November 12, 2024 • 26 mins
Lorenzo Thione is an entrepreneur, expert in Artificial Intelligence, a celebrated storyteller. and Broadway producer four-times nominated for and twice winner of Tony Awards. For someone so busy, it’s remarkable he finds the time to stay as laser focused on his health as he appears. But is he really doing all he could to optimize his body? In this episode of Healthy Longevity, Dr. Comite analyzes Thione’s recent blood work to see if his biomarkers reveal he’s as healthy on the inside as he looks on the outside.
You’ll learn…
-
How Thione, a technology expert and self-quantifier, uses wearable devices and other health data point to inform his lifestyle decisions.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
christopher quindes (00:10)
(00:01):
Hi, and welcome to the Healthy Longevity podcast. I'm your host, Dr. Florence Comite. I'm a practicing endocrinologist and precision medicine physician and founder of the Comite Center for Precision Medicine and Healthy Longevity. For those of you who've not tuned in before, welcome. And I'm really excited because today we have a fantastic guest and we're gonna be drilling into biomarkers, a term that's become very popular.
and showing why it's so important to see what's going on at the cellular level below the surface
I'm delighted to welcome to the podcast, Lorenzo Thione It's great to see you and thanks for joining us on the podcast, Lorenzo. Hi, Florence. It's great seeing you. I'm happy to be here. Excited about this conversation. Excellent.
A little bit about your background because it blows me away. You're an investor, a serial entrepreneur, and a distinguished expert at the intersection of artificial intelligence and technology, storytelling, and social advocacy. That's incredible. It's like you're a man of the world and of the future here. Where we're going. Yeah, or I have ADHD. I don't know. But...
It's just, you know, this gravitating towards things that kind of give me pleasure and joy and learning opportunities for learning and throughout my life, there have been a lot of different such things. And yes, I've been working in artificial intelligence for longer than most people kind of even expect.
Well, the people that are in the field know that it's been around for a very long time, but most people that have gotten into AI today kind of expected, you know, that it's coming out of nowhere. But in reality, I started out my career as an entrepreneur and founder in the artificial intelligence space, you know, transitioned over the years, started multiple businesses and continued to be a very engaged investor, speaker and sort of, you know,
always student of the incredible advances that we are making and have been making in this field.
You know, I was that student in middle school who loved graphing sentence structures and then paired it with my passion for computers and computation and algorithms and.
started a company in 2003 called PowerSet, which at the time we weren't even saying was doing artificial intelligence because coming out of the late 90s AI winter, so many commercial efforts had not panned out. And a lot of investors and a lot of people in the field had diffidence and skepticism and kind of considered AI mostly as a research project. So we were
describing it as an attempt at building the first or one of the first natural language powered search engines. And we were fortunate to assemble an incredible group of scientists and people, world -class experts, build some really fantastic technology, even though we were early, at a time when computational cost was very expensive and some major technical breakthroughs were still kind of a few years away.
but ended up selling the company to Microsoft. We were acquired by Microsoft and became a part of the early versions of the search engine Bing .com.
But I never lost my passion for operating businesses and starting businesses and I ended up pairing that with another passion which has always been kind of the ability to tell a good story and to excite and move someone to your side of the argument or to your
way of thinking. Yeah, to your way of thinking.
and you didn't even touch on the part of your career that you're an advocate for inclusion. We heard you were born in Italy. I think it was Milan and you completed studies at the University of Texas at Austin.
You hold degrees in computer engineering and not only did you do AI research and technology as a baby almost out of college. So you were barely 20, but you're and the co -founder of, I think it was PowerSet, And so that is fantastic. You're way ahead of it.
I know currently you serve as a managing director of GainsGel where you oversee the artificial intelligence and sustainability investment practices. It's a leading LGBTQIA investment syndicate and one of the most active private investors in North America.
So I'm out of breath now. One question, and I wanna make sure that you do sleep.
Sleep is definitely one thing that I have paid a lot more closer attention.
I'm fortunate, I've always been able to fall asleep very, very rapidly. I've never had a problem falling asleep, but I probably lived for the first two to three decades of my life with chronic insomnia effectively or excessive sleepiness during the day, effectively feeling like, you know, if I am at a lecture or at the theater or at the movie theater or watching TV or God forbid driving,
you feel like you're so groggy and snoozing. And that is first and foremost an indication that you're not getting either enough sleep or enough good quality sleep. Yeah, well, let's dig into that a little bit later because I think there may be other aspects of it, like your microbiome.
We haven't even touched on, and I'm going to just mention that you're a celebrated storyteller, which I know is part of your strength, four times nominated and twice winner of the Tony Award for your work on Broadway. You've had multiple productions, including The Inheritance and Allegiance, a musical you co -created and produced. It's just amazing what you've done, really. I'm blown away.
(00:22):
So I'm delighted to speak with you and I wanna talk specifically about your biomarkers.
And I know you've been followed pretty regularly and you're on your own course of treatment. When we first got your biomarkers, it was evident that there were some
findings that showed me that you were actually taking supplements, you were taking medication, and I think you did it in the hopes to protect your health and be as strong as possible. And it looked like you were fairly successful at that. There remain some questions that I want to dig in today, and then if we have time, we can talk about the follow -up biomarkers that you attained. I think - For sure.
Is that good? Yeah. The one thing that I've always been, and it's part of my propensity also for technology, is data is so important. It's always been so important. I think it's the most important decision support that you can get. There's a funny quote I often like to reference, which is, if you have data, let's look at the data. If all you have is opinions, let's go with mine.
But it's true. And so being from the very beginning as more devices and more tests have become available to the interested consumer to self -quantify, measure various part of your biology or of your metabolism and so on, those have always been things that I've wanted to experiment and try to integrate into the decisions, either behavioral changes or supplementation protocols that I make.
And I think that's great. I think to me it falls under the trial and error approach where as long as you're rigorous about it and you can make changes one at a time, you can see and maybe perceive what's going on. Reading the data, however, is completely a different talent and being able to cross the systems in your body from your brain to your heart, to every aspect of your health.
is also critical, because I think what's really missing is the understanding that, for example, testosterone affects the brain, cognition and memory. It's not just about sexual function and energy. It also affects the heart.
So let's start in with how we approach thinking about this. We first want to understand your health story. Where do you come from? Family history to me is the emergence of genetic factors that are relevant to your family. And so whereas 20 years ago, I used to think family history was a poor man's genetic test, I actually weigh in a lot heavier with family history because genetic.
variants or changes in genes or the genes themselves do not dictate in the same way as a family history. So the two to me are separate yet synergistic. In your case, the family, yeah, it makes sense, right? So now I - It has an impact. So if you and your parents grew up in a similar environment and you were exposed to behavioral and environmental stimuli that
you know, came from your upbringing and your parent and your family, there is a connection that is epigenetic that is not necessarily grounded in the genes. Exactly. But there are some, there are some disorders like let's say melanoma as opposed to basal cell and skin cell cancers that are genetic. You carry a gene for melanoma, it can happen where the sun don't shine. So sometimes I hear people saying, wear sunscreen, you won't get a melanoma. And I stop them and say, that's not what happens with melanomas. It's true for basal cell and skin.
and other kinds of skin cancers, but not necessarily melanomas, where there are other conditions that can be almost purely lifestyle, except you may have a propensity in your genes to allow that to emerge. So in your case, the story I obtained from you was stroke, cancer, kidney stones, thyroid dysfunction, and chronic gastritis. There was also Kruesfeld -Jakob disease. Is that all true?
Those are all truth in different parts of the family tree, but those are all true. And especially, and most surprisingly was the death of my father for CJD. Yeah. Yeah. That is almost inherently environmental and epigenetic taking agents that can cause this virus to kind of go crazy. I think the other term for it is mad cow's disease. And I think it's partly rests in.
you know, contaminated meats or different sources of food. So that's an important aspect that we probably won't have time to get into today. The rest of it speaks to what's so common among human beings around the globe, but stroke and cancer, kidney stones are also not too uncommon. Thyroid dysfunction is very common and gastritis as well. Sexually at the time, I think you spoke to the fact that you never got up at night. You didn't have something we called nocturia.
You had no thinning hair. You might have noticed at the time a slight decline in some sexual function with respect to erectile strength in your early 40s. That might've changed a little a couple of years later. And we spoke about how, you know, how maybe that we can address that. I'm not gonna go into it now. So we're going to, because I wanna look at the numbers. You are continuing to get spontaneous erections.
And, but you felt that your libido may have declined somewhat around that time. Has that all stayed the same or have you made changes that have evolved since then? I think 2019, 2020 lack of energy, kind of generally speaking, lack of sexual drive sort of inspired me to kind of look more at the potential hormonal imbalances and sort of that kind of set me on a course to start testosterone replacement therapy.
And so TRT with the regular injections of moderate doses of testosterone. And that actually from a symptomatic point of view really resolved things like very quickly, both the feeling, the energy, the sexual drive and so on, all of it was very quickly corrected by that intervention.
but then, you know, I'm sure we'll talk about it is sort of where does that leave you from the number and the biomarkers and how can you then sort of continue to optimize things without necessarily overdoing it or kind of feeling like that you've resolved the problem altogether? Absolutely. And so your goal really overall was how do you keep your health? You wanted to, you know, change sexual function and it sounds like you've made a lot of progress with sleep. So in the interest of time,
because I know you exercise to quite a bit, four to five days a week with the hours of exercise and you maintain health. We saw that in your body composition with fantastic muscle, low fat, and you were in great shape. I think from a food point of view and sugar, you tend to run on the low side with hypoglycemia. And each one of us is programmed to have disturbances, what I think of as disorders of carbohydrate metabolism, because unlike
most of the conventional medicine world. We all agree diabetes and pre -diabetes is ubiquitous, but what I've come to see over the years is, and because of certain data collection, is that everyone has a disorder of carbohydrate metabolism because it's a Darwinian issue. Survival depended on through fast or cavemen, cavewomen during the winters. If you couldn't live off your own body, then you would die. So those genes never got passed on.
So that is a very common outcome for almost everybody. I've yet to see anybody that is optimal in terms of sugar management. Your fiber scan was wonderful. You had no fat in your liver at all. And your other numbers, which we'll dig into now, were also interesting with some outliers that we want to touch on. But your sugar metabolism to start, and you should have some of this data in front of you, includes
fasting glucose, hemoglobin A1C and fasting insulin. In your case, you're in the optimal area for fasting glucose at 77. Your hemoglobin A1C, which is an average of a hundred days of how your sugar fluctuates was 5 .1, which is near optimal. We consider five or less based on data in the literature to be optimal. So somewhere in the fours is actually a little, is preferential to anything over five.
(00:43):
but you were pretty close. As well as your insulin, your fasting insulin, you were also relatively close to optimal. It was a little measurable, slightly over two, and we like it undetectable under two. So that was a good sign that you were trying to coordinate. You were wearing a CGM at the time. And I remember that low levels of sugar were detected more often than high. So you were balancing that pretty well. And that's partly probably because you burn sugar at a higher metabolic rate.
and you use up the glucose from all your activities, both in your brain and in your body. And also because you're careful about how you approach life and the way you eat and exercise. And you try to balance that. Your liver function looked beautiful. We also look at magnesium red blood cell and you were on the low side there. So what's important about magnesium is it adds a calmness. It's great for the gut. It's great for the brain, but it takes part in about 300 or more
interactions and reactions in the body. So it's critical to mitochondrial function. You can't measure magnesium, although you correct that, you can measure magnesium as it circulates in the serum, but that's not the important magnesium. The important magnesium is in red blood cells. And in your case, at the time you measured 4 .7 and we'd like that number to be closer to six. So if you haven't been, if you weren't on magnesium at the time or...
you may have changed that since then, you might wanna consider taking magnesium.
I will say overall for your cholesterol values that your cholesterol risk ratio at 3 .1 is higher than we wanted. We would want it to be less than three. And while your overall deeper dive into your triglycerides are excellent actually, and that mirrors your sugar levels, your LDL is a little on the high side at 81 for a family history of stroke.
Any thoughts there, Lorenzo? Anything you wanna add before we move on to hormones?
magnesium, I think, you know, I have had sort of the not the idea, but like the notion that I needed to supplement with magnesium quite a bit. And I probably have been less consistent with it than I should have been. But I'll make it, you know, I would say it's reasonable to kind of make it a test or a priority to see whether or not.
that has an impact or an effect. Never thought about milk thistle. That can be a really interesting addition to my stack. And as for Manjaro, definitely did not know that there was any additional sort of benefit besides the weight loss, which is definitely not something I do not need to wait to lose any weight muscle.
My bias is always to work with the body. So just like I mentioned HCG to have a direct effect on the testes and increase your own testosterone.
These agents, these peptides are glucagon -like peptides are naturally secreted in our brain and in our gut. And they control aspects of inflammation beyond fat loss. It's why fat loss is made possible, but you wanna protect muscle. You don't need any instruction on that because you're doing a great job there, but it's something to consider.
As far as magnesium, I want to give you some other hints. There are actual gene variants. There are four gene variants that make it difficult for some people to absorb magnesium effectively orally. And so one of the tips we use is taking magnesium through the skin. You can take a hot bath at night. It will help sleep. And you can use Epsom salt, which has magnesium in the bath. And that's one way of absorbing calcium that bypasses your GI tract.
your risk factors look pretty good. You didn't have any sign of inflammation in that your high sensitivity cardiac CRP was 0 .4, which is fantastic. You want it less than one. When that number goes up to between one and three, not even very high, we worry about a risk of inflammation at the level of the endothelium, which is the lining of vessels.
So that would be a critical aspect and I'm delighted to see that was absent. Your vitamin D was good. It was borderline optimal at 57 and you're a great absorber of vitamin D3, which is an over the counter. I hope you're taking K2 with that because it channels calcium into your bone instead of into your heart and other places. Excellent. And you've been on.
you've been on vitamin D, which is actually a hormone. It's a steroid hormone that we know is produced in every cell of the body. So it goes way beyond just isolating and channeling calcium to bone to prevent osteoporosis and osteopenia. It actually is fabulous for the immune system. It's anti -cancer. It's great for the cardiovascular system. So you're doing great there.
Your homocysteine and B12 and folate is another area of measurement that I think has declined over the years. But at that point in time in 2022, you had an excellent homocysteine. It was under eight and it's a marker of insufficient Bs. And sometimes it's high in people who have again, a gene variant called MTHFR. And if you're unable...
to methylate B, taking regular B12, and you're in the theater, so you know a lot of theater people take injections of B12 every week, but they're not methylated, and you can't absorb it, and you can't use it, and it leads to adverse conditions like deep vein thrombosis that can cause also pulmonary emboli, as well as early heart attack, and believe it or not, hearing loss.
or sudden sensory neuro hearing loss. So we're always careful to make sure people have adequate B vitamins. You can do a little better with your B12 at the time it was 842 and your folate was 23. We like to see a B12 closer to a thousand. It's good for the brain too. But I can't argue with the fact that you were doing great at the time in terms of the B's and the impact it has on the rest of your system. If you're not taking methylated B's, you might want to.
I think I was at the time and I stopped. I used to take, I think it's cytokobalamin or something like that. Methylated cytokobalamin is B12 and folate is B9. And so you'd want to take those agents. Also B6 and B2. I was taking B12 as a supplement because at the time I was in a strict plant -based diet. And that was one of the things that sort of was going to be missing from the diet. But,
I over time, I kind of reintroduced some animal products and meats and so on. And I stopped the supplementation of B12, but it seems like it might've been a good thing to continue it. Yeah, I think so. I think you want to be able to do that because your recent data, and again, I can quickly go over it with you, but you do have that gene. You're positive for one copy of what we call C677T.
and one copy of A1298C. There were 24 variants of MTHFR, but these are the two critical variants. And so you were doing great at the time, but methylated B products is really your go -to. And it would be better for your brain as well. Although your brain seems to be perfect. You're...
Complete blood count where we look at the white cells that fight infection and the red blood cells and whether or not there's any sign of anemia was perfect. You were right in the zone then, and that has evolved a little bit over the last two years. And that's where I picked up the issue with your B's at this moment of time. If we move into your hormones,
(01:04):
You are doing great despite all that you do. Your cortisol was right in the sweet spot at 8 .4 in the morning. We like to see it between six and 12. Your testosterone, and we really drill into free testosterone because that's the testosterone that's free to act in the body. You can calculate free from total and your total and free were excellent at over a thousand for total and at just 287.
for free. Now I would even argue that that's a little higher. We tend to keep it between 180 and 250, but different strokes for different folks. And it's not dangerous at that level. If you abuse testosterone or abuse any kind of androgen, it is dangerous. So taking mega doses, which you're not taking at this level, and we instructed you, I think, at the time to get the measurement a week after your injection. So that is a...
tiny bit on the higher side, but again, it's probably okay. You have room to move there if you want. So the changes you might've made since then, if you've added anything to that regimen is probably unnecessary. That would be my call. I prefer stimulating natural testosterone. And in your 40s, that's usually possible. There's a small percentage of men, probably 10 % or less, who are no longer able to stimulate their own testosterone.
but, and that drops out every decade of life in men as they get older, differently than women where we all hit a wall at menopause, we can't produce hormones, but in men it's different. And so most men in their 40s are able to respond and even in their 50s, they're able to respond to stimulation. It is more expensive, it's a prescription. It actually is used for fertility. So it's a very safe class of drugs. We use it in IVF for women.
to ovulate and in men to increase their testosterone. And again, as I mentioned, it's physiologic. So there's a difference between overtaking the body and giving you the product versus having your own body function. Here's the reason. When men are able to make testosterone, their testes are functional, their cells are functional and they live longer. So there's data that shows that men who father children later in life live longer.
And same thing is true for women. If they're able to conceive later in life, like in their 40s, even in their early 50s, their life expectancy is longer. And that is why I work with physiological agents, which is just like Ozempic and Wigovie, Manjaro, and Zetbound. The rest of your hormones need a little attention.
but they're not bad. Your estradiol at the time was 53 and we like to see it half of that. There are agents that can be used to supplement by lowering your testosterone. You will lower the production of estradiol with an enzyme called aromatase that changes testosterone to estradiol because they're like sister and brother or brother and sister. And you really want an estradiol that's more in the 20s rather than in the 50s.
Moving on from that, your DHT was also a little on the high side. So the fact that you had no nocturia or middle of the night awakening, your DHT was 88. We like to, again, have it about half of that with the range being 16 to 79. It is a hormone. It actually has an impact on libido and sexual function. It has an impact on bone. So it is an important hormone and a prohormone in men. But.
Too high or too low is not ideal. In fact, it's better to be too low than too high.
your journey is fascinating. And I know you're one of the most informed people I've met about optimizing health span. And I'm delighted that you're aging in great shape. I think we can tweak it even further. Perfect. I'm looking forward to getting all the help I can to beat father time. Excellent.
Thank you so much, Lorenzo.
christopher quindes (00:10)
(00:01):
Hi, and welcome to the Healthy Longevity podcast. I'm your host, Dr. Florence Comite. I'm a practicing endocrinologist and precision medicine physician and founder of the Comite Center for Precision Medicine and Healthy Longevity. For those of you who've not tuned in before, welcome. And I'm really excited because today we have a fantastic guest and we're gonna be drilling into biomarkers, a term that's become very popular.
and showing why it's so important to see what's going on at the cellular level below the surface
I'm delighted to welcome to the podcast, Lorenzo Thione It's great to see you and thanks for joining us on the podcast, Lorenzo. Hi, Florence. It's great seeing you. I'm happy to be here. Excited about this conversation. Excellent.
A little bit about your background because it blows me away. You're an investor, a serial entrepreneur, and a distinguished expert at the intersection of artificial intelligence and technology, storytelling, and social advocacy. That's incredible. It's like you're a man of the world and of the future here. Where we're going. Yeah, or I have ADHD. I don't know. But...
It's just, you know, this gravitating towards things that kind of give me pleasure and joy and learning opportunities for learning and throughout my life, there have been a lot of different such things. And yes, I've been working in artificial intelligence for longer than most people kind of even expect.
Well, the people that are in the field know that it's been around for a very long time, but most people that have gotten into AI today kind of expected, you know, that it's coming out of nowhere. But in reality, I started out my career as an entrepreneur and founder in the artificial intelligence space, you know, transitioned over the years, started multiple businesses and continued to be a very engaged investor, speaker and sort of, you know,
always student of the incredible advances that we are making and have been making in this field.
You know, I was that student in middle school who loved graphing sentence structures and then paired it with my passion for computers and computation and algorithms and.
started a company in 2003 called PowerSet, which at the time we weren't even saying was doing artificial intelligence because coming out of the late 90s AI winter, so many commercial efforts had not panned out. And a lot of investors and a lot of people in the field had diffidence and skepticism and kind of considered AI mostly as a research project. So we were
describing it as an attempt at building the first or one of the first natural language powered search engines. And we were fortunate to assemble an incredible group of scientists and people, world -class experts, build some really fantastic technology, even though we were early, at a time when computational cost was very expensive and some major technical breakthroughs were still kind of a few years away.
but ended up selling the company to Microsoft. We were acquired by Microsoft and became a part of the early versions of the search engine Bing .com.
But I never lost my passion for operating businesses and starting businesses and I ended up pairing that with another passion which has always been kind of the ability to tell a good story and to excite and move someone to your side of the argument or to your
way of thinking. Yeah, to your way of thinking.
and you didn't even touch on the part of your career that you're an advocate for inclusion. We heard you were born in Italy. I think it was Milan and you completed studies at the University of Texas at Austin.
You hold degrees in computer engineering and not only did you do AI research and technology as a baby almost out of college. So you were barely 20, but you're and the co -founder of, I think it was PowerSet, And so that is fantastic. You're way ahead of it.
I know currently you serve as a managing director of GainsGel where you oversee the artificial intelligence and sustainability investment practices. It's a leading LGBTQIA investment syndicate and one of the most active private investors in North America.
So I'm out of breath now. One question, and I wanna make sure that you do sleep.
Sleep is definitely one thing that I have paid a lot more closer attention.
I'm fortunate, I've always been able to fall asleep very, very rapidly. I've never had a problem falling asleep, but I probably lived for the first two to three decades of my life with chronic insomnia effectively or excessive sleepiness during the day, effectively feeling like, you know, if I am at a lecture or at the theater or at the movie theater or watching TV or God forbid driving,
you feel like you're so groggy and snoozing. And that is first and foremost an indication that you're not getting either enough sleep or enough good quality sleep. Yeah, well, let's dig into that a little bit later because I think there may be other aspects of it, like your microbiome.
We haven't even touched on, and I'm going to just mention that you're a celebrated storyteller, which I know is part of your strength, four times nominated and twice winner of the Tony Award for your work on Broadway. You've had multiple productions, including The Inheritance and Allegiance, a musical you co -created and produced. It's just amazing what you've done, really. I'm blown away.
(00:22):
So I'm delighted to speak with you and I wanna talk specifically about your biomarkers.
And I know you've been followed pretty regularly and you're on your own course of treatment. When we first got your biomarkers, it was evident that there were some
findings that showed me that you were actually taking supplements, you were taking medication, and I think you did it in the hopes to protect your health and be as strong as possible. And it looked like you were fairly successful at that. There remain some questions that I want to dig in today, and then if we have time, we can talk about the follow -up biomarkers that you attained. I think - For sure.
Is that good? Yeah. The one thing that I've always been, and it's part of my propensity also for technology, is data is so important. It's always been so important. I think it's the most important decision support that you can get. There's a funny quote I often like to reference, which is, if you have data, let's look at the data. If all you have is opinions, let's go with mine.
But it's true. And so being from the very beginning as more devices and more tests have become available to the interested consumer to self -quantify, measure various part of your biology or of your metabolism and so on, those have always been things that I've wanted to experiment and try to integrate into the decisions, either behavioral changes or supplementation protocols that I make.
And I think that's great. I think to me it falls under the trial and error approach where as long as you're rigorous about it and you can make changes one at a time, you can see and maybe perceive what's going on. Reading the data, however, is completely a different talent and being able to cross the systems in your body from your brain to your heart, to every aspect of your health.
is also critical, because I think what's really missing is the understanding that, for example, testosterone affects the brain, cognition and memory. It's not just about sexual function and energy. It also affects the heart.
So let's start in with how we approach thinking about this. We first want to understand your health story. Where do you come from? Family history to me is the emergence of genetic factors that are relevant to your family. And so whereas 20 years ago, I used to think family history was a poor man's genetic test, I actually weigh in a lot heavier with family history because genetic.
variants or changes in genes or the genes themselves do not dictate in the same way as a family history. So the two to me are separate yet synergistic. In your case, the family, yeah, it makes sense, right? So now I - It has an impact. So if you and your parents grew up in a similar environment and you were exposed to behavioral and environmental stimuli that
you know, came from your upbringing and your parent and your family, there is a connection that is epigenetic that is not necessarily grounded in the genes. Exactly. But there are some, there are some disorders like let's say melanoma as opposed to basal cell and skin cell cancers that are genetic. You carry a gene for melanoma, it can happen where the sun don't shine. So sometimes I hear people saying, wear sunscreen, you won't get a melanoma. And I stop them and say, that's not what happens with melanomas. It's true for basal cell and skin.
and other kinds of skin cancers, but not necessarily melanomas, where there are other conditions that can be almost purely lifestyle, except you may have a propensity in your genes to allow that to emerge. So in your case, the story I obtained from you was stroke, cancer, kidney stones, thyroid dysfunction, and chronic gastritis. There was also Kruesfeld -Jakob disease. Is that all true?
Those are all truth in different parts of the family tree, but those are all true. And especially, and most surprisingly was the death of my father for CJD. Yeah. Yeah. That is almost inherently environmental and epigenetic taking agents that can cause this virus to kind of go crazy. I think the other term for it is mad cow's disease. And I think it's partly rests in.
you know, contaminated meats or different sources of food. So that's an important aspect that we probably won't have time to get into today. The rest of it speaks to what's so common among human beings around the globe, but stroke and cancer, kidney stones are also not too uncommon. Thyroid dysfunction is very common and gastritis as well. Sexually at the time, I think you spoke to the fact that you never got up at night. You didn't have something we called nocturia.
You had no thinning hair. You might have noticed at the time a slight decline in some sexual function with respect to erectile strength in your early 40s. That might've changed a little a couple of years later. And we spoke about how, you know, how maybe that we can address that. I'm not gonna go into it now. So we're going to, because I wanna look at the numbers. You are continuing to get spontaneous erections.
And, but you felt that your libido may have declined somewhat around that time. Has that all stayed the same or have you made changes that have evolved since then? I think 2019, 2020 lack of energy, kind of generally speaking, lack of sexual drive sort of inspired me to kind of look more at the potential hormonal imbalances and sort of that kind of set me on a course to start testosterone replacement therapy.
And so TRT with the regular injections of moderate doses of testosterone. And that actually from a symptomatic point of view really resolved things like very quickly, both the feeling, the energy, the sexual drive and so on, all of it was very quickly corrected by that intervention.
but then, you know, I'm sure we'll talk about it is sort of where does that leave you from the number and the biomarkers and how can you then sort of continue to optimize things without necessarily overdoing it or kind of feeling like that you've resolved the problem altogether? Absolutely. And so your goal really overall was how do you keep your health? You wanted to, you know, change sexual function and it sounds like you've made a lot of progress with sleep. So in the interest of time,
because I know you exercise to quite a bit, four to five days a week with the hours of exercise and you maintain health. We saw that in your body composition with fantastic muscle, low fat, and you were in great shape. I think from a food point of view and sugar, you tend to run on the low side with hypoglycemia. And each one of us is programmed to have disturbances, what I think of as disorders of carbohydrate metabolism, because unlike
most of the conventional medicine world. We all agree diabetes and pre -diabetes is ubiquitous, but what I've come to see over the years is, and because of certain data collection, is that everyone has a disorder of carbohydrate metabolism because it's a Darwinian issue. Survival depended on through fast or cavemen, cavewomen during the winters. If you couldn't live off your own body, then you would die. So those genes never got passed on.
So that is a very common outcome for almost everybody. I've yet to see anybody that is optimal in terms of sugar management. Your fiber scan was wonderful. You had no fat in your liver at all. And your other numbers, which we'll dig into now, were also interesting with some outliers that we want to touch on. But your sugar metabolism to start, and you should have some of this data in front of you, includes
fasting glucose, hemoglobin A1C and fasting insulin. In your case, you're in the optimal area for fasting glucose at 77. Your hemoglobin A1C, which is an average of a hundred days of how your sugar fluctuates was 5 .1, which is near optimal. We consider five or less based on data in the literature to be optimal. So somewhere in the fours is actually a little, is preferential to anything over five.
(00:43):
but you were pretty close. As well as your insulin, your fasting insulin, you were also relatively close to optimal. It was a little measurable, slightly over two, and we like it undetectable under two. So that was a good sign that you were trying to coordinate. You were wearing a CGM at the time. And I remember that low levels of sugar were detected more often than high. So you were balancing that pretty well. And that's partly probably because you burn sugar at a higher metabolic rate.
and you use up the glucose from all your activities, both in your brain and in your body. And also because you're careful about how you approach life and the way you eat and exercise. And you try to balance that. Your liver function looked beautiful. We also look at magnesium red blood cell and you were on the low side there. So what's important about magnesium is it adds a calmness. It's great for the gut. It's great for the brain, but it takes part in about 300 or more
interactions and reactions in the body. So it's critical to mitochondrial function. You can't measure magnesium, although you correct that, you can measure magnesium as it circulates in the serum, but that's not the important magnesium. The important magnesium is in red blood cells. And in your case, at the time you measured 4 .7 and we'd like that number to be closer to six. So if you haven't been, if you weren't on magnesium at the time or...
you may have changed that since then, you might wanna consider taking magnesium.
I will say overall for your cholesterol values that your cholesterol risk ratio at 3 .1 is higher than we wanted. We would want it to be less than three. And while your overall deeper dive into your triglycerides are excellent actually, and that mirrors your sugar levels, your LDL is a little on the high side at 81 for a family history of stroke.
Any thoughts there, Lorenzo? Anything you wanna add before we move on to hormones?
magnesium, I think, you know, I have had sort of the not the idea, but like the notion that I needed to supplement with magnesium quite a bit. And I probably have been less consistent with it than I should have been. But I'll make it, you know, I would say it's reasonable to kind of make it a test or a priority to see whether or not.
that has an impact or an effect. Never thought about milk thistle. That can be a really interesting addition to my stack. And as for Manjaro, definitely did not know that there was any additional sort of benefit besides the weight loss, which is definitely not something I do not need to wait to lose any weight muscle.
My bias is always to work with the body. So just like I mentioned HCG to have a direct effect on the testes and increase your own testosterone.
These agents, these peptides are glucagon -like peptides are naturally secreted in our brain and in our gut. And they control aspects of inflammation beyond fat loss. It's why fat loss is made possible, but you wanna protect muscle. You don't need any instruction on that because you're doing a great job there, but it's something to consider.
As far as magnesium, I want to give you some other hints. There are actual gene variants. There are four gene variants that make it difficult for some people to absorb magnesium effectively orally. And so one of the tips we use is taking magnesium through the skin. You can take a hot bath at night. It will help sleep. And you can use Epsom salt, which has magnesium in the bath. And that's one way of absorbing calcium that bypasses your GI tract.
your risk factors look pretty good. You didn't have any sign of inflammation in that your high sensitivity cardiac CRP was 0 .4, which is fantastic. You want it less than one. When that number goes up to between one and three, not even very high, we worry about a risk of inflammation at the level of the endothelium, which is the lining of vessels.
So that would be a critical aspect and I'm delighted to see that was absent. Your vitamin D was good. It was borderline optimal at 57 and you're a great absorber of vitamin D3, which is an over the counter. I hope you're taking K2 with that because it channels calcium into your bone instead of into your heart and other places. Excellent. And you've been on.
you've been on vitamin D, which is actually a hormone. It's a steroid hormone that we know is produced in every cell of the body. So it goes way beyond just isolating and channeling calcium to bone to prevent osteoporosis and osteopenia. It actually is fabulous for the immune system. It's anti -cancer. It's great for the cardiovascular system. So you're doing great there.
Your homocysteine and B12 and folate is another area of measurement that I think has declined over the years. But at that point in time in 2022, you had an excellent homocysteine. It was under eight and it's a marker of insufficient Bs. And sometimes it's high in people who have again, a gene variant called MTHFR. And if you're unable...
to methylate B, taking regular B12, and you're in the theater, so you know a lot of theater people take injections of B12 every week, but they're not methylated, and you can't absorb it, and you can't use it, and it leads to adverse conditions like deep vein thrombosis that can cause also pulmonary emboli, as well as early heart attack, and believe it or not, hearing loss.
or sudden sensory neuro hearing loss. So we're always careful to make sure people have adequate B vitamins. You can do a little better with your B12 at the time it was 842 and your folate was 23. We like to see a B12 closer to a thousand. It's good for the brain too. But I can't argue with the fact that you were doing great at the time in terms of the B's and the impact it has on the rest of your system. If you're not taking methylated B's, you might want to.
I think I was at the time and I stopped. I used to take, I think it's cytokobalamin or something like that. Methylated cytokobalamin is B12 and folate is B9. And so you'd want to take those agents. Also B6 and B2. I was taking B12 as a supplement because at the time I was in a strict plant -based diet. And that was one of the things that sort of was going to be missing from the diet. But,
I over time, I kind of reintroduced some animal products and meats and so on. And I stopped the supplementation of B12, but it seems like it might've been a good thing to continue it. Yeah, I think so. I think you want to be able to do that because your recent data, and again, I can quickly go over it with you, but you do have that gene. You're positive for one copy of what we call C677T.
and one copy of A1298C. There were 24 variants of MTHFR, but these are the two critical variants. And so you were doing great at the time, but methylated B products is really your go -to. And it would be better for your brain as well. Although your brain seems to be perfect. You're...
Complete blood count where we look at the white cells that fight infection and the red blood cells and whether or not there's any sign of anemia was perfect. You were right in the zone then, and that has evolved a little bit over the last two years. And that's where I picked up the issue with your B's at this moment of time. If we move into your hormones,
(01:04):
You are doing great despite all that you do. Your cortisol was right in the sweet spot at 8 .4 in the morning. We like to see it between six and 12. Your testosterone, and we really drill into free testosterone because that's the testosterone that's free to act in the body. You can calculate free from total and your total and free were excellent at over a thousand for total and at just 287.
for free. Now I would even argue that that's a little higher. We tend to keep it between 180 and 250, but different strokes for different folks. And it's not dangerous at that level. If you abuse testosterone or abuse any kind of androgen, it is dangerous. So taking mega doses, which you're not taking at this level, and we instructed you, I think, at the time to get the measurement a week after your injection. So that is a...
tiny bit on the higher side, but again, it's probably okay. You have room to move there if you want. So the changes you might've made since then, if you've added anything to that regimen is probably unnecessary. That would be my call. I prefer stimulating natural testosterone. And in your 40s, that's usually possible. There's a small percentage of men, probably 10 % or less, who are no longer able to stimulate their own testosterone.
but, and that drops out every decade of life in men as they get older, differently than women where we all hit a wall at menopause, we can't produce hormones, but in men it's different. And so most men in their 40s are able to respond and even in their 50s, they're able to respond to stimulation. It is more expensive, it's a prescription. It actually is used for fertility. So it's a very safe class of drugs. We use it in IVF for women.
to ovulate and in men to increase their testosterone. And again, as I mentioned, it's physiologic. So there's a difference between overtaking the body and giving you the product versus having your own body function. Here's the reason. When men are able to make testosterone, their testes are functional, their cells are functional and they live longer. So there's data that shows that men who father children later in life live longer.
And same thing is true for women. If they're able to conceive later in life, like in their 40s, even in their early 50s, their life expectancy is longer. And that is why I work with physiological agents, which is just like Ozempic and Wigovie, Manjaro, and Zetbound. The rest of your hormones need a little attention.
but they're not bad. Your estradiol at the time was 53 and we like to see it half of that. There are agents that can be used to supplement by lowering your testosterone. You will lower the production of estradiol with an enzyme called aromatase that changes testosterone to estradiol because they're like sister and brother or brother and sister. And you really want an estradiol that's more in the 20s rather than in the 50s.
Moving on from that, your DHT was also a little on the high side. So the fact that you had no nocturia or middle of the night awakening, your DHT was 88. We like to, again, have it about half of that with the range being 16 to 79. It is a hormone. It actually has an impact on libido and sexual function. It has an impact on bone. So it is an important hormone and a prohormone in men. But.
Too high or too low is not ideal. In fact, it's better to be too low than too high.
your journey is fascinating. And I know you're one of the most informed people I've met about optimizing health span. And I'm delighted that you're aging in great shape. I think we can tweak it even further. Perfect. I'm looking forward to getting all the help I can to beat father time. Excellent.
Thank you so much, Lorenzo.
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Intentionally Disturbing
Join me on this podcast as I navigate the murky waters of human behavior, current events, and personal anecdotes through in-depth interviews with incredible people—all served with a generous helping of sarcasm and satire. After years as a forensic and clinical psychologist, I offer a unique interview style and a low tolerance for bullshit, quickly steering conversations toward depth and darkness. I honor the seriousness while also appreciating wit. I’m your guide through the twisted labyrinth of the human psyche, armed with dark humor and biting wit.