Follistatin Gene Therapy⎮Body Composition Devices ⎮Meet Mastermind Dr. Tamsin Lewis
Your sneak peek into the world of Longevity Docs.
Hey Docs, this week in the Longevity Docs Newsletter:
Chat: Follistatin gene therapy and body comp/impedance devices
Mastermind: Dr Tamsin Lewis
Publications: mitochondria as nutritional targets, direct neuronal reprogramming for AD,
Press: BioAge, Adamo Biosciences, Neuralink, Membership Clubs
Happy Sunday!
David Luu
🚨 Longevity Docs News
🎤 Dr. Tamsin Lewis will speak at the Longevity Docs Mastermind NYC on October 5-6
Dr Tam is a member of The Royal College of Psychiatrists (MRCPsych) and founding trustee of the British Society for Lifestyle Medicine.
Dr Tam is part of the founding team and medical director of RoseBar Longevity with The Six Senses.
As a former GB elite triathlete and Ironman Triathlon Champion, she developed a performance and possibility mindset which informs her approach to optimal health management and human potential. Immersed in a world of sporting and coaching excellence, this triggered a fundamental shift in how one can measure true health both in the present and as a predictive trajectory - our ‘healthspan’. Dr Tam’s background in psychiatry allows her to incorporate a nuanced humanistic approach to practice, behaviour change being pivotal to health outcomes.
Specific interests are longevity practices - bio-identical hormone therapies, bio-modulators/peptides and strategic exercise, techniques and supplements which research shows us improves health-span.
She has a deep knowledge of digital health and use of wearable tech driving connected health and personal empowerment. More recently, learning from Dr Robin Carhart-Harris at Imperial College, (and related experts) , Dr Tam has become interested in the neuroscience research and practical therapeutic use of psychedelic compounds.
💬 Buzz in the Chat
Walter Patterson, CSO of Minicircle about Follistatin gene therapy. Thoughts?
A tet kill switch is not novel. And it is a leaky method. Further the evidence behind using Follistatin for anything other than muscle building is ether at best. That being said, this is a GMP process which should be able to be trusted. BJ had his muscle density improve with this therapy. But longevity? And how long therapy will last for remains to be seen. A few years ago Follistatin increased levels in plasma were associated with increased risk in diabetes, and the hypothesis is via increased insulin resistance. Humans vs Mice. Or should I say transgenic humans vs mice…..
So many opinions on Minicircle. Good and bad. More and more say not worth it. Either for their method or not worth spending 25k for follostatin injection.
I do believe transgenic humans will be a thing. But the problem is that it is a system that needs more Guinea Pigs to refine the on off switches.
I have a decent amount of experience with Follistatin Gene therapy at this point, having done it myself twice. For me personally it was moderate benefit and definitely noticeable, an increase in lean muscle mass by DEXA, more strength, better dexterity and neuromuscular function. I feel like I am a better on the dance floor !
There are certainly some unknowns such as potentially increased insulin resistance or cellular proliferation, but there is always that risk reward trade off. We are careful to screen patients quarterly on biomarkers and yearly on prenouvo and Galleri and have not seen any adverse reactions. In my conversations with Minicircle and review of their data this was the case as well with the other cohorts that have received this procedure as well.
Could this all be a placebo effect ? It’s certainly possible, after all 25K later you want to believe that it did work. More data certainly needs to come out, which they are working on. So far I’m still gently positive and cautiously optimistic on this therapy and the delivery mechanism.
Next one up is Klotho Gene Therapy with the same plasmid vector - I’ll report back !
I am super interested in Klotho! Do you have density measurement in your case? I often wonder how dense this vs “pharmaceuticals” etc.
It's $25k every 2 years. So just over $1,000 per month (not including any sort of consultation, travel and lodging, and other charges)? Are there better therapies/combos that can have similar or more benefits at a better costs: benefits ratio?
The trial we did on rapamycin showed increased lean tissue by DXA at the end of 12 months. The effects were more noticeable in men. It quite surprised me - would have bet the opposite (or neutral)
Please can you share your experience with Follistatin gene therapy in women. I’m wondering if any visible muscle hypertrophic changes might happen at masseter temporalis muscle or other face muscles that we don’t want.
Another question. This Follistatin therapy was delivered using bacteria vector, right? Results are short term and less possible side effects. There is also an option of virus vector (AAV), longer lasting results, more expensive. Any thoughts on this?
Does any one trust impedance devices ?
Lol. IN DEXA We Trust. I’ve done obesity for over a decade and seen every expensive toy out there. None replicate the way DEXA does clinically @Giovanni Campanile just my 2 cents
We use the InBody 770 and find it to be very consistent in patients over years of measurement.
However, many of my patients are now getting 3D Styku Body Composition - I am not clear how this technology can measure Visceral Fat Area ( which in addition to Skeletal Muscle Mass are my 2 main areas of interest).
I do believe DEXA is one of the standards, but the limitation of course is the small amount of radiation.
When we place patients on a program of VFA reduction we measure the impedance body composition relatively frequently in order to assess improvement of VFA and to make sure SMM is not diminishing. We do the same in patients on GLPs to follow SMM.
I think if you use the same machine and follow trends it can be helpful. We did that with Tanitas. But the impedence would get wonky if dehydrated or constipated. This is an excellent idea to study different devices and see how they compare. Would any of you be interested in this?
I’m not sure about Styku . I know for body fat patients have gotten both with in body off by 5-10 % on body fat . I can check out Styku
They’re trustworthy within the limits of the tech provided you’re using handles as well.
They use an algorithm of best fit for body conmposition given electrical current impedance
The challenge is people who aren’t well represented in a normal distribution and/pr are different given ethnicity from sample population (which is usually a European/Caucasian sample)
Similar to a normal scale, consistency is key: day, time, diet, exercise etc standardised as much as possible.
Probably best use practice is first thing in the morning post void, done daily or weekly tracked as monthly average. Or indeed 1st of the month or similar.
My friend Grant Tinsley is a top body comp expert. Feel free to reference his unbiased, unsponsored research when evaluating body comp/impedance devices.
I use BIA to trend and track my patient’s weight loss. I also order DEXA scans on patients.
The benefits of BIA:
1. quick
2. Patients love the data
3. no radiation
4. you can see changes in total body water weight (extra cellular vs intracellular, too)
DEXA scans include water weight as fat free mass/lean body mass.
The insights on BIA you learn from measuring DRY lean mass are critical to dispelling the DEXA measurements that claim that lean body mass losses are from “skeletal muscle mass loss”
🩺 Publications
Modeling late-onset Alzheimer’s disease neuropathology via direct neuronal reprogramming
The findings demonstrate the feasibility and sufficiency of miRNA-induced LOAD neurons for modeling late-onset neuropathology of AD in a 3D environment. These neurons provide a platform to understand how aging influences vulnerability to late-onset neurodegeneration in LOAD patients.
Science - Recommended by Dr. Woodson Merrel
Assessing the reliability and cross-sectional and longitudinal validity of fifteen bioelectrical impedance analysis devices
Collaboration with research institutions and industry partners is crucial for advancing healthy longevity medicine and creating standardized protocols. In this article, we review the process of creating healthy longevity clinics in public hospitals to ensure the best possible care for individuals pursuing healthy longevity.
British Journal of Nutrition - Recommended by Dr. Kyle Gillett
Mitochondria as Nutritional Targets to Maintain Muscle Health and Physical Function During Ageing
While there is evidence that some nicotinamide adenine dinucleotide precursors can improve physical function in older individuals, such an outcome seems unrelated to and independent of changes in skeletal muscle mitochondrial function.
Sports Medicine - Recommended by Dr. David Lipman
Blood Biomarkers to Detect Alzheimer Disease in Primary Care and Secondary Care
This blood test (the APS2) had high diagnostic accuracy for identifying Alzheimer disease among individuals with cognitive symptoms in primary and secondary care, providing superior performance compared with the diagnostic accuracy after standard clinical evaluation (not using Alzheimer disease biomarkers).
JAMA - Recommended by Dr. Steven Murphy
🌐 In the News
BioAge Announces First Patient Dosed in the STRIDES Phase 2 Clinical Trial Evaluating Azelaprag as a Novel Treatment for Obesity in Combination with Tirzepatide
Adamo Bioscience introduces the Adamo Method, the most significant advancement in sexual medicine since Sensate Therapy was created by Masters and Johnson in the 1960s.
What is NAD? Longevity supplement used by Hollywood to prevent aging
These Membership Clubs for the Rich Say They Can Actually Slow Aging
Elon Musk says a person with a Neuralink chip could beat a pro gamer in a few years
🗓️ Events & conferences
👉 Longevity Docs Mastermind: NYC - October 5,6
Cellular Senescence - the Road to Immortality : Novato - August 12
ARDD: Copenhagen, Denmark - August 26,30
RAAD Festival - Anaheim CA - September 5-8
Peptide Therapy Certification - September 6-7, Orlando, FL
Cannes Longevity Festival: Cannes, France - June 25,27 2025
About Longevity Docs Mastermind
The Longevity Docs Mastermind is a physician-only event focused on precision and evidence-based longevity medicine. This is where the medical leaders of today shape the future of longevity.
New York City - October 5-6, 2024
Convene 101 Park Avenue, NYC