Ep. 357 Aging Well: Biohacking Longevity and Lifestyle with Dr. Nick Bitz

Today, I am thrilled to connect with Dr. Nick Bitz, a renowned naturopathic physician specializing in Ayurvedic medicine. 

Dr. Bitz is an influential figure in the natural products industry, specializing in nootropics, anti-aging, medicine, biohacking, herbology, nutrition, and dietary supplements. He is currently the Senior Vice  President of Product Development at Neurohacker Collective.

In our discussion, we cover cellular senescence, zombie cells, and distinctions with autophagy, highlighting some hallmarks of the aging process. We discuss the gut microbiome and the significance of akkermansia, also exploring the impact of senomorphics and senolytics, brain aging, lifestyle factors, the challenges of sarcopenia, and anabolic resistance.

Join us for today’s enlightening conversation with Dr. Nick Bitz as we journey into various aspects of holistic health and wellness.

“There is an idea that if you can impact just one of the hallmarks of aging, you can, in essence, undercut all 12 of the hallmarks.”

– Dr. Nick Bitz

IN THIS EPISODE YOU WILL LEARN

• How modern lifestyle factors exacerbate age-related cellular dysfunction
• Why it is critically important to consume enough fiber each day 
• Senescent cells and their impact on aging, health, and disease
• What is the difference between senolytics and senomorphics?
• How senolytics get used in a clinical setting to target different body parts
• Diet, lifestyle, and supplements for brain health
• How adaptogens are used in Ayurvedic medicine
• The role of senescent cells in muscle aging
• Dr. Bitz discusses the popular senolytic product he created with Neurohacker Collective

Connect with Cynthia Thurlow

• Follow on Twitter
• Instagram
• LinkedIn
• Check out Cynthia’s website
• Submit your questions to support@cynthiathurlow.com

Connect with Dr. Nick Bitz

• Neurohacker Collective
• Collective Insights Podcast

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Transcript

Cynthia Thurlow: [00:00:02] Welcome to Everyday Wellness Podcast. I’m your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives. 

[00:00:29] Today, I connected with Dr. Nick Bitz. He’s a Naturopathic Physician that specializes in ayurvedic medicine. He is a leading voice in the natural products industry and currently serves as Senior Vice President of Product Development at Neurohacker Collective. His areas of expertise include nootropics, antiaging medicine, biohacking, herbology, nutrition and dietary supplements.

[00:00:53] Today, we spoke at length about cellular senescence, zombie cells and differences with autophagy, some of the hallmarks of aging, the role of the gut microbiome and the importance of Akkermansia, the impact of senomorphics and senolytics, brain aging lifestyle, and last but not least, sarcopenia and anabolic resistance. I know you will enjoy this conversation as much as I did recording it.

[00:01:24] Welcome, Nick. I’ve been looking forward to our conversation. I’m glad we can make it happen. 

Nick Bitz: [00:01:28] Thank you so much for having me on. I’m excited about this conversation. 

Cynthia Thurlow: [00:01:32] Yeah. So, my community is familiarized with the concept of autophagy, maybe not as familiarized with the concept of cellular senescence, although very important and differentiating that from speaking about zombie cells, understanding what’s going on in the aging process. So, let’s start the conversation there, because I think that there’s a lot of information that I think could be of benefit for people to understand about what’s going on at a cellular level as we are actually getting older. 

Nick Bitz: [00:02:01] Yeah, there’s a lot of relationships and overlap with autophagy and cellular senescence, but they are very distinct. The area of senescence is just this burgeoning field. It’s just starting to emerge. Seems to be a lot of enthusiasm around this area of science right now, and rightfully so. I mean, it has enormous promise and potential in a lot of ways, it really points to the future of healthy aging. And so, I’m really excited about this topic in particular, and I’m excited about the tools that we can use to undercut this aging process and to really help the body just optimize over time. And so, yeah, if we step back, cellular senescence is, in short, the end of the life cycle of a cell.

[00:02:45] And so, we know that cells, all 37 trillion cells in the body. They all have life cycles. On average, they replicate about 50 times and then they stop replicating, generally. Then they move into this dormant phase that’s known as senescence. And pretty quickly, the body will get rid of those cells, most commonly through the process known as apoptosis, which is a very sciencey technical term. But apoptosis is just a Latin word that means falling off. And so, these cells essentially self-destruct. They go through what’s known as cellular suicide, and they explode from the inside. And all of their parts are recycled to create new cells in the body. And so that’s important. That’s important for tissue regeneration and just staying young and youthful and optimal. 

[00:03:36] And so, what senescence is, why it’s important to the aging process, is because this phase that these cells get locked into can become extended. So, short-term senescence is fine. It’s normal. Every time we work out, we create senescent cells. When we go out in the sun, we create senescent cells. If we have any damage to the body, we create senescent cells. So, it’s normal. It’s part of the body’s repair and regeneration mechanism. But when these cells linger inside tissues, it becomes problematic. And that really is one of the drivers of the aging process. And when these cells, these non-functional zombie cells, as they’re called, when they get lodged in tissues, it impacts the structure of the tissue, and it also impacts the function of the tissue. 

[00:04:24] And even beyond that, we know that these cells secrete these inflammatory compounds that can impact the micro environment within a specific tissue, but can also be moved systemically and create this chronic, low-grade inflammation throughout the entire body. So, senescence is absolutely fascinating. Again, it comes from a Latin word that means old man. It comes from the word Senix. And so, once we’ve understood that, we understood how that relates to these different aspects of aging. And one of them is autophagy, which you speak about quite often. 

Cynthia Thurlow: [00:04:58] Yeah. And I think for a lot of individuals, you’ve done a beautiful job differentiating the process of cellular senescence, zombie cells. And I think for people that are listening, understanding that as we are getting older, this process in many ways doesn’t work quite as efficiently. Is that correct? And therefore, we’re at greater risk for these arrested development cells. That’s how I was thinking of them as they’re arrested in their evolution. And the hallmarks of aging are based off of this process of weakened deconditioned cellular senescence.

[00:05:35] And so, for the benefit of listeners, what are some of the bigger concepts in terms of looking at hallmarks of aging? These are things that will probably not be a tremendous surprise to most individuals because they are at the basis for a lot of the changes that we see happening in our bodies or maybe in our loved ones. I’d make the argument that I think our generation is much more aware of a lot of these lifestyle-related aspects that can impact how we navigate the aging process, because it’s, I guess, the way that I look at aging. I’m not antiaging because I think that that sends the wrong message. I think it’s more about being informed about what’s happening and doing helpful things that are going to make an enormous difference.

[00:06:16] I don’t want to be the little old lady who falls and breaks her hip when she’s 70. I want to make sure I’m physically active, making good food choices, getting plenty of sleep, reducing the likelihood of having these hallmarks of aging being a larger issue. 

Nick Bitz: [00:06:30] Yeah, the hallmarks of aging are fascinating. This was an idea that was proposed in 2013 really just to encapsulate where all the science was heading. And so, there are probably hundreds, if not thousands, of theories about why we age. But the hallmarks of aging now, I think, creates the strongest foundation. And in 2013, there were nine hallmarks of aging. And over the course of the last decade, we’ve added three more. So, there are 12 known hallmarks of aging presently, one of which is disabled autophagy. I think over the last decade, we’ve learned a lot about autophagy and how any dysfunction in that area can impact the repair and regeneration processes and move cells into a senescent state.

[00:07:14] And so, there are things you can do to support autophagy. Make sure that your cells are repairing, getting rid of damaged parts as effectively as can be. But we do know how these aspects, these hallmarks are all related. And I like that because it gives us a framework to study these aspects of aging. It’s no longer different, unrelated processes. They’re all intertwined and they’re all related to one another. There’s actually an idea that if you can impact just one of the hallmarks, you can, in essence, undercut all 12 of the hallmarks. And so, we’re learning more about that. We’re going to keep adding to all of these different hallmarks that we know of. But cellular senescence is one of those hallmarks. And, if there’s damage to a cell it gets moved into that senescent state, and it really drives the aging process overall.

Cynthia Thurlow: [00:08:02] How does our modern-day lifestyle play into exacerbating these hallmarks of aging? The average person is not metabolically healthy, is probably not physically active, probably not getting high quality sleep or all these things that we know are not beneficial. But in your estimation, how is our modern-day lifestyle impacting the aging process overall? 

Nick Bitz: [00:08:27] Yeah, I mean, that’s a big question. I look upon it as it’s impacting all phases of being human. It starts at the cellular level. It’s impacting the structure and function of cells. We’re not feeding the mitochondria in the ways that we should to facilitate cellular energy. We’re not giving the cells the proper food to repair itself through autophagy. You can also step in a more broad fashion and look at systems. We know that the gut microbiome, as an example, is one of the hallmarks. And any shift there in the microbiome can have enormous repercussions throughout the entire body. So, I think what we do on a daily basis informs what happens on a cellular level, but it also has repercussions throughout the entire body and systemically. 

Cynthia Thurlow: [00:09:12] It’s interesting. I just interviewed Dr. Colleen Cutcliffe, and so we were talking about the gut microbiome and how we were both laughing because we were training at the same university, although we did not know one another. And she was saying there was no information about the gut microbiome at the time that you and I were studying at the same university. And yet now, probably since 2010, there’s growing awareness. And so, things like antibiotics, chronic stress, even jet lag from travel. And if you do a lot of travel like I do, I know that sometimes I feel like I’m upside down when I’m coming back, returning from trips.

[00:09:46] But even understanding that changes in the gut microbiome impact our food choices. They impact our cravings. They impact our ability to create a proper immune response. And so, on a lot of different levels, you appropriately identify that, there’s the cellular level all the way up to a systems approach, and it’s not as if one doesn’t influence the other. 

Nick Bitz: [00:10:08] Yeah, the gut microbiome is fascinating and it’s unbelievable. Even when I was in medical school, we didn’t know a lot about the gut microbiome. It wasn’t a huge topic. We talked about it very abstractly. When in doubt treat the gut, [Cynthia laughs] which is still, naturopathic physicians talk about that all the time. Ayurvedic practitioners talk about that all the time. But now we’re getting into the details and we’re understanding the gut microbiome in much more detail and how that relates to not only gut health, but organ health. And so, there’s gut-organ axis all throughout the body. First and foremost, the gut-brain axis, we know that there’s that bi-directional communication between the gut and the brain, and we’re learning more about how gut health and microbiome health impacts mood, emotions, cognitive performance. 

[00:10:58] And so that’s happening throughout the body. It happens in the lungs. It happens in the heart, it happens in the muscles, it’s all interrelated, and it all starts with the gut. So, if there’s one area that I would love to dedicate the rest of my life to, it probably would be the study of the gut microbiome, because it’s just absolutely fascinating and there’s so many things you can do. I mean, right now, when you get into the world of dietary supplements, which is the world that I live in presently, probiotics are the number one category, and they’re enormous. There’s a lot of interest. Most people are either taking a probiotic or they know that they should be taking a probiotic. And I think we’ve just scratched the surface in terms of what’s possible from a dietary supplement standpoint. 

[00:11:40] And to date, when you look at what’s available in the marketplace, I would say that most of the strains that are out there are really B grade or even C grade probiotics. And so, this next gen probiotic is starting to emerge in the marketplace, and they’re much more effective. People are going to feel the benefits much more than they feel their probiotic. So, I’m really excited about this field. It’s endlessly fascinating. And there’s just new studies coming out every week to learn. 

Cynthia Thurlow: [00:12:07] Yeah, it’s really interesting because I think strains like lactobacilli and Bifidobacterium, I mean, they’re easy to grow, they’re aerobic versus Akkermansia, which is more challenging, has to grow in an anaerobic environment without oxygen. And I have a family member who- it’s just serendipitous the way sometimes things all come together, who started on an Akkermansia product, has been on antibiotics for 15 years to address Lyme appropriately. And as you can imagine, her gut is decimated because of that, but it’s killed off the latent infection. And she said this is the first thing that’s helped her gut in 15 years. And so, for me, I think it’s incredibly gratifying to know that the science is advancing to a degree that it’s not just taking the antibiotic, it’s understanding that it can have tremendous therapeutic value. 

[00:13:02] And so, Akkermansia, I mean, to me, I find fascinating because it helps with– if you don’t have enough Akkermansia, you’re going to end up with a leaky gut because it’s part of this fortification of the small intestines, intestinal lining. It’s involved in GLP-1, endogenous GLP-1. So, for all the people listening that are familiarized with Wegovy and semaglutide, before any of those drugs are created, there’s actual endogenous production of GLP-1 and Akkermansia is involved with that. So, it helps with satiety and helps with insulin sensitivity. And then the other thing that I found really interesting about Akkermansia was just the fact that it’s involved in butyrate production. So, the short chain fatty acids and these are things that are critically important to have available in the distal colon. 

[00:13:48] And so much to your point, I can really now nerd out on the microbiome, because I just understand that when you have a healthy microbiome, it just makes you a healthier individual overall. And so really being diligent about educating yourself about good quality options that are available, that nutrition piece is certainly really important. I think it goes without saying most of us need to be eating more fruits and vegetables than we are. And I enjoy protein, I’m very open about that. But I do diligently make sure I’ve got brightly pigmented fruits and vegetables in my diet, because that helps feed exactly the microorganisms in the gut microbiome that utilize that as a fuel substrate. 

Nick Bitz: [00:14:26] You’re exactly right. I’ve actually moved from recommending a high-fiber diet into a high-polyphenol diet. So that idea of eating a rainbow every day is critically important. It’s really important that you’re providing food for these little critters that are living in our gut. And these polyphenol, flavonoid like compounds have a prebiotic effect, so they help to feed specific strains of probiotics. So, Akkermansia being one of them and so it’s important to make sure that you’re getting your blues, your purples, your reds, your greens, the full spectrum on a daily basis. And I think that’s a lot easier for people to do rather than looking at the amount of fiber that they’re getting because most people just aren’t going to get enough fiber. 

[00:15:08] The average American’s consuming less than 20 g of fiber per day, and that’s just not enough food for the bacteria that’s in there. And so, I think the alternative work around then is just focusing on colors. So, I love that. I think that’s critically important and it seems to be critically important, especially when you’re talking about Akkermansia, which is a keystone species that relies on these polyphenol compounds.

Cynthia Thurlow: [00:15:30] Yeah. And it’s interesting to me because I think fiber in particular, for a lot of people, is very bio-individual. And I’m the first person to say, someone will reach out to me and say, well, how much fiber should I be eating? And I think supplements can play a role here, but I’ve come to find out that a quarter cup of a resistant starch in one person could barely be tolerated. And then I have other patients and clients that can take two scoops of a product and they have no problems whatsoever. So, I really think that it speaks to the fact that whether it’s the antibiotics we’ve received over the course of our lifetime, our chronic stress, the nutrition, whether it’s pristine or otherwise, I think so many things impact our ability to break down fiber in our gut. 

[00:16:11] And I think it’s very challenging to force someone to be taking copious amounts of fiber. When it bloats them, it makes them miserable. And then they’re feeling like they can’t leave the house because they’re either gaseous or they’re constipated or whatever multiplicity of symptoms people experience. And so, when we’re looking at certainly the gut microbiome is important, but when we are looking at these hallmarks of aging, disabled autophagy, I think it is important to speak on. And certainly, my listeners are familiarized with intermittent fasting can be helpful for this. But there are other things that we can do in our lifestyle that can stimulate autophagy that I think are very important. And as the longer I get into my intermittent fasting journey, the less fasting I do and the more I do other things to evoke autophagy. So, it doesn’t just come from food restriction or caloric restriction. 

Nick Bitz: [00:17:02] Yeah. And I think it’s important too to take the conversation one step further. So, what happens after a cell repairs itself? And what can you do to either prevent further senescence or to help move a cell out of senescence so that tissues and cells can regenerate? And again, that’s the topic of senescence, which is intertwined with autophagy. But I love speaking about that as well. And we do know that intermittent fasting, water fasting, the fasting mimicking diet, they can really help to prime cells for elimination from the body. So, I think that there’s amazing things you can do that are senolytic in action and that’s the next level science. 

[00:17:42] Senolytic is essentially any substance that helps the body eliminate these senescent cells from the body. And there’s plenty of lifestyle, diet things that you can do. There’s a lot of botanical things that you can do. And that really excites me because that’s where the science is, I think.

Cynthia Thurlow: [00:17:57] It’s so interesting. And tying in what you were talking about, there are things we can do beyond just the fasting piece. What are some of the common symptoms you see when someone is struggling with senescence? Or what are some of the outward signs? Maybe things that might be more apparent to a clinician, but are evidence that your senescence is not fully optimized? 

Nick Bitz: [00:18:20] Yeah, I mean, there’s virtually no tissue that’s untouched by senescence. As we age, we start accruing these senescent cells and accumulating these senescent cells over time. It’s thought that there is a point in time where the accumulation rate exceeds the elimination rate, and that’s generally after the age of 40. And we see these senescent cells building up in every tissue. So, the brain, as an example, you see it in the skin, you see it in the heart, you see it in the muscles. There’s not any one place. And so, it is per the individual, not everybody accumulates them at the same rate nor in the same place. And so, they can be experienced very differently across the board. A lot of the science is in the area of joint health. 

[00:19:04] And so, when you get into preclinical animal studies, they’re looking at the impact that senescent cells have on joints because it’s easy to measure. In animals, we can actually look at before and after senescent cell load. That’s much harder to do in humans, unless you’re doing muscle biopsies or bone biopsies. And you’re looking directly at senescent cell count. It’s much easier to look at outcomes and function. And so, you can look at, as an example, the skin, you can look at the immune cells, you can look at joints. And so, there’s no one thing that people can look for. You can just know that all tissues are affected over time by these senescent cells. 

Cynthia Thurlow: [00:19:43] That’s really interesting. And I would imagine if anyone’s listening, muscle biopsies, bone biopsies are not pain free. So, I like the idea of observational, self-reported, or that are noninvasive, that allow people to demonstrate that there’s been a slowing of the aging process. What is the differentiator between senomorphics versus senolytics? There seems to be a burgeoning amount of information on both. When I was preparing for this, I was like, hmm, I think this is a really interesting distinction. 

Nick Bitz: [00:20:15] Yeah. So, the whole category is known as senotherapeutics. And within that there’s two buckets. First bucket is a senolytic, and then the second bucket is a senomorphic. Senolytic is any substance that helps eliminate a senescent cell from the body. And then a senomorphic is really any class of substance or nutrients that doesn’t help get rid of the senescent cells per se, but it helps delete the negative effects of these inflammatory compounds that these cells release. I would say that there probably is more research in the area of senolytics presently, but I’m seeing more and more information emerge around senomorphics. Oftentimes, you can do both to double up and make sure that you’re really supporting the body maximally. But I think doing one or the other is wise to do. I’m a big fan of senolytics just because the science is pretty strong showing that you can eliminate these senescent cells from the body. 

Cynthia Thurlow: [00:21:10] And what would be some of the more common examples of senolytics? So, if people are listening, I know some of these are plant extracts. Some of them can be drug therapy. What are the more popular senolytics? 

Nick Bitz: [00:21:24] I’ll just start by saying, this all started in 2015. There was a group of scientists at the Mayo Clinic in Scripps that identified two compounds that were able to eliminate senescent cells. And so, from that study, they termed this idea of a senolytic. And in this study, they used a pharmaceutical drug known as dasatinib, which is used for cancer. And then they used compound that’s known as quercetin, which is a widely used flavonoid. Great benefit in the dietary supplement space for allergies, for inflammation. But it was that combination that showed benefits, showed that they were able to reduce senescent cell load, and they were able to bring about these very functional benefits. This study showed that by taking these two substances, animals were able to improve frailty, improve osteoporosis, improve their cardiac output, extend their health span, and extend their lifespan. 

[00:22:18] So, that’s where the whole field started in 2015 on those two compounds. Since that time, they’ve tested a number of pharmaceutical drugs, that’s definitely not my area of expertise given that I am a holistic physician and I work in the dietary supplement space. But there’s been a lot of natural substances that they’ve discovered as well. And so, shortly after quercetin was identified, they looked at a molecule known as piperlongumine, which is an extract from an ayurvedic plant known as long pepper. Long pepper has been used for thousands of years in ayurvedic medicine, really is the cousin to black pepper. It’s a digestive stimulant, but historically it’s been used as a rejuvenative for reproduction and the reproductive organs, specifically. So, it definitely has an affinity for the reproductive organs, and then it has this rejuvenating effect. 

[00:23:08] So, it’s cool, because we’re now identifying that, in part, it’s working through that senolytic action. There’s also a compound that was discovered in 2018 known as fisetin. We’ve known about fisetin for a long time, but this was our first time identifying how strong fisetin is. And fisetin is like quercetin. It’s this yellow pigmented flavonoid that’s widely available in foods. You can get it in apples and strawberries and grapes, but in very low amounts. And so, in 2018, they tested this big panel of compounds, looking at the senolytic action of all of the compounds, and they’ve discovered that fisetin was the strongest of all of these agents. And so, from this study, we have started using fisetin at a very specific dose, which is 20 mg/kg of body weight as a senolytic agent. 

[00:23:58] And so, I would say now fisetin probably is the most buzzworthy of all senolytic compounds because of the research that opened up in 2018. When you get on ClinicalTrials.gov. You can see dozens of studies on fisetin that are currently lined up, that are in process. And so, we’re going to learn more about fisetin here in the coming year or two, no doubt. But you can get into a lot of different compounds too, that are very well known. Curcumin is senolytic, luteolin is senolytic, soybean especially some of the phytoestrogens, they’re known to be senolytic. So, there’s a whole wide class of senolytic agents that are available. And the nice thing is we know how they work. They’re very safe. We use them nutritionally for many different functions, one of which is offsetting the effects of free radicals. 

[00:24:47] But these compounds work very specifically and they target senescent cells very selectively, which is part of the beauty of using them. So, they don’t harm healthy cells. They tend to go in and disable senescent cells in terms of the proteins that they upregulate to stay alive inside the body. So, it’s amazing how they work. But knowing that we can go in and find more senolytic compounds over time. 

Cynthia Thurlow: [00:25:13] Oh, it’s really interesting. And where does spermidine fit into the senolytic. Is it considered to be a senolytic despite its name? I know people sometimes are like, how do we actually know what this does? And I’ve been down a rabbit hole learning about spermidine. But do you consider that to be one of the senolytics that you think are emerging or do you feel like these other plant-based compounds are more efficacious?

Nick Bitz: [00:25:37] Yeah, I would say that spermidine is probably mildly senolytic. It’s definitely not one of the most powerful. It seems to be more beneficial for autophagy, and that’s how I would use it. I would use it to promote autophagy more so than I would as a senolytic agent. So, it really helps to prevent cells from getting into senescence in the first place. But there is some research showing that it is mildly senolytic. 

Cynthia Thurlow: [00:26:00] Okay, and how often are we taking these senolytics? Because I would imagine that a combination therapy is more efficacious and easier than trying to take five different compounds together a few times a month. 

Nick Bitz: [00:26:14] Yeah. So, it gets really interesting when you look at how these things are used in a clinical setting. There is a concept known as intermittent dosing, which is known as hit and run. And so, these substances are used in a hit and run fashion, where you hit these cells hard and then you let the body recover. Typically, these substances are used over the course of two, maybe three days, followed by several weeks if not months, of recovery and rest. So, we know that it seems that, anyways, that intermittent dosing is much more effective than continuous dosing. So, you don’t need to use these things on a daily basis, which is great news. 

[00:26:52] So, anybody that wants to use a senolytic agent or to do a senolytic regimen, you just need to do it for one or two days and then let the body do what it does. So, it’s not a big ask, it’s not a heavy lift, but we do know that it does take weeks, if not months, for senescent cells to reaccumulate. And we have early indicators showing that the senolytic agents tend to have lasting effects. We know that one round of quercetin and dasatinib can have lasting effects that maintain over the course of seven months or more in mice. So, this is something that you just need to do. You need to do intense dosing followed by a rest. 

Cynthia Thurlow: [00:27:30] And so, for someone that’s listening, certainly the dasatinib obviously is a prescription, but these other compounds are whether they put them together themselves or they’re working off of a protocol, how does someone go about utilizing these, and how do we determine when someone is using them appropriately? I guess that’s the way that I would suggest, because I recognize that plant-based compounds, plant extracts can be as efficacious, as powerful as pharmacotherapy. And so, this is where I’m providing some degree of caution, just to say, to make sure that you’re working with someone that’s knowledgeable, because I would imagine some people may have a detox effect. There could be a significant detox effect if we’re having this hit and run mind about intermittent dosing, taking a bunch for a short period of time and then backing off and, as you said, intermittently dosing this senolytic products.

Nick Bitz: [00:28:23] Yeah, so there are several senolytic products that are available, dietary supplements that are natural, that are easily available online. I will say the great majority of them are either dosed in the wrong way, they’re continuous everyday dosing or they’re not using the right doses for these ingredients. So, we know that fisetin, as an example, needs to be at that 20 mg/kg of body weight dose, and that equates to about a 1400 mg dose. So that would be 14 mg in one day. Doing that two or three days would give you that senolytic effect. So, if you do a 30 mg dose of fisetin over the course of weeks, that doesn’t appear to have that senolytic effect. So, senescent cells tend to be heterogeneous. So, they’re not all the same. They have different upregulation of proteins. 

[00:29:13] And so, there’s not any one thing that you can do to target all of the senescent cells in the body. And so, it is important that you’re doing multiple ingredients so that you’re targeting the SCAP networks, multiple SCAP networks throughout the body, and you’re undercutting the optimal maximal number of senescent cells that you can. We also know that senolytics are not equally active in all tissues. So, there’s no one senolytic compound that can target all senescent cells in the body. And so, again, it’s important to have multiple ingredients that target different tissues in the body. And so, we’ve already identified that certain forms of curcumin from turmeric and impact brain tissue and has that senolytic effect specifically in the brain tissue. We know that fisetin has an affinity for adipose. 

[00:30:01] We know that quercetin has an affinity for bone marrow in the spine, specifically. And so, we’re starting to figure out exactly where these substances work and how to combine them. So, my general rule of thumb is just to make sure that you’re maximizing the dose, that you’re using a broad number of compounds, many different colors, and then to use them in that intermittent dosing. So, use them for one or two days, followed by that rest period. 

Cynthia Thurlow: [00:30:27] That’s so interesting, and especially about the senolytics that are specific to different tissues or body parts. Now, a lot of questions came in around brain aging. And, men will go through andropause, women will eventually, if they live long enough, go through menopause. But a lot of concerns about how to support a healthy brain as they’re getting older, what are the things we can be doing? You mentioned 40 is when, we start seeing more accelerated aging. I would imagine lifestyle is quite significant. And obviously, curcumin and brain health seem to be aligned. What are some of the things you focus in on with your patients to help support cognition, neurocognitive status as they are getting older. 

[00:31:14] It really all starts with diet, first and foremost. I mean, you build your mind based upon what you eat. We know that that’s a very strong direct link. So, you got to make sure that you’re getting the right macronutrient combination. The brain is made of fat, and so one of the things that I overemphasize are fats, especially over protein. I think the average American diet people are focusing way too intensely on protein, and I’m trying to shift that towards the area of fat. Focusing on healthy fats, especially the omega-3 variety, that seems to be critically important. Then, when you’re getting into senolytics again, we know that neurons never turn over. Neurons in the brain never actually go into senescence, but the cells that support and surround neurons do. 

[00:32:01] And so it’s important that you’re helping them turn over, move through apoptosis, and being eliminated from the body. And so doing certain senolytic compounds, especially, in the form of turmeric, as an example, can be beneficial just to clear the cobwebs and to optimize cellular communication in the brain, specifically. So, that seems to be critically important, obviously diet, lifestyle, getting enough sleep. There’s things that I would recommend doing on a daily basis too to improve cognitive performance. I’m a huge fan of adaptogenic botanicals, not only for buffering the effects of stress, but just in terms of their benefit for cognitive performance. 

[00:32:40] So, I highly recommend finding the adaptogen that is suitable to your body type and then using that every single day just to really shift your balance of hormones and to make sure that you’re just optimizing mentation, the best that you can.

Cynthia Thurlow: [00:32:54] Specific adaptogens that you like or lean into, like ashwagandha, rhodiola, etc. 

Nick Bitz: [00:33:01] Yeah. So, there’s no perfect adaptogen for all people. Adaptogens, by definition, are nontoxic and suitable for everybody. But when you get into the energetics of the plants, it gives you a different lens to look through. So, my background is in ayurvedic medicine, and ayurveda looks at the energetic properties and qualities of everything, especially food, especially botanicals. And so, you need to make sure that you’re marrying up the right herb with your body type, and you need to create balance by doing opposites. And so that’s a fundamental tenet of ayurveda. So just very broadly, abstractly speaking, if you have too much heat, you want to do the opposite of that you want to do something on a daily basis that’s cooling. 

[00:33:44] And so, you had mentioned Ashwagandha as an example. Ashwagandha is perhaps the trendiest botanical right now, and rightfully so I love ashwagandha but ashwagandha has an energetic imprint that everybody just should be mindful of. It tends to be very warm in nature, and it’s calming in nature. So, if you are the opposite of that, if you are too cold and you tend to be too riled up and your mind’s always going, ashwagandha is perfect for you, and so do that botanical every single day. Rhodiola, another fantastic herb. It tends to be, I think, the most felt of all the adaptions, because it is somewhat stimulating. But rhodiola is cooling, it’s stimulating, and it’s very drying. So, if you have problems with being too dry, whether your skin’s too dry, your eyes are too dry, your mouth is too dry, rhodiola may not be for you because it does have a very drying quality.

[00:34:40] You get into certain other categories. Ginseng has some other energetics that can complement the other two that I’ve talked about. Ginseng tends to be stimulating, very heating. So, that can be good in certain cases. I find that American ginseng is better than some of the Panax Korean Ginsengs because it tends to be a little less hot and a little bit more balancing. And so, there’s probably 20 different adaptogens that you can choose from. So, my recommendation is just to play with a few, see how you feel on them. You can even work with certain combinations. I use a combination of ashwagandha and rhodiola that really Is well balanced and complement each other very well. I use that on a daily basis, if not a weekly basis. 

Cynthia Thurlow: [00:35:25] That’s really helpful. And I don’t think we’ve actually explored ayurvedic medicine on the podcast before. And so, pardon my oversimplification, but there are three main types. I think it’s pitta, vata, and I’m forgetting the third one. But we will fall into one of those categories, correct. And through that lens, we then are able to determine how we eat and how we destress and how we focus our lives. So, perhaps we can just have a brief discussion so that for people that are not familiarized with what ayurvedic medicine is, to have a sense of where you’re coming from. And I love that you appropriately mentioned that adaptogens are as bio-individual as we all are.

Nick Bitz: [00:36:09] Yeah. Ayurveda, that is a very deep rabbit hole. Ayurveda is, in short, the traditional healing system of India. It’s considered the first form of medicine in the world. It originated some 5000 years ago and still very much alive and flourishing today. It’s considered the sister science of yoga. And so, a lot of what we’re learning from yoga practice, it just overlaps nicely into ayurvedic medicine. Obviously, the botanicals from Ayurveda that are trending right now would include turmeric, ashwagandha. All of those come from this 5000-year-old medical system. Ayurveda is a combination of two Sanskrit words, Ayu, that means life and Veda, that means science. And so, it can be translated as the science of life or the science of living. But so, it really encompasses much more than just medical diagnosis and treatment. 

[00:37:01] It teaches you how to live in harmony with the universe and understanding yourself. And it all starts with body typing. And so, there are three main body types which you mentioned, vata, pitta and kapha. And those, without getting too technical, those are different combinations of the five elements. And depending on the makeup of those five elements in your body, it gives you a body type. As an example, my body type is vata, which is the space and air elements. So, innately, I’m lacking the other three elements. I’m lacking water, fire, and earth. And so, because ayurveda is all about balance and using opposites to create balance, that’s what I focus on. Because my body type has those two elements, the air, and the space. Everything that I do is about putting more of those lacking elements into my body. 

[00:37:52] So, my diet consists of almost predominantly fire, earth, and water elements. My botanicals also have those same elements. And so those are what I need to be balanced. So, everybody, it’s important to try to identify your body type, understand the energetic properties of that body type, and then you know the specific diet that you should be eating, you know the dietary supplement regimen that you should be using. You really know everything that you need in order to create balance and live a long, happy life. 

Cynthia Thurlow: [00:38:23] Yeah, thank you for that. I just wanted to make sure if there were listeners that were less familiarized with that terminology, that they had some context to the conversation. Now, I’d love to pivot a little bit and talk about, north of 40 sarcopenia, this anabolic resistance. How in your approach to your patient care, do you– because you mentioned you think that there’s too much focus on protein. You think for brain health, we really need to focus on omega-3s and healthy fats. How do you make peace with the process of anabolic resistance that gets worse with aging that, I think is seemingly at the basis for a lot of metabolic poor health here in the United States? 

Nick Bitz: [00:39:05] Yeah, I mean, the muscle is a highly metabolic tissue. It’s important that you’re giving it the nutrients it needs to repair itself. But you need to make sure that you’re moving your muscles, that you’re needing those nutrients in the first place. So, it starts with staying active, followed by the proper nutrients post exercise. I’m a huge fan of leucine which is usually found in a branched chain amino acids. There’re some really good studies showing that, that can help get muscles to the active size that you need and to make sure that they maintain that size as we age. And again, getting back into this idea of senescent cells, we know that senescent cells build up in the body, specifically in the muscles as we age. And so, if you have senescent cells in aging tissue, it can’t regenerate properly. 

[00:39:51] And so you’re not going to see the same growth that you would when you’re younger. And so, it’s important that you’re targeting those senescent cells that are found in muscles so that you can regenerate and repair properly. And so, there are certain nutrients that do that. There are certain ingredients we know that do that. One of which is an ingredient called Senactiv. And Senactiv is a really fascinating ingredient, very novel in the supplement industry right now. It’s just a combination of two different adaptogenic herbs, notoginseng and sweet chestnut. And this combination, if you take it actually will help eliminate senescent cells in muscles. And they’ve done studies in humans using muscle biopsy before and after exercise to show that this substance, at a very small dose has that effect. So, I love that idea. 

[00:40:39] I don’t think that there’s any one thing that people should be doing. I think there’s a lot of little things that people should be doing to make sure they maintain their muscle as they age. 

Cynthia Thurlow: [00:40:48] Yeah, I think so many people still maybe not listeners to my podcast, but so many people still think of muscle is something that’s more phenotypic. It’s just the way that your body looks with clothing on, but there’s so much more to it, and certainly an area of focus of my work. And the Senactiv product that you just talked about I’ve never heard of before. So, I’m going to have to go learn more about that. Now to circle back to the senolytics, because I know there’ll be a lot of questions about this. 

[00:41:15] Is there a product that you’re currently working with that you like, that provides the diffuse distribution of plant extracts in a way that it’s maybe encompassed in one product that people can utilize as opposed to sourcing this much curcumin and this much quercetin and this much fisetin to be able to utilize that intermittent dosing pattern that you referred to.

Nick Bitz: [00:41:39] Yeah, I mean, so I have created a product with a company called Neurohacker Collective. We have a product that we created well over 12 months now, and it’s quickly become the number one selling product in that line. It’s called qualia senolytic and it’s just a beautiful product. I mean it really is leveraging all of the science that’s available currently and putting it into one product. It’s a simple blend of nine botanical extracts, giving that dose of 1400 mg of fisetin, giving a super absorbable form of quercetin, which is a phytosome form, and then a lot of other botanicals in there that are selective in terms of how they work in the body. So that product is, it uses the intermittent dosing schedule that we spoke about. So, it’s six capsules on day one, six capsules on day two, followed by several week break. 

[00:42:29] And we recommend that people over the age of 40 start using this product. You can start using it monthly. You can even use it seasonally. Perhaps one time per year. You can use it as much as you really need to, given your health status, your health needs, your age. So, I’m very fond of that product. It really is unique in the marketplace, and I haven’t seen anything else like it. So that would be my one recommendation. 

Cynthia Thurlow: [00:42:54] Yeah, it’s so interesting and definitely something I’m going to look into, because, again, as I was preparing for our discussion today and realizing that although I exercise, I sleep well, I do intermittent fasting, there are probably more things I could be doing to add to my regimen. Dr. Nick, please let my listeners know how to connect with you, how to get access to qualia, if they’re interested in learning more about your product. 

Nick Bitz: [00:43:19] Yeah, so Neurohacker Collective is available on all the social platforms. You can find out more about the brand and about products at neurohacker.com. It’s a fantastic website. Just a lot of information, blogs, articles, ingredient monographs. We have formulators, articles about all of our products, about why we formulated them in the way that we formulated them with all of the science. And so, we are an education first company, which I’m really proud of. You can find out about that online. We also have a podcast called Collective Insights, where we talk about all things related to health and wellness, including nootropics and senolytics and more. 

Cynthia Thurlow: [00:44:01] Awesome. Thank you again for your time today. 

Nick Bitz: I appreciate it. Thank you. 

Cynthia Thurlow: [00:44:06] If you love this podcast episode, please leave a rating and review, subscribe and tell a friend.