Why Aging May Be the Root Cause of Chronic Disease

In this episode of the Health Optimization Medicine Podcast, Dr. Scott Sherr, Dr. Ted Achacoso, Dr. Jup Kuipers, and Dr. Allen Bookatz explore:

• Why might chronic diseases and aging be different expressions of the same underlying biological process?
• How does metabolism drive the accumulation of cellular damage that eventually leads to dysfunction, frailty, and disease?
• What role can clinical metabolomics play in identifying metabolic dysfunction before pathology and symptoms emerge?
• Why do advanced therapies such as stem cells and exosomes often fail when the body's foundational metabolic health has not been optimized first?
• How can shifting from disease markers to health markers help extend healthspan, compress morbidity, and improve quality of life as we age?
  

What We Discuss:

00:00 Introduction: Why Chronic Disease is Aging
00:40 The Accumulation of Metabolic Waste
01:57 Aubrey de Grey’s Model of Pathology
03:26 Demystifying the "Spaghetti Map" of Metabolism
04:56 The Truth About Mesenchymal Stem Cells (MSCs) & Exosomes
05:22 Robert Naviaux's Cell Danger Response (CDR) Explained
07:14 What Healthcare Misses: Morbidity Compression
09:16 From "Normal" Lab Ranges to Optimal Biomarkers
10:28 Final Takeaways: Looking for Patterns of Health

Full Transcript:

[00:00:00] Dr. Scott Sherr: Hello everybody, and welcome back to the Health Optimization Medicine podcast. We have our faculty here with us today in person in DC. Very excited to be here with all of you. So today we're gonna talk about chronic disease is aging. That's the title. And we're gonna go through this, very excited about it.

[00:00:50] Dr. Scott Sherr: Leading off, how would you like to start this, Yap? 

[00:00:54] Dr. Jup Kuipers: Well, recently Dr. Ted explained to me, um, research from [00:01:00] the SENS Institute, um, showing actually how we currently think about what chronic disease is, and that chronic disease is actually not a separate process from aging. Um, why do some people age faster than others?

[00:01:18] Dr. Jup Kuipers: Why do some people develop diabetes or heart disease? Um, so when we look at what makes us us, we talk a lot about metabolism and metabolomics. Um, and that's the process that actually, well, keeps us humans functioning well. Uh, but inherently, metabolism is flawed. Metabolism produces waste like, um, reactive oxygen species causing lipid peroxidation.

[00:01:48] Dr. Jup Kuipers: Um, and your body has natural repair mechanisms to repair misfolded proteins or, um, repair damaged DNA. But at some point, that damage starts to [00:02:00] accumulate, and when the damage accumulation starts to exceed the rate at which it can repair, tissues start to break down. Right. You get structural damage, and then eventually pathology.

[00:02:12] Dr. Jup Kuipers: That's when, like, liver cells actually start to break down, and we can measure things like liver enzymes in serum. And that's where disease markers appear, and illness medicine actually has something to diagnose and treat. But what if, if we could actually measure metabolism going or deviating from its optimal values and intervene there even far before pathology becomes an issue?

[00:02:39] Dr. Ted Achacoso: This is a model by Aubrey de Grey, right? Formerly of the SENS Foundation. Uh, he's with another foundation now. He says that we have classified, uh, diseases all wrong. You know, the previous classification, uh, as Jaap, uh, has said, has been to classify diseases as congenital, infectious, or chronic, and [00:03:00] then, uh, aging as, you know, frailty, sarcopenia, and all of those other things that go along with older age.

[00:03:06] Dr. Ted Achacoso: Now, he says, well, we can put, uh, chronic diseases under aging because what drives aging is actually metabolism, right? Your metabolism, and then it produces damage, and then it produces a pathology. So what he proposes here, uh, is that since metabolism is like a spaghetti of, uh, undecipherable, uh, pathways, why don't we, uh, do the damage part, you know?

[00:03:35] Dr. Ted Achacoso: And Al and I were just talking earlier about, uh, MSC, uh, replacement therapy, you know, and, uh, these other- 

[00:03:43] Dr. Scott Sherr: Stem cells and stem cells immunity. 

[00:03:45] Dr. Ted Achacoso: Yeah, yeah. And, uh, you know, uh, exosomes and all of these other newfangled things that you hear about, those are already In a process of repair. So they're not foundational, they're repair mechanisms already.

[00:03:58] Dr. Ted Achacoso: Right. So, uh, fortunately [00:04:00] for us, with, uh, the, the clinical metabolomics, uh, metabolomics as a research subject came out of research and went into the lab and is now available to clinicians. So now the metabolism spaghetti that, uh, Aud- uh, Aubrey de Grey was, uh, talking about is no longer spaghetti. We can actually- By spaghetti, like 

[00:04:17] Dr. Scott Sherr: you look at those diagrams and I'm like, yeah, and so the entire picture is metabolism.

[00:04:21] Dr. Scott Sherr: You're like, what the fuck? 

[00:04:22] Dr. Ted Achacoso: Yeah. And the, the, the, the... You can now measure what the fuck these are. 

[00:04:25] Dr. Scott Sherr: Yes, 

[00:04:25] Dr. Ted Achacoso: exactly. Yeah, 

[00:04:26] Dr. Scott Sherr: yeah, yeah. Exactly. 

[00:04:27] Dr. Ted Achacoso: A- a- as I like to say, we, as medical students, we just used to memorize this. Just 

memorize 

[00:04:31] Dr. Scott Sherr: it, yeah. 

[00:04:32] Dr. Ted Achacoso: And the question that I hated the most from, uh, my patients, uh, really is, uh, "Doctor, is vitamin E good for me?"

[00:04:39] Dr. Ted Achacoso: Or, "Is this vitamin good for me?" We can now measure all of those. We don't have to guess, right? So, uh, we can actually guess the levels of all the, um, anaplerotic, uh, reactants in, in the Krebs cycle, right? Mm-hmm. 

[00:04:53] Dr. Scott Sherr: Mm-hmm. 

[00:04:53] Dr. Ted Achacoso: Uh, so, so now there's no more excuse. Right now, now the what, what was once a theoretical [00:05:00] biochemistry is now actually very clinical biochemistry, very different from the clinical biochemistry that's being taught to us, which is urinalysis, you know, um, um, uh, blood assay and all of that kind of stuff.

[00:05:10] Dr. Scott Sherr: Yeah. Yeah. Well, this makes me think of a couple things. I was actually talking to a stem cell expert just a couple days ago, and he, you know, the best stem cells that are gonna last the longest, maybe six months, maybe a year, right? Because what's actually at the base of all this is how well your cells are functioning.

[00:05:28] Dr. Scott Sherr: Metabolism, as you said, right? And so as he was describing it to me, he's like, we need to prime the body, we need to inject the stem cells, and then we need to do this sort of pattern of closing it up so that you make it work as best as possible. But if you don't do that priming, which is really what metabolism's all about, you're left with a system that's getting infused with things that's running on McDonald's and alcohol, you know?

[00:05:51] Dr. Scott Sherr: It's not gonna go very much. Well, Alan and I were talking about 

[00:05:55] Dr. Allen Bookatz: this earlier. Yeah. This is, it's interesting, right? Someone will come in and they're [00:06:00] willing to drop 20 to 30 Gs on, I don't know, 100, 200 million stem cells thinking that this is the savior. And You know, when we back up and we ask ourselves, okay, if stem cells are, are coming in and they're the repair mechanism, um, we have to ask ourselves, is the body even in a state where it is able to repair itself, right?

[00:06:24] Dr. Allen Bookatz: It, can it recognize that-- can it recognize that it's time to repair? And this goes back to, uh, Navra's, um, articles, uh, regarding the cell danger response. And for those that are listening, you'll hear us talk about this over and over again. It is the cell's ancient defense posture in response to threat.

[00:06:45] Dr. Allen Bookatz: And we can talk way more about it, but essentially, y- just to simplify it, we have on one spectrum when the system is under threat at the cellular level, everything r- with regard to growth, [00:07:00] repair, restoration shuts down because if you're under threat, right, you need to, you need to focus on survival. 

[00:07:08] Dr. Scott Sherr: Mm.

[00:07:09] Dr. Allen Bookatz: Everything else that's not important shuts down. And then there's a spectrum to which To which, uh, you know, when there is an abundance of energy and the threat's low, that the body can now start to repair itself. So if we take this, this concept and apply it to, say, stem cells, if someone comes in and they haven't had an assessment as to where they are in the cell danger response, is their body in a threat mode or is their body in a growth mode?

[00:07:36] Dr. Allen Bookatz: And you now give something that's repaired, this is, the, it's likely just a waste. And if you talk to anybody in the stem cell industry, what they feel, uh, other than it's very lucrative- It's a 

[00:07:47] Dr. Scott Sherr: Ferrari. You know? 

[00:07:48] Dr. Allen Bookatz: The Ferrari ... 

[00:07:49] Dr. Scott Sherr: they're, they're giving him a Ferrari. They're 

[00:07:50] Dr. Allen Bookatz: giving a Ferrar- Yes. Inside, inside joke there.

[00:07:53] Dr. Allen Bookatz: Um, but what they'll see is that some patients, some clients do not respond at all, no matter how many [00:08:00] stem cells you give them, no matter how frequently- 

[00:08:01] Dr. Scott Sherr: Even the coolest, newest- Even the- ... most awesome stem cells they have ... 

[00:08:04] Dr. Allen Bookatz: exactly. Yeah. Um, however, some, some do respond beautifully, and I think this is really the missing link here, is that under, you know, what is the terrain that we're giving the stem cells?

[00:08:16] Dr. Allen Bookatz: Are we giving... Is the body in a state of repair and can receive them and get the most out of them? So at the clinic that I'm working with, we have some stem cell, uh, docs, and they are 100% bought into this concept that you need to be optimized before we get stem cells. 

[00:08:33] Dr. Jup Kuipers: I like what you, what you said about the missing link, because when you look at that chain of events from metabolism going through damage to pathology, our current healthcare system is very good at, like, measuring pathology and damage and having a diagnosis and a treatment plan for that.

[00:08:50] Dr. Jup Kuipers: But we're missing the part that optimizes metabolism. And as Ted said, that spaghetti is now measurable. We can measure your metabolome- 

[00:08:59] Dr. Scott Sherr: [00:09:00] Yes ... 

[00:09:00] Dr. Jup Kuipers: and, and optimize your metabolism. And the result of that is, is twofold. It optimizes your function now, leading to a higher quality of life, improved sleep, improved energy, improved cognition, and then later down the line, um, it produces something called morbidity compression.

[00:09:19] Dr. Jup Kuipers: So we Make sure you, the years you spent in optimal health are extended. So you age w- w- healthy, you age without a lot of sickness, uh, and then die in, with a very rapid onset of disease without having to be vertical and ventilated for a 

[00:09:40] Dr. Scott Sherr: long time. 

[00:09:40] Dr. Ted Achacoso: Or, or die, or die in your sleep. 

[00:09:42] Dr. Scott Sherr: Or die 

[00:09:42] Dr. Ted Achacoso: in your sleep. You plan an 

[00:09:43] Dr. Scott Sherr: assassination of yourself?

[00:09:44] Dr. Ted Achacoso: Uh, yes, yes. Oh, that's a good one. That's my preferred mode of death, uh- ... is by assassination. So I, uh- So you're hiring out. I've, uh, I, I'm, I'm re- I'm renting two people. Um, you know, each of them, uh, are supposed to, to, uh, to assassinate me. If [00:10:00] one fails to assassinate me, the other assassin will assassinate the other.

[00:10:03] Dr. Ted Achacoso: Uh, but- 

[00:10:05] Dr. Scott Sherr: Sounds like your, your way of doing things. That medical problems. Giving this a lot of thought, eh? 

[00:10:09] Dr. Ted Achacoso: Of course. Um, but, uh, w- what has been said here is, uh, actually I would just like to, um, as, uh, uh, narrate my experience. I was asked to actually, uh, help in the stem cell program of a hospital and, um, you know, uh, I did, uh, nutrient and hormone balancing to the patients beforehand, and what happened was that they stopped going to the stem cell clinic and started becoming my patients because they said they felt better with what I was doing.

[00:10:39] Dr. Ted Achacoso: Yeah. So, um- Heard that ... so, uh, you know, they never consulted anything with me again, but, uh, you could see that it, there's now time, uh, you know, the, the technology exists to peer inside the cell and take a look at what's going on, right? And at, at the, uh, general state of body and that, as Alan says, uh, you [00:11:00] know, uh, to take a look at the cell danger response where metabolites are the primary drivers of it.

[00:11:05] Dr. Ted Achacoso: And as Joep says, you know, uh, this is an investment that you can do now because it's what's the body's doing now. And if it's always like that, then you will have a higher quality life, and a higher quality life is what again? 

[00:11:19] Dr. Scott Sherr: What is it? 

[00:11:20] Dr. Ted Achacoso: A life without pain. 

[00:11:21] Dr. Scott Sherr: Yes. Mm. And so, I mean, one other thing I would mention here is that I think is important is that- We learn in medical school normal ranges, normal values- Mm-hmm

[00:11:31] Dr. Scott Sherr: right? Which is typically a normal for maybe 18 to 65, maybe two to 95, depending on the, the analyte. And what we do at Health Optimization Medicine is shift your biology back to when you were optimal. This is not normal ranges. You don't wanna be normal for 55 or 60. You wanna be optimal, right? And then you can look at metabolism, you can look at these, the spaghetti drawing in front of you.

[00:11:53] Dr. Scott Sherr: Now you can mea- measure a lot of these analytes, and you can shift all those numbers to when you were most optimized, between 21 and 30 years of age. [00:12:00] So what-- something you said to me earlier, way earlier, Ted, was about instead of looking for patterns of disease, can we look for patterns of health? And that really just struck me, right, because that's really what, what we're doing.

[00:12:11] Dr. Ted Achacoso: Yeah. And, uh, instead of looking at, uh, uh, disease markers, can we start looking for health markers? You know, and that's my, uh, big quarrel with lifestyle medicine. Again, you're going to adjust the lifestyle of the person in order to address a particular disease. That's not necessarily right, right? You want to actually boost the health of the person, not just, uh, mitigate or diminish a disease.

[00:12:36] Dr. Ted Achacoso: And then what? You have five different diseases with five different lifestyle approaches and, you know, uh, that's already the crap that we're in right now, and we're just adding more crap by doing that. 

[00:12:47] Dr. Scott Sherr: Hmm. So in the end, aging is a chronic disease, or chronic diseases are aging. Well, I think it can go both ways.

[00:12:55] Dr. Scott Sherr: And so if you're thinking about this as a reclassification from clinicians, from people that are, are [00:13:00] in practice seeing people all the time, I think philosophers and what is Aubrey de Grey? He's a- 

[00:13:06] Dr. Ted Achacoso: Biogerontologist. 

[00:13:07] Dr. Scott Sherr: Yeah. It sounds pretty and great, but he's not actually seeing people in practice, right?

[00:13:12] Dr. Scott Sherr: And I think that what we do as a collective at Health Optimization Medicine is we are, as Dr. Ted likes to say, we are in front of a person, what are we gonna do right now to help them? And this is the framework that we use amongst many that you're gonna hear about on this podcast. Anything else, guys, or should we wrap up?

[00:13:27] Dr. Ted Achacoso: Let's wrap up. 

[00:13:28] Dr. Scott Sherr: Okay. Thanks for listening to another episode of the Health Optimization Medicine podcast. We really appreciate you being here. Gentlemen, it's good to see you, being in person, and we'll catch you next time.

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