Welcome to the Dr. Gabrielle Lyon show where cutting edge science meets innovation and practical application for everybody. In this episode, I sit down with MD PhD Anurag Singh. He did a PhD and research and medical training in immunology. We talk all about the importance of healthy skeletal muscle and aging and this amazing compound, your lithium A. I’ve gotten a ton of questions on it. We talk about how this one chemical compound may in fact help protect your muscle and your mitochondria. As always, this information is free. Please take a moment to subscribe, share with a friend. Now let’s jump into the show. Dr. Anurag Singh, welcome to the podcast. Thanks for having me Dr. A. Yes. Pleasure. You’re an MD PhD and I would love for you to share a little bit about your background because it is so extraordinary. Sure. So I trained as a young clinician early in India, you know, about the age of 19. I was in med school and then from there, after I finished my MD in internal medicine, I moved to the US to train as a physician scientist, trained in allergy immunology, started seeing patients. And after a few years of practice, I felt there was something missing. You know, more than medicine is missing the sort of preventive approach. And I was seeing, you know, a lot of COPD patients, a lot of kids for allergy and immunology. Yeah, a lot of kids with asthma and nobody was asking why is this happening? Why is the rate of asthma and allergies going up or how can we stop it early on? And so I was very lucky in the research field, you need to find the right mentors. I was really lucky to find two amazing mentors. One of them is called Professor Roger Thrall. He looks like Santa Claus, but he actually is like Santa Claus. So he trained me and he told me always you can do part-time research on reg as a clinician. And what was his specialty? So he was an immunologist. And the other guy was an internal medicine doctor that used to, professors trained me and got me hooked into research. And from there, 20 years now, you know, all into doing research and clinical trials. What was your PhD in? So PhD was actually an immunology PhD. And the focus was to really understand why we’re seeing such high incidences of asthma in kids and certain kids resolve asthma. So it was really trying to figure out the immune regulation of asthma and finding this new cell at that time, the new B cell. B cells are known to make antibodies, but the ones I found during my PhD was actually regulating the immune response. Wow, your parents must be very proud. Yeah, so well, I don’t know how much you know about Indian culture, but if you’re a doctor, you see patients. That’s the myth. And so in many ways, you know, I’ve gone against the flow. The grain. Yeah. You went to medical school at 19? I know. That’s very young. It’s very young. And then because the traditional age for here in the US would be, I don’t know, 23. Yeah. 18. Yeah, 19. So around 23 or so. Okay. 19, you then went to, was it what university? UConn? Yeah, so I trained in India. So in India, there’s one of the top med schools called the, it’s actually like the Walter Reed equivalent in India. So it was the army medical school. I could have been a army physician or surgeon. Hard pass on that one. Yeah. So then I left that because again, I didn’t see myself doing 30 years as an army’s doctor. And so I trained, I had a scholarship from the government of India to move to train to be a physician scientist in the US. And UConn was a great bet for me to do that because they had the right mix of doctors, were researchers. So I love my time there. Oh, I love that. Yeah. And I want to share with the audience why I wanted you on. You research a compound called urolithin A, which I have had many questions on. In addition, you have looked at and researched skeletal muscle and mitochondria. We’ll talk all about frailty, sarcopenia and protein. But I would love for you to share a bit about how you got interested in this compound called urolithin A and the origin story for how it even became of interest. Sure. So the, the story is 15 years plus. So we started with a very simple idea that we’re going to disrupt how science is done in the nutrition area. So a lot of companies were blending probiotics, prebiotics, multivitamins, and just, you know, starting to sell products in the market. And there was very, so we said, let’s bring the biotech approach to nutrition. And we started with this idea that we’re going to find new natural compounds that had previously not been attributed any health benefit to. So we started with thousands of compounds. We looked at what was the super foods at that time. Pomegranate was one of them. Berries was another one. So we started looking into it. Pomegranate, and you won’t believe it. We went around the world. We went to Israel. We went to Spain. We sourced pomegranates from around the world just to see what, what was in the different pomegranates. So let’s say the first four or five years of that journey was just deconstructing the pomegranate. And we found like hundreds of compounds in the pomegranate. And then we started studying which were the key actives that would have these immense health benefits. Because I don’t know if you know the pomegranate field, there was a lot of literature around that time that drinking pure pomegranate juice was going to help cognition with, you know, delay some of the, you know, aging related attributes to cognitive decline with aging. So we zeroed in on your lithium A at that time, which was thought to be a waste product. Why your lithium A? So this is an interesting story. We were based out of the Swiss Institute of Technology, which is one of the top universities in Europe, actually top 20. And it would be the Harvard or MIT. It is actually the MIT equivalent. And so we had given in the aging field, so we were very always very focused on the aging field. We gave these hundreds of compounds to this professor who was very famous in the mitochondrial field called Professor Alberichs. And he came running, he did not know we had blinded him. And he came and said, what is this one compound that you gave me, because it’s extending the lifespan of worms, because that’s where all the aging research starts by, like 45%. And nothing else matches that except caloric restriction. So things like NAD boosting modulation does boost the lifespan by 20%. Respiratrol, for example, does a similar 15 to 20%. Metformin comes the closest to caloric restriction 40%. So he was so excited that he said 45% and calorie restriction does it by like 50-55%. So that’s how we got into it. Because before we had not paid attention to this molecule called your lithium A, because it was thought as a waste product. And then he said, well, it’s this molecule. And so that started 15 years of research. That was pretty exciting, wasn’t it? It’s that, you know, when you start from a notion that you would do this for the next 10 years, but you’re never sure what you’re going to land up with. And then you have after seven, eight years, the Eureka moment. And then it was clear to us that we needed to get to humans, do multiple randomized trials. And that’s what we have been doing till about a few years back, we got convinced to launch the products. Wow. And the Eurylithin A compound, you had mentioned that it was was it originally discovered from pigs eating acorns. Yeah, so it was a that’s a funny story. So Iberian ham, right? And it tastes so good. Which I’ve never had. So it’s it was known acorn is another source. So the origins of Eurelithin A is that it’s a postbiotic molecule. What does that mean? That means that your gut microbiome would metabolize the dietary precursors that are present in these super foods like pomegranates and berries. So these have what we call polyphenols. And there’s a class of polyphenols called elegitanins. So these become metabolized by the gut microbiome to release this molecule, which by the gut, which is called a postbiotic Euralithin A trick is not you can be drinking a glass of juice or a bowl of berries, but a lot of people about two thirds of the population doesn’t have the right gut microbiome. And so that started the other side of story that if two thirds of the world, healthy population is not able to make this molecule naturally, like, you know, we need to supplement them. And so that’s, that’s the whole. And how did you guys come to that conclusion? You were saying that certain populations have the capacity based on their gut microbiome to take these elegitanins and make this postbiotic Euralithin A.

 So we have run randomized clinical trials the world though, where we’ve gone and looked into the French population, the Italians, Canadians, many trials in the US, and I’m running one in Asia and India, actually my origin country. And it’s fascinating because in Europe, we see about 30 to 40% people have this molecule at different levels. Now, are those levels enough to give you what I call a therapeutic benefit?

 Probably not. But from dietary exposure, that means these people have the right gut microbiome to convert and make Euralithin A. In the US, it’s even lower. It’s like 10 to 12%. So we did a study in Chicago downtown area and it was about 10 to 12% people had it. If you give them a glass of… So 90% of individuals will be unable to leverage this. 90% of individuals will not getting in from real world diet. Now, if you give them the healthy diet, which not everybody is eating. Yeah. And in Chicago, they just eat a lot of pizza. Yeah. Then you can boost that number up to let’s say 30%. In India, what I’m figuring out is that it’s actually very low. I’m not a producer. I can drink six glasses and I have actually had six glasses of juice in one go and my body refuses to make it. And I think it’s because your gut microbiome is seated in the first 1000 days of your life. And a lot of practice in these, let’s say countries and Asia and Africa is to give a lot of antibiotics. And my parents told me I had pneumonia, all kinds of stuff at that time. And I took a lot of antibiotics and that I think messed my gut microbiome forever. That’s an unusual thought because I think a lot of people are thinking, well, there’s nothing I can do about that. We do know that you can modify the gut microbiome. You can. Yeah. But maybe not in the capacity to then generate particular compounds. Do you believe that’s true? I believe that’s 80% true. I think in, let’s say, the developed world in Europe and US, you can certainly train your gut microbiome to a certain extent. Because if you’re not eating the right foods, if you’re supplementing with probiotics and prebiotics, maybe there’s a chance if you have the right flora and we know actually now what’s the right gut microbiome that you need to produce your latin A. I think in countries where like from from India, there is absolutely no chance because yeah, your gut microbiome is late in the first 1000 days of life. And then you think you can eat right and you’re eating right, but you’re getting, and I think that’s the idea. The gut microbiome is, to me, is a polypharmacy. It’s really is this source of immense, healthy molecules that should be mined for, and we’ll talk about your latin A for sure. Yeah, of course. It is. It’s very fascinating.

 And the, how would someone know if they’re a producer? And by the way, I have a test in my kitchen. I do. I have not taken it. How would someone off the street or is it something that people can test for? So it’s a test I developed. You developed it. I developed it. I bled many of you are really an underachiever. I mean, you must just look at yourself in the mirror and go, gosh, I bled myself. I could contribute more. All my 10 fingers. I took all my colleagues, even this, you know, all the founders and I, you know, kind of gave them a glass of juice and try to see. So we have now developed a minimally invasive test. It’s requires a dry blood spot test. It requires a little finger prick spotting a few drops of blood and you send it to a lab in the US. And in a few days we know if you’re a producer or not, because this molecule is easily detectable in the, in circulation in the blood. Is it an all or none? Actually, no, actually, what we see is about 60% people don’t make it at all. Even if they are exposed to a healthy diet, then they’re about 20, 30% who have the right microbiome, but just need to be eating right. And that when you provide that they, they can make certain low levels of your litany, which may not be enough to, to give you these immense, powerful mitochondrial and longevity benefits. 10%, which I’m fascinated by absolutely, because these are what I call the blessed ones. They, they are born, I don’t know, with the right microbiome. They eat right. And these are what I call super producers. And I have in mind a study where I want to follow these super producers and really see if their muscle health actually, you know, and we can talk about it is already so powerful that they don’t need any supplementation. That would be an amazing study. What does, I have two questions. Number one, is there a level of your lithium A that should be so for example, if I were to test in my clinic, your lithium A as part of a blood panel, just as if you could do, say vitamin D, that might not be the best example, but you understand the concept. Is there a blood level that we look for that’s optimal? So we know now because we’ve looked at thousands of people, I think it’s about 100 nanograms per ml of blood and your lithium A gets metabolized. So you can detect your lithium A plus some of its other metabolites that circulate. And so with that, we can very accurately tell what is that level you need to hit to really get the benefits. What does it do? And why do we care about it? So great question. So your lithium A is a very potent natural activator of mitophagy. So for your audience, mitophagy is this well-conserved garbage disposal pathway in our cells. It’s very much like a topology, which is autophagy being cleaning up waste in a cell. So it’s really a topology inside the mitochondria. Now what happens with aging with stress is that we always have this concept of a balance between healthy mitochondria and unhealthy mitochondria. And as we age or in our muscles age or brain cells age, we shift that balance towards more unhealthy mitochondria. So a lot of mitochondria that are damaged and you need to recycle them. And that’s a process that goes on an autopilot. But with aging, it kind of stops or gets very slow. And so you really have a lot of waste inside your mitochondria that you can’t clean out. And so Parkinson, for example, is a mitophagy problem in the brain. Sarcopenia, I believe, is a problem in the muscle. And so what your lithium A does very well is it revs up the garbage disposal machinery. It’s almost like the garbage taking van shows up at your door every day. And once you clean the waste out, what happens is now the cells have the building blocks to create near healthy mitochondria and they make more energy. So that’s really the fundamental process how your lithium A works. And you had said that it’s, you know, we were talking before we started podcasting that there is the mitophagy and then there is the, did you say the biogenesis is even potentially a next level step that the compound helps? Yeah, so this is a question I get a lot. Can we combine this with other mitocondrile? So you can improve mitochondrial function today by three ways. You can improve the, as you said, biogenesis, meaning you can create newer healthy mitochondria. You can take the healthy mitochondria and make them more efficient. So there are things like CoQ10, carnitine that boost, make mitochondria more efficient. But so far there had not been yet a mitophagy activator, which is what your lithium A is. It cleans the waste out. When you clean the waste out, these become building blocks of near healthy mitochondria. So that’s biogenesis. And we see in multiple randomized trials, we see mitophagy happen very fast. And then after a month of supplementation, it all becomes biogenesis. So that’s the key point. It’s not like if you keep taking your lithium A forever, you will always be inducing mitophagy. You clean the waste and you get a lot of new healthy mitochondria. How, and if someone was healthy and they’re thinking, well, I’m fit, I’m active, I might not make your lithium A. Would you say, well, you could take it and it’s going to somehow benefit above and beyond the natural capacity of the body. Or would this be for someone, let me give you an example. My husband, who is very into running marathons, he swears by it. Here’s what he says. And this is just purely anecdotal. He’s a very fit former Navy SEAL.

 And what he will tell you is he feels that his endurance has increased and his energy has increased. And he noticed that after, I think it was after maybe two months or so, where he really noticed a difference physically, I would say he’s an extraordinary healthy individual.

 My question is, would this compound in the data, you know, for the day, not just anecdotally, help an individual who is already has efficient mitochondria? And if one could even test for that? The answer is yes. So we started obviously looking at older populations, the first, because when you’re a trialist, which I am, you want to give yourself the maximum chance to success. And we know with aging, older people get damaged mitochondria. So we started there. Then we went younger. We saw effects in older people, improved endurance, just like what you’re saying. And older, would you define that as 65? 65 to 90. The oldest participant in the trials we’ve had is a very energetic 89 year old lady who swore by it. It was a blinded trial. And she knew, and she kept telling us that I think I was in the right product, not the placebo. And she was, she knew it. She was gardening more. So we’ve looked at younger middle aged 40, 50 year olds. And recently we’ve completed a trial in Olympian athletes. And I think your husband that you’re referring to probably fits that mold, a very high view to very high. So the problem there is sometimes over-training, if you exercise also too much, you get a lot of muscle damage. And maybe you can’t really push your, your athletic ability further. But what we are seeing in these individuals, these younger, very athletic, very fit individuals is that your ultimate acts on two fronts. One, it, it initiates better muscle recovery. So now you, again, you clear out the ways faster that over-training is causing. And so you get better endurance. The second is a lot of these individuals get inflamed very fast. A lot of athletes are inflamed. They have very high C-reactive protein, which is a marker of inflammation. Produced in the liver. I was going to ask you, how are we quantifying muscle recovery and inflammation? So muscle recovery in clinical trials is mostly looking at creating kinase or lactate levels and seeing if you can blunt the damage of, of the elevation of those. And then the inflammation is by looking at a C-reactive protein in blood and certain biomarkers that we call cytokines like interleukin 6, which is very closely linked to muscle strength as well. So we find with a month or two months of supplementation, actually that’s the, probably the gold standard marker. I tell every clinician who asked me, how do I measure mitochondrial health? How do I tell if your stuff is working? I said, well, look first at inflammation because we always see a blunting of and dampening of inflammation in every trial we run. Thank you to Our Place for sponsoring this episode of the show. Our Place has changed the game for me. Our Place makes cookware and a number of other kitchen appliances. Now, in case you didn’t know this, I’m a mom of two little children. 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 Do you want to know what I drink in the morning that is a little bit salty and gives me a huge pick me up? Well, I’m going to tell you. And that is element chocolate element. That’s L M N T in my coffee. I brew a black cup of coffee with a shot of espresso. And then I put a scoop of collagen and a little bit of M C T oil in it and one fourth a packet of element chocolate. Sometimes I use chocolate mint. I’ve also saved chocolate caramel. It’s kind of this like chocolatey caramel. Amazing. So I get my caffeine. I get some collagen for of course, hair, skin and nails. And I get electrolytes in my coffee, sodium, potassium, magnesium, all amazing. I have now created my own supercharged drink. Maybe you get headaches with your caffeine because you dehydrate yourself or maybe you get headaches because you sweat a lot while training or maybe you just live in Texas where it’s hot. And so you definitely sweat a lot. You definitely get headaches. And this is why I love to add electrolytes to what I’m drinking and it can be coffee. It can be water lately. It’s been coffee and it tastes amazing. You can get yours at drink element. That’s drink L M N T dot com. You’ll get a free sample pack when you use the code Dr. Lyon. And by the way, if you don’t like it, it’s totally risk free. You’ll get your money back. No questions asked. I love this stuff. You will too. Back to the show. Have you done a trial that just blew your mind? Because how many trials just to put this in perspective for the listener, you have been working on this compound for how long? I know that you’re with an A and the company that you’re with, which is Midopure. I think it’s extraordinary. Has been, I want to say 15 years between. So we are now counting 17. But who’s counting? I say 15. Yeah. And that it’s in total, I would say it’s about 15 randomized clinical trials completed ongoing for your collaboration. And then there’s also if someone were to go into the PubMed or Google Scholar, however you get your material, you will see that there are multiple groups looking at your within A because I was, you know, I was looking at, I think Stu Phillips was involved in one at Master University. And there are various other really well respected groups. Yes. That are looking at this compound. In our research, I always say is you’re not a lighthouse on your own. You need to have multiple top investigators run their own research, run their own randomized trials. And if you just look since our first publication came out around 2016, the amount of publications around year-old in A every year in PubMed is over 100 papers, 100 top publications every year. Wow. It’s incredible. So it’s growing. It’s, you know, a metabolic health is a big one, cognitive health, and these are research we are not doing. We are very focused on muscle, and we are moving into immunobed, and we can talk about it. But a lot of these individuals are looking into every, I mean, mitochondria are present in every cell type in the body, except red blood cells. And they degenerate in every cell type. And so it makes sense for a lot of them to look in different directions where mitochondria are just important for energetic, you know, abundance in those cell types. Do you suspect why this compound, and you might not know the answer to this, why do you think urolithin A has such an expansive impact, not just on muscle, but again, I was looking at some of the data on rheumatoid arthritis, on chondrocytes, and just all the plethora of different cells in the body? To be, that’s what blows my mind, even until today, we had the scripts, the paper you’re mentioning, the publication was done actually by the Scripps Research Institute in San Diego, they started looking at osteoarthritis patients, and they found that actually in the chondrocytes, it’s the problem is autophagy and mitophagy, and you get this sort of collection of bad mitochondria. So they called us up and said, well, we know only one compound that induces mitophagy, can you give it to us? And we gave it to them. And what they found was that even in these models of osteoarthritis, they could recover a lot of the damage of the joints and lower the inflammation. So there is so much potential in this molecule that still now why I think it is, is because I think the mechanism of action is very well thoroughly studied. A lot of times people don’t really know how omega three take an example. Correct. Yeah, we don’t know how it works. I mean, we know what it does, but really what receptor, what mechanism we don’t know. And the second thing is it’s bioavailable. And we know how to measure it. A lot of times even vitamin C, you know, we all gone through the COVID crisis, we take a gram of vitamin C, we don’t know where it’s going, do we really need it. So I think these are things which allow people to very easily study the benefits of uraltena. And for the science nerds out there, the mechanism of action, can you say what that is? Would you say for the listener, it is based on mitophagy? Is there a different level you want to take that? So it’s mitophagy linked to oxidative stress. So as we get older, our cells get older, they get stressed, you know, they get stressed, they struggle with the energy requirements that a cell needs, they don’t absorb nutrients very well. It’s the classical, I don’t know if, the hallmarks of aging. So in the field, everybody talks about the hallmarks of aging. And this links to how inflamed your cells are, how your microbiome changes with aging. I personally believe mitochondria dysfunction is not one of the hallmarks of the aging, but I think it’s the center piece of. Oh, interesting. And if you look at the other hallmarks, there’s, you know, telomeritration, epigenetics, which requires, in my opinion, really intense interventions. If with a certain nutrient, you can reverse mitochondria dysfunction and target improve all of them, or at least most of them, then you can actually delay and improve health span. And that’s what muscle span and muscle span, which I think is a very powerful idea, because muscle to me is the longevity organ, as probably listeners have heard a lot from you. Because if your muscles are not moving, your body’s inflamed. And what I think now we are very excited about is how the mitochondria and muscle are damaged, and that causes these damaged mitochondria causing inflammation. So this axis of inflammation and poor mitochondrial health is coming together. That brings me to your urolithin A’s impact on skeletal muscle. How does that impact skeletal muscle? What are some things in, say, aging versus young adults are healthy or obese? Is there a variation? Oh, yeah. So this is a study I did long back where I was studying 70 year olds who were running marathon versus 70 year olds who were couch potatoes, let’s put it that way, they weren’t moving. And the single and we took muscle biopsies from these and built the groups and we started looking at it, what was the thing about this muscle span that was and the key was the mitochondrial health in the muscle cells. So mitochondria are important for metabolic in a muscle is a metabolic organ. It’s needed for absorbing glucose, breaking, you know, it’s an acid oxidation, amino acids, the reservoir. So it is so important and mitochondria are the factories that are doing all this, right? So we realized in these older adults that weren’t moving well, it was the mitochondria. So that’s the sort of genesis how we started getting into muscle because we found that muscle with aging was the most compromised mitochondria. So some of that weight, say that again, that aging that out of the mitochondria in the body, that the muscle was the most one of the most compromised, because it requires such a high energetic demand. And I spent 20 years and doing randomized trials for muscle. For a long time, the field believed that if you just improved muscle mass, that was enough. So pharmaceutical companies started boosting and blocking myostatin, which is basically one of the, you know, receptors needed to control muscle growth. So by blocking myostatin, they thought they could boost muscle mass, which they did. In these trials, they did see about three, four percent increase in muscle mass. Problem was the strength was never improved and the muscle quality was never improved. And how do you define muscle quality? Muscle quality to me is the energetic capacity of the muscle to just do a bit more, right? So if you have good healthy mitochondria in your muscle, your muscle contract better, it will have better strength. And I think it’s you need both muscle mass and strength. And that’s what I call muscle quality. I absolutely agree with you. And so they looked at just improving muscle mass alone. Yeah. That didn’t seem to have the health benefits, even with a three to four percent increase, which that’s that’s tremendous. That is tremendous over six months. Now, the nutrition field was doing a lot of high protein supplementation in parallel. You know, everybody needs a gram or with aging, you need a bit higher per body kilogram body weight. And so we were doing these trials with 30, 40 grams of high protein supplementation, which would show mixed results. And the mixed results was if you added exercise, if you got the, you know, the mitochondria going through exercise. And that actually led us to start studying the effects of your latin A on what was happening at a muscle specific level. And so what we found first in many models of aging was we started seeing about a 10 percent increase in muscle strength with aging. We started seeing about a 40 percent increase in muscle endurance. And that led to the translation into humans where we see similar things. The was there a synergistic effect of dietary protein with your latin A? So I don’t have the answer yet. There’s a trial that Stu Phillips is running independently of us. The idea there is that you can induce rapid immobilization in a healthy individual. And that causes you to lose about five to 10 percent of your muscle mass and strength. And so you would rapidly within two weeks by putting a knee brace. It’s almost like somebody getting injured or hospitalized. And then what I think Stu is doing in that trial is that he’s giving high protein of 20 grams supplementation and then comparing it to high protein plus mitral pur. So we have to weigh. That’ll be really fascinating to see what those results are. Yeah. We have done that in models of aging, not in humans, but we have I have a very amazing scientist who have taken a look at that in in older rodents. And what we see is that actually the combo of protein and and mitral pur actually boosts mitochondrial protein synthesis, which boosts muscle protein synthesis. So with aging, you hit this anabolic threshold resistance to can just keep giving more protein. And so that’s what mitral pur does is by it kind of unlocks that resistance. That would be fascinating. It would make sense because it’s the compound urolithin A seems to act similarly as exercise would. I don’t know if it’s more similar to endurance or resistance training. Is it more similar to endurance type activity? I think it’s when you do a mix of endurance and resistance, I think that’s the kind of in between signature and at least at the molecular level that we see. And I don’t like to say it’s exercise in the pill, but I think probably the closest thing that one way. It’s hitting the same biology that you would expect exercise to hit on mitochondria in the muscle. And that would be and it’ll be really interesting to see the results from Stu’s. Yeah, I can’t wait. I know it’s done. I know he’s crunching the data. He’s crunching the data. And probably I think in the next few months we will hear the data come up on this trial. I suspect and maybe we can get Stu on to talk about it that there’ll probably be some muscle sparing effect. It would make sense.

 And this is what I think we need to do. We need to keep doing more trials, more research to really unlock how these compounds and nutrients work. And I think have this independent validation from different top professors in the world. How does it affect fat loss or weight reduction? Because oftentimes when you think about obesity and you think about, let’s say, myosteotatosis, fat infiltration in skeletal muscle, by improving many of these individuals have impaired mitochondria, impaired efficiency. Have you looked at or do you believe that there is a potential for weight loss with urolithin A and does the dose variation change? Right now, the current dose recommendation I give my patients is 500 milligrams daily. My husband takes a thousand milligrams daily. I’m curious as if one were to continue to increase that, would that have a different effect or a more robust effect on weight loss if at all? So let’s talk about the dose first and then I’ll get to the second part of the question. So the dose that when we did our first studies, giving increasing doses of urolithin A to older adults and healthy adults, and we were taking biopsies and we were measuring in the blood how much levels of exposure to urolithin A we were getting. 500 milligrams was the dose where we started seeing the mitochondria turn from, let’s say, dysfunctional to a healthy phenotype. We saw better cellular health. Now, a gram, we just saw even a very double effect than what we were seeing with 500. With a gram, we were starting to see these also very powerful effects on dampening inflammation compared to the 500. So 500 is sort of this homeostatic dose. If you’re on it for a while, you will get the benefits. But if you’re looking as if you think like a clinician here, if I have somebody with chronic fatigue or with inflammation, I would go very fast with a higher dose and then switch back to a maintenance dose. Would you go beyond a thousand? Do you think that there may be benefit? So it’s not always linear. So we actually did these clinical trials where we gave double the dose. We did two grams and after a while it saturates. So it’s not always a linear exposure to the molecule. I think the body needs time to absorb it and its half-life is around a day. It’s a relatively long half-life of the molecule. And so I do think what we have not done, and as I’m thinking, we’re talking, what we need to do is split the 500, the gram dose into morning and evening, so twice a day to see is it the total exposure that is important or is it multiple, increases in the levels that we could. So this is something we will do. I mean, that makes, that would be very interesting. Does it affect weight loss? So weight loss, that was the second part. We have not run those clinical trials because they take long as we’re all seeing with the weight loss craze with the GLP-1 now. You need to go at least 12 to 18 months to see effects on weight loss. We have, again, actually a group out of Baylor published a trial a few years back in a obesity model and they showed about a 10% to 15% decrease in weight and better with urolithin A. So this is an independent study run out on a model of obesity. There have been studies done on fatty liver as well, in models of fatty liver and steatosis and remarkable effects. So it’s something we need to do. But, you know, again, there’s a thin line when you do trials in nutrition where sometimes an IRB and human ethics could say that this is a drug trial because you’re starting with, I don’t know, fatty liver patients or very obese patients. So if we do overweight, it’s okay. So I think these are ideas to… Do you think that just like metformin, metformin came from, was it goat lilac, some kind of lilac compound? Do you think that urolithin A will ever become a drug?

 I think it has the potential certainly to go that route. A lot of people who have write to me personally, actually I was at a conference and the lady who had multiple sclerosis came after my talk and hugged me and she said, I was like, okay, what’s happening here? She’s like, you have changed my life. And those two seconds were so satisfying because, you know, no research, no publication can make you feel what she made me feel in those five seconds. And I think it has potential in those areas, I think. But I think by going the nutrition route, again, back to our fundamental desire was to disrupt the nutrition field. We see even in healthy individuals that people who take urolithin A have better cellular health. That means now, when you have better cellular health, you will absorb better vitamins, you will absorb better minerals, you know, that’s how, and protein even. So I think it has potential in the drug space and there are groups studying it for Alzheimer’s, Parkinson’s. We’re just not, we’re letting them run with it. Let them get the IRBs. You had mentioned GLP1 and GIP agonist drugs. Where do you think, well, I’m curious as to what your thoughts are about them first. And if there’s a role or synergistic role of urolithin A, because one of the things that there’s a lot of discussion in the media that the use of GLP1, GIP drugs will affect muscle mass. I actually don’t believe that there is, I’ve never seen any data that they actually affect skeletal muscle mass directly. I think that the data would support more the decrease in dietary protein and perhaps lack of exercise or movement. And I’m just curious to know your thoughts on the drug class and its impact and then where urolithin A plays a role in that. I think the GLP1 drugs are amazing drugs. They will probably be the first trillion or billion dollar, hundred billion dollar drugs. At least. At least as a class. They were first developed, it’s important to talk about the history there, because they were first developed as anti-diabetic medications. And the way they work is by boosting insulin production, blocking glucagon, but they are special because they do two other things. They delay gastric emptying and they hit the sort of the reward appetite center in the brain that makes people eat. I think the data is still coming out, as you mentioned on their effect on this drastic loss in muscle. I don’t think it’s drastic. I think it’s just when you’re in a short span of 12 months, you’re losing 5 to 10% of your muscle. In addition to the fat loss you’re seeing, that it may be okay for a younger adult or middle aged adult. But for a 70 year old, if I think about, let’s say an obese sarcopenic patient who’s on it, who loses that much muscle, I think the jury’s out there. If losing 10% what they would normally lose in 10 years, they’re losing it in that short span of 12 to 18 months. How does that impact falls? How does that impact their mobility? So I think there needs to be some where I do think coming from the nutrition side, these are expensive drugs, these GLP drugs. People take it for 12 to 18 months. They spend what, 1,000, 1,500 bucks. Once they get lean away from them, there needs to be a thinking that yes, exercise is key, protein is key, but there needs to be sort of a GLP1 support protocol. That’s where I really see urotena and mitopurone playing a role because you’ve lost that much muscle in that space. You need to supplement it with protein and exercise, but you’ve also metabolically challenged your mitochondria because it’s such a fast change. It’s almost like starvation. If you think about it in 12 months, you’re losing a lot of body weight. I think that’s where you need to support the muscle. And that’s where I think things like urotena, mitopurone and creatine could play an immensely big role. And I just want to highlight for some people, I worked on some of these early studies and when they talk about muscle or it’s typically when we were looking at it, it was lean body mass. It was 8%, like you said, between 8 and 10%. But if someone was on a lower or RDA protein diet, so pointy grams per kg with exercise and a higher carbohydrate diet, they also lost a significant more amount of total lean body mass. Lean body mass defined as everything is organs, all tissue other than fat and bone. I would say that weight loss can happen. I think that we’re not looking at skeletal muscles in a sensitive manner. We’re usually using DEXA, which 40% of the lean mass could be skeletal muscle mass. But that being said, you have to train and you have to improve dietary protein. You will lose lean tissue, but the only way to, and quite frankly, it’s tricky because the question becomes, do you work on building first and then work on some kind of body composition change, which maybe more specifically would be fat mass change? No, I agree. I think the body is losing fat. And if you stop using these drugs, there’s a chance the fat will come back. What are you doing now to make sure the muscle,

 support is there and that your muscle comes back and you have the good muscle mass and good muscle strength as a result. So I think that’s where I really see the nutrition field opening up. I see a lot of potential that these will become such big mainstream, not just drugs, but a lot of times people are using them as lifestyle medicines now, right? That you will need to think, as you said, can you give more protein? Can you give more nutrition to your muscles to sort of be healthy now that you’ve lost a lot of your weight? Certainly. And I think that there’s probably some nuance to the way that these drugs are being used. Maybe an individual doesn’t go to a full dose. Maybe they take a dose sparingly or a longevity dose. I mean, I would love to do even a trial with V-GOV plus mitopurin and see if at the end we had better muscle in the V-GOV plus mitopurin versus just V-GOV because that would also… That’d be incredible. You really need to provide the evidence. We were talking a bit hypothetical here, but I think what we need to do, as you said, is put the hardcore evidence-based medicine. Which is one reason why I wanted to talk to you because of all the trials you’ve done, all the trials on your lithium-A, and that is fascinating. The supplement world is the wild, wild west. It is. I never talk about or recommend anything that I don’t believe in or take, or that I feel has a lot of promise. And I think this compound is fascinating because it shows this gut muscle connection, this kind of gut muscle access, and also just the interface with everything. And it makes me think how exercise also impacts everything. Does your lithium-A affect appetite at all? I know its main action is on mitochondria, but I’m curious.

 Not that I know. Hmm. Not that I know. Do you think that there are specific measures that could be taken if someone is using a GLP1 or a GIP? Yeah, I think they need to have a dietician and a nutritional support. They need to have talk to their physician on the follow-up. But once they lower the dose, as you were saying, or wean off, what is needed out there to… So that’s where I really believe there’s a big opportunity for nutrition. It keeps your mitochondrial health good. If you add in things like creatinine top, and that’s where I’m now thinking of what’s the ideal GLP1 support supplement, if I can call, would look like, then you have creatinine, which can boost the strength part of things. And so now we’re talking about sort of the space where nutrition has a role to play for combination with the GLP1. Do you think that there are any foods that also act synergistically? Yeah, so there’s a lot of… Well, GLP1 is a peptide-like molecule produced naturally in the body. And as we age, as we chemo-beasts in this case, you lose the natural capacity to make GLP1. And so the gut microbiome is very key. And there is a fascinating paper a few years back published showing acromancia, there’s these class of bacteria in our gut, the healthy bacteria, cochlear manzia that are boosting GLP1. And we have looked at the microbiome to circle back to the producers, the blessed ones who make urolithin A, the one class of, let’s say, the gut microbiome that really shone through us, these people had more acromancia. So is acromancia responsible for producing urolithin A or involved in that? We’re still studying that. Yeah. And I wonder even from a practical aspect, could you take your urolithin A and support it with, I don’t know, other a la-jatanins? Because, you know, when you really think about it, foods are typically a food matrix. Yeah. Well, they always are. And then foods are often eaten with other foods. And maybe there is a synergistic effect with, I don’t know, green tea or catechins, things like that. So this is actually the exciting stuff going on in our laboratories right now. We’re trying to figure out where is the synergy with people who are fasting or on a ketogenic diet, would it synergize with ketones or would it synergize with certain amino acids like leucine? And as you said, with the green tea catechins. So we’re closely looking at the synergies. So you’re laughing because I must be on to something here. Yeah, I think you are. And any preliminary research, any preliminary data on that? So the one thing that surprised me, we’ve again taken a 360 and looking at even minerals and vitamins. The one place where we saw an absolute synergy is magnesium. Really? Yeah. It’s a combining mytopuric magnesium. Is there any specific kind? Is it glycinate? Yeah. So well, it’s not yet at the clinical trial level. It’s taking muscle cells and putting mytopurine, knowing what mytopurine does and adding different doses of magnesium onto it and really seeing that even better biogenesis and better. I think magnesium is a very understudied mineral and people haven’t really looked into, of course, you have to talk about threonate or glycinate, which absorbs better. And I think that it’s also a nutrient at risk. I was looking at the NHANES data set and it seems as if the overall consumption of magnesium has gone down alongside other vitamins and minerals. Yeah, no, absolutely. I think that’s the area we’re really focusing on right now is where is the synergy? Because as you said, I mean, we should always do food first and maybe people who don’t have the capacity or let’s say those who have the capacity to make ureletin A, maybe they can take more berries with ecomansia like probiotics and boost their ureletin A production. And then they don’t need that high level of a supplementation of, let’s say, with ureletin A. So that’s where I think a lot of new research also needs to be done. One of the most important responsibilities you have as a human is to get your blood work done in a regular cadence. You cannot outwork, outthink, or outmaneuver your own health. Health is the great equalizer to all dreams. InsideTracker is the blood work company I use and recommend. No one loves getting their blood work done, but at least I can make it easy and affordable. By using my link, InsideTracker.com slash Dr. Lion, you can get 10% off the InsideTracker subscription and any plan. By using data from your blood, nobody else’s, DNA, and fitness trackers like Apple Watch or a InsideTracker gives you personalized and science-backed recommendations on things you can take control of to optimize your health. 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I am bringing to you Puri-03, which is a high-quality, well-tested fish oil. Let me tell you about this. Puri-03 is third-party tested and certified by Clean Lake projects, I’m sorry, Clean Label Project. What it is, is it makes available the testing results. No contaminants, no heavy metals. These are things that, as a provider, as a mom, I’m very concerned about. I don’t want to be giving a supplement that is a concentrated supplement that has a whole bunch of contaminants. Puri-03 is a world-class supplement line and company. I absolutely am thrilled to bring this to you. And by the way, they are offering my audience 20% off. All you have to do is use the code Dr. Lion for 20% off. Puri-omega-3 fish oil has a high dose of 2000 milligrams of omega-3 fatty acids, EPA, DHA, and natural triglyceride form. I personally can tell the difference. They also have products that have little packets where you can throw it in your bag. It has vitamin D in it, it has magnesium, no fishy flavor, nothing. It truly is what I think is going to be on the forefront of top products. So support your health, throw it into your regular routine, go ahead and grab your Puri-03 and that is p-u-o-r-i.com slash Dr. Lion. That’s p-u-o-r-i.com slash Dr. Lion. Do you think that there’s a place for, and I know that children are very understudied and there’s a whole issue with IRBs and we see that in the protein research world, children are typically not, just because of the ethical challenges with that, they’re not able to have muscle biopsies and things of that nature. Do you think that there is a protective effect of, and this is purely speculative, I’m sure, but I know that nobody reads more about your lithium-A than you do. Do you think there’s a protective effect on the microbiome? So for example, if a child has to be on antibiotics and this is a postbiotic, I’m curious, do you think that there is any potential preventative place for your lithium-A? It’s a great question and I think there is. We have actually even done studies to see when is the first time in life you’re exposed to this molecule. So we have actually gone in and looked at lactating mothers to see if it’s even presented in like the first food you eat in breast milk. And fascinating enough, the mothers who are eating right and we have their dietary records, who have exposure to berries and pomegranates, it’s there. Wow. It’s there in breast milk. So definitely young ones are getting exposed to it, but as you said, it’s a long and tricky road to study something. And same with pregnant women. And same, but we’re getting more and more interested. There’s a famous professor in Princeton called Colleen Murphy. She’s been looking at the effect Eurotona has on ovarian aging as well. And we think that there’s a lot to be done in the pediatric space and in the sort of the woman’s health space with this molecule. You know, that makes me think about how you, when we first started chatting, you had traveled all throughout the world. You looked at pomegranates and your family was probably like vacation,

 in various places. Are there other compounds that, because not everybody has access to pomegranates, you know, I live in Texas, it’s about 5 million degrees here. Last time I checked, there’s no pomegranates growing. But this seems like it’s a compound that is critical for human health, which makes me believe that there are various compounds found in all regions that would be of benefit. Yeah. So that would, what we’re talking now is finding the next 10 mitopuris or your litany. And I’m going to make that just so you all know, I’m going to make, and I said y’all, which please definitely delete that. I’m kidding. I’m definitely a Texan now. I’m going to find it. Yeah. And no, so that goes back to what I said. I think the gut microbiome is indeed a polypharmacy. I think it’s very understudied. People have always focused on pre and probiotics, which is really pre is the food for the healthy gut bacteria and pros. You want to keep your neighbors happy, you know, with other happy neighbors. Meaning your happy gut microbiome. Yeah, exactly. But I think the postbiotic is what these bacteria are really making for the host, which is us for our health benefit. So the prebiotic is for the bacteria. Love it. The gut microbiome, the pro is just to keep the neighbors happy. What you have. And the postbiotic is what these colonies and thousands, billions of bacteria are making as a result for us as human hosts for our benefits. So it’s a symbiotic relationship. So do you believe that, sorry to interrupt you, do you believe that someone should have a pre, a probiotic, prebiotic and postbiotic? I think that would be a dream product. If we knew the right probiotic, that would induce a lot of postbiotics. If we knew the prebiotic that would help the probiotic. It’s very individual, which is a challenge. So right now it’s all population based. Yeah. So that’s the challenge. And before in my former life, I did enough failed probiotic trials and I have a lot of scars for that to know. Thing is you need to, I think once they, these probiotics become happy in your gut, they become lazy also. So you need to kind of cycle them out over time. So you need to always, and there’s no one magic probiotic strain in my opinion. So that’s the challenge I see for the gut microbiome field, but for the postbiotics, you’re absolutely right. They are probably communities in the world that have been eating different kinds of foods. Or nuts, for example, people who eat a lot of fermented fiber foods, they produce a lot of short chain fatty acids like butyrate and propionate and acetate. Now we think there’s a link there too, because if you’re making urolitin A and if you’re, you probably have a high chance of making other postbiotics. And so I think this is a fascinating study where we can dig in into the whole libraries of postbiotics and really study which are the ones that are truly beneficial to us. Do you, um, the pomegranate, say you get pomegranate kombucha. Have you guys looked at is there urolithin A in pomegranate kombucha? Because there’s a lot of metabolites there. And I have a really good friend, her name, do you know Suzanne Devkota? Name rings a bell. So she is head of the Microbiome Institute at Cedars-Sinai. Okay. In LA. And she was talking about how she’s actually mirroring a lot of kind of the conversation that you and I are having around this postbiotic. And she was talking about how the people will eat for the fermented food or drink kombucha. Um, the kombucha that she said had the highest amount was something called GTS or something like that. Um, and I’m curious is, say for example, their pomegranate GTS. Do you think that that, and I know that this is just a hypothetical question. It’s possible. So we haven’t looked in kombucha, but we have looked in oak aged whiskies because oak has one of the highest concentrations of elegitanins. And over time, these are fermented years, you know, so cool. And there are traces that you can find in. And now I guess you’ll have to drink a lot of whiskey. No, I actually don’t drink alcohol at all. I think it tastes terrible. So would you rather take two pills or drink? I don’t know. Well, I think that, um, the, you know, I don’t normally, um, promote companies or, um, things of that nature on the podcast. But why I think that what you’re doing is so extraordinary is I truly believe there are a few lessons to be learned here. Number one, you had an idea. You had an idea, you and your cohorts had an idea of how are you going to disrupt this nutraceutical world? And the way in which, and I’m putting words in your mouth, so please correct me, but the way in which I understand it is that instead of coming out with a product, you guys have spent millions of dollars and your lifetime, your adult lifetime, a lot of sacrifice, looking at the data saying, is this worthwhile? Do we feel honorable about bringing this compound to market in a clinically tested way? Which I think it shows a lot of curiosity, scientific integrity. And, um, I think that’s how it should be done. Well, I appreciate that. And I think that was the fundamental idea is to put the hard yards. There’s longevity has become a buzzword now. And I always say we were doing it before it became cool, but you know, the cool kids. And I think that the inspiration that I want others to take out of is that this will become the new norm. You know, this for the nutrition field, when you’re thinking about a new nutraceutical or a health product, you have to put the hard yards in science. You have to do the number of RCTs and, and, and doing a randomized clinical trial requires time. It requires working. I mean, just to do the first trial, we went around the world, we found there probably only two groups in the world that can actually measure mitochondrial function in a clinical trial setting. And it’s very laborious. You have to put the older adults in the MRI like machine, they exercise as they exercise, you can see the ATP drop, and how fast the ATP comes back after exercise in the MRI machine is an indicator of how good your mitochondria is with contrast. They’re using some kind of tracer. Yeah, they’re using spectroscopy. Yeah. So they know the wavelength at which ATP and phosphocreatinine, which is the molecule that tags along with the ATP and, and, and nutrition companies are not known to do all this. And that’s what we wanted to bring to the table. Was there, was it a, for you, was it a personal thing? Because again, your MD, PhD, you ended up having really good mentors. You were always interested in science from time you were 19, which do you have a photographic memory? I do actually, I do. Yeah. So, well, actually, what triggered were two things. One was, I was working with one of my coworkers in the lab in Yukon was, was a naturopathic doctor. And he was convinced there was so much potential in a compound he had found in the stem of pine apples at that time, it’s called bromelain that’s needed for wound healing. And we started studying it as a drug for asthma. And it was this amazing. So he was a naturopathic doctor, but he was a PhD? He was studying for his PhD because he was trying to also do what I was trying to do from a medical doctor. He was trying to bring more credibility to naturopathic doctors who do research. And his name is Eric Seacor. So he hooked me on to this. So I owe that part of the, let’s say the curiosity to him, because I realized at that time, how much potential there was in these natural products that had never been studied. I mean, I always say we wanted to be the genetic of the nutrition space, bring in the deep signs. And the personal was, I lost somebody close to MS. And for me, that was a lot of roots were in the diet and a lot of answers could have been, you know, there. And that’s why I told you the story where somebody, MS came and hugged me. Oh, I see. For me, that was such a satisfying moment. But I do think back to your point, I think we are the starting journey of, you know, this is just one compound. I think we can discover that with input from really the longevity guru is the next 10 big postbiotics or molecules that can really disrupt not just nutraceutical, but how we think about modern medicine and pharmaceuticals. Yeah, because you don’t want to wait when you’re 80 to really treat how you’re going to walk or your gait speed. You want to be active in thinking about in our 40s and 50s, this sort of health span approach. How do you want to be when you’re muscle span approach? I made up that term. No, I love it. I think muscle, if you’re not moving, you’re dying a slow death, right? I mean, so I think that’s a great powerful term to communicate. Do you think that there is some protective effect? So we have what 40 million people on statins statins have? Yeah, they might lower cholesterol. Yeah. But they also do a number of other things that affect skeletal muscle. Do you think that there is a potential benefit from the the world is very divided. And people all care about their health. And you have some individuals that all are, well, my doctor said to do this, it’s pharmaceuticals. And then you have all another group of individuals that say, Okay, well, it has to be all natural. The truth is, it’s probably in the middle. And there is leverage for both. And there’s importance for both. Yeah. Everything has a cost. I haven’t seen any cost benefit or a negative cost to your life and a because it’s a natural compound. Potentially, I suppose if someone put into a drug like metformin, because metformin has been known to decrease B vitamins, right, it can deplete B12. Is there any negative effect of your lithium and or because of its positive effect on mitochondria, can it be used in combination with other medications to potentially help maybe then be more effective or be less cytotoxic? Yeah, I love this conversation, because we’ve talked about almost material to create five more companies. I am very curious. And the way that I think about this is what are the people at home thinking? And maybe they’re not thinking that but so as a, as a physician scientist, I really think this hybrid approach of statins, as you said, or steroids, corticosteroids, these are both these class of drugs are great medicines, but they have big side effects on muscle, right? A lot of huge people Google on statins, about 20-30% of them have muscle spasms, muscle pain, rhabdomyolysis. And I think there is certainly a case profile of how pharmaceutical and nutraceutical could be combined to blunt the side effects, perhaps, of a lot of these modern medicines, steroids and other induces corticosteroids, probably if you’d, if you just actually, and I’ve looked into it, when you throw steroids and muscle cells, you, they atrophy like crazy. So all these people and these drugs, they probably have severe muscle issues. And they don’t know about it. And they don’t know. Yeah, doctors are not being, we’re not measuring skeletal muscle mass directly. Yeah, mitochondria health, cellular health is not a curriculum in modern med schools, right? So I think there’s a certain educational piece to modern medical training that needs to be put on preventive. So that’s the one thing where I feel very strongly about. And then the second question, I forget, what was the second question you said? Well, I asked about the combination and then any side effects. So there’s always a cost benefit. Yes. And I’m curious as to that. So today, I guess, 15 trials in 1500 participants, we’ve, again, 30% people make this naturally. So it’s a very safe evolutionary, all of us were making it, we’ve lost it, right? So I think, and now we have thousands, probably hundreds of thousands of customers have been taking it. The few things that sometimes people come to me and complain is that, oh, I have too much energy. So if you can think, and some people say, well, I used to sleep seven hours, now I sleep maybe less, but I wake up very energetic. So these are, you know, it’s hard to, but I would say if I was to do a health economic sort of cost benefit ratio, from a nutrition perspective, it’d be very high on this product. Because, you know, if you can extend the muscle span by five to 10 years, imagine the health economic benefit and health insurance needs to think about this also, this is what, you know, how do you compensate people who are living a healthy lifestyle? Yeah, we’re in this concept of muscle span, we’re beginning to educate more about that. It’s, you know, obviously early life, the way in which you treat your skeletal muscle, myonuclei satellite cells. Also throughout life, if you’re active, you’re building connective tissue, you’re building joints and ligament and tendon strength.

 Some of the some of these recent papers that are coming out are around immune function, rheumatoid arthritis, I would love to hear is that what is that? Is it acting on a different mechanism of action? How is it affecting chondrocytes? Yeah. What are chondrocytes? How is this benefiting individuals from a very practical standpoint? Yeah, it’s been fascinating. So we started with muscle we spend well because muscle is the most important organ and now right our day.

 We started asking, well, what about heart cells? What about chondrocytes? What about immune cells? So we are in that journey where we are now starting to go beyond muscle span and look more at health span. And it’s fascinating because the answer is always on mitochondria and how poor your mitochondria are whether they’re in chondrocytes. I’m a trained immunologist and for 15 years I’ve been telling people in my company that the roads cross in muscle and immune biology. And there’s this field that I really think will be the one of the biggest fields is called immune metabolism. And by that I don’t want to sound nerdy, but immune cells have also thousands of mitochondria. And there as we get old, our immune system goes for a toss much like a muscle. Senescence. Senescence. Senescence stem cells. So what we are seeing now and actually we just did a finished randomized clinical trial with the Buck Institute of Aging. Which is for those listening is a highly respected institute. Probably one of the premier aging research in California. And what we found is that as we get old, there are two kinds of main immune cells in the body, T cells and B cells. T cells are educated in Oregon called the thymus that we all in believe it about 20s, 30s. And we left with only let’s say a million T cells that can re-educate and fight viruses, bacteria, whatever. And then the B cells make antibodies. What we see is that the T cells, particularly a class of T cells that are involved in keeping cancer at bay or fighting viruses in their stem cells, the mitochondria in their stem cells, they go away. They become really dysfunctional. And when you give these individuals healthy adults who are aging, might appear, what we see is that we can bring these super T cells back to life. And it’s the same thing like what we see in muscle. So it’s not anything different. It’s just that at the whole body level. That’s why I think this is what I call cellular nutrient because it actually keeps your cells happy at a foundational level. Whether it’s the immune cells, muscle cells, really doesn’t matter. And so most of the data now that we are seeing is linking that piece of immune health to other pieces like muscle as well, where we were already seeing a dampening of inflammation. Do you think that it’s an aging effect or an inactivity effect or lifestyle effect? I think it’s a lifestyle effect. I do too. Yeah, I think it’s all our sedentary activities of staying at a desk. I mean, we all used to, yeah, be so much more active. And I think we always had it. We had the right drug. We always had exercise that would keep you healthy. And we’ve lost that to a certain extent with our sedentary activity. So I think what we’re seeing is the connect that with poor mitochondria, you get this leakage of the damaged mitochondria. The immune system recognizes that as a danger signal and starts going haywire. And when you sort of dampen the mitochondria, they become healthy. The immune system also becomes healthy. Where do you think the future of your Lithin-A is going? And I do also, before you answer that, want to mention, I don’t actually recommend other your Lithin-A products at this time, unless you can show me that it has what it says and it does what it says it’s going to do. Where do you think the future is of your Lithin-A studies? So I think you’re just starting. I mean, look at Omega 3. I always say Omega 3 took 20 years, probably for people to know what Omega 3 is and what its benefits are. We still don’t know. We still don’t know how it’s affecting. It’s different for men, for women. It’s important in the growing years for the kids, for their brain. That’s about the most we know. So I think there is a lot of education on the benefits of your Lithin-A. I think where it is headed is more research, because I do believe research is two words, re- and serge, and you need to keep doing more reproducible evidence-based science to show that. And the third is what we already talked about is the synergy with other nutrients and other combinations. On the other products that you mentioned, we have looked ourselves. There’s now a lot of Me2 products out in the market. Yeah, I noticed that. And there’s actually a famous longevity researcher out of Singapore who has published a paper. She looked at all the NAD supplements and your Lithin-A supplements. And actually, NAD supplements were only 20% had what they claim. And I actually don’t recommend NAD or NMN supplements. Yeah, well NMN now is classified as a drug, so it’s even different. But in your Lithin-A field, well, and we find is that most of them don’t have it. And those that have it, there’s somebody putting, for example, your Lithin-A diacetate. So they’re trying to somehow go through the intellectual property that we have put behind 15 years by adding something here and there, much like in magnesium field, they put either trionate or glycinate. But these, we don’t know the safety of these. We have spent 15 years also documenting the safety of this. And we know it’s safe. So I think that’s where I just would like people to

 be a bit careful and only go after the products that are safe. They have the FDA grass on your Lithin-A. And I think in the future, we are looking at how we can even improve the absorption better. How can we make it– Yeah, I was going to ask you about that. How are you going to– are you good on time? Because I do want to ask you about skin. I’ve been using Mito Pure topically. Of course, I don’t want to miss your flight. So are you good on time? No, no, no. We are good. Well, this is a new area because a lot of people start asking, well, what do I feel every day if I take your product? And a lot of people started coming and telling us about how in the mirror they were feeling looking better. And I was like, okay, are they really kidding or– Really? Were people saying that? Yeah, the oral supplement. Really? Yeah, so we started saying, okay, let’s not look into that, but first see if we can put it topically and see an effect on the skin cells, also mitochondria, that are required for collagen production. So we started looking– Oh, I see. It still is all mitochondria. It’s not a different mechanism of action in that. And we have looked into it. We have done our hard work there as well with trials putting topical your Lithin-A Mito Pure on age skin cells and individuals with wrinkles, for example. And we see that it’s all about energy supply of the skin and skin feels more hydrated. And so we’re now trying to get into where we’re going to combine and do a trial with the oral supplement and a topical sort of inside out. So there’s a lot of ideas. There’s no shortage of ideas. Interesting. So I’ve been using Timelines skincare product, but I will also say, and don’t tell Ian this, but I’ve been using it as body cream. You guys don’t make a body cream. Yeah, not good. So the face cream I’ve been putting on my body. I think it’s softer, smoother. I can’t tell you for sure. But what I will notice is because it’s summer, I’m not using Retin-A. And Retin-A is very well documented. There’s a lot of good data behind it. But looking at some of the skin data that you guys are putting out, I’ve been using Retin-A now because it’s summer or not Retin-A, but the your Lithin-A topically. And I definitely think that that’s very helpful. I mean, again, this is just anecdotal, but I do think that it’s very helpful. Yeah, so again, I think this is how I see the longevity space really going into and certainly becoming more tech focus. People are now, there are these apps now, everybody who’s using a longevity product is using these apps to see there’s this sort of notion of biological age. Can you measure how your cellular health is? So I think I really think that’s where we are also headed is how can we shape how people see longevity? Just not as living longer, but living longer, stronger from the muscle space, looking good, the immune system is healthy enough to fade off. So it’s all about living better as long as you could. I absolutely couldn’t agree with you more. I love it. Let’s wrap it up with just a quick summary of how one, if we’re going to give them a protocol. Yeah. And obviously you guys can check with your doctor, whatever that is. But how would you say someone should start with your Lithin-A? Yeah, I would take so we have a few preposition of products today. We have the berry flavored, pomegranate flavored powder, which a lot of people like to do. A lot of sports teams are on it and they like to put it in their smoothie. And it’s NSF certified. And all our products are NSF certified. And then we have the pills and we’re on works of, potentially even a gummy in the… I’ve been waiting for that gummy for a year now. Yeah, gummies, you have to make sure they survive the Texas heat and all these things. I’ve had some early editions of them. They’re amazing. They are. So I would start, we’ve tested all these products. They all give you the same bioavailability. So that’s where again, we are different in terms that we want to clinically validate each and every product. Does it have to be taken with food, fasted around exercise? We have tested that as well. Most of the trials are done at a fasting state, but we have compared the fasting state to a fed state with a heavy breakfast. The exposure to your Lithin-A is identical. So it doesn’t really matter. But the first thing we recommend is that take it in the morning. Start with 500 milligram unless you talk to your doctor and you have some underlying inflammation or fatigue issues. Yeah, I start a lot of the patients at 500 twice a day.

 I don’t know if there needs to be a specific time to keep the steady state because the half-life is a day. So I try to have that continue steady state exposure, same time daily. Yeah, that makes total sense. And then for a lot of people, a lot of athletes take a gram because they just feel they need to recover faster and not be as sore as they were. And it affects muscle soreness? It does. It does. Well, the first thing we see is that athletes, at least the trial data we have run, is that people feel less and they don’t have as much exertion after, let’s say, running a 3k race or a 5km race. They feel less sore. They feel that they recover and they’re ready to run the next race and keep their optimal performance. So that’s what I recommend. 500 milligram, if you have, as a clinician, if you feel the need to give a higher dose than give it for a while, it takes, it’s not a magic pill. It does take about a month to two months to start having an effect. And the best data we see is around the two to four month time. Does someone need to cycle it through, go on it, come off of it? I mean, a lot of people have told me about their experiences doing that because, but I see it as hitting the same biology as exercise. To be honest, we haven’t done the trials on this or even longer term, like a year trial, and that we certainly need to do. But if it’s like exercise, you don’t do exercise. So I agree with you. I was just curious as to what you thought. You don’t do exercise just for two or four months and then say you’ll have the benefits forever. So that’s where I feel we need to keep bringing more evidence on the table. But I feel happy that this is sort of knowing the half-life and the profile that is something that you can take. I’ve been taking it for four years myself. You look great for 25. No, I’m not. Not that 19 year old who went to med school anymore. But I can validate that I have not been sick with all the craziness in the last three, four years with COVID. And I do believe that’s where a gram dose really helped me. Do you think that because it takes four, you said it takes four to eight weeks to feel an effect. If someone knows that they’re going into surgery and maybe they’re going to be on bedrest, could they start it right then and there or would they want to start it a month prior before bedrest? Great questions. And I think we would need to generate the data. The trial that Stu is running, by the way, is exactly so. It’s given before the bedrest period and then through the bedrest period. And then I guess potentially another study we are looking at, actually, this is in Cacexia patients or the cancer population which has Cacexia. Which is for the audience muscle wasting. It’s muscle wasting, falling radio and chemotherapy is how fast the muscle can can regenerate and how fast even the immune system can regenerate. So I think personally, a lot of athletes ask me also, this is free workout during workout post. To me, it’s for athletes post-workout for sure. But for the everyday person like me, I take it whenever I can, to be honest. So if you know that you’re going to be, my professional recommendation would be, for example, my patients who I knew that are going to be going to surgery, we have them start a month in advance because we know that their training capacity is going to diminish. And even if they’re going to be traveling a lot and potentially not sticking to their overall training plan, I think typically do. Dr. Anurag Singh, it’s been such a pleasure. I could talk to you for many more hours, but I will let you out unscathed. I’m so grateful for your time and I’m really grateful for the work that you’re doing because I think that your company and the science that you’re doing is you’re showing scientific integrity.

 And with that, really that moves the needle and it holds everybody to a higher standard. So thank you so much. Thank you for having me. Appreciate the discussion. Appreciate all the ideas that we shared together today and yeah, look forward to keep working together. Thank you. The Dr. Gabrielle Lyon podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. And no patient-doctor relationship is formed. The use of information on this podcast, YouTube, or materials linked from a podcast or YouTube is at the user’s own risk. The content of this podcast is not intended to substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their healthcare professional for any such conditions. This is purely for entertainment and educational purposes only.