're not going to put something in your body that's not useful. We're going to put something in your body that's going to have some real longevity benefits. And follistatin has been studied again for 2 decades. Follistatin is something your body makes.

It it it's basically a way for your body to put on more muscle because the higher your solistatin, the lower your myostatin, which is basically imagine the brakes on your muscle. And so if you take the brakes off a little bit, it's not like you're gonna get jacked like the antibiotics, but it will make it a little bit easier to put on muscle. But much more importantly, and this is why I like olastatin, it's very anti catabolic. Right? And because as you get older, especially after age 60, your catabolism increases, like, exponentially.

Right?

Dr. Mark Hyman
So what is catabolism ideal?

Dr. Adeel Khan
So basically yeah. So if there's anabolism and catabolism. So anabolism is building building more tissue, and catabolism is what happens with aging, which is loss of tissue. We actually lose I forgot the exact percentage, but we lose some, like, you know, very large percentage of our total tissue mass as we age. And that's loss of mitochondria, that's loss of muscle, that's loss of bone density.

So we lose a lot of tissue as we age. And so if you can maintain as much tissue as possible, that's gonna be a net positive thing and especially muscle tissue because muscle tissue is the most metabolically active. It has all these protective cytokines that are released called myokines that, you know, turn off tumor suppressor that help prevent cancer, help with diabetes. I'm sure most people know about the benefits of muscle and anything we can do to help preserve that, I think is gonna have a net positive effect on your health. There's obviously a lot of people get concerned.

They're like, how do you know this is a 100% safe? Because it's new. It is new, obviously. And and and I'm not saying there's not enough long term data to know is it gonna do something to you 20 years from now. We can't say that for sure, but what I can say and the reason I'm a believer in it and the reason I've done it for myself and obviously patients and and many I've I've injected hundreds of people with it.

And the reason is because and the reason patients like it too is because the net positive of having more muscle and having reduced systemic inflammation, which is what follistatin does, to me is gonna outweigh any theoretical risk that maybe we don't know about. But I think it I think it's unlikely anyway because we understand how follistatin works.

Dr. Mark Hyman
So let me just break this down because that was a lot. So first of all, just to make sure I understand, you can insert into your cells through something called a plasma, which essentially is a communication vessel that can then take a gene that produces a certain protein. And and it's something that you normally would make, but you don't make as much of as you get older. And so the the you don't have the benefit of this molecule at the same level you had when you were younger to build muscle. So you can insert this gene that produces this thing called follostatin, which then inhibits, the thing called myostatin, which then myostatin is the thing that prevents you from building muscle.

So that's why as you see people get older, they lose muscle, they look more frail, they don't have as much, you know, bulk, and that's because they're having lower levels of this follistatin. So by actually putting it in your cells and having, like, a little factory to make extra follistatin, you actually can stop this process where you which prevents you from building muscle as you get older. Is that is that right?

Dr. Adeel Khan
That's exactly right. And it's it's one of the drivers, but that's a great, great summary. Yes.

Dr. Mark Hyman
So so so is there a risk of inserting this gene from who knows where into your body that because it sounds scary. Right? If you oh my god. I'm gonna get some

Dr. Adeel Khan
Yeah. I mean, what if the gene what if the part of like, some of the risks, for example, in theory could be what if what if the vector that we're using migrates, what if it goes somewhere we don't want it to go? But plasmid vectors are very well studied and very well kind of documented how they work and they have a very high you know, they have a high safety profile because they're very inert. Meaning, they don't stimulate your immune system. They don't caught they don't have any, you know, known serious risk, but there are vectors, for example, so people can understand, like, what is with the vector.

For example, when they use the COVID vaccine they use something called a lipid nanoparticle vector, LPV. But the LPV, if you read about LPV, the vector that they use unfortunately can migrate and that's why some people get myocarditis or pericarditis and and and the vector can also be immunogenic so that's why it stimulates some people's immune system and that's why they get autoimmune conditions and and it's and that's why we know now neurologic

Dr. Mark Hyman
conditions. Exactly,

Dr. Adeel Khan
we know that the vaccine actually has some harm then more than we probably thought when it first came out And so so basically the plasmid vector though as compared to like a lipid nanoparticle vector is a lot safer just just for comparison.

Dr. Mark Hyman
It's incredible. So so there's really 2 that I've main gene therapies that I've heard about. 1 is follistatin, which is is around and available now when you go offshore. You can get it. Not cheap.

And then there's this new emerging technology around the clothogene. Now can you tell us about the clothogene, clothogene therapy, where we are in the research, and what it does and and actually how, we're maybe gonna be able to use this clinically soon?

Dr. Adeel Khan
Yeah. So, colto is a really, really interesting peptide because the the word itself comes from the Greek of saying the one who controls the threads of life, which is a bit dramatic, but basically but basically it's like woah holy what does this also do? Does it control my life? Yeah well yeah what they thought what they realized they found this accidentally in some animal research, and they found out that animals that had higher levels of colto lived 30% longer, and then they've seen similar data in humans of people who have higher levels of colto naturally not only live longer, but they're protected against dementia even if they have the APOE4 gene, which is super interesting. And then it can actually help with kidney chronic kidney disease too.

So the two levels where most of your clotho is produced is your brain and your kidneys. And so those are the 2 main medical indications which colto is being very very like looked at like there's a lot of research going on right now and there's a lot of biotech companies looking at colto. But our platform, I believe, has the most applicability just because of the ease of use and obviously being able to just give it same technology through a plasmid vector which is just an injection in your arm or your stomach and then optimizing your coltula levels. Aculto is more definitely more high risk than follistatin because if you're you don't want your coltal levels to go too high either. If follistatin levels go too high, it doesn't really have any harm.

It just saturates and there's not really much that happens. But coltal, if your if your coltal levels go too high, it can cause your PTH to go down and it can it can kind of mess up your hormonal system and there could actually be other detrimental side effects. So colto is definitely exciting but I think we're still, you know, at least a year, a year and a half away before, you know, after the clinical trial that we're starting now, before we can start offering it to people. I'm gonna be doing it on myself actually next month, so I'll keep you posted.

Dr. Mark Hyman
Oh, wow. Very well. I hope you're okay. It just it it caused some level of something to go down. What was that you said?

Dr. Adeel Khan
PTH, parathyroid hormone.

Dr. Mark Hyman
Parathyroid hormone. Right.

Dr. Adeel Khan
So you have to monitor so you have to do blood work for that. Yeah.

Dr. Mark Hyman
So so this what did this do? Because it's, you know, the the follistatin seems really clear. It just prevents the breakdown of muscle. What does clotho do biologically?

Dr. Adeel Khan
So it activates Wnt genes which are these regenerative pathways. The Wnt gene pathway is kind of well known for being one of the more important ones that a lot of different regenerative molecules work on and Clotho helps with that too. So it can facilitate regeneration and repair as well. And it can also, in terms of in terms of helping with neuronal death, so there's something called, the intravated stress response, which is what your neurons when they are under stress, they have this stress response called ISR and colo can help to mitigate that so there's less neuronal death. And that's why it can help with various that's why there's so much interest for so many different neurogenic conditions.

Dr. Mark Hyman
Mhmm. And and so this really fascinating kind of field of different things that we're discovering that the body has built into it innately, whether it's certain proteins it produces or stem cells or whether it's, you know, peptides. And the the the there seem to be kind of this explosion of research in this area. I mean, Ozempic is a peptide. It's not one of the biggest, sort of, most profitable drug in history, I think.

But it's it's, it's just something that the body naturally makes. A GLP one agonist is something the body naturally uses to regulate its function. And so a lot of these compounds are talking about are being explored, which are actually helping activate the body's healing repair system by using these different compounds that come from different sources. And we're still sort of sorting through what works, what doesn't work, what the research is. You know, do when do you feel like this is ready for prime time?

I mean, this is gonna be covered by insurance that health care because right now, it's not accessible to most people. The price is so high. I mean, I remember I bought my first computer in 1988. It was a Mac SE 30, and it was $35100 for 4 megabytes of hard drive and 1 megabyte of RAM on a floppy disk. You know?

And it was like this tiny little black and white screen. And now, you know, you I get my iPhone, which is, you know, probably have more computing power than what took the men to the moon for the first time. Right? So how how are we looking at this field in terms of, you know, the the the research advances, when it's gonna be clinically kind of more widespread and when the costs are gonna come down?

Dr. Adeel Khan
Yeah. So the costs will come down and then I I believe in the net really, like, not we're not talking like 10 years. We're talking within the next 5 years because we're very close to this kind of automation and of manufacturing. There's a company in Silicon Valley that actually just just started that's and they're doing well. They basically figured out how to automate cell manufacturing using robotics and so using using that plus bioreactors which allow you to grow a lot more cells a lot quicker will significantly reduce the cost of manufacturing these cells and obviously if the cost of manufacturing goes down then the cost of the consumer goes down.

But then there's also So

Dr. Mark Hyman
like they do it's almost like that you know to get rare diamonds it's hard but now they make these artificial diamonds that Right. Exactly.

Dr. Adeel Khan
Exactly. Yeah. And so that's so that's that's the first thing. And then the the the second thing is there's economies of scale, which just means as more people do it and there's more demand, then obviously you can lower the pricing as as there's gonna be more people who are willing to do this type of treatments at a lower price point. And that's one of the things, you know, I'm at I'm very adamant about making this stuff accessible to the average person.

And the only way that's gonna happen as you as you just said is there has to be early adopters. Right? You bought a Mac in 1988 and probably not many people had a Mac back then. So it's like, but there's gonna be early adopters for every technology just like, you know, I was an early adopter Tesla personally. I bought an electric vehicle before anyone else really did, and I was I was and but now it's becoming much more common.

And so I think it's gonna be the same thing with this where it's like, okay, there's gonna be the early adopters. There's gonna be people who are more into this stuff. And and also, I think the way to think about it is if if you have the means to do this stuff, you're kind of you are paving a better way, for a future of people because we're at least our company, you know, we're we're investing all of our profits back into r and d and trying to push this field forward and trying to really make a difference in regenerative medicine, you know, as opposed to just trying, you know, as opposed to just kind of using it for, just for profit for yourself type of thing. So that's why I'm and but the but the only way to push this bill forward is you have to, at the end of the day, do controlled clinical trials, because that's the only way you're gonna get insurance companies and regulators to buy into this. And that's that's the long game.

But by being able to offer these offshore treatments that people are willing to pay for and people actually get real results for, they're funding our ability to do the research, which ultimately will be used as justification for regulators to approve it, which I think will take probably 7 to 10 years, you know, in terms of getting approvals for specific medical conditions. Like, I think osteoarthritis for example is not very far away. We're already getting incredible results with the mu cells and hydrogel scaffold which is kind of you know like a jello that protects the stem cells allows them to stay there so they don't migrate and and the results are incredible and you know just before I came on this call with you I was talking so we're working with a company that's making custom scaffolds using 3 d bioprinting and that can actually resurface an entire joint And that's that's they've already done that in large animal studies so the human trials are next and that's what we're going to do and you know so this stuff is not that far away.

Dr. Mark Hyman
So this whole field of regenerative medicine is definitely, super exciting to me because it's it's it's always what I thought of in functional medicine, which is how do we use the body's own healing power to get better? How do we just get rid of the things that are causing harm and adding in the things that are supporting the body's own repair and healing? And so now we have all these exploration of, these biological products that were not have been discovered really over the last decades that now are being used clinically. And and there are these sort of longevity enthusiasts or, you know, athletes or kind of early adopters who are starting to use it, including myself, and and seeing, you know, quite significant benefit. Do you do you see this becoming part of, like, mainstream health care at some point?

Yeah. I mean,

Dr. Adeel Khan
look, in Japan, I keep bringing up Japan because they're just so far ahead of us, but in Japan they actually cover intra articular stem cell injections for knee osteoarthritis and cartilage defects. And so and those are culture expanded stem cells and so you know the fact that the reason I bring Japan up too because it's not like Colombia or Mexico or Panama you know some random country that doesn't really have a any sort of developed economy and like rigorous like Japan Japan has like rigorous standards like they're very meticulous with everything and so so to me the fact that they're able to approve not only approve it but actually have insurance companies reimburse people already, just shows you like what's possible. But I think America there's just so many politics right and and the politics unfortunately affect the ability for us to offer these to patients and what I believe is a solution is personally you know if our company becomes big enough I'm gonna get some regenerative medicine lobbyists and you bet you bet you I'm gonna get I'm gonna get them to start lobbying for us because I think that's the only way to really get this stuff moving in the US.

Dr. Mark Hyman
Yeah. I mean, so are there there are there seem to have probably a lot of companies involved in producing different products and compounds, and and there's a lot of money going into this. But is there a lot of funding of research on regenerative medicine and who is this something coming from governments? Is it coming from private insurance?

Dr. Adeel Khan
Well, no, it's that's a problem, right? Like, that company I was just talking about, for example, a 3 d bioprinting company, they got they got a NAS national NIH grant, you know for $18,000,000 they're able to do some animal studies and some preliminary phase 1 stuff but now they're hitting a roadblock because obviously they have to they need more money to do more trials and it's so expensive to do clinical trials in the US that you and they can't get any more money from NIH. So basically, they have to go to DC's venture capital or private equity and try to raise money and they're having they can't get it. It's like too hard because they're biotech and it's high risk and yada yada yada. And so it's really hard for these regenerative medicine companies to fund and find money and to and honestly, that's that's actually been my strength is I'm good at finding technology, and I have I have a good network, and I'm able to help, like, the new cells, for example, professor Gizawa, unfortunately, hasn't had the, you know, she she she had funding, but then lost her funding because of, again, politics, and but I'm able to, you know, help her with that stuff, and I have and then obviously, I have marketing and other resources.

And so we can and that's that's kind of my, I guess vision with this stuff is being able to actually drive this stuff forward by doing the controlled clinical trials of very promising technologies that I believe that you know based off the science I think are gonna be a huge part of the future of medicine.

Dr. Mark Hyman
Yeah. It's pretty it's pretty it's a pretty exciting moment. I mean, we're we're seeing the, you know, the advances in health care medicine happening so fast, but just the sad thing is it often takes decades between the discovery of something that works and actually having it end up in the doctor's office or your clinic. And and and, you know, you you created an incredible,

Dr. Adeel Khan
setting up. I think that's gonna change thanks to social media, funny enough because alternative media is becoming more and more popular. And I think people will demand that their doctors or people know that, hey, look, I deserve to have this as an option, you know? And I think that's what it comes down to. Patients have the right to have all their options explored and especially options that are safe and can be just as effective as surgery.

So I think it's it's you know it's unfair to patients to not be able to for the doctors to not even know anything about this stuff and not be able to have a conversation with their patient about it just because they don't know unfortunately they don't know anything about regenerative medicine And just because, I mean, you and me don't learn anything about regenerative medicine in that school. Right? So there was no education.

Dr. Mark Hyman
No. That's amazing. So so, tell us more about how people can find you, about your clinics, where they are, because maybe people listening wanna go try it out. So how do they how do they get in to learn more about what you're doing?

Dr. Adeel Khan
Yeah. Well, I'm in I'm in Dubai now, but we do have clinics in, Los Cabos, Mexico, which is probably closest for most of our US patients and then we have a clinic in Europe and then we have a partnership in Tokyo as well. And then maybe, Mark Hyman and I may maybe we'll have something in Abu Dhabi soon, but, but, yeah, our web our company is called Eterna, like Eterna without a l and eternal dot health. But my Instagram, I have a t you know, I'm very responsive on there and it's at dr.akhan, k h a n, and I try to be as helpful as possible. I I've we've helped many patients with chronic diseases and, you know, sometimes we know affordability can be an issue and we do try our best to help those patients with hardship pricing and stuff like that and so it's not you know it is expensive but we are also we are are trying our best to work on that and also starting a foundation to help cover those costs for like you know for veterans and for people on disability and stuff like that.

Dr. Mark Hyman
That's amazing. So we'll we'll put the link in the show notes to your website, which is interna.health and to in social media so people can find more about you. We'll link to some of the sort of research that we've talked about. And and it's just it's an incredible field. I just can't wait to see where it's going.

And for me, as a guy who's, coming up on 65, I'm like, thank god. So I think, you know, getting all the old injuries kind of fixed up and keep moving up so I can keep skiing and playing tennis and climbing mountains and having fun. So I I really appreciate the work you've done, your your enthusiasm, your dedication to thinking about this, to learning about what's on the on the leading edge, trying to sort of navigate a very difficult and complex world. And, I know we'll be hearing more about this from you in the future. So thank you so much, Adeel, for being on the doctor's pharmacy podcast.

Dr. Adeel Khan
Yeah. Thanks for having

Dr. Mark Hyman
me. Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts. And follow me on all social media channels at doctor Mark Hyman, and we'll see you next time on The Doctor's Farmacy.

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