A very healthy lifestyle

I am 32 years old, and I spent $200 thousand on "biohacking"

Article Sergey Fage became one of the most popular on Medium and was liked by a number of well—known figures in Silicon Valley - Mark Andreessen, Peter Diamandis, Naval Ravikant, Kara Swisher and others. Sergey has finalized it in Russian exclusively for vc.ru .
Translated by Artem Slobodchikov.

Key points

I'm the CEO of a technology company. I wanted to become more energetic, healthy, happy, confident, strong-willed and intelligent, improve my mood and concentration, as well as prolong my life. For the last 4-5 years I have been engaged in biohacking of the body and mind with the help of logic and a scientific approach.

To do this, I optimized sleep, nutrition and training, went through thousands of tests, took dozens of different medications and hundreds of supplements (in the photo below — part of the pills I take every day), worked with great doctors, meditated more than a thousand times, went to a therapist — and spent about two hundred thousand on all this dollars.

The results are excellent. Objectively, I dropped fat from 26% of body weight to 10% (data below), raised VO2max (maximum oxygen consumption — vc.ru ) to about seventy (this is very high) and improved performance on most biomarkers. Subjectively, I feel happier, calmer, more energetic. I became more confident and focused. And smart, if we mean by the mind the applied ability to solve complex problems.

I included in the material a large amount of personal health data, test results, even indicators of the content of bacteria in my intestines (yes, seriously). You can share all this anywhere, I don't care.

I think the popularization of my methods can greatly affect society. Especially the gap between rich and poor — people like me will be able to live more productively, get richer and invest even more in improving their own efficiency.

Important: before you decide to repeat after me, it is very important to consider the state of your health and consult with a specialist. Everyone is different, and what worked in my case may be dangerous or useless for you. I am not a doctor, and this material does not contain medical recommendations. It's just my personal story.

Briefly about yourself

My name is Sergey Fage, I am Russian, I am 32 years old. He studied at Cornell University, dropped out of Stanford Business School, founded several technology companies: TokBox - a leading infrastructure company for b2b video communications (bought by Telefonica); Ostrovok — the largest online travel company in Russia with a turnover of about $500 million in 2017; a new and so far secret AI-a company in Silicon Valley. Passed Y Combinator. I worked at Google for a short time.

I used to have a lot of problems. I was nervous, insecure, introverted in places, had problems with excess weight, concentration, mood swings, anger management, procrastination and other things that many of us face. What I describe in this article helped to get rid of all this.

Why am I doing all these weird things

Obviously, regardless of life goals, there are things that are useful to everyone. I, like many others, want to be a more energetic and strong-willed person, fall into melancholy less often and be self-confident enough to calmly meet a beautiful girl in a supermarket queue.

All these things depend on changeable and temporary mental states. Which, in turn, depend on human biochemistry. If you have ever meditated, taken drugs, had a bad night's sleep or been ill, you know that this is really the case: with biochemical changes, your personality itself changes, and all the things described above become easier or more complicated.

My goal is simple: to precisely manage my biochemistry in order to increase those physical and mental states that are useful to me.

What exactly do I want

Good mood, self-confidence, concentration, energy, willpower, resistance to stress, intelligence, calmness, health, long life, absolute indifference to any social restrictions. Always and everywhere. With minimal investment of time and minimal risk.

What I do: Summary

There are only six blocks.

Important note: all blocks work in a complex way. It will not be possible to sleep well, eating incorrectly, not doing physical activities and neglecting stress control. Accordingly, you will not be able to train, eat properly and not experience stress if you do not sleep well — willpower alone will not be enough.

Methodology

In all the blocks, I follow the same methodology, analyzing specific things:

1. Is it scientific: are there studies that confirm the chosen tactics?
2. Is it logical: is there a logical explanation why the chosen tactic is beneficial and does not cause harm?
3. Is the possible end result worth the cost of achieving it (risk, money, time, energy)?
4. According to whether several independent experts (for example, doctors) with the chosen approach? Do they practice it themselves?
5. Can I track my subjective or objective metrics related to this tactic?

To be honest, I am very conservative and paranoid about such things. For example, before taking a new drug, I research it for months, communicate with several experts and start with low doses. In such things, you need to be careful not to hurt yourself.

Sleep hygiene

Goal: it is enough to sleep regularly, spending a lot of time in the phases of rapid (REM) and deep (slow-wave) sleep.

Key tactics

• Sleep stages need to be measured. I have friends who have compared the work of different sleep tracking devices with the indications of real somnological laboratories. Judging by their data, Oura Ring showed itself best. The screenshots below show examples of what indicators it measures. I like my metrics, I have been in a deep sleep for a long time, but my resting pulse and heart rate variability used to be better. I don't know why.

• Block the cold blue light three to four hours before bedtime. There are special orange glasses for this (I love Gunnar Optiks) and apps for devices (f.lux).
• The bedroom should be dark (use an eye mask if necessary), cold (18-19 degrees Celsius) and humid.
• Wake up at the same time every morning. It's hard, but easier than going to bed at the same time (which is generally impossible in practice).
• Evaluate what helps you sleep and what hinders you. Serious research, of course, will not work, but you will notice certain trends. For example, I don't sleep well after even a minimal amount of alcohol, and the gym in the evening raises my pulse at night.

There is more information in this book. If you want to dive into the topic, you need a free chapter about sleep, I didn't really like the rest. Sleep is very important for willpower, which affects everything else described in this material. Remember that the things mentioned in the other blocks will help a lot.

Optimal nutrition

Goal: eat good food, don't eat bad and make it a habit.

Scientific formulation of the goal

Minimize insulin levels, maximize the rate at which glucose is excreted from the blood, optimize various growth factors (IGF-1, mTOR, and so on) for things that are useful (muscle building), but not those that are harmful (increasing the number of cancer cells).

Key tactics

• Do not use sugar in any form. Sugar is poison. That is, no sweets, fruit juices, bread, pasta, honey, and so on. Nutrition experts argue about many things, but they agree on one thing: sugar is extremely harmful to health.​

• Do not eat industrially processed food - only natural.
• Do not eat cheap products made from animals that are bred on an industrial scale.
• Consume mainly plant-based food. Although I think that becoming a full vegetarian is not optimal.
  
  
• Try to eat organic food, especially when it comes to animal products. In principle, it is worth spending more money on food if possible. The cheaper it is, the more tricks the manufacturer used to make the sale at such a price profitable.

• Many of these decisions are harmful to your health. My favorite examples are: manufacturers inject saline solution to increase the weight of meat in supermarkets, feed animals with other animals that have died from diseases, constantly use antibiotics, and so on.

• In my opinion, it is worth not drinking alcohol at all, as it negatively affects the quality of sleep, and not adding salt to food, as it increases blood pressure.

• I practice cyclic fasting: three to four days a week I eat only once a day. You can search the Internet for "cyclic fasting", there are many studies confirming that this technique is very useful.

  In 2016, a person who discovered that fasting through the process of "autophagy" cleanses the body of cancer cells and improves the immune system was even awarded the Nobel Prize in Medicine. After several times fasting for 24 hours becomes easy.

• I also try to keep myself in a dietary ketosis — that is, to eat food with a high fat content and a minimum of carbohydrates. If you look, you will find that this is also scientifically justified. But it is very difficult to do this.

Eating habits are very difficult to develop — it can take years. Don't try to do everything at once, it's too difficult. Try to move in small steps. By the way, I am far from ideal and still sometimes eat bread or pasta and drink a glass of wine.

Optimal physical activity

Goal: maximize the benefits of metabolic processes (hormones, insulin sensitivity) with minimal time and risk of injury.

Key tactics

• We need to warm up. I recommend these articles, they explain the approach much better than I could ever do myself.
• Spend most of your time in the gym on exercises involving the legs: deadlift, squats, leg press. The logic is simple: this is how the largest muscles of the body are activated — it brings much more metabolic benefits than working with small muscles like biceps. Important: at first it is worth doing these exercises with a trainer, because there is a risk of damaging the lower back.

• HIIT (high-intensity interval training). If you are doing running, walking and other aerobics with long-term non-changing loads, it is worth switching to high-intensity intervals. This way, less muscle will be burned, metabolic results will be better, and much less time will be spent.

  There are a lot of materials on this topic on the web. To be honest, when I now see a person on a treadmill, stepper or exercise bike, I can barely overcome the desire to explain to him that what he is doing is practically useless. He won't even lose fat, since fat is more about hormones than calories.

• Sit less. Buy a desk for standing work.

My weekly program:

• Two or three times a week I go to the gym. 15 minutes of warm-up, 45 minutes of leg exercises, 30-45 minutes to train other muscle groups in order from large to smaller.
• On days outside the gym, I do high-intensity running: a five-minute warm-up, eight sets of 20-30-second intensive runs (that is, you run so that you can't run faster), 60-90 seconds of walking, five minutes for a hitch. If you do everything right, then by the end of the intervals you should feel that you are going to feel bad now.

It was the easiest thing for me to get used to sports specifically. Personal trainers have helped a lot in this, but now it's all become so routine that I don't need them anymore.

Mental health

Goal: maximize stress resistance, social support, make life meaningful, get rid of a bad mood.

Key tactics

• Meditation. I am absolutely non-religious and do not support any mystical interpretations of meditation, but the technique itself definitely, absolutely works. I meditate every day, and I feel that it brings a lot of benefits.

  The most important thing: I realized that the "sense of self" and "free will" are cognitive illusions. And that we don't make any decisions about our thoughts and moods, they just climb themselves. This awareness helps to get rid of any bad moods, negative desires, unnecessary emotions easily and quickly. If you want to learn more about this, I highly recommend Sam Harris's book Waking Up (just don't read it if you are a religious person and it's easy to offend you). ​

• Psychotherapy. To his psychiatrist (a graduate of Stanford and Harvard, a neuroscientist who helps highly effective people on Wall Street and in Silicon Valley become even more effective) I come with questions like "How can I improve my intelligence?", "How to exclude days with a bad mood?", "How to easily and calmly talk to random beautiful girls and not worry about this topic?" etc.

  We discuss specific strategies based on scientific research and the behavior of other highly effective patients. If you haven't seen a psychiatrist, try it, it's very cool.

• Never lie to anyone about anything. As strange as it may sound, this is a really working social hack: people begin to like a person much more if he tells the truth all the time — regardless of how insulting or embarrassing it is.

  They begin to trust you more if you tell the truth, even in situations in which any other person would lie. And this helps you quickly realize what you need to develop. I used to lie a lot, but now I try not to do it ever. I also recommend the book Lying Sam Harris, it explains in great detail why this makes sense.

Well, a little bit about sex. This is a key element of the evolution algorithm, so it is not surprising that it greatly affects mental health. I have long been annoyed by two key points on this topic in which I disagree with society. Therefore, I came to the conclusion that I need to say: "To hell with social norms" — and start doing what I want (of course, adjusted for the consent of all involved, it is impossible to harm other people). And to be more precise:

• I want to talk openly about my sexual habits, fetishes, porn preferences, and so on, because I think there is nothing to be ashamed of. This is common to everyone. And, by the way, it's interesting to others when you talk about it honestly. In addition, at the same time you discover new interesting opportunities for yourself.

• I am absolutely against sexual monogamy. That is, I want to be in a long-term relationship with excellent and very attractive women, but at the same time openly (that is, with general consent and participation) have sex with other women. This is normal and natural. Statements to the contrary go against the way our neuroscience works.

  Sexual novelty and experiments, emotional intimacy and trust, transparency in relationships are unconditional requirements for this area of my life. Society insists that it is impossible to get all this at the same time. My experience and the experience of some of my friends confirm the opposite.

I will not write here about the meaningfulness of life, because I have always had it. I don't know how to solve the problem of her absence. Mental health is one of the most difficult points, and the other blocks help to achieve it.

Medical tests

Goal: find the "bugs" in yourself and fix them. Everyone has imperfections.

Key tactics

• Blood tests.
• Genetic tests.
• And others (determination of body fat percentage, CMM, monitoring of the cardiovascular system, measurement of toxins and glucose levels, as well as microbiome and allergen tests). Some of them are very useful, others are just interesting, but not particularly applicable yet.

I will tell you about what tests I pass and how I interpret them below — there are hundreds of metrics and recommendations. I will note right away that it is not easy to interpret the tests. This is a new area of knowledge, the data is very complex, and if you want to benefit from it, you will have to spend a lot of time and effort.

I would like to note separately: the tests clearly show that my health has not deteriorated due to the "crazy" program that I have been running for several years. Judging by the huge number of tests, I am more than healthy. In addition, judging by biomarkers as indicators of aging (this practice has not been fully studied), biologically I am much younger than my 32 years and am more likely to be around 23-25 years old.

Dietary supplements and medicines

Purpose: depends on the specific case.

Key tactics

• Metformin. This diabetes medication lowers blood sugar without causing hypoglycemia. Apparently, it helps prevent cancer and heart wear, and also passes the first tests as an anti—aging drug approved by the FDA in the USA (yes, the FDA has recognized that aging is a disease that needs to be treated). I take one gram in the morning and one in the evening. Tablets with prolonged action, which reduces intestinal discomfort. ​

• Lithium. I use it as a mood stabilizer and a substance that can positively affect cognitive functions. Every day in the evenings I take 100-150 milligrams of lithium carbonate. Smaller doses are unlikely to have any effect on the body, and in large quantities lithium is toxic to the body, so you need to be careful here. ​For comparison: people with bipolar disorders take 1000-2000 milligrams for a long time, so it is doubtful that my dosage will lead to any negative consequences.
• Modafinil. An excellent stimulant of cognitive abilities. I take 100-200 milligrams every day. In search of evidence, it is enough to read this article in Scientific American. Unfortunately, modafinil is banned in Russia, it is difficult to get it without a prescription from a foreign doctor. I hope this will change, but for now I do not recommend resorting to any illegal actions.

• Antidepressants (selective serotonin reuptake inhibitors). I take ten milligrams of escitalopram every day. The world is becoming a little more pleasant — this is very important for me.

  Specifically, escitalopram is the latest generation of SSRIs with minimal side effects. Before taking the doctor, they checked my genotype on the pharmacokinetics and pharmacodynamics of escitalopram (rs4311(T;T) and rs2032583(C;T)). The result showed that I have a seven times higher chance of a positive reaction and a significantly lower chance of side effects. A great tool if you use it correctly.

• Thyroid hormones. I take 25 micrograms of T4 and 20 micrograms of T3. Usually, my level of these hormones is slightly below average. After I started the appointment, my general mood improved, I became more energetic, and my cognitive functions seemed to improve.

• Growth hormones. Every morning I inject myself with half a milliliter of somatropin (about eight times less than bodybuilders take). My natural IGF-1 level is very low (115-125), and due to injections it increases to 160-180.

  This is a very controversial point, because many people try to lower their IGF-1 levels in order to become more resistant to cancer. I decided to increase it a little, because this way I gain muscle faster and get rid of fat, which in itself reduces the risk of cancer. It is also possible that the drug has a positive cognitive and neuroprotective effect, but this is not known for sure.

• Blocker of estrogen receptors in the pituitary gland. I take 50 milligrams of clomid in cycles three times a week. The reason is simple: my usual testosterone level is average, and the level of LH/FSH (from which testosterone is produced) is very low.

  FSH/LH is a bottleneck in my testosterone cycle specifically. Advantages: more energy, better mood. I also want sex wildly, which is either good (when I'm in Russia), or leaves a negative effect (when I'm in Silicon Valley).

• Phenibut (GABAph). I just started and didn't have time to collect the data, but I feel much better recovering during sleep. I use the wording from docparsley.com , which provides small doses of this drug.
• Food additives (dietary supplements). I take a lot of other non-medicinal drugs. In general, I try to drink what is possibly useful and less likely to be harmful. Many of these drugs are probably useless, but no one knows which ones.

The list above lists all the non-medicinal supplements that I am currently taking. A team of very highly qualified medical researchers with whom I work has recently studied a lot of scientific papers on all these drugs.

They came to the conclusion that the additives located in the dark green zone are most likely useful, but there is no consensus on those at the bottom. However, they did not recognize any of them as harmful.

It is worth keeping in mind that drugs act differently on everyone, depending on genetics and other factors. Some of them may be useless to you or even harm you, despite the fact that they help me. I have been selecting them for many years of experimentation and studying how they work, with the involvement of doctors and passing a huge number of tests.

I do not recommend taking any medications without the supervision of a professional. Medicines, the turnover of which is controlled, must be purchased only by prescription received from a doctor. Once again: I'm not a doctor, don't do anything stupid, think for yourself.

To summarize

• It's a long way to go. If you want to benefit from all this, you will have to spend years. The earlier you start, the more benefits you will get.
• A lot of this can be obtained for much less than $200 thousand. The most expensive thing is doctors and testing. But there must be a database about sleep, food, sports, stress management. These things are much cheaper, and you need to start with them, not with medicines.
• All these blocks work together and help each other. For example, if you don't sleep well, you won't be able to do other things — there won't be enough willpower.

• People think that medicine exists to treat the sick. However, with the help of medicine, it is possible to improve the abilities of healthy people to superhuman.

  A simple example: I use almost invisible hearing aids, despite the fact that my hearing is fine. They allow me to hear much better than an ordinary person, which helps me formulate my answers to other people's phrases more accurately and be more convincing, because I better distinguish the tone of the interlocutor's voice and other things that together give me an advantage in an important social situation.

Speaking of which. It seems to me that under the current system of healthcare organization, due to such personalized medicine, the gap between rich and poor will become even greater.

People like me will be able to pay for all this out of pocket and get access to point drugs through private doctors who work to improve the abilities of wealthy people, not to treat patients.

The rich will be more energetic, focused, healthy, strong-willed and socialized. And over the decades, these advantages will only bring more and more money and power, which can then be invested in more and more improvement of their abilities.

I have nothing to offer here. I just note that this will become a more serious problem than the current mess with social injustice.

Part Two: Biomarkers and research

Now I will present the results of an in—depth analysis of hundreds of biomarkers that I track, along with data and comments. For example, about insulin sensitivity, hormones, ketones, microbiomes, toxins, athletic abilities, fat content, mercury, allergies and much more.

In short, the final conclusion is this: I am very healthy, much younger than my chronological age and more efficient than most people. And with a high probability, I will live longer than 120 years even without any breakthrough technologies - that is, a longer and healthier life than anyone else in the history of mankind.

The statements are bold and partly I make them to convince you to read this article. But they are all backed up by data.

• All indicators, except Lp(a), are within the norm, many are radically better than the norm. I will add that this is despite my high-fat ketogenic diet. So for me personally, the statement that fat is to blame for the increase in cholesterol is obviously false.
• Particle values are more important than milligrams per deciliter. Unfortunately, I have not found a single laboratory in Russia that studies particles using NMR technology.
• Lp(a) is a very unpleasant genetic factor in 10-15% of the population, which helps blood to clump and significantly increases the risk of heart disease. Nothing can be done with it yet, but soon there will be drugs that will change this (PCSK9 inhibitors). I plan to start taking them in five years. Lp(a), by the way, perfectly illustrates that we were created for a world where wounds from saber-toothed tigers are much more dangerous than heart disease at 80 years old, and therefore this stuff has survived in the algorithm of evolution. It's time to take matters into your own hands and clean up all these bugs.

Excellent indicators for inflammatory markers are much better than optimal ones. For example, there is so little C-reactive protein that it is not detected by instruments.

There is a lot of evidence that inflammatory markers play a key role in all serious diseases associated with aging (cancer, heart problems, neurodegenerative diseases), so I am happy with such low indicators. Everyone should know about their inflammatory markers.

The endothelial function of the vascular walls is also fine, and it plays a key role in preventing heart disease.

Here it is worth mentioning some genetic factors that you should be aware of. Especially important is information about ApoE (a key gene in determining the likelihood of getting Alzheimer's; I have low) and MTHFR (a very unpleasant thing, because of which vitamin B12 is poorly processed in me).

In fact, I have too much TSH, the laboratory in vain considered such an indicator optimal — it should be less than two, so my thyroid gland works more than it needs to produce T3 / T4. Errors in "optimal" indicators are usually associated with the fact that laboratories work with sick people, which means they are looking at a population that is unrepresentative.

You also need to know your vitamin D and homocysteine levels. Previously, my vitamin D score started somewhere near 24, but I increased it with supplements. Homocysteine started at about 12, and I lowered it — again, with the help of supplements. Low vitamin D levels or high homocysteine levels are associated with many diseases.

The image above shows the data collected during a number of studies. They show that a relatively high level of vitamin D in the blood helps protect against a variety of diseases. It is extremely unlikely that you will be able to achieve this naturally, unless you work as a lifeguard on an Israeli beach and spend many hours in the sun every day.

The most important thing is that my kidneys work just fine (eGFR and Cystatin-C) — here the indicators are better than 90-95% of people in my age group. This is especially important because all my supplements additionally load the kidneys. eGFR, by the way, is one of the key markers that can be used to assess the "true biological age of a person."

The images above are mostly related to insulin sensitivity. Biochemically, this is one of the most important things in the body, and low insulin sensitivity stimulates cancer, atherosclerosis and neurodegenerative diseases.

My glucose, insulin, and HbA1c readings are normal, but not great, but it's not even that important.

The most important is OGTT (Postprandial Evaluation in the image above). It shows the results of a special test: first, markers are measured, then a person drinks 75 grams of dextrose (fast sugar), after which the markers are fixed several more times at certain intervals.

If you do this test, require three dots and insulin combined with glucose. The way this test is usually carried out in Russia (two points and only glucose) is absolutely useless.

This test shows how effectively the body gets rid of sugar. In my case, it is very effective — even after I drank 75 milligrams of a very sugary substance, the total blood sugar level rose slightly, and then my body, with the help of a tiny amount of insulin, removed a lot of glucose and reduced its content to 46mg /dl (~2.5mmol/liter).

Most people in this case would feel like they have hypoglycemia, but my sugar level is always so low that I didn't even feel dizzy.

Alpha-hydroxybutyrate is elevated due to the ketogenic diet. It's good. Ferritin is lowered due to the fact that I eat well and often donate blood for tests. This is a very important indicator, especially for men. According to some hypotheses, women live longer partly because of the reduced iron content due to regular menstruation.

Respiratory Quotient

Now a little more about insulin and glucose. The big graph is the result of a test called RQ, which shows how much oxygen and carbon dioxide passes through a person's lungs at rest. You just need to put on a gas analyzer and sit still.

The graphs above show that at rest (that is, almost always) my body is 85-100% fat-based, a little protein-based and practically does not use carbohydrates. That's exactly what we need. In my case, carbohydrates become the main source of energy only when the heart rate exceeds 150 beats per minute. This makes physical training easier for me, since glucose reserves in the body become a narrow energy link much earlier than fat reserves.

A graph from Peter Attia. He runs an excellent blog and is also one of the world's leading experts in preventive medicine. In particular, he is particularly well versed in insulin sensitivity and ketogenic diets.

If you read more about the fact that cancer cells mostly feed on sugar, and ketogenic diets are more efficient in terms of metabolism and generate less harmful waste per unit of energy, you will see that optimizing glucose processing and minimizing insulin is a good way to increase life expectancy. Not to mention that you can also lose weight this way.

By the way, here is a graph of body fat content. It is formed on the basis of 33 points measured by the same personal trainer using the same method (using subcutaneous calipers in 15 different places). This is a somewhat inaccurate method. DEXA scanning is better, but it was difficult to get permanent access to the necessary equipment.

I think the absolute values lie a bit, and bioimpedance/DEXA shows that I am somewhere between 10% and 11%, and not at the level of 7%. However, the general trend can be traced, and it is good. Besides, it's cool that I've lost almost no weight: it means that instead of fat, I'm building muscle, and this is very good for health. This is described in more detail in the book Body by Science: A Research Based Program to Get the Results You Want in 12 Minutes a Week.

I don't have any illustrative photos "before" and "after", but I used to be chubby, as my friends and colleagues constantly remind me.

If you are interested in ketogenic diets, then everything is simple: ketones are measured using glucose meters and ketometers like those in the picture above. Important: ketometer strips are expensive. And to reach the level of ketosis, as I have above, you will need to spend a lot of time and effort.

But at this level of ketosis, cancer cells will die. And by the way, I already have them, and you, even if you are 20 years old. It's just that there are not enough of them, and constantly being in such a metabolic state, you do not allow them to develop. In addition, the brain works more efficiently on ketones (it takes a long time to explain why, you can search the Internet).

You can also use a CGM implant that monitors glucose levels in real time and sends the data to the iPhone. It will help you understand what kind of food and activities are harmful to you.

The image above shows my indicators at the time when a few years ago I was stressed, worked late and ate a lot of chocolate while sitting in the bathroom. Notice how much a midnight spike in blood glucose is greater than a slight increase after eating a normal meal at six in the evening.

This graph tells me very clearly and unambiguously: "Dude, by eating this shit, you're making yourself worse. You've just hurt your body, and I'll show you in real time how much." An excellent motivator, gamification of one's own biochemical states.

CGM is a cool thing, but it's expensive (the price of Dexcom G5, which I used, started at $4 thousand), and it's difficult to configure it. However, it seems to me that they are the future, and I will use these devices more often.

Imagine a device that monitors testosterone levels, which can also maintain it at the right level through a connected Bluetooth pump, based on the time of day and the person's occupation. This would constantly optimize your mood and energy.

Do you want to negotiate aggressively? Switch yourself to the appropriate mode via your iPhone. Specifically with testosterone, by the way, this is already possible (although not with all molecules), only an engineering problem remains. If someone does, I'm willing to pay a lot.

Back to the blood tests. A couple of notes about the screenshot above:

• Liver markers are at an excellent level, which is very important for me specifically because of how many supplements and medications I consume. I am often asked how I know if pills are becoming an unbearable burden for the liver. I know from these tests.
• Hormones. My indicators are not very good here, hypothetically due to a childhood head injury, after which the pituitary gland function was disrupted and I decided to become an Internet entrepreneur. For example, my brother has the same problems with Lp(a), homocysteine and other things, but he is much taller than me, which hints that there was some external factor that lowered growth hormone.

As I mentioned above, I artificially increase thyroid hormones, IGF-1 (via growth hormone) and testosterone.

Testosterone is worth talking about separately. In short, my level is average, LH/FSH is low — and they initiate the production of testosterone. The synthesis of FSH/LH, in turn, is reduced by estrogen, which enters the pituitary gland. And estrogen is a product of testosterone processing. This is how this "feedback cycle" works.

I started taking an "estrogen receptor blocker", which occupies the same receptors in the pituitary gland instead of estrogen, while not reducing the production of FSH/LH. The result is clearly visible on the charts: in a very short period (two months), the amount of free testosterone has increased significantly. This greatly affected my mood and my energy reserve. Well, again, the fact that you constantly want sex.

In general, I have high levels of EPA/DHA (Omega 3) and low levels of Omega 6 fats and trans fats. This is the result of an excellent diet and supplementation. It is to such indicators that it is worth striving.

The graph above shows that I used to have an elevated level of mercury in my blood and I got rid of it. Hypothetically, this was due to a dental amalgam, which I was once unwisely made. I solved the problem: I stopped eating fish with a high mercury content and improved liver function with the help of B-vitamins and other supplements.

Mercury disrupts many neurobiological processes and affects mood disorders and other things. A very unpleasant thing, you need to get rid of it.

Two CIMT test results are shown above. They show the thickness of the cervical arteries (the thicker, the worse) and warn cardiorisks much in advance. Another factor proving that my lifestyle is working.

There is also a comparison with other people in my age group. Thanks to this, I know that if nothing changes, then even at the age of 85, the probability of developing cardiovascular diseases will be very low for me.

Excellent test, non-invasive, highly recommended.

VO2max is an indicator of how effectively the body performs gas exchange at high loads. Accordingly, based on it, you can judge the capabilities of your cardiovascular and pulmonal systems.

How it is measured: you need to work out physical activity in a mask connected to special equipment (as in the photo above). As the quote from The New York Times describes, VO2max significantly correlates with life expectancy and acts as an excellent indicator of real biological age.

My VO2max has risen very much over time and is now close to the performance of Olympic medalists, although I do not have any athletic achievements and I do not load my body the way they do.

I think the main role was played by training with high-intensity intervals (HIIT) and weights, but I don't have accurate information, although recently, when I stopped doing HIIT, this metric really decreased. In general, another sign that my approach is working.

The above shows the results of the GI Effects test from Genova Diagnostics. It studies feces for bacteria, parasites, metabolites and other interesting things (it's a very fun activity to send these tests via FedEx).

I think this is a very interesting test, but so far I do not know how to use it for real, and not to draw simple conclusions in the spirit of "do not take antibiotics, drink probiotics and prebiotics."

The microbiome is a very new and interesting area of medical knowledge, but so far we do not know whether certain microbes cause conditions like diabetes or obesity, or whether their presence is only a correlation. If you want to know more, take this course on Coursera — it is very informative.

Here is another interesting test (Genova Diagnostic Toxic Effects), which shows that I have fallen somewhere on harmful volatile organic compounds (benzene, styrene, toluene and other rubbish that is contained in plastics and exhaust gases). As a result, I improved ventilation at home and in the office, stopped eating and drinking from plastic containers and try even more not to be near people who smoke.

Interesting information: once I passed this test after I smoked a joint with pure marijuana (which is rare), then the toxins just went off scale. If you can't stop smoking, at least switch to vaping.

Inhaling the products gorenje grass or tobacco is very harmful — I was shocked after I found out how many toxic chemicals got into my body only after one evening in good company. The fact that marijuana is not harmful is a myth. Although THC itself doesn't seem to be very harmful.

The results of two tests for allergy and sensitivity to external stimuli. I passed them because due to the consumption of foods to which a person is sensitive, inflammatory processes increase, which (as mentioned above) increases long-term degradation processes in the body.

I realized that I shouldn't eat tuna and scallops and that I am allergic to certain types of mold. I also have a clearly acquired sensitivity to gelatin due to the fact that I take many different capsules. Cool data.

Other interesting tests and metrics:

• Pulse at rest at night. It can be measured using the Oura ring or any other devices. Mine is about 55, which is not bad, but it could be better.
• Heart rate variability is another interesting metric that correlates with the state of health more strongly than the pulse at rest, but I do not yet know how to interpret it.
• Pressure. Ideally, it should be slightly lowered. Mine is usually at 100/60. This indicator can be improved if you consume less salt, drink tea with hibiscus and change your lifestyle in other ways that I wrote about.

I have passed many other tests, but this is already a very long material. The key findings are as follows:

• My health has not deteriorated, despite all my follies. Moreover, judging by all the tests, I am very healthy. Many markers related to biological age show that I am about twenty years old, although in fact I am 32 years old. Also, all indicators are constantly improving, which means I'm doing something right.
• There is a lot of data that helps to understand your problems and fix them. It is important to know your metrics.

I also have my own approach to working with indicators. The image below shows the main causes of death in the United States. Judging by my markers, my probability of dying from most of them is extremely low. So if my behavior does not change (and I intend to continue to improve my performance; besides, new technologies will appear over time), then even when I am 80 years old, my risks will be low.

In general, my main threat is cancer. That's why I pay so much attention to maintaining low levels of sugar and insulin, which, apparently, cancer cells feed on. And I do not forget about immunity — it is slightly weakened due to the fact that I (like almost 100% of the population of the Russian Federation) have CMV. I am very interested in iPSC (induced pluripotent stem cell) therapy, with which the number of lymphocytes can be restored.

According to my estimates, even without serious medical progress in a hundred years, I will be in excellent mental and physical shape and will eventually live longer than any other person in history for 2017. And with technological progress (which by 2085, when I will be 100 years old, will obviously come), immortality is quite achievable.

In general, I am constantly confronted with all sorts of myths that the human body is unable to overcome the barrier of 115 years. This is nonsense:

• Already in Monaco, for example, the average age when people die is 90 years.
• These people (obviously) were born in 1927, lived in a period when we didn't even know about genes and certainly didn't optimize our biomarkers. Do not forget that atherosclerosis, cancer and neurodegenerative diseases are long—term metabolic processes, and when you see the symptoms and start to deal with them, it's too late, the system is destroyed.
• ​In rich countries (except the USA), life expectancy continues to increase by about 2.5 years every decade. The fact that life expectancy increases only in poor countries is a myth.
• I suspect that even without radical technologies and just with my current regime, I will live to be more than 120 years old. And with regenerative medicine, gene therapy, nanotechnology, by 2040-2050, there will be all opportunities to live forever.
• And, of course, every year I will invest more and more money in optimizing my health, which will eventually allow me to earn more money and move this cycle forward.

I may be wrong, but according to my estimates, there are now less than a thousand people on the planet who know as much about their health as I do — it's so tedious, expensive and not obvious.

However, this technique will soon become mass. It provides advantages in many areas of life. Thanks to her, I often feel like a "superhuman" because of the degree of control over my health and behavior that I have. And people usually adopt what increases their competitiveness in society.