Why You Need a Health Dashboard with David Korsunsky

In this Episode

• • [02:31]Stephan welcomes David Korsunsky, the founder of Heads Up™, a digital health analytics company based in Scottsdale. David provides a brief overview of how he started founding Heads Up™.
  • [07:45]David delves into his motivations and shares his initial health optimization journey, drawing inspiration from industry leaders like Tim Ferriss and Dave Asprey.
  • [10:35]David outlines the sleep optimization strategies that significantly impacted his well-being.
  • [14:00]David breaks down the concept of Heart Rate Variability (HRV) and highlights its importance.
  • [19:40]Stephan and David explore tools for tracking health metrics, such as sleep. David highlights how his software integrates data from devices like the Oura ring.
  • [26:42]David describes how to derive actionable insights using a health dashboard. He also explains how his system processes data, including DEXA scan results, after upload.
  • [33:29]David examines methods for assessing biological age.
  • [40:40]David introduces peptides and shares the specific ones he uses.
  • [45:21]David discusses the frequency of usage and tracking health metrics through Hyperbaric Oxygen Therapy (HBOT). He also emphasizes the role of monitoring VO2 Max for longevity.
  • [59:06]Learn how to set up a personalized health dashboard.

Jump to Links and Resources

David, it’s so great to have you on the show.

Thank you, Stephan. I know we’ve been trying to connect for quite some time now after our meeting in Miami Beach, Florida, if my memory serves me.

At a Biohacking Congress event.

Here we are, full circle. It took us a while, but we got there.

Yes. First of all, I would love to hear about so many people’s lives as you do with your Heads Up™ technology and platform.

I was working in the technology industry. I’m not in healthcare by training. My background is in technology, not unlike yours. My job was to go into these large computer data centers the size of a football field, and my job was to figure out why the system was running slow. You’re looking for a needle in the haystack at that point. One of the techniques we would use is to collect seven days of performance data on every single machine in the system. Hundreds upon hundreds of individual servers, and each server had hundreds of performance statistics. Each of those hundreds of performance statistics was measured every 20 seconds.

You get this mountain of data back, and then you have to retroactively analyze the patterns and see where the breakpoints were in performance—pretty standard analytics. Every industry has this, but I got really, really good at doing that. This was right around when some of the first consumer-grade health sensors were hitting the market. Some of your listeners might remember the Zeo, this headband you wore. It was like the coolest thing in the world back in 2011. It was the first consumer device that gave you some actionable data about your sleep.

I had one.

I did, too. Seeing the biofeedback helped me realize that I had some work to do to improve my sleep quality. Subjectively, I would have told you I was sleeping fine, but when I really looked at the numbers, it turned out I was getting a lot less sleep than I thought. Sometimes less than six hours. Most nights, it’s somewhere between six and seven.

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But then I went on the Zeo website, and there were all these awesome tips on improving your sleep environment—the quality of your mattress, the temperature of the room, eliminating ambient light, and avoiding meals before bed. I just went down the rabbit hole on this because I would feel so much better as I started improving my health.

As I got deeper into this whole world of the quantified self, which it was called at the time, biohacking is the term du jour. But back then, it was called the quantified self. I started seeing the same problem I had in my day job. “Hey, there’s all this data here, but there are no real tools to help people make any sense of it.” I’m like, “Well, I know how to solve that problem. We just need to pull together some good tool sets here.” Actually, we wanted to make the toolset available to individuals who were starting to become invested in their health because it was traditionally the doctors who had those tools. You’d go to the doctors, and they’d pull up your data on some screen.

You never see the screen, but they’d pull it up, and there it is. Or you could log into your underwhelming patient portal and look at some of your stats there. It was terrible. That’s when I started working on the first integrated health dashboard in 2015 while still gainfully employed. Then, I took the leap of faith. An investor offered me some money to quit my job and do it full-time. And I was making pretty good money at that time. I had a cushy setup. I made my director level at the company. I had respect, salary, title, and all of the trappings you’d need just to ride that sucker out for the next 20 years. Or I could knock on this other door and jump off a cliff with no parachute. 

You know the old adage, “Leap and a net will appear.”

I leaped. It’s just been the most amazing, beautiful, challenging, and rewarding experience I could have ever imagined.

Yeah, it’s amazing. When did you go full-time into this business and get that investor to sign on?

That was in the summer of 2017. Someone writes you a check for $100,000. As a first-time founder, you’re doing backflips, and then you realize that five months later, you’re like, “Okay, that money’s gone. So now what?” Then you have to go figure it out. You have to figure out how to capitalize your company. That’s a whole multi-year process of learning how to work with investors and how to raise money. That’s a skill set I didn’t have. I’d never done that before. I’d been a salaried employee. So you have to figure that whole thing out. But it’s been seven years since I’ve been full-time on the project. Six and a half. Roughly seven. Summer of 2000. Yeah. Knocking on seven.

Awesome. You mentioned starting all this out because you were trying to improve your sleep and use the Zeo as a measurement tool. What did you end up doing that made the biggest difference in your numbers?

Well, the zeal was one thing, Stephan, but you may recall at that time, some of the early luminaries in quantified self were guys like Tim Ferriss, Dave Asprey and Robb Wolf, and they were writing books and publishing on the topic. I discovered the DEXA scan from Tim Ferriss’s book. I started getting DEXA scans and more detailed information on my body composition. So, zeal was just the gateway drug into health data. That got me hooked. I started doing DEXA scans, and then I started changing my diet. The first major step for me health-wise was learning how to get off the standard American diet and off processed foods. At that time, it was the paleo diet.

However, the paleo diet was more of an unprocessed, low-carbohydrate diet. As soon as I did that for a few months, all my blood tests didn’t necessarily get better in the way that traditional medicine did. My cholesterol went up, and I ate more fat in my diet, but my body composition changed a lot. I lost a lot of weight that I had not been able to lose for five or seven years around the midsection just by learning how to cut out processed foods. That was the first big leap.

Then, I took it a step further when I discovered the ketogenic diet. The difference between paleo, which is what I had been doing, and ketogenic was that I had to carefully measure my blood sugar and my ketones because you cannot get into ketosis if you’re consuming too much carbohydrate. It was just that next level of detail.

You needed to be able to get into a state of ketogenesis. Once I was in ketosis for the first time, I’d never felt like I had that much control over my appetite before. It was the most powerful appetite regulation that I’d ever felt being in ketosis. Like, you could have put my favorite cheeseburger and fries right in front of me. When I’m in ketosis, I can just politely push it aside and say, “You know, I’m just going to have something more low-carb.” 

But when you’re not in ketosis, those cravings are back. That was the next major leap of faith. Then, it’s just been an experiment with all types of health optimization: hyperbaric therapy, peptides, you name it. I’ve tried it at this point largely because I want to learn what these modalities do. They inform how we build our software but are also part of my quest for continuous health optimization.

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Awesome. You started with the Zeo, read some tips for your sleep, implemented that stuff got rid of all the ambient light, lowered the temperature in the room and all those different things. What of the sleep optimization tactics really made the difference for you?

The biggest one for me would have been room temperature, quite honestly. I realized that the colder the room was, even though you’re not cold in bed, you’re actually warm in bed, but your head is cool. Lowering the ambient temperature in the room had the biggest impact. The second biggest was simply being mindful of how much sleep I was getting in total volume because my previous mode of operating would have been waking up at six in the morning, getting my coffee, and commuting down to Palo Alto. 

But I realized on most nights that it only led to five and a half six hours of sleep. I did not have enough data to know that it was that low. The data helped me realize that it was lower than I subjectively thought it was. Seeing the numbers made me go to bed a little earlier, sleep in a little later, and try to reach 7 or 8. So it was just room temperature. Then, I had some actionable data that helped me realize I needed more. Those were the two big ones on sleep.

Nowadays, there are a lot more options than in the Zeo. You have the Oura Ring and other kinds of wearables, such as a Fitbit or something. But what kind of measurements are the most important from a sleep perspective? Is it deep sleep? Is it REM sleep? Is it overall sleep? Is it a sleep quality score? I guess this would change depending on which device software you’re using. What are the most important metrics here?

As you mentioned, from device to device, WHOOP, Garmin, Oura, Fitbit, etc., have different algorithms for measuring deep and REM sleep. Once you settle on a device, you can loosely optimize those stages. There’s some debate about how we’re even classifying those as stages. There’s debate about whether those are the right ones to use. For me, there are a couple that I look at very closely. The first is my resting heart rate during the night. As an Oura user, Stephan, I’m sure you’ve seen that you can look at your resting heart rate on the readiness tab.

That gives you an indication, first of all, of how low your heart rate went that night. The more rested you are, the lower your heart rate will go. I’ll be as low as 45 beats per minute on a really well-rested night. On a day when I’ve over-trained, I could be as much as 55 beats per minute. And we also work with a lot of professional sports teams. So I’ve asked them, what are you looking at with your athletes in this data? Because these are the people at the highest end of human performance. So they’re looking at resting heart rate. How low did it go, and when did it hit its lowest point? That’s an Oura number. And the second number I look at is my nocturnal heart rate variability. I probably look at that as the most important, even more so than sleep score, readiness score.

Can you describe HRV heart rate variability?

Heart rate variability and resting heart rate are the two that I’m paying the most attention to. The third is just this handy little AM readiness score, which I’m sure you’re familiar with. It is a nice little roll-up of the data. I’ll quickly glance at that in the morning. However, the real numbers I look at are resting heart rate and heart rate variability. Those are the two big ones.

The more variability you have between each heartbeat is an indicator that your central nervous system is well rested and well recovered.

Can you describe heart rate variability, why it’s important, and what the canary in the coal mine is for poor score? What does that mean?

Heart rate variability has been used in the professional sports community for a very long time. Prior to the OURA ring, you would just put a heart rate monitor on a chest strap, and you’d sit still for five minutes in the morning, and it would spit out your reading. That’s still a very reliable way to do it. Even if you don’t have a sleep device that measures heart rate variability, you can buy a Bluetooth heart rate monitor chest strap, and there are apps on your phone. You wake up, sit for three to five minutes, and get an HRV reading. Essentially, heart rate variability is different than heart rate. Your heart rate is how many times per minute your heart beats.

45 beats per minute. But between each heartbeat, there’s an elapsed period of time, typically about a thousand milliseconds between each beat. But it’s never exactly a thousand. Sometimes it’s 997 milliseconds, sometimes it’s 1002. So there’s variation between each heartbeat. That’s why they call it heart rate variability. Now, the more variability you have between each heartbeat, that’s actually an indicator that your central nervous system is well rested and well recovered.

It’s a little counterintuitive. More variability between the beats represents an autonomic nervous system in a state of recovery, repair, and balance. Less variability indicates an autonomic nervous system that’s under duress. That’s a rough way to put it. Simply put, Stephan, it’s the most accurate way to put a number around stress on the body today. Stress is a very nebulous term, right? “I’m stressed out. I’m under a lot of stress. I’m in a high-stress period.” But there’s no way to quantify it. Think of HRV as a way to quantify stress.

Now, stress can be emotional, like something happening to you in your workplace. It can be something that’s happening to you with a family member, a loved one, or a colleague. There’s that emotional stress. It could be from a traumatic event that’s happened to you. So there’s that part. There’s also physical stress, like an injury to your body, a broken bone, or a virus, for example. Then the other type of stressor can be environmental. Typically, these are things like heavy metals.

Things that we take from our environment would be EMF, poor air quality, and things that we’re taking into our food, air, and water. Those are all definitions of stressors on the body. HRV is the way to measure stress. The other part of your question is, “What’s the canary in the coal mine?” As you start looking at heart rate variability, you’ll realize that, for example, when you have alcohol, it will significantly decrease your heart rate variability.

If you use tobacco or cannabis before bed, a body that’s overtired. Let’s say you’re traveling and you’re out of your home environment, you’re in a different time zone, you’re sleeping in a hotel, it’s uncomfortable. Anything that causes stress on the body will decrease heart rate variability. When you can learn to optimize that number, I think it’s probably one of the thousands of biomarkers we look at on a day-to-day basis at our company. If you ask me to pick one, it’d be heart rate variability. You should learn what it is and how to optimize it.

If you’re willing to share, what was your HRV score when you started optimizing your own health, and what is it now?

Anything that causes stress on the body will decrease heart rate variability.

It’s funny because I have five years of data in Oura, and like lots of things, it ebbs and flows. I can see periods in my life in 2020 and 2021 when I was at an extremely high state of heart rate variability. That’s also when I was doing a lot of cardiovascular conditioning. Having a really strong heart muscle means that if your heart is stronger, you’re actually going to be more efficient with blood flow. Your heart rate and your resting heart rate are going to be lower. That correlates with high heart rate variability. I could see the times when I was training hard and in good physical condition. My HRV was up, you know, then I got injured, I got plantar fasciitis, and for the next two years, my heart rate variability went down way below where I was before.

Now I’m starting to run again, and I’m starting to do hyperbaric therapy and starting to do some other things. Within the last three weeks, I definitely started to come back up to the level I had been at a few years ago. But I think the most important thing is to look back and say, “Okay, wow, I know I can be at this level. I’ve been at this level before. I’ve fallen off here for a year or two while I was injured, sick, or too busy to train the way I want to.” But you know where your baseline is. Now, I’m getting close to where I was two or three years ago. Again, this is where we use data not just day to day, but now looking at that data over the last five years longitudinally actually can be very insightful.

Awesome. You’re tracking that not just inside your Oura Ring app but also in your software.

Correct. Our software will allow you to synchronize your Oura Ring with our system. Then, we can look at other metrics besides the sleep data and other health indicators. I have a dashboard with my Oura data, but I also have my VO2 Max, weight, and body fat percentage. I also have the blood sugar data that I’m looking at.

You’re wearing the continuous glucose monitor for those listening and not watching. You just showed that you were wearing a CGM.

I want to look at all my health data in one place. You’re an SEO guy. You know the value of having all the stats in one place. As you know, getting all the stats to feed into one system, even in marketing analytics, is really hard. Sometimes, you have to write your own script to pump data from A to B, or our dashboard kind of does that for you automatically. We just synthesize it all for you. We look at the Oura. But put that in the context of all your other health information.

Are you tracking macros using an app or some other approach? I understand that this is important for gaining muscle and lowering body fat percentage, but it’s a lot of work, and it involves manually entering data into an app like MyFitnessPal.

There are some good ones out there, MyFitnessPal and Cronometer. We pull the data in from both of those. But as you mentioned, it’s tedious to be punching everything that you eat into an app every day. Luckily, these apps are getting very sophisticated. You can just scan the barcode on a package. Some of them just take a picture now, and they can use AI to deduce the food. But really, what you want to do is track your macronutrient intake for at least a week or two, and maybe every so often, do what I call a reality check on yourself. 

What you really want to look at is the 2000 calories I eat on a day-to-day basis and what percentage of those came from protein versus fat versus carbohydrate. Generally speaking, if you’re looking to keep body fat in check and drop weight, you’re going to want to minimize refined carbohydrate intake and maximize protein. Then you can use fat basically as a kind of hunger lever if you will. For example, bulletproof coffee or some macadamia nuts. These are very high-calorie foods. They have a lot of fat in them. High-fat foods tell your body that you’re full.

Instead of reaching for chips, for example, or something that’s got a higher blood sugar load, you can satisfy that with some salted macadamia nuts for example. Your blood sugar doesn’t budge. It’s helpful for everybody to at least learn how to understand what they’re putting in their body. Track your food for a week, look at protein, fat, and carbohydrates, and then you can adjust that balance to achieve your health goals. If you’re super fit and athletic and training hard every day, probably whatever the heck you want.

Maybe not Twinkies, though.

If you’re looking to keep body fat in check and drop weight, you’re going to want to minimize refined carbohydrate intake and maximize protein.

No, but they can eat a ton of food because they’re burning 2,3000 calories a day. You can burn a thousand calories in one intense workout. Obviously, you’ve got to calibrate it. But let’s just take people sitting at information workers like you and me, for instance, who aren’t professional athletes. If we want to really self-optimize body composition, then we need to know how to control our macronutrients, which are protein, fat, and carbs—an insightful exercise to do once or twice. Then let’s say you have to drop 10 pounds. You might need to start tracking again, and you need to be accountable to yourself. The nice thing, Stephan, about the continuous glucose monitor right here is that this can actually be a surrogate for tracking your macros.

With this handy little device, all I do is make sure that I’m keeping my blood sugar in check and avoiding these high blood sugar spikes from processed foods. That gets me pretty much in the ballpark of where I want to be with where I used to track macronutrients. As long as I keep this in check, I will point to my CGM. Now, I can be reasonably assured that I’m maintaining a healthy level of carbohydrates. Then, I just make sure that I’m eating adequate protein on a day-to-day basis. You don’t necessarily need to do the detailed macronutrient tracking as much, but it can still be very helpful.

Apparently, there’s a wearable that tracks your macros, so you don’t have to figure it out and write it down, scan barcodes and all that. It’s a smart band called the HEALBE GoBe3. The GoBe3 from HEALBE is a tracking device that tracks calorie intake, body hydration, and stress levels. I actually have one, and I never ended up using it. I think I wore it once, and that’s it. I just didn’t like wearing it.

It will be interesting to see how they do that. Presumably, they’re measuring HRV, and I don’t know how they’d measure the macronutrients.

Well, they shine a light on your capillaries and measure the blood going through them. I don’t know exactly how they’re doing it, but it’s an estimate of your macros, proteins, fats and all that. That appeals to me more than anything.

Counting, if it gets in the ballpark, can at least get you a reasonable approximation. As I mentioned before, when I first did the ketogenic diet, you had to keep your carbs under 20 grams a day for three or four days to get into ketosis. Well, what the heck does 20 grams of carbs even mean? If you’ve never counted that before, it’s meaningless. Then, you have to start tracking it all. It’s a really good educational exercise to do. I’d love it if there were more passive ways to collect the data like you described with the Golbi. I think finding easier ways to get that information would be interesting.

When someone is using your health dashboard, are they getting actionable insights and recommendations, or they’re just getting the data that then they need to figure out, like, “What are the things I’m going to do to improve my sleep hygiene because these numbers suck? Or what do I do now to improve my cholesterol and triglyceride levels because, over time, I’m trending much worse than I thought?” When I show all the back-to-back scans and blood test results from the last five years. 

If we want to really self-optimize body composition, we need to know how to control our macronutrients: protein, fat, and carbs.

We kind of look at it as a three-part problem. The first part of the problem was whether we could even get this data glued together. That was the first problem we had to solve because you’ve got all these doctors and patient portals—20,000 of them in the United States. Can we get all those to pump data into one system? First, it was like, can we solve the plumbing problem? We worked on that. The second problem was, could we just analyze and visualize the data? Is there an actual business there? Can we monetize? Will people pay money for the app? Will doctors pay money to use this in their clinic? We spent the next chunk of time on that. We’ve just started releasing our first recommendations, which you described. However, rather than making recommendations, for example, we noticed that X was low. Try Y.

Instead, we’ve focused on helping to identify positive trends in the data and surface those to the individual. It becomes very easy to know when you do something right. And then you can say, “Okay, what did I do? What actions did I take that led me to that positive outcome?” And you might say, “Oh, wow, I finished eating dinner at 4 pm last night and did some meditation before. So that’s what got me.” 

We’re really trying to teach people to recreate the things that lead to success. We also work a lot with medical professionals who use the software with their patients or clients every day, and they will ask us to find signals in the data that surfaced to them, and then they’ll reach out to you with recommendations. Because health is such an individualized N of one topic, Stephan, that each person sometimes a good score for you might be a terrible score for the next person.

Because we work with everything from diabetes clinics to professional athletes, it makes the recommendations really hard. We’ve chosen to focus mainly on the analytics, which we’re going to glue all together. We’re going to make it intelligent to understand. You’ll pretty much have to figure out how you want to attack it on your own, but we’ll also give you the data to know if what you’re doing is working. 

We’ve stayed away from recommendations, protocol development, and that kind of thing and focus more on things like, “Okay, is this even working?” There are lots of great health programs out there that will help you with whatever your goal is. We don’t do that type of content for weight loss or disease management. What we really want to do is just have the measurement platform. That may change as we grow, but that’s where we’re at in our current instantiation.

When you don’t get enough measurements on a particular metric, it’s hard to change because you don’t see a trend. For example, if you get a DEXA scan once every five years, that’s not going to be very useful for you. So, in the case of a DEXA scan, how often do you recommend it, or did you get scanned when you discovered the DEXA and wanted to start using that as a measurement device?

I got my first scan. I think my body fat percentage was like 27%. I’m like, “Whoa, okay. I’ve got some serious work to do here at my age.” So I started working really hard on it. At that time, I was going every six months for a DEXA scan because I was making changes between those scans. I wanted to give it at least six months to see if it was working, changing my training regimen and diet. When I’m really focused on it, every six months, I’d say at least once a year. Between those, I just have a regular bathroom scale that I bought.

That is when I stepped on it on the same day as my DEXA scan. I know they’re pretty close, so at least the body fat is close to the DEXA scan. I’ll use that between the DEXA scans just to get some more frequent calibration. So that’s kind of the cadence I use for DEXA. And then, as I’m aging, I’m now 47 years old. It’s interesting to see, “Well, okay, what were my DEXA scans when I was 10 years younger?” 

If you read any of Peter Attia’s work, you’ll know he’s basically saying you should optimize your metrics, too. If you really want to live to be 60, 70, 80, or 90 years old, with a very high quality of life, disease-free, and really thriving in those later stages of life, you should be at the highest percentile of your current age bracket for body fat or VO2 Max, and you should even be in the higher percentiles of people in younger age brackets. 

Can I keep the same body composition I had 10 years ago and 10 years from now? Can I still keep those numbers the same as when I was 35? When I’m 65, are the numbers as good as when I was 35? When I’m 75, the numbers are as good as when I was 35. That’s why, like even once a year, if you get that data, this is going to help you over the next 10, 20, 30, 40 years to have these baselines that you can aspire towards.

Another thing that I don’t think is talked about hardly ever is companies going out of business and the tools that you were using, like Zeo, becoming brick and obsolete.

That’s why having copies of all of this stuff, like DEXA scans, you can get them anywhere nowadays. However, accessing this information in different formats is also important. With the DEXA scan, you just get this PDF file. I’m like, “Okay, great, I got 20 of these PDF files. What the heck am I going to do with these?” Like I was stuck on a snowboarding trip, and we got rained out. I just had nothing else to do. I sat in the cabin and put them on a spreadsheet just to see the trends in the data. It was really insightful.

Now, with our system, you just upload the PDF, and we’ll strip the data. But you still need the source documents. As you said, there may be some time when our company doesn’t exist anymore, and you will have to rebuild your health data somewhere else. You still need the originals, but we’re trying to help make it easier to get the trending information.

Awesome. Before we started recording, you also mentioned that there are ways to measure biological age. Let’s talk about some of those companies, their validity, and what actionable insights you’d get from those tests.

Understanding your biological age through various tests can be eye-opening. It’s not about how many years you've lived but how well your body is holding up against time. Share on X

I use a taxonomy, which is your lifestyle data. This is the stuff we measure at home. It changes from day to day. Then you have your labs. That’s when you draw blood, and they’ll run your labs. You could get your labs once a year with your annual physical. But now we have a new category of testing: biological age testing. This is actually a way to measure potentially our entire lifespan and the rate at which we are aging.

There are different ways to do what’s called a biological age test. Some companies use telomeres as an indicator of your biological age, just like the caps on the chromosome. You can also look at the integrity and length of those chromosomal caps. And that has been long established as a very strong indicator of longevity. They found that for people who have been through very stressful experiences or are aging at a very rapid rate, those telomere lengths will be shorter.

Conversely, they’ve seen in people who live long, healthy, extended lifespans. I’m generalizing here significantly, but they tend to have longer telomeres overall. That was one of the first ways we started measuring our own rate of aging.

If you and I were the same age, Stephan, we would have measured our telomeres and led very different lives. We will probably have different results. On average, the one of us with the longer telomeres will have a longer, healthier, disease-free life. Once those telomeres wear down, the DNA replication process is more subject to failure or error—copy-paste errors. These copy-pasted errors introduce the potential for disease. That’s the traditional way of doing it.

Biological age testing is a way to potentially measure our entire lifespan and the rate at which we are aging.

I’ve done a couple of telomere length tests. There’s a really good company out of Spain called Life Length. I’ve used their telomere test. Now, there’s another company called TruDiagnostic, and they’re measuring the aging rate on several scales. They’re measuring telomere length. They’re also using a new biological age clock that’s been discovered. It’s called the DunedinPACE clock, a new way of measuring our rate of aging. For every year chronologically on the calendar that you age, this will tell you how much you’re aging biologically.

When I ran my test, it said for every year on the calendar, you’re only aging at 0.83 of a year. Actually, because of all the things I’m doing with my health, I’m aging at a slower rate than the calendar year. They’re collecting massive amounts of data sets and looking at DNA methylation pathways to figure out how people are at the rate of their aging. I’ve used the TruDiagnostic test. If you follow any of the work by Bryan Johnson and these other guys, you can go to this website called Rejuvenation Olympics. 

It’s all of these hardcore longevity hackers. They’re all uploading their true diagnostic results, and they’re looking at who can improve the most. What are they doing to improve? There are communities building to figure out what is actually able to slow our rate of aging the most. If you check out Rejuvenation Olympics, this is now a community of people sharing their longevity test results and protocols to figure out what’s working.

It’s really fun and exciting, and if you’ve got a little bit of a competitive angle, you can jump in the game and start seeing how well you can move. Then, Stephan, in closing, there are other tests that will run regular, routine blood work, but they have developed algorithms that can give you a good indication of biological age through routine blood work. Then there’s a company called GlycanAge. They’ve developed a way to test the glycation on the proteins. I’ll probably butcher this, but. But they’ve got another. Let’s call it another method for assessing biological age relative to chronological age. This is a new type of testing.

These tests are getting better and more sophisticated. They’re capturing more data, and their algorithms and datasets are improving. That’s the great thing about crowdsourcing. They get a couple million people to do their test. With the right machine learning, those AI tests are going to get increasingly accurate. Now, we have some tools to start measuring our lifespan. 

And again, I’ll quote Peter Attia here. He’s like, “You get these bonus decades, 60, 70, 80.” How do you optimize for the bonus decades? Well, the first thing you do is look at some of these age-rake clocks we’ve discovered. Where do you stack up against other people your age? Just seeing that number relative to my peers, “Okay, I have some work to do. What am I going to do about it?” Then you go down the rabbit hole.

What’s been the most surprising thing you’ve found going down these various rabbit holes?

You have to have this attitude of never stop learning because science is changing so quickly.

You just have to have this attitude of never stop learning. Because science is changing so quickly, our understanding of health is changing very quickly. I think just being able to, first of all, not get overwhelmed is the first thing I would counsel people. Because, man, as soon as you start working on your health and acquiring information, it’s like a tsunami of stuff you can find out there. It can get very overwhelming very fast for people just getting into this game. I think I’ve had to really learn how to not get overwhelmed with information, take in information, and decide what from that I want to process and what I want to discard. I am able to pick one or two things at a time that I want to try and measure, and I am just working on a couple of things that I can really test objectively and get some feedback. As I mentioned, it’s always changing as science evolves.

I think we have to just keep an open mind. What we thought works today, in a few years from now, turns out we might be totally wrong, or there is a completely better way to do it. I think just having that kind of beginner’s mind with all of this stuff and always being receptive to what’s new, being mindful of avoiding dogma. Many people are really set in their opinion about how it has to be done in terms of health. When I see that type of dogma, I usually try to turn in the opposite direction and keep an open mind. Those are just random collections of Things that come up in response to your question.

You mentioned peptides earlier in our conversation. What peptides are you taking? What do you recommend, or what have you heard? I know this is not medical advice. All standard disclaimers apply. Consult your doctor. What have you found personally to be effective in terms of peptides?

This is a really fascinating new area of research. Obviously, we know what peptides are. They’re essentially the amino acid building blocks that the body uses to repair, recover, and create new immune system growth hormones. The most popular peptide out there is, of course, insulin, which diabetics use—type 1 and type 2 diabetics. That’s a peptide. There are lots of peptides that are out there medicinally and that are FDA-approved. Tesamorelin is an FDA-approved peptide for abdominal fat loss.

There are lots of them out there that have made it through clinical trials, and they are now FDA-approved. Others are still in the experimental phase and haven’t gone through the clinical trials. For some of the ones I use personally, Stephan, I use some growth hormone-stimulating peptides. You can buy an exogenous growth hormone, which means it is external to the body, or you can take the peptides, which will signal the body to produce its own growth hormone. There are two peptides I’m currently using there. One is called Tesamorelin, and the other is called Ipamorelin. It’s another one called CJC-1295. I was taking that when I stopped.

I use some just as a 47-year-old guy wanting to maintain a high level of lean mass growth hormone. I use those two. I’ve also tested the GLP1 weight loss peptides. I’ve tested semaglutide, and I had a good experience with it. I’ve also tested Tirzepatid, and I just restarted it. I’ll probably go back to a 12-week cycle. I take a very, very low subclinical dose. I don’t want to suppress my appetite mainly because I want to preserve my lean body mass. I’ll take a dose that does not keep my appetite low but provides all the other benefits of the peptide, which is inflammation reduction and keeping blood sugar in check.

For the growth hormones I mentioned, I’ll occasionally cycle on the GLP-1 weight loss ones and regularly use BPC-157. That’s just an anti-inflammatory soft tissue wound healing, general internal immune boosting peptide. It also works really well with growth hormone peptides. They work synergistically. The BPC actually helps create more receptors for growth hormone. And then, occasionally, epitalon. There are different ways to pronounce it.

The pineal gland regulates our melatonin, sleep-wake, and circadian rhythm.

That’s a peptide that targets the pineal gland in the brain. The pineal gland regulates our melatonin, sleep-wake, and circadian rhythm. There’s a protocol where you do that once a year for 10 days. I’m just about to start that again. I’ve been cycling through most of them, educating myself as I go, experimenting on myself. I’ve had mostly positive experiences. I had a bad allergic reaction to one peptide called MOTS-c. You can develop these reactions to any peptide or medication; for example, I had to stop taking that one.

I had a similar experience after taking a CJC-1295 for quite some time. I had to stop taking that one and switch over to some different ones for growth hormones. It’s been interesting experimenting with all of these. They’re subtle, and it’s not like overnight, you’re gonna see results. But if you have a solid diet and lifestyle, first of all, you have to have a solid foundation or the peptides are a waste of money, just like supplements. If you don’t have good nutrition, exercise, sleep, and a foundation, those things are just not really going to work. I do have all of those foundations, and I experiment a lot with them and those peptides.

I’m sure there’s more that will come across our radar screen. The FDA just put the screws down on a lot of the peptides that haven’t been thoroughly tested, probably for good reason. It was getting a little too out of control. I think there were a lot of people who were probably using them without the right level of information. I do think it was helpful to put some guardrails on there. But for people who do know what they’re doing or who are working with a talented practitioner, they can be awesome.

Awesome. What sort of issues or opportunities are you going after with your hyperbaric therapy?

I’ve been in this game for a long time, and of everything that’s come across my desk, if you ask me to say what’s the one thing we have that’s closest to the fountain of youth, that would be regular and consistent supplemental oxygen and hyperbaric therapy. It is the safest, most well-tolerated and most effective tool we have to help regenerate every single cell in our body. Even the damaged tissues that the body has a hard time repairing can be improved with hyperbaric therapy—vascular health, skin sleep, inflammation, you name it. 

I think it is hyperbaric, and there was just a study that was published on hyperbaric therapy with telomere length. Going back to the conversation you and I just had about telomere length, they showed a 20% improvement in telomere length through hyperbaric therapy. We can link to that study if we need to, but that one is the one that if I could pick any single one to use for the rest of my life, it would be HBOT. It’s just it’s oxygenating every cell in our entire body.

It leads to new mitochondria, and it leads to new energy. It heals damaged tissues, helps with vascular blockages, and helps with wound healing. Again, just like some of the other things we mentioned, hyperbaric is FDA-approved for a very small number of conditions like gangrene, CO2 poisoning, and wound healing. What do we biohackers do? We use it off-label. What’s it approved for? My insurance is not going to pay for it, but off-label, it works for all these other things—weight loss, longevity, skin health, better sleep, and higher HRV. We’re just off-label. I think it works great for pretty much everything across the board with very few side effects or contraindications.

Cool. Do you have one in your home, or do you go to some facility nearby?

I do. We have a partnership with a company called OxyHelp, and they have a home-use chamber. You can actually sit inside the home-use chamber. There are two seats. It looks like a small two-airplane seat, but it is more comfortable. You can go in there, you can sit in the chair, you can lie back, you can watch TV, you can work on your laptop, and you can just go do your hyperbaric therapy for an hour or two a day and also watch some Netflix or get some work done.

How much time do you spend in the chamber?

I’m looking to get at least three to five hours a week. More is obviously better. A typical session, if I’m pressed for time, is anywhere from 30 to 60 minutes. Suppose I’m not pressed for time; I’ll go for two hours.

What’s the biggest impact you’ve seen in your metrics by doing this therapy?

What I’m really looking for is heart rate variability improvements. As I mentioned earlier in the show, I’m looking to return to the optimal levels I saw in 2020 and 2021. That’s the one thing I’m looking at. It’s only been maybe a month since I’ve had the chamber, so I don’t have enough data, but I’m starting to get consistently back to those levels. I’d really like to see if I can even exceed the levels I had back in 2020 and 2021. I also have a family member who’s got some kidney damage and has some apt atherosclerosis. With him, we’ll be looking very closely at the kidney markers, creatinine, an important marker of kidney function, and some of the cardiovascular markers, lipid levels, and calcification and inflammation in the arteries. Those are a couple of the things we’ll be looking at.

A calcium scan every five years or whatever gives you a sense of calcification in the arteries. You mentioned a metric earlier, VO2 max, but you didn’t explain it. Could you briefly explain it?

This is one of the most exciting metrics in longevity. It’s a measure of your cardiovascular health, which is how much oxygen your body can use at its peak. So what is the maximum amount? It’s an indicator of your cardiorespiratory fitness level. Another study involved over a hundred thousand people, so it was a huge data set. What they found was that as your VO2 Max increased, the rate of all causes of mortality decreased. 

What was interesting about this study was that there was no upper limit. With a lot of things, there’s a point of diminishing return on a curve. There was no point of diminishing returns.  There was a corresponding exact proportional decrease in all-cause mortality with no upper limit. I ran and got my VO2 Max tested. Stephan, much like you, I have all my stuff right at my desk. Here is the printout. This shows you the maximum VO2 by age. 

I got my levels tested, and I looked at what I should be at for males 40 to 49 years old. I’m in what you would call the average category, which is my average level of cardio fitness. Again, if you can start to say, well, what’s the optimal range for someone 10 years younger than me? Could I get my VO2 Max into the optimal range for someone who’s 37? Of course, you can. You just have to work on it. The VO2 Max is this cardiorespiratory number that is highly correlated with longevity, and it’ll cause mortality. 

We can train to increase our VO2 Max. That’s one of the metrics that will get us into those later stages of life. But what you don’t want to do is get to be 60 or 65 or 70 and not even know what VO2 Max is because you potentially missed the boat. If you can get that number now and start optimizing for it and keep it in that top percentile of people your age, you’re doing more to ensure you’ll have the highest quality of life possible.

This gets to a very important question that we talked about covering in this interview before we started recording. What’s my why? Why am I doing all this? Everybody has their own why. Let’s talk about what this means for our listeners.

When I first started looking at that Zeo data, Stephan, as a newbie in health and wellness, I started realizing that I could actually make steps on my own, absent of a doctor, to start making very significant improvements in my health. That light bulb moment where this became something fun and motivating and rewarding for me, looking at the numbers, making a change, seeing the improvement, kind of the self-gamification around that, I became connected to my health at that moment. I left my corporate job, as you and I talked about not too long ago and jumped off the cliff with no parachute.

Our mission is to get 100 million people connected to their health, which means they engage with their health on a daily basis.

I did it to say our mission is to get 100 million people connected to their health, which means they’re engaging with their health on a day-to-day basis. They’re making changes on a day-to-day basis. They’re getting invested in the outcome of their health and not waiting for the doctor to tell us it’s time to get invested in their health. That’s why giving people this information is important so they can make smarter, healthier choices every single day. That’s longevity to me; the choices we make day to day are compounded over 40 years.

Someone who wants to quit smoking but hasn’t achieved that needs a bigger why. If somebody improves their health, they’ve figured out that there’s a big enough reason to do so. If they haven’t made that change, then they haven’t connected it to a why that matters enough.

Everybody’s motivated by different things in their life. Some people love watching sports, and some people love tracking their financial performance in the stock market traders. Our system is for people who want to do that for their health. As you mentioned, sometimes, sadly, you do have to have the oh shit moment before you’re ready to make a change. 

For some people, it just becomes natural and organic and something they do, but by human nature, sometimes we have to have a very serious, in some cases near-death experience before we’re really ready to make change. This is a slightly controversial topic, but it also starts to get into the promise of psychedelic therapy. What that allows us to do is potentially tap into the things that are blocking us subconsciously and that we’re not in touch with. Can we remove those blockers below our level of consciousness so that we can make those changes easier and understand what’s holding us back?

Have you done any psychedelic therapy or experiences, journeys, or anything?

It’s been a profound part of my own personal journey, part of my own self-awareness, part of my own spirituality. It’s something I’ve worked with in the past, and I will probably return to it at some point in the future. It’s helpful to be able to let go of the things we accumulate in society from time to time. I look at it as like dropping some baggage. We don’t need spring cleaning emotional stuff; we can just drop it off. In that regard, I just had a fascinating interview with a woman on my podcast, and she uses ketamine therapy for people who have eating disorders, anorexia nervosa, and bulimia. 

She’s trying to figure out why they have the eating disorder. Okay, we know you have it, but why? With the ketamine, she can figure out what the trauma was earlier in that person’s life that led to the eating disorder. That’s an example of where these can become very medically useful. Now, the person intellectually understands the trauma and can make the change and start losing weight. Before, all they knew was they were overeating for a reason, but they didn’t know, you know, what was really triggering that. I’m encouraged to see where we can go with more of these psychospiritual medicines that are now becoming FDA-approved.

We live in interesting times, for sure. I have one last mundane question, but I’m super curious. Do you wear an Apple Watch?

I wear an Apple Watch religiously during the day, and I track all of my physical workouts on the Apple Watch. I just went for a run this morning, put the watch on, and went for a 30-minute run. When I go to bed, I take it off and wear the ring. Oura’s really their zone of geniuses. What happens to you when you’re asleep? For functional utility, I wear the Apple Watch during the day, so I use both.

Okay, but you’re not wearing it right now, are you?

I took it off because when I’m working at the computer, it tends to get in the way. It’s right here. I’ll put it back on as soon as I step up from my desk.

You don’t need it 24/7; you just need it during your runs.

I use the watch mainly to track my physical movement, activity levels, step count, and workouts.

When you’re sitting sedentary getting interviewed, will you take it up?

Yeah, I don’t know. It just gets in the way of the keyboard and stuff. So I take it off at my desk. But as soon as I step up from the desk or record all of my workouts, it’s really interesting to see how hard I’m pushing myself, what heart rate zones I’m in, and then also just how many total calories burned. Am I doing it on a monthly basis? Those are some of the things I used to watch for. Tracking workouts, Garmin, Apple Watch, and WHOOP. They’re all great for really giving you good hard data on your workouts for the fitness junkies out there.

That was an awesome interview. Thank you so much for sharing your story and all your exploration and optimization work, all the cool tools you’ve identified and, of course, the amazing tool you’ve created. To wrap up this interview, what is the website and the best, most important resource that you’ve developed for our listeners?

Thanks, Stephan. Our website is headsuphealth.com. You can set up an individual dashboard, start measuring things, and start tinkering. Then, for practitioners, we also have a way to deploy the dashboards to patients so that you can help collect data and understand what’s happening to patients during the visits. That’s our contribution. Here are the tools to measure. If you want to reach me, you can shoot an email to support, and that will get to me personally.

Great. Thank you again, David. Thank you, listener. Go out there and make it a great week. We’ll catch you in the next episode. In the meantime, I’m your host, Stephan Spencer, signing off.

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