Bryan Johnson & Kate Tolo On Curing Their Incurable Diseases, Addressing The Disparity In Women's Health & The Don't Die Mission

The Rich Roll Podcast

The episode features a deep dive into the lives and missions of Bryan Johnson and Kate Tolo, focusing on their shared goal to 'don't die' by curi

Key takeaways

• Kate Tolo achieved an endometriosis diagnosis in just 42 days through intensive multi-modal testing, significantly faster than the typical six-and-a-half-year wait for women.
• Bryan Johnson is utilizing iPSC (induced pluripotent stem cell) technology and Yamanaka factors to epigenetically reverse cell age toward an embryonic state.

Main topics

• Longevity and Anti-Aging
• Women's Health Disparities

Notable quotes

I simply want to say yes to existence.

Conclusion

The episode provides a profound look at how extreme scientific experim

Transcript preview

Speaker 4 (0:00) This episode is brought to you by Go Brewing. Fall is beer season. You got your game days, you got your tailgates, you got people gathered in somebody's kitchen. And here's the shift that I really love. At every single one of these gatherings now, somebody isn't drinking. Maybe a lot of somebodies. The old move was to hand that person a seltzer and an awkward, apologetic look, but no longer. The new move... is to hand them something genuinely great. And that's Go Brewing, started by my friend Joe Chura, and a mission I believe in enough to have become an investor. They were one of the first breweries in the country to go all in on non-alcoholic, and the craft is super legit. Gold and silver at the Best of Craft Beer Awards two years running. More World Beer Cup medals than any other brewery. A spot on the New York Times Best N.A. Beers list. No added sugars, no shortcuts. It just happens to leave the alcohol part out. Now you can find them in over 9,000 stores. But the good stuff, the exclusive small batch releases, this is what you want, only lives in their beer club, shipped straight to your door. Stock the cooler for the season, and somebody at your table is going to be really glad that you did. Visit gobrewing.com slash richroll50 to get a full 50 % off your first subscription order to Go Brewing's beer club. Speaker 2 (1:26) If we are to be, don't die, we both have to cure our incurable diseases. So either they get us or we get them. Speaker 4 (1:33) Anti-aging entrepreneur Brian Speaker 3 (1:35) Johnson. Revealed a recent diagnosis of Speaker 2 (1:37) autoimmune gastritis. Kate Tolo is the most measured female in history. One Speaker 4 (1:42) of the sharpest content minds. Kate pitched Brian, what if the science experiment was done in public? Speaker 1 (1:47) So we're spending $2.6 million on my protocol. I was like, oh yeah, I think I have suspected endometriosis. Brian hears about it and I was diagnosed in something like 42 days. Women typically take six and a half years to get a diagnosis. I Speaker 2 (2:01) think it's possible that we have a cure within like six months. This has never been done before. We've done all of this in four weeks time. Speaker 4 (2:09) There's a perception that this is about you wanting to live forever. Speaker 2 (2:13) I can't understand what living forever means. I simply want to say yes to existence. And what I really concluded is that... Speaker 4 (2:26) Super nice to be here, you guys. Thank you for inviting me into your beautiful home, into the sanctum. I'm excited to talk to both of you together. And my first question really is for Kate. I just want to know, what is it actually like to be in a relationship with this lunatic? Speaker 1 (2:46) Yeah. To look over and you're just smiling. Yeah, just, you Speaker 2 (2:50) know, have at it. Speaker 1 (2:51) Yeah. It's a lot. It's definitely different. Brian is a unique, special human being. And I've known that since day one, since the first moment I looked into his eyes. And honestly, I feel like it's out of my control. I don't think I am in charge of whether or not I love Brian. My body just does. And so Speaker 4 (3:12) what, what is your kind of like relationship history prior to this, like in terms of like other guys that you dated and, and the kind of Delta between that and the experience of like living with Brian? Speaker 1 (3:23) Yeah. I mean, I think Brian's just one of a kind. So I would categorize myself generally, like both in relationships, but also lifestyle, how I think about the world as a fairly normal average bell curve person prior to meeting Brian. And so even. in just the way I live life now. It's entirely different. Speaker 4 (3:42) Initially, you came in as an employee, right? You were working here for quite a while, right? That's right. Speaker 1 (3:49) Before Speaker 4 (3:49) the relationship blossomed. What attracted you to want to be in his employ to begin with? What was it inside of you that wanted to be part of this whole thing? Speaker 1 (4:00) It was his neurotech company that I fell in love with so deeply. I was 21. I just moved to New York. I had grown up in a small town with immigrant parents, so I didn't have a ton of exposure to like, what is an engineer? And you know, what's a consultant? Like that, those words just didn't mean anything to me. I got to New York. I was working in fashion because I learned how so when I was eight years old. And I started to see the world for the big space that it is and learned about AI. This is back in 2016. I thought that is the next thing happening. I surveyed the world trying to find somebody who was actually working on solving the issue of the crisis that AI might bring. I really felt like the only path forward would be to merge humanity and AI in some capacity to be able to speak the same language. I was looking into brain tech companies, brain interfaces. These are, can you translate the human experience into a computer's experience through some sort of interface? Speaker 1 (4:53) 2016 December, I was sitting in a cafe in Brooklyn and I got an email from Singularity University and I had a quote from a man named Brian Johnson. And the quote resonated deeply with me as a person who's working on this, whose vision aligned with mine. So I started reaching out to him and it took a number of years and I was just every year paying him on these various platforms saying, I would love to come work your neurotech company. But of course, going from fashion to tech is a really hard transition to make. And so... Yeah, it took a while. And then eventually he responded, I think by chance, by accident. And then we started working together and it took us about a year and a half of when we started this project for science and for health before it actually took off. Speaker 4 (5:37) And Speaker 1 (5:38) then I transitioned full-time to that brain. Speaker 4 (5:40) How do you feel about how this AI experiment is going so far in the years between 2016 and what we're seeing currently? and this premise that the future is some merging of humanity with this super-powered technology. Speaker 1 (5:57) Yeah, I definitely was naive and I've been humbled by what's happened across the last six, seven years. I still have hope that if we can quantify and understand the human experience enough that we may be able to have a world where we truly merge. What we're building is ultimately a path where we can swallow artificial intelligence to use it for humanity's benefit. What we're really trying to have survive is our kind, so not our biological beings necessarily, but our shared intelligence, thoughts, collective consciousness, our libraries, the internet, those spaces where we come together and it's something other than our biological. It's our spiritual selves collectively. That's ultimately we're trying to hitch that onto the backs of AI because AI has the capacity to run away as a train and become its own thing and then where our existence is at a threat. Speaker 4 (6:53) Right. How are you reconciling that vision? that aspirational vision with the potential for this being an existential threat that will auger the extinction of our species. It's like one or the other. Brian, what's interesting about everything that you're doing, and maybe this doesn't get enough attention, is the fact that the substrate that's underlying all of this really is AI. I had the privilege of coming to one of your... Jeffersonian dinners and the provocative prompt to instill the conversation to follow is if there was a superpower AI that had your best interest at heart and would basically tell you everything you need to do to be as healthy as possible, would you surrender all of your decision-making over to this AI with the understanding that you could never revoke it? It would never expire. And that's the very provocative question, obviously. I mean, did I get it right? Is that essentially the prompt? And so the premise is that If we can understand this and we can empower a certain technology to help us make these decisions for us, because we're terrible at making these decisions, we're emotional beings, etc., that humanity by proxy would be better off as a result. That remains kind of the thesis. I Speaker 2 (8:15) mean, the question itself is really more to draw out the person's beliefs than it is to practically answer the question. And so I... In this Jeffersonian dinner, I set the stages where I give two purposely provocative statements that draws people out. And in doing that, they show their cards, their beliefs, their biases, their preferences. And then I take that and then I flip it around and give them a mirror. And so it's a process that I go through. What I'm really trying to do is with AI, what's happening now is We are trying to say intelligent things about reality. And when you bring up the topic of AI, Speaker 2 (9:06) You can go down a near infinite number of paths in trying to string words together that try to make sense. You can talk about jobs. You can talk about meaning. You can talk about utopia, dystopia, solving cancer. But I think the purest insight is it's possible no human can say anything intelligent about AI. And I don't think we fully internalize that. that relative to AI, we may be cavemen in terms of our ability to understand what's coming. And therefore, our models of reality, our perceptions of ourselves, our goals as a species, maybe they don't translate into the bridge. We don't know. And so what I'm really trying to do is I'm trying to say, me as Brian Johnson, can I say one intelligent thing in this moment? And what I really concluded is that I simply want to say yes to existence. That's all I can say. Outside of that, I have no idea what to say. I don't know what to think. I don't know how to feel other than like, I say yes to existence under all circumstances. Speaker 3 (10:17) And Speaker 2 (10:17) that's what this project is about. And so of course, people hear us through the language of the things we do together, the experimentation and the therapies and the performance art. that's really it. It's the species at a moment in time of transitioning to something different that we can just openheartedly say, we want existence. Speaker 4 (10:39) There's a perception that this is about you wanting to live forever, but there's a ripple in that. There's a difference between this notion of living forever and don't die. How do you distinguish those two things? Speaker 2 (10:53) The human brain is very funny. If you speak about it through the frames of Buddhism and reincarnation, it doesn't necessarily, a person doesn't feel concerned about that reincarnation cycle. If you talk about it through a Christian lens, that you go to heaven, that's soothing. If you talk about it from an Islamic lens, that is soothing. If you talk about it without those safe landing spots, it drives people. crazy. You know, like I can't understand what living forever means. I don't know how to compute that. And so you're just putting them in unknown land. And then the same is true if a person's an atheist. And so the mind has certain tracks that it follows that says this is a safe thought process or this is a dangerous thought process. And then if you try to do another frame where, you know, we're speaking today on a Tuesday, tomorrow's Wednesday, all three of us are probably excited for what's coming tomorrow. And then when tomorrow comes, we're probably all excited about Thursday. So being excited about tomorrow is the same thing as living forever. You're just doing one tomorrow at a time. And so it really is just a, it's how the mind processes information. If you catch somebody off guard of living forever, but you don't give them like a really constrained container, like it's this, it feels like this, it looks like this, and you feel safe like this. people are like, I don't know, man, that kind of sounds really scary. I don't think I want that. That's bad. Speaker 4 (12:19) The impetus for having this conversation now is because of the health journey that Kate has been on. And so I want to hear more about how that has unfolded and what it is that you're trying to communicate publicly around women's health. We were chatting earlier, I shared that. Over the course of many years of hosting this podcast, I've had the good fortune of conversing with many very accomplished women doctors who all share this sentiment that the science is lacking in terms of our understanding of the female body, like when it comes to hormonal health. the issues that are unique to women that kind of get lumped in with just overall health and the canon of science that is basically all of these studies are essentially performed on men. And so there's a real gap in understanding. And I think there's a lot of women who suffer as a consequence of that oversight. And this is something that you've decided to address head on. do it with storytelling by sharing your own kind of personal experience with some of the things that you're contending with. Speaker 1 (13:33) Yeah. So we're spending $2.6 million on my protocol. I'm measuring 1,900 biomarkers. I'm doing around 100 days of this just to get baseline data on what happens to a female's body as she goes through the menstrual cycle. So you can think about the female body as a waveform. And we know generally there's a waveform. X biomarker changes in this way and this biomarker changes this way. But we don't actually have enough robust data on exactly what happens through the female body. And so I'm taking on that challenge with Brian's protocol and setting it up. What we were able to do was take his baseline pretty much one day and then start off to the races in terms of optimizing. But for female health, we don't have the luxury of having this huge data set on what we can compare me to and actually understanding the female body. So for example, something as simple as cholesterol. We know that in the first half of the cycle, it can be up to 19 % higher, the result, than in the second half of the cycle. There's one study that looked at this in women, and around 6 % of women actually tested high, out of range for cholesterol in the first half, and then they get tested again and they're back into the normal range. It has these implications because nobody, when they go to the doctor to get their blood drawn, is being asked, where are you at in your cycle? We can compare reference ranges. for cholesterol specifically. Another study looked at around 400 metabolites in the blood, so these downstream byproducts that are happening in the body, and around half of them, they discovered, did fluctuate through the cycle, but that has not been characterized. We know it moves. We don't know how. We don't know what's normal. It's a really hard measurement problem because to be able to do that, you need lots of women. tracking their hormones daily. Then as soon as the LH surge happens and you transition to the second half of your cycle, you go in for blood work testing. That's an extremely logistically complicated problem to solve. So we thought, why don't we start with my body and see if we can create the most quantified menstrual cycle ever? So now I'm on day 29 of that process. Speaker 4 (15:38) The impetus for this was an endometriosis diagnosis. Can you talk a little bit about that? What is endometriosis? How is it traditionally treated? And how are you kind of like treating this differently or using it as a means to better understand the female body? Speaker 1 (15:57) You know, actually, we started this process. And then as my team were asking me about my health background, I was like, oh, yeah, I think I have suspected endometriosis. And they were like, oh, okay, when did that happen? I was like, seven years ago. Did you do anything about it? No. Like I got hurt when I was like 22 from the doctor. You know, you can go get surgery to figure it out. I'm not getting surgery. I have no idea. I'm young in New York and I'm like, I'm not doing that. And so all this time goes by and my symptoms get more and more severe. But because it's a general trend and I know that surgery is the option, I'm like, I don't want to go down that process. Then Brian hears about it and he's like, I think we can solve that. And so he starts calling doctors and scientists from around the world, sometimes at 4 a.m. when he first wakes up so that he can catch them in various time zones. And through just pure persistence, like in a startup-like mentality, he's able to essentially organize four different ways to confirm my... diagnosis and get me diagnosed in something like 42 days. So like an insane change. Whereas women typically take six and a half years to get a diagnosis. They live with it for a very, very long time. Oh, that's interesting. I Speaker 4 (17:04) mean, what is it and how many women suffer from this? Speaker 1 (17:07) It's around one in 10 confirmed women suffering from it. But the suspicion is that it's much, much more because it's such a general disease that affects so many people and lots of women just never get a diagnosis. And what it is, is in the uterine lining, you have cells that grow outside of the lining. And then that creates problems because they act as if they're still in the uterus. And so they cause all these issues like fusing organs together, scarring, having nerve firing. So they're very, very painful. And so like, for example, one of the symptoms that's very obvious for endo that I experience is pain while defecating on my period. Somewhere in my bowel system, there's endo lesions that are firing while I'm on my period and just causing excruciating pain. Speaker 4 (17:55) And so this is something that develops over a long period of time, hence six and a half years before a proper diagnosis? Speaker 1 (18:04) No, the reason it's that long is because surgery is the traditional way of diagnosing it. I see. And it's expensive to get surgery. It's very invasive. And so women just put up with it. Or they go to Speaker 4 (18:16) the Speaker 1 (18:16) doctor saying, hey, I have painful periods. And the doctor will be like, that's normal. And then they're sent home. But there's a real missing education around what is endo? What can you do about it? So what we were able to do, we got a transvaginal ultrasound that came back negative. Then we went and got an endospecific protocol because it turns out you really need someone who's trained to do these ultrasounds for endospecifically. And then it came back positive. Same thing with my MRI. Firstly, it came back negative. We went and did an endo. protocol for MRI came out positive. I got a blood test done and I also got a saliva test done. So with four different modalities, we were able to triangulate this and get a confirmed diagnosis. And at the same time, I also got diagnosed with two other issues at the same time that I had no idea that I had, PMOS, formerly known as PCOS, and then a condition called adenoma. So my uterus is essentially swollen and it shouldn't be. Speaker 4 (19:08) So 10 % of women are suffering from this. It goes... undiagnosed, misdiagnosed, or diagnosed late. And traditionally, the treatment is surgery, and that's it, right? And so the exploration that you're on is, are there better ways of detecting this? And are there alternative treatments that could be effective short of having to cut you open? Exactly. And where are we at with that? Speaker 1 (19:34) Oh, man, it's so sad. So much of it is just like... pushing things forward. It's laying there. So we're actually right now working on getting this blood test available so that women in the US can go and get this blood test drawn at home. And that'll give them signal on if they've got it or not without having to go and get an expensive MRI or ultrasound. And that's Speaker 4 (19:53) a reliable test. So you don't have to do all of the multiplicity of tests that you had to do to really confirm this diagnosis. That's right. Yeah. Speaker 1 (20:01) Yeah. Yeah. And Speaker 4 (20:02) why is that not already widely available? Speaker 1 (20:06) a combination of sexism, people not knowing about this disease, the fact that there's many different ways that this disease can present itself. Yeah, it's just an infrastructure issue, just not enough attention on this so far. Speaker 4 (20:22) And is this initiative something that's being celebrated by the broader medical community? Are you getting pushback and criticism? What is the feedback, Ben? Very positive. Yeah. Are there women doctors who are like, finally, I'm glad somebody's doing this? Because a lot of the criticism that you get, Brian, is like, well, if you have all this money, you're spending all this money on yourself, why don't you put it into trials like gold standard science? You could be approaching this totally differently that would benefit humanity and also kind of serve the purpose that this mission that you're on. These N of 1 experiments, how valid are they really? So it's easy to like... you know, for like a traditional scientist medical approach to like have a battery of criticisms around like what you guys are doing. But this seems like it's something that you've is not, you're not getting that kind of. No, like a Speaker 1 (21:15) sigh of relief, like finally, and especially like Brian as a male in power, dedicating his brand, his platform to this cause, like just women around the world. And especially in academic setting, they're just like. finally somebody's gonna put the spotlight on this. So yeah, it's really a testament. Like, Brian truly, um... I have a hard time accepting love and being seen and being taken care of. But that entire first process, Brian was just all in reading books on female health, educating himself. So, yeah, I was really lucky. You're Speaker 4 (21:52) feeling seen. Speaker 1 (21:53) Yeah. I mean, and it's complicated as a result. It's really complicated. Oh, let's talk about that. Yeah. Speaker 4 (21:58) Why do you feel that way, Speaker 2 (22:00) Kate? What Speaker 1 (22:01) do you think after having been with me for five years? Speaker 2 (22:04) Yeah. So Kate, we've been trying to get to the bottom of this, actually. And the hypothesis we had is that Kate is not legible to herself. What does that mean? She can't understand herself. She struggles to understand herself. And I think, and we also were trying to explore this hypothesis that women are not broadly legible to society. And so when you read the history of female health, the same words the Greeks use, they're trying to understand planetary alignment. And so they were trying to figure out planets and they would like... draw these circles, like they spit in circles to make sense of the orbits because they couldn't make sense because their assumption was they thought Earth was stationary and the planets are circling the Earth. Speaker 4 (22:53) Sure. Speaker 2 (22:53) First of all, like I Speaker 4 (22:54) ask a question about like Kate's psychology and Speaker 2 (22:57) you're talking about like planets and... Yeah. And so in the same way, they refer to the womb as the same kind of chaotic structure. So they're like the planets are chaotic and the female womb is chaotic. And so there's a deep history of seeing females as chaotic, as like systems that can't be understood. And it's not like a central thing. It's recent. And so there's a bunch of carryover where women have never been as legible to the world as men because they're more complicated. in the same way as planets were at some point in time. But the women thing is never fully resolved. And so that's what we've been working on is in part what Kate is doing by this quantification is by showing how her microbiome changes throughout her cycle and her eyesight and pain tolerance and metabolism and breast size and, and, and, and, and. You basically see like there's a system that moves. just not in ways that have been intelligible or legible. Speaker 3 (24:04) But Speaker 2 (24:05) really, it's a system that produces life, that produces these cycles. And so in many ways, we've been trying to figure out how to explain this to the world. It's not just about biomarkers. Kate is not trying to be the healthiest person in the world. She's not trying to biohack herself. It's a legibility project. And to me, it's really at the heart of what does it mean to be female and what does it mean to be a male understanding a female? Speaker 4 (24:30) This episode is brought to you by Element right here in Black Cherry Salt. I'm deep in a fall training block right now, which is the biggest sustained running volume that I've attempted since my back surgery. And here's the thing that nobody tells you about rebuilding endurance at almost 60. Hold on one second. Speaker 4 (24:51) It is good. The margins get thinner. When I under fuel or under hydrate, I don't just feel it on the run. I feel it for the rest of the day. A little bit of a headache, some brain fog, a three o'clock fade. It's not a mystery. Often it's as simple as inadequate electrolytes, which is why Element lives in my home gym. It's a zero sugar electrolyte drink mix and carbonated drink with sodium, potassium, magnesium, and none of the sugar or dodgy ingredients that typically you find in these sports drinks. So if you're training for anything this fall, this is a low-cost experiment with a high hit rate. Get a free eight-count sample pack of Element's most popular drink mix flavors with any purchase at drinkelemente.com slash richroll. Find your favorite flavor or share it with a friend. Speaker 4 (25:46) This episode is brought to you by Birch. Ah, I can just feel it. Here's an honest question for you. When did you last upgrade your mattress? We replace our phones every couple of years, our running shoes every few hundred miles. But the thing we spend a third of our lives on, a decade, 15 years, given how essential sleep is to well-being, that math strikes me as backwards. I've been sleeping on a Birch mattress for about five years now, and it taught me what I've been tolerating before. sleeping hot, waking up stiff, blaming everything except the slab of synthetic foam underneath me. Birch, on the other hand, is built from actual materials, organic cotton, natural latex, responsibly sourced, all engineered to breathe, and no polyurethane foams, no fiberglass, none of that questionable off-gassing. And they give you 120 nights on your own bed to see how your body responds. It's all risk-free. Your sleep is the foundation of everything else. So the upgrade is overdue. I want all my listeners to enjoy a deep, restful night's sleep with a new mattress from Birch. Go to birchliving.com slash richroll for 27 % off site-wide. That's birchliving.com slash richroll and get 27 % off site-wide. Speaker 4 (27:09) Well, legibility is an interesting word choice. I mean, it's really marginality. The long history of women being marginalized and men being confused by women and being dismissive of them and just saying, well, they're complicated or she's being hysterical. And that's the real context here of talk about an idea that we've incepted. It's like, oh, this less than perspective of women and what they're capable of, etc. That has been a real violence in terms of existence and the shared consciousness, etc. In an expansive way, it's really... an awful legacy, how we have treated women, perceived them, made assumptions about them, and that's reflected in the canon of science in terms of how we understand them. And this is sort of an antidote to that. Legibility is a digestible word that sort of sidesteps just this really awful history in terms of how we've conceptualized women and their... their role and their strength and their power and the like in society. And so this is like a small example of just let's celebrate these women. Let's improve that. Let's change that understanding. Yeah. Speaker 3 (28:30) One Speaker 2 (28:30) simple thing with her endometriosis is that I've been working on my language to communicate to men what is endometriosis. So how is it the case that you have this? This is Speaker 3 (28:40) a Speaker 4 (28:40) whole black box to us. Like, I don't know. Speaker 2 (28:42) Exactly. My Speaker 4 (28:42) daughter had an issue and I was like, I don't know. This is like a girl problem. You know, like it's a mystery. You know, we don't talk about it. It's between the women. You know, like this is not functional, right? Exactly. So Speaker 2 (28:54) if you were hanging out and you're my friend, you're like. Oh, Brian, I've never heard of endometriosis. What is it? I'm like, okay, Rich, it's like one in 10 women. So it's a major disease, right? So here's what it is. It's like an alien is inside of you, fusing your guts together, and then it feels like you get kicked in the balls. Speaker 2 (29:14) That's what endometriosis is. Now, if a man is experiencing that, they're like, man, this sucks. We got to solve this. So it's like this thing that exists. But with women, Speaker 4 (29:22) it's like, oh, you're being emotional or like, you know, like just it'll go away or like, yeah, the dismissiveness of that. Exactly. Yeah. Speaker 1 (29:33) Yeah. At the same time, I've