In this episode of The Psychedelic Podcast, Dr. Daniel Stickler and Paul F. Austin explore the cutting-edge field of longevity and precision-performance medicine.
After over a decade as a general surgeon, Dr. Stickler abandoned modern medicine’s reductionist approach and forged a new path toward holistic health and optimization. He believes that addressing deficiency mindsets and focusing on purpose, love, and community can help people move beyond simply existing and truly thrive. Through his work, Dr. Stickler has discovered ways to reverse biological aging and help people achieve enhanced states of being.
Dr. Stickler shares his insights on how humans can live a life of excellence, the revolutionary field of gene-editing technology, and his transformative psychedelic experiences.
Dr. Daniel L. Stickler is the Co-Founder and Chief Medical Officer at Apeiron ZOH Inc. He is the pioneer behind systems-based, precision-performance medicine, a new paradigm that re-defines medicine from the old symptoms-based disease model to limitless peak performance and systems science in all aspects of life.
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0:00:01.5 Paul Austin: Hey, listeners, welcome back to the Psychedelic Podcast by Third Wave. Today, I'm speaking with Dr. Daniel Stickler, the co-founder and chief medical officer of Apeiron Zoh.
0:00:12.8 Daniel Stickler, M.D.: It just makes so much sense to look at things altogether rather than trying to look at the human system from a reductionist model. And the whole reason I went into this is because I realized that all this stuff we were doing in medicine was reductionistic and was not as effective as it could be. And it's not a system that we can change at this point. It's like we were talking before this, Buckminster Fuller, you've got to completely abandon the system and start over with something and that's what we did.
0:00:47.2 Paul Austin: Welcome to the Psychedelic Podcast by Third Wave, audio mycelium, connecting you to the luminaries and thought leaders of the psychedelic renaissance. We bring you illuminating conversations with scientists, therapists, entrepreneurs, coaches, doctors, and shamanic practitioners, exploring how we can best use psychedelic medicine to accelerate personal healing, peak performance and collective transformation.
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0:04:33.3 Paul Austin: Hey, listeners, I'm so excited to have Dr. Daniel Stickler on the podcast today. I met Daniel a couple months ago as he interviewed me about microdosing for the Neurohacker Collective podcast. I had heard about Daniel's work from several friends and knew that he was an incredible human at the pioneering edge of longevity, psychedelics, and precision medicine. And so we wanted to bring him on the podcast today to talk about that overlap. I just wrapped up the conversation and it was even better than I expected. We talked about peptides. We talked about Nietzsche. We talked about what longevity means. We discussed stages of consciousness and how Daniel works with clients to help them stabilize at more transcendent states. We got deep into biomarkers. We talked about the pillars of longevity, reducing biological age. This really was one of those wide ranging conversations and what Daniel said at the end is, there's something to be said about being a deep generalist. And that was this type of conversation. Daniel knows medicine, precision medicine really well but he also has knowledge and context around a broad array of topics. And we were able to bring in a lot of that context into today's conversation.
0:05:58.2 Paul Austin: Dr. Daniel Stickler is the co-founder and chief medical officer at Apeiron Zoh. He is the pioneer behind systems-based precision performance medicine, a new paradigm that redefines medicine from the old symptoms-based disease model to one of limitless peak performance and systems science in all aspects of life. He is the clinical faculty age management medical group at American Academy of Anti-Aging Medicine. He is a medical director for the Neurohacker Collective in Kuya. He is on the scientific advisory board for True Diagnostics. He's a Google consultant for wearable technology, epigenetics, and AI in healthcare. And he is also a guest lecturer at Stanford University on epigenetics in clinical practice. Without further ado, here's my conversation with Dr. Daniel Stickler.
0:06:49.9 Paul Austin: Hey, listeners, welcome back to the Psychedelic Podcast. Today, we have Dr. Dan Stickler, the co-founder of Apeiron Zoh, and a pioneer at the intersection of longevity, complex systems, precision medicine, and our favorite topic, psychedelics. Dan, it's an honor and a pleasure to have you on the podcast today.
0:07:13.4 Daniel Stickler, M.D.: Pleasure to be here and excited to talk about these things.
0:07:18.4 Paul Austin: So as I was doing a little bit of preliminary research on your background, on what brought you into this space, there was a phrase that stuck out that I think will provide an appropriate context for our conversation because I think a lot of what you're doing is within this frame, within this paradigm. And that phrase is systems-based precision lifestyle medicine. I'd love just as we open up, if you could help our audience to understand what that means... What does it mean? What is precision lifestyle medicine? What does it mean for it to be systems-based? And why is it that you chose this path to pioneer?
0:08:03.1 Daniel Stickler, M.D.: Yeah, it's a mouthful to say.
0:08:04.9 Paul Austin: It is.
0:08:05.0 Daniel Stickler, M.D.: And I will try to keep it concise. What it is, is the human system, if you looked at the being, the human system, and you said, what kind of system is that? How do we define this system? Is it a simple system? No. Is it a complicated system? No, not really because complicated systems don't adapt. They will stay consistent with what they do. Is it a complex system? Yes, and in fact, it's a complex adaptive system. And in order to truly assess a complex adaptive system and understand it, you have to use complexity thinking and this is where I think a lot of medicine has just gone down a no-win road because they've looked at using complicated thinking to define it. And this is what I ran into as I went through medical school and then later as a general surgeon. I couldn't understand why certain aspects were overlooked and we had all these algorithms. Algorithms do not work on a complex adaptive system because it adapts, it changes with different things. And the other thing was I went into functional medicine because of that, but then I realized functional medicine was very similar too, because they're always looking for the root cause and complex adaptive systems never have a root cause for an output.
0:09:37.2 Daniel Stickler, M.D.: They're always a combination of all this different network of interrelated stuff. And we focus on organ systems, like we focus on the liver, we focus on the heart. And it's like, you've seen that those complex systems maps where you have all these dots and all these lines interconnecting them everywhere. In complex systems thinking, you look at the relationship between everything. You don't look at the nodes themselves. And when we look at the organ systems, we're looking at nodes. So it makes it very difficult to understand that a small perturbation in the node of the liver will have a profound effect at some place else in the system. Just kind of like in physics, they talk about the butterfly effect. In quantum physics, they're talking about how the butterfly flaps its wings in Brazil and creates the Tsunami in Europe. It just makes so much sense to look at things altogether rather than trying to look at the human system from a reductionist model. And that's the whole reason I went into this is because I realized that all this stuff we were doing in medicine was reductionistic and was not as effective as it could be. And it's not a system that we can change at this point. It's like we were talking before this, Buckminster Fuller, you've got to completely abandon the system and start over with something. And that's what we did.
0:11:04.0 Paul Austin: A few words that I wrote down as you're talking about the simple versus complicated into complex systems, the word anti-fragility, which a lot of our listeners have heard me talk about before, popularized by Taleb. This is central to navigating complex systems. Another one is iatrogenic, how our medical system tends to over-prescribe or over...
0:11:33.2 Daniel Stickler, M.D.: Cause harm.
0:11:35.7 Paul Austin: Indicate, yeah, and not allow the full system to be. And then another thing I underlined, because I think it's relevant to this concept of precision medicine, is what you said around how algorithms don't work for a complex system. And I want to go a little bit deeper into that because my understanding of precision medicine is that we're using blood panels, we're using the Oura ring, we're using other metric-based systems to understand the individual as a whole. And then the, I don't want to say interventions necessarily, but the choices that we're making about how to approach that individual are potentially coming from... It's not an algorithm necessarily, but maybe your experience and intuition as a medical professional. So I'd love for you to just explore even that paradox of... I often hear about precision medicine talked in sort of conjunction with artificial intelligence. And there's a lot of promises that artificial intelligence is going to really make precision medicine more mainstream. And yet, when I think of artificial intelligence, I think of an algorithm. So could you just kind of like flush that out in terms of the polarity and the tension between algorithms and precision medicine?
0:13:00.8 Daniel Stickler, M.D.: Yeah, there's certain things you're going to run into that have algorithms that will work in the majority of systems, but they won't work in every system. And that's where this variability comes into is, you don't want to apply algorithms across the board and think of it as law. And that's a lot of what medicine has been doing now in computer sciences with the machine learning and everything, because they're able to take so many variables to look at, that they're going to get more accurate with what they're kicking out because they're looking at hundreds of variables where we may look at three or four, because that's all our brains can really handle when we're looking at interactions and relationships in these systems. So, yeah, I love machine learning and the algorithms. We're actually using machine learning in one of our companies to work with understanding these inputs and how they interrelate, see correlations between things. It's really an exciting world to be in right now.
0:14:09.6 Paul Austin: So I'd love to hear a little bit more, just to further ground this conversation about the client work that you do in terms of why are people coming to you? What are maybe some of the challenges that they're facing? What process are you bringing them through? And what are some of the modalities that you're utilizing during that process?
0:14:33.0 Daniel Stickler, M.D.: So we work mostly with healthy clients. They're coming to us because they know their potential to be better than where they are. Whether it means taking them from homeostasis to a more optimized state or even taking them from an optimized state to an enhanced state, the differentiation between those two, one is more optimized through lifestyle and biologic processes, whereas enhanced is where we take medicine, technology, whatever it is, and we're able to actually get the human system to go to levels that is not capable of on its own. And so that's kind of the enhanced state. But when we do this, what we do is we rely on data and, complex systems, the more data you have, the more accurate you can get on things and understanding the relationships between them all. So we get 124 blood markers. And we do 600 polymorphisms in their genetics that we look at. We're looking at their additional laboratory values along with like epigenetics so we're looking at methylation marks relating to biologic age. We have five different tests that we do for that. And we're also getting like their movement and flexibility. We're getting their body composition, their bone densities. We map their brains with a full clinical QEEG.
0:16:20.5 Daniel Stickler, M.D.: We map their autonomic nervous system. So we hook them up to a machine that looks like a lie detector. They've got probes on their fingers, on their chest, on their belly, on their shoulders, on their nose. And we take them through five stressors and we see what happens to all of these markers in their system under stress. And then we see when the stressor is removed, do they get back to baseline or do they maintain an elevated state that is going to impair them? Because it'll climb throughout the day as they encounter stressors. But once we do that, then we gather all this data along with... We sit down with them for about three hours. A psychologist also meets with them, dietician, and then we all get into a room and we review them. So all of our docs, all of our clinical people will, we call it a whiteboard session. So the person who's got this patient will present them on the whiteboard for the next hour, all of the data, what they think is going on. And then everybody gives their input, which is so valuable because everybody has our biases.
0:17:22.5 Daniel Stickler, M.D.: I have my biases when it comes to things, some that I don't even realize. And it's amazing how much you miss when you're going, oh, I think this is what's going on. And then somebody will say, well, did you consider this? And I'm like, huh, yeah, that's a big deal. And so we're able to get multiple brains kind of communicating from all different backgrounds to kind of set up an assessment and plan for the clients. And then throughout the year, we monitor them with wearable technology, like the Garmin watch or the Oura ring. And we collect all of their biometric data each month and sit down with them and go through it each month and see what's happening in their system that's creating anything that's becoming better or becoming worse.
0:18:11.6 Paul Austin: I wrote down, it's almost like a 360 for well-being.
0:18:17.2 Daniel Stickler, M.D.: Yeah, we used to call it a 360 review. Yeah, that's interesting.
0:18:20.6 Paul Austin: Yeah. Because that's a very leadership sort of executive term, of course. And I imagine a lot of the people you work with are executives or founders or folks.
0:18:30.2 Daniel Stickler, M.D.: Actually, mostly entrepreneurs that are founders and people who have exited and they're bored.
0:18:37.5 Paul Austin: Yeah, they want to get the more granularity. And even the polarity that you set up of the myopic, right? You have the 124 biomarkers, you have the 600 polymorphisms, you have all these elements, and it's still within this whole complex system. So even though that one thing might be off, it doesn't necessarily mean that something is wrong or that is the main variable to point to, which is where having multiple brains and perspectives in the room is so valuable in that way.
0:19:06.0 Daniel Stickler, M.D.: Two other things that I forgot to mention is we work with their breath structure and mechanics as well.
0:19:13.4 Paul Austin: Interpret nose breathing versus mouth breathing.
0:19:15.9 Daniel Stickler, M.D.: Well, in terms of that plus, is it in the chest, how much is in the chest, how much is in the belly, and what is their CO2 production? CO2 has become such an important factor, especially in stress and anxiety, and we're finding a lot of people just don't know how to breathe, and so we work with them on that, but the thing we've added most recently is we're working with developmental stages of consciousness. We use a test from Stages International, that Terri O'Fallon has created, working with things like Kagan model the spiral dynamics and Ken Wilber's model to really have a developmental kind of chart of how people progress through the stages of consciousness, and it's really helpful to understand at what stage of consciousness people are. And in relating to them and what you are trying to get them to do and how you communicate, it's just amazing how much that's added to our success.
0:20:23.1 Paul Austin: That's so fascinating, have you found a relationship between physiological well-being and stages of consciousness?
0:20:30.5 Daniel Stickler, M.D.: We find a lot... So we do quality of life inventories on all of our clients, and we find that the people that are at... And it's not like a hierarchy, these developmental stages, but people that are at further developmental stages, they tend to have a much higher quality of life in general, we monitor that every year with our clients, and now we're gonna start monitoring how their stages of consciousness development progress throughout the years too.
0:21:02.0 Paul Austin: Wilber has that phrase, I was just teaching a lecture right before this for our training program for coaches, Wake up, grow up, show up.
0:21:13.6 Daniel Stickler, M.D.: Clean up, show up.
0:21:13.7 Paul Austin: Clean up as well is in there. And this is where I think, and this is where I wanna welcome psychedelics into the conversation, 'cause of course, this is where psychedelics can have such a powerful impact is on these stages of consciousness, 'cause they often allow an awareness, an insight into these higher states of being, these integral transcendent states of being, but that doesn't necessarily mean that the individual stabilizes at that level, so so much of integration then is how do we close the gap or the delta between where we actually are and that state of being that we experience on Ayahuasca and Ketamine, on psilocybin, on whatever it is. I'd love for you to just for a little bit of context for our listeners, what is your relationship with psychedelics, both personally and professionally, what role have they played for you, and what role do they play in your medicine practice?
0:22:15.0 Daniel Stickler, M.D.: And so my first foray into psychedelics was in 2012 in Peru, and we had done... We'd gone to Cusco and we went... After a day of prep, we went for a full day of ayahuasca in this little Amazon village, and after that, we did the three-day hike of the Inca Trail, which was just a profound experience and the Ayahuasca was profound. Life-changing, but I came back, talked about all this great stuff I experienced, got back into my routine and lost most of it, so I experienced the state at that time, so I did not really integrate into a stage, and I've done various psychedelics over the years. We do ketamine therapy in our clinic, we don't do a large volume of it, it's just mostly for our clients, but I've seen profound work being done there with that. I know I'm in a community where psychedelics is extremely... They're extremely popular, and there's all wide ranges of how people use them, what they're getting out of them, in general, it's just pretty profound, the impact that it has on the person, but the person also really needs a good ego container to begin with.
0:23:53.2 Daniel Stickler, M.D.: If they don't have that ego container, I think Young had talked about this, where our early years are to develop the ego to the point where we can contain this next transcendent state, if we don't have a strong enough container, it'll shatter when we try to do this. And I've seen that happen with people, but yeah, if you've got that good base, it really can lead to profound changes for people, as you've seen, I'm sure.
0:24:20.9 Paul Austin: And I'm glad you brought up even the concept of ego-containment because one substance that has become quite popular, especially in the last few years has been Bufo alvarius 5-MeO-DMT the Toad, and what I hear time and time again, and I've noticed a pattern with this is those who don't have that sort of well-established egoic structure from maybe early childhood, they go into 5 MeO, and it can sometimes send them sideways here for a month after, for three months after, for six months after.
0:25:00.3 Paul Austin: There are a lot of challenges, there may be psychosis, there may be other things that come up, and this sort of just speaks to the importance then of who is the practitioner that you're working with, how are they on-boarding you into this? What type of assessment, what type of questions are being asked, because although psychedelics are incredibly powerful and efficacious catalytic, there are also certain risks and certain things to be aware of of stepping into that, that landscape, because there is a relationship between awesome and awful, heaven and hell, madness and these mystical experiences, and in some cases in the line can be extremely, extremely thin. Right?
0:25:54.1 Daniel Stickler, M.D.: Yeah, if a practitioner is not asking you whether you have a family history of psychosis or you've had any psychosis personally, they're taking a major risk because that is something that we have seen quite a bit of of people that they didn't have any problems, but they had a family history of schizophrenia or something, and sure enough, it will kick them into a really awful state, so a good practitioner will take an adequate history physical exam, like Ibogaine, you never do Ibogaine without getting an EKG first, that's criteria.
0:26:39.5 Daniel Stickler, M.D.: And people with high blood pressure, ketamine can raise the blood pressure 10 12 points on average, so all of these things have significant impacts on the system that needs to be really mitigated against or watch for. We're actually at the psychedelic science conference in Denver in June, we're gonna be premiering our genetic panel for psychedelic response, we're gonna include MDMA, ketamine, psilocybin, DMT, cannabis, and it's genetic predispositions to people with low metabolism, you can tell, or they're high metabolism for a certain drug. There's ones that will predict more risk of psychosis with certain drugs, how impactful they'll be like MDMA, some people just don't get much of a response from MDMA, and we found some genetic variance that the research correlates with that, and it's nice to have that as a practitioner, to look at somebody's propensities, and know this person is a very slow metabolizer of ketamine, so if you're giving them ketamine, you might wanna do a much lower dose than what you're gonna do 'cause it's gonna really be persistent and higher levels in that person.
0:28:03.6 Daniel Stickler, M.D.: So yes, I agree with you completely, that assessment is an absolute necessity.
0:28:08.9 Paul Austin: I love that. This genetic panel for psychedelic responses, there have been a couple of early tests for that, but none of them, I think have proven to be all that useful or consistent, like reliable. And considering your background and what you've done, I personally like as soon as that comes out, please let us know, 'cause we'd love to amplify to all of the folks who are coaches and practitioners in our community who are interested in this because I... I'll backtrack a little bit for this genetic panel, is this for medical doctors only? In terms of working with clients?
0:28:48.8 Daniel Stickler, M.D.: No.
0:28:50.1 Paul Austin: Is this something that will be more...
0:28:52.6 Daniel Stickler, M.D.: We're not a direct to consumer, we're business-to-business on genetics.
0:28:57.4 Paul Austin: Okay.
0:28:58.1 Daniel Stickler, M.D.: So we have coaches that we've trained, that use our genetics, and we're just gonna be making that available for them, we also create a lot of genetic panels for physicians and hospitals, so we've got the background but one of the things that makes us different is we didn't develop the genetic company as a business, the genetic company was designed to just support our coaches so that we had something that we could be consistent with, and it suddenly became... It became a business of its own because we were clinically betting all of the panels, so we have lifestyle panels, we already have a cannabis and neuro-transmitter panels, we have an Ayurvedic prakriti panel, so people can find out genetically what their propensity for doshas are.
0:29:43.6 Paul Austin: That's cool.
0:29:44.8 Daniel Stickler, M.D.: But we've used all the clinical data to develop them, and then we would test them in clients and see how well they correlated then we would fine-tune them based on clinical experience.
0:29:57.9 Paul Austin: Wow, that's incredible.
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0:31:50.2 Paul Austin: Okay, I'm gonna come back to the psychedelic stuff, but earlier on in the conversation, you mentioned optimization versus enhanced state, and I'd love to hear some of your reflections on when working within a psychedelic experience, would you consider that to be more of the optimization or would you consider that to be more of the enhancement?
0:32:14.4 Daniel Stickler, M.D.: That's kind of a whole different category, I think.
0:32:18.3 Paul Austin: Yeah.
0:32:18.7 Daniel Stickler, M.D.: It's funny, I was having a conversation with my new lama, I'm going through Vajrayana Buddhism training right now. And I was talking to him about a psychedelic experience and what I had gained from it, and he's one that has taken vows to not do any mind-altering stuff, he took it 30 years ago.
0:32:42.3 Daniel Stickler, M.D.: And he was explaining it from a karmic perspective, we have these seeds within us and these seeds will grow or not grow, and he was like, It's not the psychedelic that gives you what you're getting, he said The Psychedelic is like watering the seeds a little bit, you could have maybe gotten it from mantra or trance or meditation or psychedelic that was the little piece that did that, so yeah, psychedelics and consciousness, they're kind of in that category of off on their own, I think.
0:33:21.9 Paul Austin: It's almost like the mystical, the non-dual, the transcendent, right?
0:33:28.8 Daniel Stickler, M.D.: Yes.
0:33:28.9 Paul Austin: When we think of optimization and enhancement, it very much feels like terminology of a dualistic world view when we step in the psychedelic space, there's sort of just breaks that in a way.
0:33:40.6 Daniel Stickler, M.D.: So your mind, body, when we're talking optimization and enhancement, and then we're into spirit when we're talking that consciousness piece.
0:33:50.6 Paul Austin: Which I think is a great transition for the next question that we briefly touched on before pressing record, which is Nietzsche. And you studied Nietzsche college, you minor in philosophy, and you made a comment before we went live that you kind of forgot, not forgot, but just put a lot of the philosophy side until the last five years, and I love just to hear your reflections on what learnings were facilitated by studying Nietzsche, that have been influential in terms of the metaphysical perspective that you're bringing to medicine.
0:34:34.1 Daniel Stickler, M.D.: Yeah, it's amazing how it all plays together in life, I discovered existential philosophy, taking it as an elective, and just... It resonated with me, I was like, "Wow, this is perfect." And the University of Pittsburgh where I was at the time, they were one of the top philosophy programs in the country. And so I dove all in and I was an atheist at the time. And it just really made sense to me, and some people saw Nietzsche as very nihilistic, even Buddhism, you can look at Buddhism, and you can say that it appears nihilistic, but he wasn't... In fact, the Buddhism and Nietzsche were both very much the middle way.
0:35:25.8 Daniel Stickler, M.D.: Nietzsche talked about being the Dionysian and the stoic at the same time, you have that middle way that you can travel and... Yeah, it just made so much sense. But then I got into medical school and the hours of commitment to that, and then being in general surgery residency, and then being one of the busiest general surgeons in my town, after I got out, I didn't have time for any of that.
0:35:57.4 Daniel Stickler, M.D.: Everything was just about work and learning about new techniques and all of that, and then I just walked out of surgery one day after 10 years and just said, I'm done, I'm not gonna do surgery anymore, and I started focusing on this optimization and really working with people who were fairly healthy to achieve better states, and it felt really good, and over time we started adding the brain piece, the nervous system piece, and then all of a sudden consciousness started coming on board for us, and I'm like, "Huh, okay.
0:36:33.8 Daniel Stickler, M.D.: This reminds me a lot about the stuff I was learning in existentialism." And so I started diving back into that, started studying the Buddhism again, and it all just came together. It was like that seed was finally watered in me, and it sprouted, but it never really took off, and it just took off.
0:37:00.8 Paul Austin: The word of the company that you've co-founded Apeiron Zoh. Apeiron means that which is unlimited, boundless, infinite and of course, what was central to Nietzsche's philosophy is this concept that we are as god's.
0:37:15.2 Daniel Stickler, M.D.: Yes.
0:37:17.7 Paul Austin: And the capacity to step into that is so critical, and the reason I bring this up in this conversation is because sometime when we get into optimization and blood panels and biomarkers or perspective can get a little myopic and zooming out about, "Well, what is the larger metaphysical lens here, why are we doing what it is that we're doing?" and what are you facilitating, essentially as a medical doctor, as a facilitator, as someone who is pioneering the space and this capacity.
0:37:56.9 Paul Austin: I think what psychedelics open up, what these higher states of consciousness open up, what modern technology has made more and more available is that for the first time in history, there's a capacity for not just one lotus flower to bloom here and there Jesus Buddha, Muhammad. But for potentially hundreds, if not thousands, if not millions of lotus flowers to bloom, and I think when we're talking about those states of consciousness, the stages of transcendent being this larger metaphysic that I feel is very relevant here is how are we supporting... How are you supporting clients and the people that you're working and to step into that sense of god-hood and what that might entail?
0:38:44.1 Daniel Stickler, M.D.: Yeah. Reminds me of Nietzsche's, "Thus Spake Zarathustra" and it talked about the Ubermensch, which is the Overman and the last man. And the last man, so people were given a choice. They could be this Ubermensch or the last man. And the god thought everybody would choose to be the Ubermensch, you know, to really take the risks for the greatest rewards, but have the risks of the greatest depths of failure and sadness and pain, but also you get to experience both. And he was shocked that everybody chose the last man, which was the person who chose the path of least pain and greatest comfort. And there was no real dynamic of their life. It was very flat. And we see that today. I mean, we see people going through life and, you know, that's their choice. I mean, you know, in Buddhism, the goal of the Bodhisattva is to bring everybody up before we can get to that point of enlightenment. And, you know, that's, we found over the last 20 years, we looked at, we typically work with pretty high performers, but we work with people from stay at home spouses to military veterans to billionaires.
0:40:17.5 Daniel Stickler, M.D.: And, you know, there was five common things that we found. Like if you look at Maslow's hierarchy and his later stuff as well, you know, the guy who doesn't have food to feed his family, his whole goal with every day is to find food and his mind is occupied with nothing but that. And so he doesn't have the opportunity to learn an instrument, to dance, to sing, and do all of these things that can advance the human state. He just wants food. But in the higher needs, we see this too, where people have deficiency mindsets. They may have half a million dollars in the bank and they still see that they don't have enough money. They will have this need for respect in the community that they don't have, even though they're wealthy, they're successful or whatever it is. They still have this deficiency mindset of, I'm not enough. We have people that don't feel love. They're just, they're always questioning love. Even when they're married, they'll be like, I just don't know if she loves me or something. So those deficiency states, while we don't think about it, those occupy our minds too, so that we can't advance to that transcendence that is available.
0:41:46.2 Daniel Stickler, M.D.: And one of the things we work with is helping people to resolve those deficiency mindsets that they come in with and purpose, love, community. I mean, those are all huge pieces that we work with them on to help them get through that. I mean, you don't find that in a typical medical evaluation and that's such an important piece. I mean, our biggest metric of success every year is what's their quality of life score? Is their quality of life score improving? Because it doesn't matter if you get all their blood work into an optimal range and you get their body composition perfect, if their quality of life doesn't improve, you haven't done your job. They're coming to you to have a better quality of life.
0:42:38.8 Paul Austin: And so much of that is relational. So much of that is about community. It's why even, you know, the probably more mainstream conversation around this is like the blue zones in Costa Rica and Greece and these other spots. What they find time and time again is what is central to longevity is the relationships that we cultivate because that is often what makes life worth living.
0:43:04.5 Daniel Stickler, M.D.: Yes.
0:43:06.6 Paul Austin: Speaking of longevity, there is sort of a common thread that is coming up more and more, which perceives disease, I'm sorry, perceives aging as a disease. And I'd love to hear your sort of thoughts on... Because a key thing that you're focused on is longevity, what longevity entails. Do you believe that aging itself is a disease? Do you think it's something that can be sort of solved, if you will? Yeah, I'm just curious to hear kind of... We talked a little bit about this before we went live, right? We want to be vital. We want to live to our fullest. And yet we also accept that death is inevitable.
0:43:55.5 Daniel Stickler, M.D.: And we wanna to die well, you know.
0:43:57.3 Paul Austin: And you want to die well. Yeah.
0:44:00.2 Daniel Stickler, M.D.: Yeah. That's not an easy question to answer because even in the longevity world, in the researchers and clinicians, there is a major lack of agreement on any of this. You have a group that believes that it's just the accumulation of damage over time, just like a car that just gradually breaks down from wear and tear. You have another solid group that looks at it as our DNA is programmed to age. And the purpose of that is by turning over our DNA with each generation, we get adaptations to a changing environment. It's just like, you know, if you dropped one of us back 12,000 years ago, we wouldn't survive not because we lacked skills, but because the environment is so different that our genes aren't adapted to that environment. So you've got to have that transition of the epigenetic marks on top of genetic drift. So the consensus is all over the place and it gets even worse when we talk about, you know, will we ever cure aging? I mean, I don't see it as a disease. Disease implies, you know, something that's external that's causing this in a sense. And, you know, aging is just a natural process that we go through. Can we reverse it? Well, right now there are aspects that we can reverse.
0:45:29.1 Daniel Stickler, M.D.: I mean, we reverse biologic age quite a bit. You you know, when we look at methylation marks of the Horvath clock and the DunedinPACE of aging, GlycanAge, all of these things, we can actually reverse somebody from being, you know, two years older than their chronologic age to being five years younger in a matter of six months to a year. And we can keep it moving in some cases. What does that translate to in longevity and health. We're not sure, but it appears that the people who do that are physically healthier, mentally healthier. So I suspect that it's actually working in that regard. There is, sorry. There's a lot of new research right now. I mean, you want to talk about some research, the small molecule work that's being done to get hair cells to regrow and people that have deafness from aging. I mean, that's in human trials right now. Another company, turn.bio, they just did a major webinar on the, it's called ERA, epigenetic reprogramming of aging.
0:46:43.4 Daniel Stickler, M.D.: And they have this technique where they can take these messenger RNAs and microneedle them into the skin. And not only functionally, but also structurally, the skin reverse ages, I mean, in some cases, the equivalent of 30 years in changes in the skin. I mean, you talk about a unicorn company. I mean, I would invest in them if I had the money to do it, but I don't right now, but they're going to be, you know, they're doing it the right way. Going for something that's very obvious. The skin changes will be huge. And I think they're getting ready to start clinical trials in humans, which I will volunteer for if that happens. I tried to get into the hearing loss one, but I didn't have my hearing test from years ago that showed when I had normal hearing.
0:47:32.0 Daniel Stickler, M.D.: But my right ear, I had a firecracker blow up when I was a kid. And now I have like maybe 10% hearing in my right ear. But I mean, this stuff is amazing. These gene editing, I mean, gene editing can be done in a garage laboratory and they're already doing human testing with this using like FGF21, they're doing KLOTHO, all of these genes. I mean, Liz Parrish with, I can't remember the name of her company, but she's already had it done to herself and she's being monitored by Harvard and they're watching these changes in her muscle mass and the age of her muscles and everything and it's showing really good improvement. But you know, having, being able to hit all of the systems simultaneously, I don't think we have anything that's going to do that. So it's gonna be just a repair and recover over time with different organ systems. And you know, until we can, I mean, we're, we're like in baby steps in this, but the potential is enormous. I mean, I think we're going to see a pretty substantial, youthful, healthy, longevity into the 150 and 200 year olds within this next generation.
0:48:52.9 Paul Austin: Really?
0:48:55.2 Daniel Stickler, M.D.: Yeah.
0:48:57.0 Paul Austin: Wow. That's the first kind of mic drop that I've had on the podcast in a very long time. I mean, in everything you just spoke about, I wrote down the epigenetic reprogram aging, sounds like Botox on steroids in a way, right?
0:49:13.9 Daniel Stickler, M.D.: Yeah.
0:49:14.7 Paul Austin: What would be the difference between that and something like Botox?
0:49:18.5 Daniel Stickler, M.D.: So as we age, we accumulate methylation marks on our DNA and these methylation marks, typically what they do is they turn gene expression down or turn it off. And so as we age, we accumulate these, they're methyl groups that attach to molecules of DNA and it decides whether it's going to be transcribed or not. And the big thing was when they hook the young rats and the old rats circulation together back in the early 2000s at Stanford and the old rats actually rejuvenated, I mean, truly physically rejuvenated. That started this process of, okay, what are these factors that are causing this? And so they initially isolated what they call the Yamanaka factors. And these were, I think they've narrowed it down to OSKM right now, but they would inject these into old rats and the old rats would just completely rejuvenate. I mean, it was like Benjamin Button type stuff, but they would die of tumors within two, three weeks. And so they've been working on this since about 2010, trying to figure out how to make this work.
0:50:28.5 Daniel Stickler, M.D.: But these small molecules like the ones they're doing for the injections in the ear, they're portions of these OSKM Yamanaka factors and they're highly successful with it. But what they're doing with the epigenetic reprogramming of aging is it's a messenger RNA that gets into the skin and reestablishes the youthful profile of the methylation on the gene. So the genes can be expressing everything from a youthful standpoint rather than from an aging standpoint. And the messenger RNA degrades in like 48 hours. So it just goes in, does its job and it's gone. So it's really, really an efficient process.
0:51:16.7 Paul Austin: So just to put a cap on this for the listeners, you know I read about longevity here and there. I love doing podcasts like this with folks like you, because there's a lot of rich, interesting information. Some of it flies over my head because there's sort of a more technical jargon to it. I'm tracking everything you're saying, but at the same time, I wouldn't necessarily be able to remember all of it. And I'd be curious if for the listeners at home, many of them are interested in optimal wellbeing, many of them are interested in longevity. What's sort of like a few core things to pay attention to, to look out for, to start to integrate as part of a longevity practice?
0:52:02.9 Daniel Stickler, M.D.: Well, at least 60 to 70% of aging is related to lifestyle. Only 10% is related to your genetic predisposition.
0:52:10.2 Paul Austin: Gotcha.
0:52:12.0 Daniel Stickler, M.D.: So people who say, oh, my grandfather lived to this old, so I'm going to be okay. No, it's 10% of it, but lifestyle, good healthy eating and a good healthy eating plan, not necessarily... I mean, people are promoting a vegetarian approach to diet, but we're omnivores and it's not so much the vegetarian, but it's really like a low methionine type of protein diet. So what we focus on in our clients is we try to, we check their genetics to see what their genetic predispositions are, but we modify everything around a... What we would say is a low grain Mediterranean style diet. Lot of fish, a lot of vegetables, very little red meat. And that seems to be, from the research, something that's really positive. Keeping stress under control. And I'm not saying avoid stress, but I'm saying learn to not let stress affect the body. And that's a lot of what we do with that neurofeedback and neuro stimulation that we do in the office. And sleep. I mean, sleep is a huge one. If you're, and I'm not going to tell everybody to get eight hours of sleep. I mean, you look at the data and seven hours seems to be the optimal sleep time.
0:53:35.9 Daniel Stickler, M.D.: I know I'm going to get some grief from all the sleep doctors out there, but you look at all the Fitbit data for a billion nights of sleep and they look at resting heart rate compared to how long you sleep. It's a U-shaped curve that peaks out at seven hours. They also found that people perform better cognitively with seven hours versus seven and a half versus six and a half. So getting that good quality sleep and making sure you're monitoring your structure of sleep. So the deep sleep, how much deep sleep are you getting? How much REM sleep are you getting? How much restful sleep are you getting? What's your readiness score? What are your stress scores? Which is something we monitor in all of our patients. I mean, I've worn a Garmin watch all but maybe a dozen days in the last six years. It's always on my wrist. I have all the data. I can see what everything impacts on my system, whether it be a food or an exercise or even people. You can see how your stress changes when you're with certain people versus other people, which is really kind of Orwellian, but it's there. [chuckle]
0:54:42.3 Paul Austin: And what for you personally, right? Having tracked all of this data over the last six years. What is optimal for you for where you're at, for your stage in life, your profession? What have you just found works really well for you when it comes to sleep, when it comes to exercise, when it comes to food, when it comes to longevity in general?
0:55:03.2 Daniel Stickler, M.D.: One of the things is not eating a lot. I eat two meals a day and it's usually small meals. I'll occasionally supplement with protein drinks. But I mean, that's key. I also have a strict routine of going to bed at 9 o'clock. So I'm in bed usually 8:30 or 9:00 every night. My wife and I are both very fixed. I mean, if people ask us to go out to dinner here in Austin, we'll be like, okay, we have to eat at 6:00 though, 'cause we have to be home in bed at 9:00. And they know that. So they, they accommodate us with it. But we get up at either 4 o'clock or 4:30 in the in the morning. That's our natural wake up time. And we spend four hours in the morning. We do meditation and then we just lay in bed together. We'll talk, we'll do massage, we'll make love. But every morning for four hours, that's been our routine for the last four years now. Even when we're on trips or on vacation, we did the same thing. And the body loves that routine of knowing when it's going to bed because it will actually start to turn everything down when you're in a fixed routine. And we don't eat generally past 6 o'clock. I mean, if we go out to eat, we do, but usually we're eating our last meal before 6 o'clock. And we don't watch any TV. That helps too.
0:56:24.8 Paul Austin: No screens right before bed, minimizing blue light, all the sort of standard things. So you go to bed at 9:00, you get up 4:00 to 4:30, but then you're in bed for maybe another four hours and maybe till 7:30, 8:30. So, Although you're sleeping, let's say, seven, seven and a half hours, you're relaxing for about half the day in total. And I think that sense of relaxation is just so not part of the way that we live today. We're always on, we're always stimulated, we're always going, we're always active. And what I found to be true and what the research also reflects is that stress, constantly being on, being in a sympathetic state, you know cortisol levels high, That is sort of like a core central factor for a lot of other lifestyle aging disease.
0:57:22.0 Daniel Stickler, M.D.: Well, and I think the relationship too, you know just the talking that we do in the mornings, I mean we talk about really cool things, we talk about consciousness, we'll read to each other, so we'll find a really cool article that one of us will read to the other one, we'll be reading different books on generally the same subject, and we'll be pausing and saying, Hey, listen to this, but that connection that we have, I mean I had a client just this past week, and I was like, how much time do you spend, you know you and wife together? And he goes, well we, we plan two to three hours at least twice a month, and I'm like, Oh wow, okay. [chuckle] That's not much time.
0:58:12.1 Paul Austin: Right. Not much time at all for an intimate partner. And like I would even speak for myself sometimes that deepening of vulnerability, that rawness, that deep intimacy and familiarity can feel boring. And so, what I'm even hearing in how you're describing this is there's rituals, there's routines, there's still a sense of novelty even within the sort of spending a lot of time and a lot of connected sort of energy with each other.
0:58:44.2 Daniel Stickler, M.D.: Yeah, and I mean we, yeah we call it, we make love for four hours every morning, and somebody said, Man, that would exhaust me, I'm like, No, it's not like penetration love for four hours, I mean that's part of it, but we're massaging each other, we're doing this and it's every morning we do that, we're reading to each other and that's our love making.
0:59:06.1 Paul Austin: Wow, well, thank you for sharing that on the podcast, I think that that will be surprising to many and also inspiring as something to explore and deepen with a partner and a spouse. Okay. So we're into the final 10 minutes. There's a couple of other things that I wanna touch on, one of which we have not touched on yet is Neurohacker Collective, so the way that we were able to connect and meet, it was a couple of months ago. The microphone was turned around and you were interviewing me about microdosing, which was a phenomenal conversation for anyone who's listening to this...
0:59:39.6 Daniel Stickler, M.D.: It was.
0:59:43.5 Paul Austin: Go, go check it out. I'd love to hear kind of your thoughts on Qualia, I believe they're going through a re-brand now, but generally, Neurohacker Collective. Why is it that you got involved with Neurohacker? And what is it that you love about Qualia their sort of flagship supplement line nootropic.
1:00:02.3 Daniel Stickler, M.D.: So I think it was 2016, fall of 2016, and I had clients that were coming in, and I was big into nootropics at the time. So we were trying all these different nootropics and they were a bet... They were hit and miss you know, 50% of people would have a really good response. 50% of people were like, Ah, didn't do anything for me. And suddenly I had like five or six people in a row come and tell me about this Qualia nootropic they had started taking, and they were all raving about the effect of it, so I got some of it and tried it and I was like, Wow, yeah, this stuff, this stuff really works. And so I reached out to them and I said, I'd love to talk to the formulator. And they got back to me, and I had a podcast at the time, so I interviewed Daniel Schmachtenberger, who is probably one of the greatest thinkers of our time, and Daniel and I, we did an interview and we started talking about complex systems, and so we spent five minutes on the product, and then the rest of the time talking complex systems. And then even after the recording, we stayed on the phone for an hour and a half chatting, and a couple of months later, he reaches out to me and he said, We're looking for a medical director, and I'd love to have you in that role.
1:01:23.3 Daniel Stickler, M.D.: And even though I was busy and didn't have the time for it, I couldn't pass up an opportunity like that, and so Daniel and I became very close friends, and as well as his brother, James, who's the CEO, and they are one of the few supplement companies that I looked at and I actually modeled my supplement company thinking after that because I was just amazed at the way the formulations were done, I mean, it truly is a complex systems process, they look at, Okay, well, this is going to affect this system and this one will affect this one, but this one may interfere down here if it does this, so how can we... I was just like, Okay, this is the way things should be done. And that's the story, but they've continued to do that with their products, they put out just some of the best quality products on the market, and I am honored to be involved with them.
1:02:22.7 Paul Austin: Yeah, I first heard about Qualia, it was probably 2017. I think this was back when, it was like 10 different pills that you had to take and they all had a different size and...
1:02:33.2 Daniel Stickler, M.D.: Step one and step two.
1:02:34.1 Paul Austin: Yeah, yeah, it was, it was...
1:02:35.7 Daniel Stickler, M.D.: But let me tell you that was the one, that one is still my favorite. I have cases because I quit selling it and they gave me the cases of it, so I still take it.
1:02:45.2 Paul Austin: Really?
1:02:47.3 Daniel Stickler, M.D.: Oh, yeah. It is an amazing product.
1:02:50.7 Paul Austin: What do you notice as... Or what is the difference then between what they have now and what they had before, and subjectively, what is the difference in the felt experience? Is it just more clarity, more sharpness, more focus?
1:03:02.5 Daniel Stickler, M.D.: Well, again, it varies by the person, I mean, everything is bespoke for people in health. You know, I have people that rave about the mind product, and I get a good result from the mind product, and if I didn't have something else, that's the one I would take, but the two-step formula, I mean there's nothing that compares for me, as far as the impact it has, it had a couple of things in there that they couldn't sell because they were taken off the allowed supplementation, like Noopept, Noopept is in the two-step formula. And I love Noopept and it works so well in synergy with the other pieces that are in there.
1:03:47.6 Paul Austin: What is Noopept?
1:03:47.7 Daniel Stickler, M.D.: Noopept is a peptide that can be taken orally and it just really turns the brain on. It's a very small peptide, I think it's two amino acids, and so it doesn't get broken down very much in the stomach and intestine and we absorb it as it is, but I know a lot of people, and I mean you can buy Noopept from research chemical companies in capsules and everything, I know a lot of people that take it and just rave about it, and it's one of my favorite.
1:04:22.2 Paul Austin: Let's open that up a little bit more. We still have a little bit of time. Peptides in general, peptides are something that you specialize in, if you had to just give sort of like a three to four minute overview to our audience about what are peptides, why are they useful and why are they becoming more and more talked about and in Vogue and in sort of the health and well-being community.
1:04:40.5 Daniel Stickler, M.D.: So let's start off with this, I mean you look at medicines and you look at supplements, they all have a target effect that you're trying to achieve, but every one of them also has an off-target effect, so even though you're getting positive results in this one area, you're gonna get a negative impact in another area, so what you look at with them is, does the net result result in something I'm trying to achieve, and that's how we go through medications and supplements with our clients. Peptides are different because they're modeled after proteins and peptides, amino acids that our body already makes. So the body is actually familiar with these structures, and so they have binding sites that are highly specific for these little molecules that these proteins they go in there and they just attach to a receptor and cause an event to happen. In larger proteins and in... I mean, there's peptides, polypeptides so it depends, it's just a nomenclature based on the number, but something like growth hormone, growth hormone is essentially a protein, but it's like this big ball of protein and it's got like 20 different keys on the surface of it, and these keys are specific for receptors in different areas.
1:06:04.4 Daniel Stickler, M.D.: And so if you give growth hormone, it's gonna go around the body and it will find all 20 of these places to attach, so it'll affect multiple systems. What they've done with peptides is they've taken pieces, they have just pulled individual keys off of these proteins and they say, Okay, we want the effect of growth hormone specifically on fat cells to get them to mobilize fat, and so they sequence that one little segment, it's folded the same way the proteins fold, so it's an exact copy of the key, and then they just send it into the system with an injection in most cases, and it goes and it does its job, it's very laser-focused on target effect with very little, if any off-target effects, which is what has just... I've fallen in love with the peptides, I started using them back in 2017, I actually created one of the first courses on peptides for clinicians back in 2018, 2019, and I mean, they're just the darlings of the industry for me, and if they're not part of the tool belt of a clinician, they're missing something. Right now, the big thing is this Ozempic and Mounjaro, which are both peptides. Ozempic is GLP-1, so it goes and it activates GLP-1 receptors in the body and causes massive weight loss effect, insulin sensitivity.
1:07:33.0 Daniel Stickler, M.D.: I mean, it's just wonderful. And then Mounjaro is a Tirzepatide which is a combination of GLP-1 and GIP, which are two different ones. And that combination effect. I have never seen a paradigm change in weight loss like I've seen with these. And we started using Semaglutide, which is Ozempic. We started using it back three years ago, I think, and we knew that this was going to be huge.
1:08:04.1 Paul Austin: I only first heard about peptides, I went to this RUNGA event in May of last year that's hosted by Joseph Anew, who's now actually part of the team at Third Wave, and there was just like an injection station where you could go get some peptides and I tried them out, and they were great, and then I think I heard in the new... I think Kim Kardashian or something has been talking about peptides, there's been some celebrities who have recently been talking about it. So it seems to be more and more in the zeitgeist, if you will, of health and well-being. And yet, if I were to go ask my parents in Michigan if they utilize peptides, they'd have no idea what I'm talking about, so it feels like it's still on that pioneering stage...
1:08:46.9 Daniel Stickler, M.D.: There's ones that accelerate healing, there's ones that enhance cognitive function. The one that all the celebrities are talking about is the Ozempic, the weight loss one. That's what's got it becoming so viral with there's a worldwide supply chain issue.
1:09:03.3 Paul Austin: Obesity problem. Oh really? Why is that? Is it 'cause it's coming from China or...
1:09:12.3 Daniel Stickler, M.D.: I don't know, I think most of it's being produced by the pharmaceutical companies, but compounding pharmacies have been able to produce generic versions of it because of this deficiency in the supply chain, but Semaglutide, which is Ozempic from compounding pharmacies, you can get it for $200 for 12 weeks of it, and it's like $1000 a month for the brand name stuff, but it's about to be removed from compounding pharmacies because the supply chain is catching up, but now we've got Tirzepatide, which is the Mounjaro, which is in deficiency, and it's gonna be in deficiency for a little while. So we aren't gonna be able to use that one for a while, too.
1:10:00.1 Paul Austin: Wow, well, this has been... My favorite podcast conversations are the ones that come from the widest landscape possible, and so just the fact that we were able to talk about Nietzsche, Ayahuasca, longevity, peptides, blue zones, you know you name it. We really covered the gamut today, this is, I think, really one of, if not the only podcast that we've had on this overlap of precision medicine, longevity, psychedelics. I think in a round two, I would go a little bit deeper into your understanding of psychedelics and physiology and inflammation and all these other things, but for now, I feel like this is...
1:10:40.5 Daniel Stickler, M.D.: I'd be glad to come back so, I've enjoyed this.
1:10:43.4 Paul Austin: And you'll be more than welcome to come back. This I think is a good taste of the brilliance that you bring to the table, so I just wanna thank you, Dan, for the pioneering work you've done and this, it is the future of medicine, it is a totally new paradigm that you're helping to pioneer, and I'm just so appreciative that you took the time today to be with us and share your wisdom, knowledge and your heart. It really meant a lot to be here with you and to hear you just riff and share on all of these wonderful, brilliant things.
1:11:14.3 Daniel Stickler, M.D.: Thank you and much gratitude for that.
1:11:17.1 Paul Austin: Yeah, and I will see you in Denver at Psychedelic Science, and this is just a invitation to all listeners as well, we will be at the MAPS conference. Dan, you said you'll have a table there for the... Is that for the genetic testing.
1:11:30.1 Daniel Stickler, M.D.: We'll have one for a genetic testing and then one for our non-profit that works with veterans and PTSD.
1:11:36.9 Paul Austin: And what's the name of the non-profit?
1:11:39.1 Daniel Stickler, M.D.: The Apeiron Zoh Foundation. [chuckle]
1:11:41.2 Paul Austin: Oh it is, oh fantastic.
1:11:42.3 Daniel Stickler, M.D.: Yeah, not complicated.
1:11:44.2 Paul Austin: Okay. And is that, I mean just quick, can you... Before we end today, what is the mission of that non-profit?
1:11:54.0 Daniel Stickler, M.D.: Yeah, my wife spent 30 years in the military, she retired as a Colonel in the Air Force, and she worked in human performance, so she worked with all of the special operators, a lot of the drone pilots and skiffs and that, and she saw how impacted they were as far as their physiology and their mental health and we started working with some veterans with some ketamine therapies and found some just amazing results with it. So we developed the non-profit because most of them can't afford a lot of these more intensive programs, you know you can go to ketamine clinics and get your $500 sessions and do that, but we spend a lot more time with them, we do a lot of different modalities. So we work with optimizing their physiology as well as working with their mental states, so we developed that non-profit to help support them.
1:12:54.7 Paul Austin: And it's a phenomenal balance to the optimal performance, human well-being. I know a lot of entrepreneurs, founders, those who have become successful when they've had their lives transform through psychedelics, they often then wanna give back in that way and support the process of people, specifically veterans or sexual assault survivors or folks like that, so they can have a similar healing, because I think one thing that we all agree on is Psychedelics are tremendously powerful, and accessibility is key to ensuring that everyone can benefit from the potential that they hold.
1:13:32.9 Daniel Stickler, M.D.: For sure.
1:13:34.2 Paul Austin: Absolutely. Any kind of like final things that you wanna tell our audience in terms of your website, in terms of things to check out, in terms of places to point them to, as a sort of final invitation?
1:13:50.6 Daniel Stickler, M.D.: I think just to leave you with a statement, I mean our mantra is live the life of excellence. And what does that mean? It's not a matter of successes or wealth or anything like that, but fully experiencing life and all its emotions and all that it has to offer, and you know, just be that Übermensch.
1:14:17.6 Paul Austin: I love it, Daniel Stickler, Dr. Daniel Stickler. It's been an honor. Thank you so much for joining us on the Third Wave's podcast.
1:14:24.8 Daniel Stickler, M.D.: Thanks, Paul.
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