Transcript of Can Longevity Go Too Far? Regenerative Medicine, Testosterone & the Cost of Living Longer

I had a panic attack. Ended up seeking out a functional medicine doctor, and she looks at me and says, Dave, you're fat. I'm only 40. Where does this go? That opens up your world again.

For those of you listening on Apple and Spotify, the dude's absolutely freaking jacked out of his mind. He's fucking constructed, okay?

How much shit are you willing to eat to get what you want? Come on, man. Living the process made me much more effective in helping other people to do it. We have artificial intelligence models now that allow me to actually customize your own stem cells for your problem. It's pretty incredible what our team has done.

Say that again for the honest, because that's baffling.

We can get people to live to 120 or 150. That will allow people not only to live longer, but to live fuller. Well, we're entering a period of med tech, Sean, where we're about to fuck with nature a lot.

If you remember, Drastic Park, don't mess with nature. I mean, there were dinosaurs eating people.

That's a problem. A bit in the ass, right?

What's up, everybody? I got my good friend David Carly here with me today. He's a renowned physician, regenerative medicine, and just has an overall amazing personal story and entrepreneurial journey that I want to share with you guys today. Super Jack to have you on, man. Welcome to the show.

Sean French podcast room. Hey, this is it, man. It's like New York. If you can make it here, is that the deal? Maybe.

I don't know. It's good to be here, man. Hey, man. I'm blessed to have you. I would have win the right, but I probably would have knocked the mic over. But dude, it's super awesome to be sitting in front of you again. I was on your show a couple of months ago where we got acquainted a little bit. Right off the bat, we had an amazing conversation and truly enjoyed my conversation with you on your show. It was just very deep and challenging, and I enjoyed it. So I'm grateful to have you here today.

Well, I would expect a lot of challenge to come back from you today, Sean.

I'm not I'm not a spiteful little bitch.

Let's get after it.

No, we'll do it a little differently here. It's all good.

It's an honor to be here. Honestly, it's an honor to be here, and I appreciate the opportunity to have a chat today.

Hell, yeah, man. I think the This is going to learn a lot from what you have to say. Let's do it. You have a very powerful personal story about your health. I guess let's just get into that part first.

I've become known in the regenerative medicine space, and I'll give you the story, but a quick segue. What's happening in the world right now is this intersection of longevity medicine and personalized medicine and regenerative medicine. Those things are crashing into each other. We talked a little bit about it before we went on, and it's about integrating all those tools together. My entry into that was a personal story. I'm in my early 40s, I think maybe 40, right around 40, actually. How old are you 33 now? Sorry. I am 54. I will be 55.

So we're about 15 years ago, roughly?

Yeah. Okay. Yeah. Ways back. I'm full-time practice. I had just had a baby at the time, running a biotech company, CEO of that, and I'm in business school. The impetus for business school was I started a biotech company, didn't have any clue what I was doing, so I figured I might as well go learn some business. Anyway, so I just burned out. I fried. I was I was functional. I was keeping up with life, but inside, I was just dying. I had no energy. It was hard to focus. It was hard to maintain that arduous, brutal schedule. I didn't know what was wrong with me. I'm a doctor, I'm supposed to know what's wrong with everybody. But self-diagnosing at that point, I think if you looked at me, I looked normal, but I was feeling horrible. Ended up seeking out a friend of mine, a colleague who was a functional medicine doctor, Functional medicine is what we now know as common place, biomarkers and looking at all your labs and trying to figure out what's wrong a little bit more holistically. I went to her and we did a very comprehensive workup and evaluation. It's a funny story.

She walks into the room and we had done all this work for several hours leading up to it. Finally, we're about to review everything. She looks at me, sits down, looks at me very seriously and says, Dave, you're fat. Point blank, period.

You're fat.

But I was metabolically unhealthy. I was putting on belly and things that happen to most men as the age. We now know back then, it wasn't quite as common place, but we now know that's often a hormonal issue. Women go through menopause, and we've been correcting that for 50 years, but men have only been andropaused, the equivalent of menopause in men versus women. We've only been addressing that in maybe 10, 15 years. We identified, I had low T. I had all the symptoms, and it's amazingly hard to self-diagnose sometimes as a doctor. You're so focused on trying to help everybody else. Sometimes the self-help element of it can fall to the wayside, and we can become unhealthy as a result.

I want to dive into something really quick. You're right, but the low T for the audience is low testosterone. As you guys know, men get older and they lose the production of that hormone. It's very essential in not just maintaining lean muscle mass, but also gaining some more muscle mass as far as sleep. It affects our sleep. It impacts fat burn. It has such a profound effect on everything we need to be in order to be physically healthy and mentally healthy. I have that story, too. To your point, It's like my buddy Jeff Delaney always says, it's like you're running a race with a flat tire because you're doing the weight lifting, you're trying to eat pretty decently. The problem is there's a disconnect in that chain because until you have the hormone level support, you honestly, mentally, if I have low T, I can't distinguish on how to, okay, that's going to be the best thing for me to eat, but leave that alone because of X, Y, Z. But when I'm optimized hormonally, I now have that intuition and that know-how. I'll be like, okay, I need to double up on this here.

Today's an off day, so I don't need this. I don't need all these carbs today because I'm not lifting. There's a lot of I'm going off on a tangent, but I love talking about this shit, man, because everybody's different. Everybody reacts a different way. If you put me on a bunch of rice and a bunch of even sweet potatoes, I'm not going to look as good as I would, and I'm not going to operate physically and mentally as good as if I kept a really strong, protein-rich diet with fruit as my carbs and a little carbolin for my intracarb, right? But to your point, man, all these things work together. Sure.

It's all integrated. We've called it integrative medicine for years, but we didn't always have the tools to fully integrate, and now we do, and it's now accelerating and progressing. But that's a podcast in and of itself. Sure, of course it is. Dietary recommendations and then personalized medicine and genetically driven, nutrigenomics, all kinds of things. But the point is-That was a big word. Yeah.

The fuck was it?

Nutrigenomics. That's using your DNA. Okay. Your personalized genetic footprint to influence what we recommend you eat. Oh, wow. It's something called nutrigenomics.

So like food intolerances and things like that?

Sure. Exactly. So you may respond better to this versus that. So that's an emerging field that is making progress. Ai is driving everything faster now. It's been really, really helpful in that regard. But to get back to the testosterone issue, one of my colleagues, and it is a fascinating topic, I agree, one of my colleagues coined Something I always, like one of my mentors, he said, Testosterone is the match that lights the fire. You have a guy who's functional, on the outside looks perfectly fine, functioning, dad, business, life, et cetera. The problem with that guy is he's feeling lousy and he becomes more and more ineffective with workouts and training and so forth, and they lose interest because they're not producing a result. It's psychologically discouraging. So if your testosterone is in the toilet and you go to the gym and eat good and train really hard, number one, you're exhausted, it's hard to do, but your body doesn't respond to it. And eventually, that lack of positive reinforcement, you lose interest and you lose health as a result. Then you slip and you slip and you slip and you slip before you know it, you're 40 pounds overweight, unfit, unhealthy, metabolic syndrome, all of the secondary problems that are associated with that.

And now we got to play catch up. So one of the interesting things in hormone optimization, and it's astounding to me that this is still a controversial topic at this point in time. I don't understand it. Because the data clearly shows that the upside clearly outweighs the down, unquestionably. Nuances aside. But if you fix that guy, a lot of times what happens is they didn't realize how bad they were feeling until you fix it. It came their new norm because it's not something that happens overnight. You wake up one day with low T. It just erodes little by little by little, and you adjust and adapt to a new normal, which is, I feel like, crap.

Your baseline is soThat's your baseline.

And you settle in, and that's the deal. But it's fixable and correctable and in a healthy way that can promote health, not just give you symptom control or fix a symptom problem, but actually promote health. Who doesn't get health problems? Young men with normal testosterone levels. Interesting. They don't get cancers, and they don't get heart disease, and they don't get all these things. But one of the fascinating things you touched on that I want to hit is we think of testosterone as the physical part, which is an important part of it. But there's so much psychological and mental to the testosterone optimization. Sleep being the one people often say was unexpected. When I started testosterone, I slept so much better because we think of testosterone as this activating agent. In fact, it can calm you, which is It's just paradox. It doesn't make sense. But we hear that over and over and over again. I'm known for regenerative medicine, but a lot of men ask me to manage their hormones and stuff, and I have certifications and training in that. But it's amazing to me I see that if you don't address that critical piece, everything else doesn't do as well.

It's interesting, and you're right, because you're talking about the mental aspect of it, right? Going back to when you were 40, 14, 15 years ago, where this story began, you were in there with your doctor and she's like, Hey, here's your issue, you're fat. But that is easy to fix. I mean, as long as you stay on track and you stack habits and you do all that. But the biggest part of it is when you're Going through all that, how is your mental state? Because that, to me, is typically where men really, really struggle. When we're in our 40s and overweight, we get really depressed and we don't know how to fix it. Talk the audience through your journey from that point on, fixing if there was any mental, I don't want to say issues, but any lack of confidence, things going on and how you overcame all that.

Well, I think there's several levels that you're managing psychologically. One is I'm only 40. Where does this go? I'm feeling terrible now. What if I'm 60 or 70? Am I going to be worse?

Where's the light at the end of this freaking tunnel?

There's a fear. There's a fear element to it. I feel that. I think that was one. But I had another episode that really was what prompted me to go to the doctor. I was giving a presentation to peers, an academic presentation. I was on the podium, excuse me. I had a panic attack. Oh, shit. I'd never had a panic attack in my life. I'd done a million presentations, and there was no reason to be nervous, but I literally had a panic attack, and I had to fight hard to get through that presentation, and I did. But it was that. Then I had a second episode, actually. I went home for the holidays around this same time. I remember you decompressed your family in the holidays, and I went for a run, and I came back, and I wasn't feeling so good. I thought, Man, maybe I'm getting a bug. We went to a Christmas show with my family that night, and we go to dinner, and I I had a second episode, two panic attacks. I don't know, this was over the course of probably a couple of months. If you've ever had a panic attack before, you feel like you're dying.

You feel like you're having a heart attack. You can't breathe. You're shaky. I didn't know what was wrong with me. My family didn't know what was wrong with me. I ended up in an ER. I ended up in an emergency room, and I had a chest X-ray and EKG and all of that. And the doctor, everything came in normal. They didn't check bloodwork at that time. That's what prompted me to go to the doctor. I think the whole your fat thing, some People might say, Oh, that's insensitive. But no, that doctor, for the reasons you just mentioned, she had to reel me in. My mind is swimming in a million different directions. I don't know what's going on. She needed to capture me. The, Hey, you're fat, had a little bit of shock value. But then it was followed up with, But we're going to fix you. You're going to feel better. You're going to do better. And it was really effective, albeit somewhat blunt, but it's what I needed. It was great. She was fantastic. Fantastic, fantastic doctor. She has since retired. But I credit her for really getting me back on track. And then I ran with it and did all kinds of fun body goal things.

And we can talk about those if you want to. But it allows me to look like this at age 54. Without it, I could not. I don't think so.

The only people that can see what you look like are the individuals watching on YouTube. So for those of you listening on Apple and Spotify, the dude's absolutely freaking jacked out of his mind. He's fucking constructed. He's constructed. I'm thinking, if I need a bodyguard, I got my boy here and I got my boy Dan behind the camera. I got two big sons of bitches protecting me. But what I'm really interested in you sharing with the audience is that progression, though. From that day that she reels you in, what did you start doing in small increments that the audience can take home. If they're struggling with a little bit of a health journey, first and foremost, go get your blood work done. See where you're at. But from that point, where'd you take it?

Yeah, you don't fix it if it doesn't need to be fixed.

You got to name it, man.

It needs to be a medical reason, not just for vanity's sake. No. But vanity, by the way, can be a very powerful motivator. It sure can. And we can use it. I think it was first psychological. It's a new lease on life, really. And testosterone works pretty quickly. You feel better soon. A couple of doses and you're feeling a lot better. That opens up your world again. It allows you to... Focus is another big one with testosterone. You're able to focus and stay honed in. That drive that you'd had that was getting harder and harder and harder to maintain, we're driven people. We need that. That's our juice. It gives you that back. Now, you can start to think about what it is you want, what it is you want with business, what it is you want with family and relationships, what it is you want with your body and your health. It puts you back in the game, takes you out of the stands and puts you back in the game. It's the fire. You have the vote now.

It's the match. You finally have a vote again.

Now it's like, Oh, man, let's get this. I was a college athlete, and I'd always been very athletic all my life. I was the kid who read the bodybuilding magazines back in the '80s and '90s. I always thought that was cool. I was never a professional bodybuilder, but I always thought it was cool. So I started training, and my body responded to the training. And then I got interested in nutrition. Like a lot of doctors were criticized for this, in fact, I wasn't trained in nutrition in medical school. We're taught how to take care of the sick, not the well. So that pivoted my journey from sick care into well care. And I've been involved in researching and developing that ever since. But I use myself as an example. I'm preparing a book manuscript, and we talk a lot about this journey, but living the process made me much more effective in helping other people to do it.

That right there, though. I think the audience is probably like, Oh, here they go again. Here, Sean goes again on the word process. That is everything. The process is everything. You can set a goal, you can set these big mountain of achievements. But if You're staring at those goals and you're really focused every day on getting closer to that, you're going to feel so overwhelmed. Your mental health is going to struggle. But if you dial in on the process that you set, you take action on that process, but going deeper, creating standards. Sure. I mean, a standard is so deep rooted in you. It is who you are is what you do. As long as you hit those standards daily within your process, this up here, those goals, they They start to get closer and closer. But too many people aren't focused on the process and the standards. They want to fast forward, skip blind, ended up on the top of the mountain. It's not the way shit works. So that word process to me means something massive, especially as it pertains to this show.

And by the way, we talk about building bodies, even with this, to start on an optimization that takes a long time. I've been doing it for years. You don't do this in six months. So if someone comes in and wants me to work with them to try to get to get more muscular, get lean, et cetera, get healthier, I say two years minimum. Oh, yeah. Anything less, and you're either going to overtrain and burn yourself out, or you're not going to hit your goal and you're going to want to quit.

I'm a year in, and I'm night and day from where I was last year at this time.

Well, I know a lot of bodybuilders just because I'm interested in the field. And what people don't recognize is those guys peak often in their 30s, and they've been training for 10, 12, 15 years. It takes a long time to build a body you want. But what optimization, whether it's hormone or otherwise, and there are things, nutritional optimization, sleep optimization, all the biohacking stuff that we're seeing and hearing every day, you still have to commit to that process that you're talking about, but stay with it for a very, very long time. It's not a quick fix. Nothing is.

But that's the lesson for everything, isn't it? A lot of people start something and they get excited about it. They're super motivated, but then they fall off because they're unwilling to do it. It's so funny. I always quote my boy Dan on this. I used to work for him at Paychecks. That's where I started my sales career. He used to sit people in the room and say, What's the true definition of commitment? He always said, Is doing what you said you were going to do long after the emotion wears off? That's where people stop, but that's where you're built. I I think that definition is the same thing for determination, discipline. It's like doing those things long after the emotion wears off.

Well, I thought about our previous conversation when you were Miami, and I knew you'd ask me today, what is your definition of determination and building on your point, I think determination is continuing when everybody else would quit. And so often that's what it takes. Everything I've done that's good in life, and I've had success in life and failure in life, plenty. But it was always harder than I thought, took longer than I thought, and required way more work than I thought when I ventured into it. I'm a big goal guy, and as are you. I think you hear that from other entrepreneurs. You hear what's Elon staring into the abyss and drinking, eating glass or something like that, whatever his famous quote is. I don't know that one.

That's interesting.

Entreprene is staring into the abyss while eating glass or something like that.

Makes sense. You don't get it unless you're an entrepreneur, but that makes sense.

It is as hard as everyone says, depending on your industry. In our case, FDA regulated stem cell therapeutics were a bear, a complete bear to try to tackle. But if you have the drive and you have the know-how and you have the optimization, in this case, as an aging male, then it's a systems problem. We started a new clinic. I was in my 50s. I started a brand new clinic after a previous clinic was acquired. We're integrating all these things like I'm talking about. My wife works with me, and I hop on my staff. It's systems, systems, systems. We can provide great technology, but if our systems suck, we're going to be a shit show. Systems are everything when it comes to business and building businesses and scaling businesses, if you want to try to do that. If you don't have the systems, it It's not going to happen. It's a wish, man. Health is the same way. Health systems, strategy, determination, consistency, habit, all the things that are so cliched, and we hear from everyone, but it's actually true.

Well, They're cliché for a reason, right? Yeah. You talk about systems, whether it's your entrepreneurial journey, your marriage, your relationship with your kids, there are systems involved. Sure. You have to be consistent within those systems. If you fall off of those things, then progress is stalled. I like to say you're either getting better or you're dying.

Well, personally, when we fall off systems, what allows you to rebound habit? If you fall off, habit allows you to rebound. I was part of an entrepreneur group A number of years ago, Andy Frisela and Ed Milet started. The Arte thing. I was in for a very first class. Did you like that? I did one year of it in the very first class that they did, and it was fantastic. I couldn't maintain it because I just got so busy. But anyway, there was lots of great things. But one of the things we did that I loved is everyone had to set a body goal in addition to their entrepreneurial and business goals. People would say, I want to lose 10 pounds. I want to lose 20 pounds. My goal was I wanted to get to 5% body fat.

On a Dexa or on a-On Dexa.

It had to be Dexa. So a true 5%, not what I think is 5% or a caliper or anything like that. A true 5 %.

Dude, and how tall and big you are, bro, that's a freaking massive goal.

It was a massive goal. Now, why did I set such a massive goal? Well, that was part of the exercise of Areté was to think like a world shaker. But I had to set the goal big because at the time, I was struggling a little bit with business and so forth. The medical practice was always fine, but the business part was not. It was part of the reason I joined the group is to network and learn and so forth. But I I had to relearn how to win again as an older person, not winning as a 20-year-old or winning in athletics or winning as a doctor or whatever. Winning as an entrepreneur was a different type of win.

It is different.

But the principles are the same no matter what the application. So with a really hard body goal, I remember. So I got to 7% really easily, and I'm like, I'm going to breach through this. This is a cakewalk. I was thinking I was living at about 10, 11%. But From 7: 00 to 5: 00 was a nightmare for me. It took a long time. This was timed, by the way. And if you didn't hit it, it was for charity. We did it for charity. So if you didn't hit it, you had to spend more money and do all this. We ended up giving them money anyway, so it was fine. But I remember I had to hit it right after Christmas. At the very end of it was Thanksgiving and Christmas. The very end were two holidays to hit my goal right after Christmas. I did a couple of Dexas, and I wasn't there, and I thought I was there, and I still wasn't there. Anyway, my trainer at the time, we were having trouble just getting that last % or two off. He goes, Just stop eating. I'm like, Stop eating? Stop eating altogether.

Altogether, Stop eating. Just stop. I said, For how long? He's like, As long as it takes. Because we're talking about 5% is extreme. That's like getting on stage. It's not normal and it's not healthy, by the way.

You You can't live at five.

It was crazy, but it was also a really tough goal to try to strive towards. So I literally stopped eating. I continued to train.

How long did you stop eating for?

It was, I think, five, six, seven days, something in that range. And then went for the Dexa, 5. 4%. I hit it, and that was right before Christmas. That's wild.

Let me ask you this, because this is what I find interesting. When you chase hard things like that and you hit it and you're willing to whatever it takes. I mean, you're talking not eating for a full week, right? Maybe water. I don't know if you did bone broth.

Yeah, we have to hydrate.

How did you do bone broth? Or was there no?

No, it was just electrolytes. It was a true... Look, we do it all the time now. We intermitt fast, right? But back then, it was a little bit different. But yeah, it was just lights and water.

That commitment to that goal and you hitting that. This is what I want to tie in with the audience, because I believe that everything is connected. What we do in one area of life and how we handle that area is how we handle everything else. How did the rest of your life pick up because you were handling that over there?

Well, that one took a lot of focus. I can't say that everything was flourishing as I was hit that end. It took serious commitment. I wouldn't say it revolutionized it, but I remember going back to our take because we had to go back and present to each other. We We had ourselves as accountability partners. I hit it and it was a big deal. Everyone said, Oh, you look so amazing, wonderful, blah, blah, blah. They asked to describe your experience with the process. I said to the group, and I think it was about 40 or 50 of us, all very successful entrepreneurs, I just had to learn how to win again in a different way.

Wow.

I had to learn how to win again. I wasn't going to hit it until I was able to make that last sacrifice harder than I thought, longer than I thought, more difficult than I thought, and had to learn how to win again. That I could apply to virtually everything else.

Right. So thereafter, you were able to apply those principles and that journey For me, the reason I wanted to touch on it, because like I said, I think everything's connected. For me, it happened real-time. I was 31% body fat in November of last year. 230 pounds. I got down at one point to 186. I'm 195 right now. A little more healthy for me, but still moving to body recomp and all that stuff. But what happened for me is once I took care of that one thing, I started eating better. I started moving my body more. Started getting better shape. My mind kicked on. I was more articulate. The show blew up. Everything. I couldn't get someone to invest in the show. When I took care of that, had two investors come in, built this full freaking team, and now we're doing things in the back half of 2025 that I thought was going to take me to 2027 to hit. You know what I mean? For me, I think it just showed everybody that I was finally living the life of determination and discipline like I talk about on my show outside of my show.

Probably your vibe changed, too. Oh, way different. You grew to yourself. Yeah. That you could do something that wanted to, again, as we've done many times, and we have to continue to always do.

But it's- Real quick. Sorry, sorry, sorry, sorry. Because I don't want to forget this. Because as we get older, we say, Oh, well, I'm older. I can't do this anymore. I can't burn fat like I did when I was 25. My metabolism is healthier now than it was when I was 30.

Not with a testosterone of 200, right?

No, no, it's probably wrong.

Once that's healthy, yes, of course. That's part of the issue. But your energy probably improved, your outlook improved, your confidence improved. That's a vibe, right? People feed off of that stuff. If you're throwing negative energy down, you interview people for a living. You can probably I know what someone's off. If someone's not got great energy or someone's not there. I know when someone's off, yeah. But what was interesting about it, Sean, is that was a body goal. I've since done many body goals. I want to go up, I want to go down, I want to go left, I want to go right. What I learned is I could change my body, and I had the skill set and tools to do it. Now I'm bigger and more muscular, and there's pros and cons to all of it. But in business, I'm still, to some degree, at the seven I was still learning how to win, trying to get to the five. It was because our biotech company is 15 years old, 16 years old, and going on 16. It's in the process of trying to scale. And that's one of the hardest pieces is to take a business to scale.

What does that require, by the way? Systems, processes, all that stuff. So it was immediately applicable lessons, but I haven't hit 5% on business yet. That's still a work in progress, and we're still continuing to do that. But having the know-how that you can and having the confidence that you can, because the hardest thing, I think, in business and entrepreneurship, especially in a really difficult biotech business environment, you've been in med tech, is maintaining your confidence that your idea is right and that your idea is ultimately scalable, especially when it's a disruptive idea, which mine was. Maintaining confidence requires a deep dive in your soul to weather those difficulties and the determination and grit needed to get there. I like to refer to my my entrepreneurial journey as the Rocky Balboa entrepreneurship. I get punched in the face for 11 rounds hoping to win in the 12th, and that's what it was like. But I'm not in the 12th round yet. I'm still maybe in the 10th or 11th.

You're stuck in the 10th or 11th. I get it. No, I understand exactly your analogy and where you're coming from. Absolutely. I love the Rocky movies for reference, dude. Because that's-They're so applicable. That's why America loved Rocky so much because it is literally Americans. They love a comeback story. Everybody's getting the shit kicked out of them right now. Everybody's getting the shit kicked out of them years ago, too. But it's like, you got to hang on. Hang on, train systems. Go to Russia like he did. Go to your proverbial Russia, and work your butt off. Then you come out, and then maybe you do get to that 12th round and you do win. Then it starts all over again.

But the beauty of it is no guarantee you're going to get to round 12. That fear of failure, I don't want to say fear. That risk of failure is always profound. Even when you scale, it's still profound. I think the take home point was something like a body goal, something like this exercise that we did in the entrepreneurial group, and that you have to set for yourself periodically in life, especially as you get older, maintains that confidence level that you can. It's possible. Eight, nine out of ten in businesses fail. Well, why can't you be the one? That doesn't.

I think you talk about the confidence. Having that internal confidence, that is done by handling the shit and doing the hard things that you need to handle and do.

Yes. It's also partly done by making promises to yourself and keeping them.

Yeah, you can't lie to yourself. But see, that was my point earlier when I started talking about the show and asking you, what was your experience? Because once I took care of the one thing that I couldn't take care of my whole life on a consistent basis, everything started to open up. My speech pattern changed. Before, it would be like every seven words would be the F word. Now it slips out every now and again. If I'm kicking it with Matt on a show, then of course, I'm going to drop an F bomb.

Matt can draw that out.

He's just a fucking horrible person. But for the most part now, it is a different energy. I communicate much better. I think it's because my lights are on, man. I could say, Okay, that's probably not where I need to go with it. But once I fixed that for me and did the hard thing and didn't lie to myself and kept my word, everything else opened up. That's the message I want the audience to really take from the first part of this conversation and going to the latter part is like, if you say you're going to do something for yourself, do it.

Do it. And suffer for it if you have to, which you always do.

Let's talk about that word. I really love that word suffer or suffering. A lot of people will say, This is miserable. I am suffering, so therefore, I'm not going to do it. I truly believe in building a body, building a practice, and building a show, building a great classroom for an elementary school teacher. You better suffer a little bit. You have to suffer.

Well, if you don't have to suffer, how hard is your goal?

That's what I'm saying. But that's the point, though, man. See, we get that. I think a lot of people at the very base level do get it, but the moment they have that suffering, it's 4: 00 AM or, damn, I didn't get the gym today. It's 6 PM and I'm exhausted.

Or the level of suffering that's necessary.

It's a lot. I feel as though you don't have to be a masochist to be like, Oh, I'm suffering.

I love this shit. It feels that way sometimes.

But it really does. Like, Oh, here I fucking am again doing this thing. This hurts. This is suffering mentally and physically. But you learn something so deep about yourself when you're willing to execute those moments. I feel like more people need to be comfortable with that word.

Yeah, it's a fine line between a variant of martyrdom and success. A shout out to my friends. When I lived in Denver, I trained at Armbrust Project. Gym. That's where Phil Keith trained, eight-time Mister Olympia. Dylan Armbrust, who owns the gym, used to train a lot of professional bodybuilders. When someone was struggling, go to Dylan, Hey, Dylan, you have any advice for me? I'm plateaued. I'm having a hard time. What do you think Dylan would often say, You need to learn how to suffer more. You're not suffering enough. If you want it, then learn how to suffer more. I always remembered that because I think it's very applicable. Maybe this is a good example, To look like this at 54, I purposefully induce a state of chronic pain every day, pretty much. Now, is that good? Is that healthy? It's healthy here for sure because it's keeping those batteries charged and it's keeping that determination muscle firing. But most people want to live and want to exercise and have fun and feel good But for me to look like this, I have to suffer every single day, pretty much. I do it partly because I just like it.

It's my thing. I also do it, and I'll use an analogy. When patients come in, I'll often joke with them. If you go to the cardiologist, Check your heart. The cardiologist walked into the room and he was or she was obese, smoking a cigarette and eating a donut. Would you listen to what they had to say? So part of my personal responsibility to patients who are looking to help their a arthritic knee or shoulder or rotator cuff or just help their body in general, I have to live that process. Or why would they listen to me? It's like a trainer who's unfit. Would you listen to a trainer who's unfit? Trainers, in my opinion, should be more fit than me. Or certainly on my level at a minimum. So I take it as a personal responsibility to do this as an example to hopefully encourage or motivate or whatever might be the case, others to say, Hey, if I can do it, I'm just as busy as the next person. I'm a dad, and I'm a husband, and I have businesses, and I have a busy schedule, and I always sleep well, and always eat perfect.

But you know what? I make it a purposeful commitment in my life because it's what I believe in, and I get it done. But it is hard.

I love what... What was his last name again?

Dylan Armbrust.

Armbrust.

Cool name for a gym owner, right? Armbrust. Armbrust. That's pretty good, What Mr..

Armbrust said, he's like, You need to learn how to suffer more. That's that point of failure. What he's saying is in the gym, if you're getting 10 easy, go up and wait, struggle 8, 9, and 10. Fail to secede. Yeah, really push yourself, suffer through those reps and those exercises a little bit more. That's the same thing with everything because people get to a point. Guilty as charged. I don't speak from the top of a mountain. I speak from the scars. Yeah, for sure. There would be moments where I get so close, but then I would let up because that temperature gage, that internal temperature gage was set at 70, and I needed it at 100 or a 90. But I get comfortable with the 70, and then I would stop. I would literally stop doing what I'm doing. I would stop suffering. Whereas now I push myself in the gym, and I'm like, Okay, I'm going to suffer a little bit more. Dan knows this. The same thing with the business. I choose suffering much more than I choose the happy moments. What I mean by that is I go, Okay, what more can I do?

What more can I implement? How do we take this to the next level? This is going to be a little bit of suffering. Maybe it's a little more travel. Am I willing to do it? Let's talk to the wife. Hey, there might be some times here. There's this potential tour coming up that I might be a part of. It's going to be two months. I'll be coming home. I'll be back and forth. There's going to be a sacrifice. There's going to be some suffering. But is it worth it? We get to make those decisions, right? But I choose to stay in that word.

Yeah. My own internal voice in my head is, how much shit are you willing to eat to get what you want?

Come on, man. It better be a lot of shit.

There's no way around it. You're eating shit. You need a little bit of shit and get some of what you want, or you need a whole lot of shit and win in the 12th. Yeah.

Oh, man, it's true.

The doubt voice that's in in all of our heads, in my opinion, it's really just it comes down to determination and how far are you willing to go? I'll go back to that. Areté is in my head now that we were talking about. I think Ed, my let at one of the meetings said, part of the reason I'm successful is other people get tired. I don't let myself get tired. I keep going. I am tired, but I don't let myself be tired and let that tiredness affect my ability to get what I want. That is another good definition of determination.

Yeah, it's like doing something you said you're going to do, even if you don't emotionally feel like doing it.

You've gone to the gym when you feel like crap and you still got to get the work done. This goes back to why David Goggins has become so successful is he's pushed that to a whole another level of human performance. Then to say that we think our max is 100%, it's probably only about 70 or 80. There's still more left in the tank, but you have to really eat a lot of shit.

You have to tap into it.

You have to tap into it. That's a mental game. Yeah, it truly is.

I want to touch on, because we're getting to the back half, I want to touch on regenerative messes, medicine a little bit, stem cells, specifically. For a long time, it was something that athletes and people had to travel to Mexico and get the stem cell treatment. Now, I guess as of July, Florida is one of two states. I believe Utah is the other one, right? Correct. We actually get stem cell therapy here in Florida. Walk us through that and what that means, not just for your business, but for people in general.

Yeah, it could be. It's a blessing or curse scenario. For 15 years, I was limited. I've been researching and developing stem cell therapies for a long time, and we were limited to using the patient zone by the Food and Drug Administration. That's what we were allowed legally to do. There were people breaking the law and doing things they weren't supposed to do. I set up a company that's FDA-registered and audited, so we got to play by the rules. In July, Senator Turnbill proposed a bill signed by Governor DeSantis, which said, with informed consent, and it's a very detailed counseling that we have to do with patients, and with a vendor providing the cells that checks a whole bunch of quality checks and balances, we are allowed to offer to patients unapproved cell therapies from a donor, from a different person, and most of them are from birthing tissue cells. So placental dry, umbilical cord, work as jelly, amnion fluid, et cetera, which is where the models that are typically used in the-It's all I am the on stuff, right?

Correct.

I fought for years to try to make-Do you like that?

Did you like that? I'm very smart, right? I'm like, Hey.

That or you researched it and you're curious like most. Smart. All right.

Then you didn't know that about me.

Well, I do now. Yeah, there you go.

I just had to make it-There'll be a quiz at the end.

There is a quiz. It's open book, though.

Don't worry. Sorry for the interruption.

I'd worked for all this time to figure, and we were humming. We were figuring out how to make a person's own stem cells work fantastic for them. We were getting tremendous results. We have 5,000 patients in our database under study. And just when that If something happens and I get your stem cells dialed in for you, the law changes to open up this whole new world. So at first, it was a little bit like, oh, crap, I just figured out how to do the other thing. Now I got to start all over again, which is literally the approach we're taking. Because unfortunately, With all of these offshore claims, there's tons of anecdotal evidence that people are getting better, but there's no publications, there's no podiums in academic conferences. The lure of a donor cell, someone else's cells is several for one. People think, I'm old, I don't have good stem cells. Not totally true. You still have plenty of good stem cells. Not quite as good as they used to be, but we've shown that they still work great in many applications. There's a lot of celebrity endorsement of, Use baby cells, they're younger, they're more powerful.

In a test tube or in culture conditions, culture conditions, that seems to be the case, but we don't know if that applies to actual human conditions yet. We haven't proven that yet. What the law will allow me to do, I already have thousands of patients under study using their own cells. I will take the same rigorous scientific and academic approach to donor cells, and we will match patient populations and directly compare one to the other to see what works better. To finally answer the question once and for all, what works when, where, and why? Making no assumptions that one size fits all. A 75-year-old smoker may require something different from a 23-year-old athlete. A cartilage problem may require something different from a tendon problem. The confines of the law in the US are that we're allowed to apply it to orthopedic pain condition, painful conditions or wound care. It has to fit under those three indications for us to apply these donor cells. The law was extremely controversial, but I think if we don't screw it up, will be an incredible opportunity for us to learn and advance and progress, because there may be situations where a donor model makes much more sense.

If you're healthy and your cells work great, why don't we use those? I know your cells won't hurt you. We don't know the long term data yet on donor cells 20, 30, 40 years out. We don't have it. It doesn't exist. So it created this opportunity, and it was a little bit daunting because I had to start over from scratch because it's about Our whole biotech approach over the past 16 years has been, cells can be thought of like a drug, like a pharma type of model. There's a particular cellular dose and a measurable, predictable response. We have worked tirelessly for years to be able to predict how your cells are going to work for you. We have artificial intelligence models now that allow me to actually customize your own stem cells for your problem. It's pretty incredible what our team has done.

Say that again for the audience, because that's baffling.

Over time, we developed a model which analyzes you, your medical history, your age, your sex, your body mass index, the medications you're on, your baseline cell counts. Our AI-driven model tells me, based on the thousands of patients that we've treated, exactly what biologic to make and what cellular doses to apply to you to give you the best chance for success. That's what we've done over 16 years. Now, that is a model that we continue to validate. We can't just roll that out. So that requires... You've been in the space, so you don't just start doing that. So we continue to test that model and refine it. But it exists. And AI was the last piece of the puzzle that allowed me. I thought of this 15 years ago, but I didn't have the tool the statistical firepower to make it work. Now we did. We got some really smart people on our data team to help move that over the presence. Now I got to do it all over again because the knock on donor cells, which these are culture expanded cells, meaning we take a placental, we dissect the cells that we want, we culture them to grow more of them, then we freeze them at minus 80 degrees temperatures, then we thaw them out, and then we put them back into the patient.

That's a lot of handling. There's a lot that can go wrong. Some of my peers have questioned and actually done some research to question whether these cells, by the time they go back into your body, are actually still alive. So part of the law calls for a post-thaw viability analysis. Viability means what percentage of the cells are actually alive. So what we've done is, as usual, take it one step further than that. So when the cells leave the lab, I know how many are in that little vial and how many are alive. It's not 100%, by the way. We freeze them to minus 80. I got to keep them at minus 80 in my clinic, in my lab. Then when we're ready to put them in, we thaw them in a water bath under a specific protocol, and reintroduce them. But before we reintroduce them, what we're developing now are protocols to remeasure the dose and the viability. Again, because it wasn't the viability of % that were alive when it left the lab, it's the % that are alive when I put them into your body. That is our dose.

How big of a discrepancy from when you get it and freeze it to when you thaw it out in the water bath, the drop in percentage of live?

Not enough data to say accurately yet because literally this just started in July, and we only have a handful of these done at this time. But the interest is astronomical for this stuff. We're getting a lot of inquiries and lots of patients who are interested. Somewhere in the range of 15 to 30% die before they get frozen. It's in that ballpark. Now the question is when we thaw them out and put them back into the patient. And I don't want to give data yet because we're still refining that remeasure model in our laboratory. So that's not validated yet. So I don't want to be unfair to the industry. But we would expect to lose probably another double digit %. So if 100 million came out of the placenta and we lost 20 % of those, and we lose another 20 %, now we're at 60 % of the original dose. That is our dose, we think. Because here's the kicker, can dead cells produce a positive therapeutic effect? Seems weird, right? These are living cell therapies. If the cell is dead, Could it produce a positive effect? But remember, the cells release things when they go into the body.

And if a cell dies, perhaps it could release growth factors and anti-inflammatory proteins and signals, because these are placental or amniotic umbilical cord stem cells to help a developing baby develop. Perhaps some of those signals are still in that vial, even though the cell is dead, and we could still potentially get a positive therapeutic effect. That's some of the exosome. You've heard the word exosomes? Yeah, of course. Exosomes are just the signals that stem cells release to perform their therapeutic function. If the cell dies, maybe it still releases its exosomes, and maybe those exosomes are still in there, and maybe those exosomes will still produce a positive effect. That's why we have to measure what came We come out of the lab and then remeasure, again, before it goes into the patient. Because if we lose a certain percentage, but we see that therapeutically, the patients continue to do well, there's something else happening in there that we've got to go back and figure out.

Is there a way now to test the growth factors of those dead sales?

There is, but it's very complicated and slow and expensive. Some of the research that we do is limited by what the market will bear. That market is growing, so we just We applied for an NIH grant before the government shut down, so that wasn't helpful for the grant. But now that we're reopening, we're actively seeking because there's such tremendous opportunity here, if it's done correctly and responsibly, that we anticipate More and more industry monies will be thrown at this. Grant monies will be thrown at this because as this longevity push continues, stem cells will be a key part of it.

Yeah, and that's what I really want to touch on, too, before we run out of time is longevity. This is all very fascinating stuff. I think this is all stuff that people have been in the space of wellness or wanting to get in the space of wellness and wanting to live longer, wanting to feel better, really diving into this stuff. But we're getting to the technology where people are spouting like, Hey, we're going to have the ability to keep someone alive until 100, 120 years old, 125 years old, because the heart's still healthy and everything else is healthy. But there's a bigger problem here.

A huge problem, a huge evolving problem. Yeah, let's talk about that. I call it the orthopedic longevity crisis. So we can make our brains and our hearts and our lungs and our organs and our muscles live longer. It's realistic to expect that our generation could live to 100 pretty regularly. The generation behind us.

Because that'd be so bad ass, bro.

The generation behind us, maybe 100, 200, 150, maybe more. Who knows? But we do not yet have a solution to a deteriorating orthopedic system. And The reason is our orthopedic tissues, cartilage, tendons, they're what we call avascular, so they have no direct blood supply to them. Because they have no direct blood supply, they can't heal. So trauma and mileage and wear and tear is cumulative. It just builds up and builds up and build up with no ability to reverse it yet. So if we can get people to live to 120 or 150, but their orthopedic systems are shit, that's not a very good quality of life. I'm alive. We talk about lifespan and health span, right? They're two different things. We need to be thinking more in this longevity movement about an orthopedic solution that will allow people not only to live longer, but to live fuller longer.

Yeah, what's the point of being alive if you're not truly living?

Exactly. Then we're a little behind in orthopedics. I'm hoping that, again, resources will be pumped into this, not only us, but many people working on this that will come up with some of those solutions.

But early on, is there anybody in the orthopedic space that understands and has identified this issue and is maybe trying to work ahead a little bit?

Yeah, I like to think I'm one of them, but there are others. Sure, of course. It's a really tough nut to crack, though. It's a system that's designed to fail. Ethically, it makes you wonder if God designed it to fail Well, should we change that? There's that question. We're entering a period of med tech, Sean, where we're about to fuck with nature a lot. There's an old quote from... I love movie quotes. There's an old quote from the movie Jurassic Park, where Jeff Goldblum says, I think it was, Nature always finds a way. Remember, they made all the dinosaurs women, and they found a way to reproduce or something like that. So I always say, the more we fuck with nature, the more nature may bite us in the ass. So are we really smart enough? And it really gets into the genetic engineering model programming cells to perform specific functions. I'm very excited about the concept of taking your stem cells out of you, making Taking them young again, and then reprogram them to go back and do you regenerate your cartilage in your knee? I love that. That possibility, that potential exists. We don't have the code cracked yet.

But again, it's about on/off switches. It's about turning things on and off inside of our cells. If you turn it on, then, God damn it, you got to be able to turn it off, too. So it's an on/off switch problem that we're slowly figuring out. So for a long time, I was concerned, we are not smart enough to outthink millions of years of evolution and nature. The question is, is AI smart enough to do so? And that remains to be seen, but it certainly has given us an intellectual firepower beyond what we were capable of previously, and it's now accelerating. So it'll be interesting to see what that allows us to do safely. And as that capability continues to increase, our ability to manipulate nature will continue to evolve more and more and more. I hope we can control it.

I hope so, too. It's crazy because I could sit here and say, I got three beautiful children. I want to see them grow up. I want to be able to walk my daughters down the aisle. I want to see my son raise his family. Hey, if they can keep me alive until 80 to 100 years old, that's great, man. I would obviously want to do that 100%, but I want to feel good when I'm doing it. But I also don't want these other potential fallouts of really screwing with nature. That's a whole other thing because if you remember, Drastic Park, don't mess with nature. I mean, there were dinosaurs eating people. That's a problem.

A bit in the ass, right?

That's a big freaking problem. This has been very interesting, man. It's an episode to where I feel that there was so much educational value that was given to the audience that hopefully that they can hold on to. If you miss something, rewatch it again, relisten to it again, and share it with somebody you know, love and trust. But, dude, thank you so much, man. Thank you.

Yeah, I appreciate you letting me talk to your audience, and congratulations on the audience. Thanks, audience, for supporting Sean. He's terrific. I hope it was useful. I hope you guys get something out of it. Keep an eye on us. We're going to be working hard with that determination to try to continue to bring you guys some solutions.

Before we let the audience go, I want you to tell them where they can find you, your website, so they can learn about you as a physician and how they can potentially Carly, go see you to feel better, and then where they can find you on Socials.

Social is just my name, David Carly. I'm very searchable, googlable. Carly with a K-A-R-L-I. David Carly, K-A-R-L-I. If you want to just search me out, you'll find all this stuff. But our clinic is the Carly Health Institute, carlyhealth. Com. My biotech company is Gray Ledge, G-R-E-Y Ledge, greyLedgebiotech. Com. That talks about a lot of the work with patients' own stem cells and the research and development that we're doing in a lot of our data work as well. Between those three things, you'll probably learn more about me than you care to know.

I have some questions for you offline, too. This is really cool. For the audience, thank you guys so much for listening. Again, please, if you haven't subscribed or haven't been following the show, please do that. If you find yourself loving this episode or the show in general, share it with somebody you know, love and trust. Until next time, guys. It's David Sermon.