How To Fix Fertility: A New Personalized Playbook

Hey, everybody. Welcome back to the Futurist Society, where, as always, we're talking in the present, but talking about the future. Today I have a very special guest.We are talking with Kirsten Karchmer, who is the CEO of Conceivable, an app that is attempting to fix the fertility issues and help people conceive. Thank you so much for speaking with us, Kirsten. Tell us a little bit about what you're doing.

So, like you said, you know, we're on. A study came out in 2015 that said that less than 3% of couples could afford fertility treatments.And at that time, I had a very high touch type of concierge care that we provided at my clinics in Texas. And. And I just decided that I'm part of that problem and I want to also be part of the solution.And so I spent the last eight years trying to build a digital twin of myself. So how can I.You know, basically, I envisioned if I came to live at your house and just sat on your couch all day and told you what to do and told you what to eat and told you, educated you about what you needed and provided the right food and the right supplements all day, every day, and then kept checking, how's this going? How's that going? Is this make. Should we fix this? Do we need to optimize this? And.And that brought to Birf the first version of the Conceivable app, which is now in market.

Yeah. And honestly, I downloaded it and I interacted with it a bit, and I can see the benefits of it.I. I think that the idea of bringing out behavioral change by technology is something that is going to be the next wave of healthcare. And I see that happening with your app. For those of you guys who don't know, she. Kirsten has been in this space for a long time.She was helping people conceive in a clinical practice. You know, she practices acupuncture. And, you know, I. I think that even.Even that, like, I. I didn't realize that that was something that could help people. And now since meeting Kirsten, I've done my own research, and there's a lot of good evidence on acupuncture.And more importantly is, I think that even if you are in that situation, which is an advising situation, you can take that opportunity to talk to people about their diet, talk to people about their lifestyle choices. And stuff like that. And I know that's what you were doing, and you were unlocking a lot of gains from that for your clients.So tell us a little bit about the behavioral changes that you advise people on to help them conceive.

So I think that the biggest thing that's missing in healthcare right now in general is personalization.And so you can see a lot of fitness trackers, health trackers, even, like apps that can make, you know, menu plans for you, but they're still pretty cookie cutter.

Mm-hmm.

They're not actually really personalized. Exactly. To the person. And I think this is why, you know, as, um, as I mentioned before in an earlier conversation we had about the success rate.So, you know, in the clinical pilot that we conducted with 105 women, they increased the likelihood of natural conception by between 150, up to 260% with no human interaction in four months or less. It really should have been eight months. But just these studies cost a lot of money in this early stage, you know, organization.We just didn't have the budget for it, but we did want to show that, that it did produce significant increased likelihood. And so to your question, you're like, but wait, here we're talking about behavior change, people.I say, like, what are the most important behavior changes to make in terms of optimizing your fertility? And obviously just getting healthier in any way will help.The problem is, is that too many of us have been educated from Instagram about what healthy is and what it looks like.Like, for many women, it's too thin, it's over exercising, it's not eating enough real food, too many protein bars, Protein Shakespeare, not having any time for themselves, and a lot of unmanaged stress. You know, women, they kind of have two modes that are acceptable in society. Happy and happier. If they're sad, they're a baby.If they're mad, they're a bitch.

Right.

And so women really, historically have just gotten really good at just putting on a happy face, which means they're internalizing all of those emotions. And those emotions in Chinese medicine at least become pathology, right? It's just internalized stagnation of energy. And so we want to look at that.So, you know, we broke it down into five specific categories. Can you make and restore and conserve energy? Can you make and regulate blend? Can you make and regulate hormones? What is your stress level?What's your heart rate variability, and how is that affecting the rest of it? And then temperatures, because that's a whole other conversation.Conversationally pioneered using basal Body temperatures is predictive indicators of fertility outcomes, hormone levels and things like that.So, so the personalization comes through the assessment that the user takes and then figures out what are the specific areas this person needs to work on. And often those interventions are very simply, like, if you don't have cervical discharge, it's going to tell you to drink water.And that's probably the most important thing that person can do around improving cervical discharge. It doesn't need a supplement, it doesn't need, you know, after a month or two, she's getting hydrated and she still doesn't have cervical discharge.This is a new revelation. Now the app needs to go in and figure out, well, I thought it was dehydration, but now she's hydrated, she still isn't. What else could be going on?Ask more questions, give any recommendations.So it's typically around things you do, how you sleep, how you eat, how you digest, what you eat, when you eat, the amount you eat, how you cope with your feelings, how you cope with stress.What's your heart rate variability like tracking your heart rate variability to see what are the things that actually dysregulate your nervous system. Personalized menus, personalized supplement recommendations.

I never thought that in talking on this podcast would be, we would be talking about cervical discharge. Like, I feel like that's something that did not come up in my bingo card for this podcast.

I'm actually on my best behavior too, so I'll try to not say anything too uncomfortable for anybody.

Yeah, no worries, no worries. But let me tell you what I like about the app. So I like the fact that it attaches to wearables.I think that that's a source of information that as the medical community we haven't really unlocked. I think we're still in the baby steps of that. And so the fact that you have that in your app, I think is really, really good.And I do think that, you know, the idea of notifications or some sort of tracking mediated through technology, if that is able to change behavior, that's something that is going to lead to increased fertility. But you know, you talk about Chinese medicine.Let me, let me give you the, the pushback that I think that western medicine would say about this stuff. Like number one, do you have any peer reviewed information that shows that these people are getting any benefit?I know you said some statistics, but you know what, what, anything peer reviewed that, that you could highlight that would speak to those people like me who are in the western medicine establishment.

So, you know, we have not done a peer reviewed study yet. That was the first.Basically we did that study as a clinical pilot just to verify, well, one, to compare what were the outcomes of seeing me in my clinic. I had very high success rates in the clinic, so that was sort of the gold standard.And it's like, could the app even get 50% as close to, to my, my success outcomes? And it actually beat me. So it was one of the reasons why I stopped being a clinician.It's like, how can I spend, charge somebody $5,000 to schlep up to my clinic every week, get acupuncture when they can spend $15 a month and get better results? Like, kind of a shocker. There is plenty of peer reviewed data though, identifying the subclinical factors that we're working on.

What do you mean by, what do you mean by subclinical factors?

So subclinical factors like having less than four days of bleeding, having more than six days of bleeding, having more than 21 days between, having ovulation occur after, on cycle day 21 or later, having poorly timed ovulation, just in general, significantly. Being exhausted exponentially increases your risk for miscarriage.It's correlated with infertility because the mitochondrial activity, you know, exercising to exhaustion four or more times per week decreases your likelihood of conception by 70%.

Dang.

This is all peer reviewed data. This isn't my clinical observation. These are peer reviewed studies. So.

No, that's great. That's, that's awesome that you're highlighting those things. I think that's that kind of evidence. Honestly.I, I think that, I think the most people can see, like if you're able to change people's behavior, that's something that's going to be beneficial for everybody involved. And I think everybody, even in western medicine realizes that coaching someone to do something is, is really important.You know, they have these things like health and wellness coaches right now that, that, that help people lose weight or help people, you know, get more fit and that leads to better health outcomes. That's something that I've seen in my own life.Like, I started getting really serious about my own health and like my cholesterol levels came down and like my energy level went up and all that stuff. And that has yielded secondary benefits for me, even though it was like, it wasn't the actual thing that I was chasing.Once I got those things into position, then the other things started happening. And I can see that happening with fertility, especially for the stuff that you're tracking. Right.

And so, you know, Our goal is not to build an app for fertility or even just for women's health, but we're really, our goal is this year to build the first operating system for women's health. Because an app or a tracker tracks information. It's unidirectional, it's not personalized.It basically says you got 10,000 steps or you only, you know, only ate 400 calories or 4,000 calories.And what the system that we're building is able to assess a woman's total overall health without any labs, very affordably, give a good picture of like, you know, where are they at? But then at the same time as she's tracking more data, the AI is learning.It's learning because basically it looks at the, the set of problems that she needs to work on. It makes a hypothesis of what behaviors will help. It gives her recommendations. Then it sees, did she do those recommendations?Because the app asks, are you tracking what we told you to do? If she's not tracking, she's probably not going to get very good results because it is a two directional experience.And as she's tracking, what should happen is that, say she's only getting five hours of sleep and she's really tired, so we got to fix the sleep issue. And so say we've already had the conversation, she knows what to do, but she's not doing it.So then the app needs to, the AI needs to go back and say, okay, let me keep trying to figure out how can I help you to sleep a little bit more. Let's keep problem solving on this. So the app is learning. Oh, okay.X percent of the people who are not sleeping enough who have this specific problem that we make this recommendation to, they don't do it. So then the app needs to come up with either our help or on its own with different varieties, breaking it down into smaller pieces.We have like a whole chain of like things that it can alter it. And so then it becomes an operating system that is two directional, right?You have information coming in, you have outcomes, and then you have information going out. So the app is learning and then we're translating that across a whole woman's lifestyle.Because the disease, I mean reproductive life cycle, because the whole, every single reproductive problem that a woman can have, specifically like pcos, pmdd, endometriosis, there's so many others, but are the most significant pro predictors of the diseases that are likely to kill women. Diabetes, heart disease, estrogen dependent cancers, suicide and stroke.So by, you know, ultimately like they have a saying in Chinese medicine, the good doctor treats the patient, the great doctor will treat society, but the master will learn how to make herself obsolete. And when I saw the study results that the app had actually beaten you, first I was really embarrassed and like, how did the app beat me?I thought it was really, really good. And. And it was better. But second of all, I remembered that saying, and I was like, oh, that's step one of being obsolete. They don't need me anymore.They needed the system that I came up with and the interventions. But actually, now I'm starting to become obsolete.And so, ideally, if we can address women's health problems earlier around their, like, period health and pcos, endometriosis, what we are hoping to prove is that actually by improving those behaviors, lifestyle, and factors that are contributing to those conditions on the backside, we're reducing the incidence of those conditions as well. That'll take us 20 years to prove that, but that's the goal.

Wow.Did you think about the operating system yourself, or do you have, like, a team of tech people that you're working with that you guys brainstorm this? Or, like, how did that idea come about?

It was my idea to. I mean, I'm the ideal person on this team, right? So it's like, I have an idea. My team is like, too many ideas. Okay, Way too many ideas. We.It takes us so long to build every one of your ideas.But I just kept saying to my team, like, as we were thinking about, because people are used to using trackers, and I think trackers are complete garbage. Like, I think actually they're quite injurious to women. They don't change the outcomes.There's no data that show that trackers actually changed outcomes in any way. And so as we were looking to try to position conceivable, I was like, it's not an app, it's not a ring. It's not a supplement company. It's something.It's a system. It's a system that helps you live in a way that produces optimal health.We are starting with fertility because that's where I have the most credibility. And, you know, but. But in Chinese medicine, you're never treating anything like fertility or pcos. You're always treating everything.So the patented technology that we have is extensible to all chronic illness, right? Heart disease, diabetes, stroke. I have ms, you know, definitely. It's how I'm here without ever taking any medication for my Ms.I mean, I had 15 years in which I had no lesions. Like, they just went away. Menopause Kind of put a, you know, changed that a little bit. Not, not dramatically so. So, you know, I have my.That my CTO is the former head of product from Apple, so pretty robust technical team. And at first they're like, no, we can't build an operating system. And I was like, that's what we're building. I don't want to build an app.I don't want to talk about this as an app. This is not just like something that's like, oh, you just use. I want to integrate this into every. Like, we can make it more and more robust.The everyday needs that women's have. Like, we even made the app. It's.Can't do it just yet, but in the next 30 days, they'll be able to, you know, it gives you personalized menu plans for every week of your period. It can tell you the macros. You track it by taking a picture of it. But then it gives you a grocery list.And soon will be a button that just says instacart and you can click on the things that you want and just have those things delivered right to your house. So how do we make optimal health. Like, forget about the fertility. How do we make really optimal health possible for all people who want it?

That's really awesome. I. I just started diving into optimal health, and I feel like that there is a hunger for that. People are getting it. People are coming to me about it.You know, it's. It.I feel like I live in a system where I'm putting out fires, but more people are talking to me about how, okay, I'm gonna put out this fire, but I also, like, don't ever want to have any more fires again. And that, that's like a. An interesting shift that I'm seeing in, in healthcare. I just want to take a second.When you're talking about trackers, you're talking about. You're not talking about, like, wearables, right? Like, you're talking about the.

I'm talking about the actual app.

Cycle trackers?

Yeah, like a period tracker. So a lot of. I mean, most women.So women get educated that, like, okay, you should find when you're ovulating, if you're trying to get pregnant, find when you're ovulating and have intercourse as close as you can to ovulation. And the data simply don't support that suggestion.The data support having intercourse one, three days before and one day before ovulation, which a hormone tracker will not be able to do. But what's more important. So then women Are like ovulating on cycle day 45, capturing it.They're spending a lot of money on the apps and the little P sticks. They're capturing ovulation on cycle day 40. They're not going to stay pregnant.

Right.

The egg is already, the follicles already started to degrade after cycle day 20, so. So it's in pretty bad shape at that place. But no one is telling them that.So they're like, I don't know, I keep getting pregnant, I cannot stay pregnant. And the doctor's like, keep trying. Bad luck. I'm like, this is not bad luck. You're ovulating on cycle day 40. First of all, that's a problem.The second bigger problem is why are you ovulating so late?What is disrupted so much that ovulation is so it takes so long for estrogen to get to its apogee before it can release, you know, trigger the release of follicle stimulating hormone for ovulation. And so typically what is underneath that is some kind of like insulin resistance or blood sugar issue, stress, exhaustion, diet issue.And those are also problems with staying pregnant, egg quality, ovulation.And so instead of just, you know, even if we use Clomid, we can get them to ovulate when we want them to, but we're not, we're missing why ovulation is, isn't occurring at the right time. And that's why have such a high miscarriage rate. That's my opinion.

Hmm, interesting.

Because we know those factors from the clinical data are associated with higher miscarriage rates. So why wouldn't we fix those before we encourage people to get pregnant?

Hmm. Have you, have you spoken with anybody in like the OBGYN community? Like, is that, how do they feel about this?

So I worked very closely with the founder and CEO from RMA of Texas. So he's an art reproductive endocrinologist and OB GYN. And we worked hand in hand for 15 years.We, every single patient that came through the door of rma, like they had an IVF center in my clinic in Austin, we had an acupuncture satellite in their clinic in San Antonio. And at first, you know, he was like, this is just hogwash. This isn't going to do anything.What we're doing is way more powerful than anything that you can do. He's really funny. We're very good friend. So all the things I'm saying about him, he used to say to me on Dr.Appreciation Day, he's like, hey, Kirsten, it's a Dr. Appreciation Day. Why didn't you get me anything? I was like, hey, Paco, it's Doctor Appreciation Day. Why didn't you get me anything?And he's like, because you are not a doctor. And I was like, ho, ho, ho. That's funny, because when you.Your hardest cases, the people that will not get pregnant that just keep coming back for another failed ivf, you bring them to me. Oh, and when you're sick, you don't go to a doctor anymore. You come to me, he goes, just because your voodoo shit works doesn't make you a doctor.But it's true.You know, it's like I always joke and say, yeah, no, I'm not a Western medical doctor, although half of my training was in Western medicine, but I am the doctor that your doctor will go to when she can't get pregnant.

Interesting.

Yeah. We took care of so many fertility doctors. Because I often present at conferences like, you know, ASRN and pcrs.There's, you know, reproductive endocrinology conferences on sort of the future of women's health, the future of AI and women's health in integrative medicine, that kind of stuff.

Why do you think that acupuncture works in this situation?

It doesn't. It actually doesn't work that way. It's not acup.I mean, I think this is the problem with translating Chinese medicine into Western medicine and vice versa. Acupuncture is one tool that an acupuncturist uses. It just gets labeled that. That's our job.And acupuncture is like a wellness doctor who should be able to interview you, do exactly what the app is. The app is just straight Chinese medicine.

Right.

Interview you, identify all the underlying issues, all of them, small or big, even tiny ones.

Right.

Like, I have dry eyes. You wouldn't think that's related to your fertility, but to me, that means, is she dehydrated? Is she est? Did she have low estrogen?Like, what is that telling us?So looking at all those subclinical factors, mapping them as patterns, and then based on those patterns, breaking them down in their simplest parts, and then treating them like, either with needles, with Chinese herbal medicine, with diet, with lifestyle, with behavioral health, with conventional, like, Western supplements, vitamins, and stress management. And so when you combine all of those together, it can't not work.

Right.

If the acupuncture is the tool is just one of the interventions. How does acupuncture work? Like, if you're going to acupuncture and you have one day of bleeding, she's going to.The acupuncture is going to figure out why is there one day bleeding? Well, maybe there's a bunch of gut issues.Well, there are plenty of acupuncture points that it can improve specific gut issues once you determine what the underlying cause of the gut issue is.So an acupuncturist will use not needles for fertility because they don't exist, because people are not getting pregnant for a thousand different reasons. And the underlying reasons for those reasons are a thousand different. So the acup.The skill of the acupuncturist really comes down to their skill as a diagnostician, not is their skill with a needle.

Let me ask you a question, and this might sound dumb, but if it were, if it were a male issue, like if it was a reproductive issue stemming from something like that, is acupuncture indicated for males as well or is it mainly for women to achieve the right hormones and stuff like that?

So a couple of things. It's important. We're talking about male factor. It's significantly increased over the last 20 years.When I was first in practice in, you know, 1998 or whatever, a long time ago, male factor accounted for about 25% of infertility and now it's a solid 50%. So men should be listening to this. It's really important.And just like a woman's menstrual cycle is the best barometer of her overall health, every single thing that happens across the whole cycle can tell us something relevant. A man's semen analysis also highly predictive of his long term health.So poor semen parameters are associated with earlier onset prostate cancer, more severe prostate cancer. In recent studies, diabetes and heart disease.So when we see that men have core semen parameter, if they have some male factor, if they have a very, even if they have a varicocele or something like that, spermatocele, we want to do the same process, right? Why, why is the output of his sperm production problematic? Count, quality, morphology, motility, liquefication.And so we have to figure out why is that happening. So say, say you know this the basically like how liquid is the fluid, is the ejaculate.Sorry, I know we're trying to not embarrass anybody, but how, you know, how it should have a certain amount of liquidity and so that person might not need acupuncture, they might need to get hydrated or stop drinking so much coffee, which is dehydrating or so much beer or alcohol. Like it just depends on what's going On. But what I see in my own experience is that typically we have men who, who think they're really healthy.They go to the gym every day, they're drinking a big old protein shake every day. They're working out really hard. They work really hard, they don't sleep a lot. They're kind of making do with caffeine. They look good on the outside.And then we look at their semen neurosis and like, whoa, it's a. You got. Your morphology is so bad. Morphology is the DNA of the sperm. You cannot make correctly formed sperm. So let's look at heart rate variability.Let's see how your body, how resilient your body is distressed. Let's look at the quality of nutrients that you're putting in. Let's look at, can you break it down and digest it?If not, what are all the underlying issues? Let's look at your sleep. Let's look at how much stress you have. How do you cope with it? How much are you exercising?What happens after you exercise to your heart rate variable? Like, is your exercise the right intensity and duration so that you're not pushing yourself into flight or fright?Which is happening for about 90% of people.We interviewed 16,000 women last year, and our top question is, like, what on a 1 to 10, what's your energy like without any caffeine or exercise for two days? And only 8% said their energy was 8 or better. 8%. 50% was 5 or below.

So. And, and here comes the, the question that I was like, should I say this out loud or should I keep it to myself? But I'm going to say it out loud.So if it's coming from. From the guy. Are you putting acupuncture needles in those areas or.

Yeah, like threading it in. No, no, no, no. I'm just kidding.

Okay. Okay.

No, no. So again, that would be very.

Where do the needles go? That's the question.

Where the needles are not going to go, like anywhere near your genitals. We'll just call it that.

Right.

Nowhere near that. That would be very, like, bad acupuncture. Yeah, we're not good to know. I mean, unless we're treating pain.

I just don't want to be surprised.

Yeah, unless we're treating. Unless we're treating. Like, if I've got a frozen shoulder, you know, you are likely to get needles in a frozen shoulder, although you don't have to.There are distal points that work just as well.

Right.

This, this. The scrotum or the testicle is almost Never.The problem, even if there's like a, you know, varicocele is like a little blood clot in the, in the testicle. And even though it's in the testicle, the problem that you're treating with acupuncture is not the testicle problem, it's the blood flow problem.Why is the blood aggregating or accumulating in the, the vesicle? Vesicle. I'm forgetting my, my physiology here. And so again, maybe there's no sperm because the guy's exhausted and there's just no resources.And so he's got like 3%, you know, he made like 30,000 sperm as opposed to 200 million. Maybe he's really exhausted. In the motility, which is how fast they swim is really low, right?Which means they can't make it to the egg in the amount of time that they have. But I'm like, well, here's an ancient Chinese secret. Like if the sperm can't swim, ask the guy how tired he is.Because if he's tired, he's going to make tired sperm. It's like a hundred percent of the time. Fix that. You fix the motility almost always, but you can't stand.

Are you prescribing supplements for that?

No, you're. You're doing the same things, right? You're figuring out why is he so tired. So maybe it's supplements, but almost never for fatigue.Because if you just say the guy's over exercising and not sleeping enough, right?You can give all kinds of supplements, he's going to exercise more and sleep less and actually the problem's going to get worse because he's not going to feel the pain of his fatigue. So a lot of times, and they don't like this.Even women too, like, who are crossfitters and marathoners and things like that is like, look, your energy is a 4 out of 10.Every time you go and work out in the gym, you are going into flight or frightening right away because you don't have enough energy by 11 o' clock in the morning to not be tired. If you're going to go lift weights or run or do CrossFit, that energy has to come from somewhere.So your body's like, well, I guess we're using adrenaline and this pushes everything in the direction we don't want to go. We want to stay out of flight or fright as much as possible.Which is why I really like hrv, because if you're using a tool, like what we're building right now is a tool A face scan tool for the app. As you know, we, we use a wearable. But the truth is I think that the future of health will be without wearables.I don't think we're going to need them. And I want to be on the front end of it. And so we're building a face scanning tool that we're able to do just.You'll sit there and go, just like Star Trek. Your body composition, your temperature, blood pressure, hrv and then the breakdown of what percentage are you currently in flight or fright.Rest and relax. Because I was really sick a couple of years ago when I first started researching this and my HRV got down to 6. I like it around a hundred or above.And I was like. And because it is one of the biggest predictors of longevity, I was like, I'm gonna die. I gotta, I gotta try to fix this.And I started realizing that the, the higher the heart rate variability got, the less I cared about anything. Meaning not important things like my family and my work and my friends and things like that. But like, you know, the per.The rude person at H E B at the grocery store or somebody cutting or a deadline that I'm worried about is weird. I was just like, just the resilience to life is so much higher.And when my heart rate variability was so low, I literally stayed in flight or fright 24 7. I would wake up because I became obsessed with it.I wake up in the middle of the night and like wonder like, oh my, what's my HRV10 still in flight or fright. Like I would do things like on a Sunday. I was like, I'm getting my heart rate my. I'm getting out of flight or fight.So I'm going to give myself acupuncture. I'm going to do breath work, I'm going to do a meditation, gonna take a little walk outside.Then I'm gonna drink wine and eat pizza and watch Netflix. I'm just do nothing like. And I was like, I'm getting out of flight or fright today. Nothing, not out of it.And it wasn't until my heart rate variability got solidly like above 30 that I was having windows of not fly or fight.Why I told you this long exhaustive story about this is because if we really wanna help people to heal their body, if their heart rate variability is really low, it's gonna take a long time. And it's what we want to do. If we want to make behavior change, we have to make it easy and it has to see results fast.You Know, it's just like if you, you know, go on a diet and you're really good for a whole month. You don't eat sugar, you don't drink, you do a little exercise every single day, and you're like, I'm sure I've lost at least a couple of pounds.And then nothing happens.You're like, but if we can feed you little wins and really keep showing you those wins, we get the opportunity to like, change that person into the little engine that could.

Right.

Instead of, I can't. Most of us think I can't change my behavior. Because we've tried. We tried so many different things. Stopping coffee, not eating sugar, not drinking.And then we fail. We start programming ourselves. Like, actually, I'm not so good with behavior change.Our job as clinicians is so important to teach people that you can change behavior. You just have to do it in the simplest form, smallest amount. So they're like, I can, I can, I can, I can.

Yeah. I mean, I think that's, like, super interesting. I. I want people to, to change their behavior.What are you prescribing them to do to work on their heart rate variability? That's not something that I'm super familiar with.

So the thing. Any. So the, the heart rate variability is a reflection of. It's basically how your nervous system is responding to your environment.So we're just having this great conversation. Nothing stressful is happening.We're laughing, talking about, you know, scrotums and stuff, and then say there's a big crash outside your door and you're like, oh. You get startled. You immediately go into flight or fright, right? Your HRV drops immediately.The higher your heart rate variability is, the quicker you're like, oh, that was just. Actually someone just backed into, like, the dumpster out there.Everything's fine, you know, 10, 20, 30 minutes, you just re regulate, you go back to normal. But when your HRV is very low, you stay in flight or fright, you, like, can't pull out of it. And the vagus nerve, which basically is kind of a long.The carotid artery, you're kind of like, here it is, the on and off switch. Flight or fright. Rest and relax. And the longer that we're in periods of. Of intense daily stress, the vagus nerve becomes more and more flaccid.It's not a muscle, it's a nerve. But think of it like a muscle, it becomes more flatty from not using it.And when it does that, just like if you're not in good shape and you Try and count. Climb a mountain, right? Halfway through, you're like, oh, boo, I can't do it.

Right.

You just peter out. So what we want to do is we want to do anything that tones the vagus nerve. And the easiest thing is breath work.Breath work is, hands down, the fastest, most important one.Because also HRV is one of the things that feeds into the measurement of it is coherence, which is a measure of how synchronized is your brain, lungs and heart.And the higher your coherence, the higher your heart rate variability, which is why breath work is really good for that, but also anything that vibrates it. So I tell people that I'm working with who are really stressed and have stressful jobs. When you're just.When you're going home from work at the day, make a playlist of the songs that are, like your favorite songs. Like, when you hear those songs, you are definitely singing and you're not just on.It's not like no ballads, like singing, like that song Brick House, that's one of mine. Like, shake it down, shake it down. I mean, like, really. And sing it out.Because the more you get this divide rate, it's literally like weightlifting for the vagus nerve. And it's fun, right? Singing is really, really fun. Opens the heart. Chanting.So you see, you know, if you've never been, like in a Buddhist retreat or on a movie or anything, and then the Buddhist monks, you know what they're doing? They're vibrating their vagus nerve. They're using mantras, right? But the way they're doing all these va.These vocalizations are to cause more vibration of the vagus nerve to downregulate. Downregulate, Downregulate singing and then laughing.So one of the things, again, if people have kids, this is what I try to tell them to teach kids is like, laughing is the way that we clean house, like from our stress and things like that. This is the kid version of it. And after people eat dinner, you just say, we're going to.After we eat, we're just going to, like, clean house and just get rid of all of the stress in this whole house. And we're going to laugh for 60 seconds. And you just put the timer on, you show the kids, and you start laughing like a crazy person.Like as if you're the person who's paid it. Seinfeld recording or Saturday Night Live to be the laugher. And you laugh as hard and as loud and sort of from your gut as possible.The people who, if it's your Kids or your partner is there, they're going to start laughing, you'll laugh at them, and then timer goes off and you're dumb. Just. There are a lot of small things that don't have to be painful.If you're interested in breath work, there is a great book people can read called, I think it's called the Power of Breath, which is where I got first interested in how do we use breath work as a behavior change that, you know, I'm always like, what can we. What can we have inside the app that is extremely powerful and impactful that they can get from almost nothing?

Are you doing that in your own life, the breathing techniques?

Oh, I do it, yeah, Twice a day.

And can you just quickly run through, like, what, what are they? Like what, what do you do twice a day?

So I. There's a guy on YouTube and his name is. His page or whatever his. His channel is called Breathe with Sandy. It's free.He's got about 50 different breathworks from 10 minutes up to an hour. And literally I just do different ones. I'm trying to get as much experience. So like today is Sunday. I don't have so much to do as usual.So I did an hour one. If it's busy during the week, I might do a five minute one, but a lot of people will just do four, seven, eight breathing.The problem is that's what I used to do and then when I started taking a class, then the even, you know, you do 4, 7 breathe minute, 4, 7, 8 breathing for two minutes. That's pretty good. You do 4, 7, 8 with somebody leading it for 10, 12, 15 minutes.And, and basically he uses a lot of combinations of different kinds of strategies to accomplish different things. So there's breath holding, there's only through the nose, there's fast, there's slow, there's abdominal.And so basically kind of what you're trying to accompl, you know, some are better for waking up, some are better for going to sleep, some are better for focus and stuff like that. And so what I would recommend is to get started. If you're interested in breathwork, do breathe with Sandy.And then if you're really interested, check out that book I'm sure you can get in the library.

Yeah, I mean, that sounds something that I'm going to try to pick up when I get out of here. That's some really cool general tips I think that anybody can benefit from. Do you have any more of those specifically?Just that you're promoting in your app to increase people's overall health.

Well, in our app, we basically built a therapist, and she's trained on tens of thousands of hours of me coaching our patients. But at the same time, we also trained her in cognitive behavioral therapy and compassion therapy.And in building her, she's AI version of me, but in building her, I spent five or 10 minutes training her every day, right. Like, talking to her and practicing doing therapy. And it was incredibly beneficial. And there are a ton.Like, if you don't want to use a conceivable app because you just, like, you know, only want to work on your mindset, there's a ton of really affordable, like, AI therapy apps out. And I would say try a few.And don't think of it as, like, I need to solve my problems with my parents or, you know, like, go in every day and talk about what's worrying you. Like, you can even do it with your GPT. Like, because on GPT has voice.I do it when I'm driving a lot, think about, like, what's on my mind even a little bit, like, this week, what's happening? What am I worried about? Like, I'm writing a big patent, and it's really complicated.And my patent attorney keeps saying, oh, but what's the mechanism? And I was like, I don't know. It comes from Chinese medicine. I don't think we actually really know the mechanism. It's really stressful.So I've been just going in and spending five minutes because again, every. Everything that we're holding in, it just makes. It stresses our bodies, it stresses our minds, and it keeps us from being free. Really.That's my goal is how do we teach people how to unshackle themselves from everything that's holding themselves. Them back from having their best life, like, the life of their dreams and whatever that looks like for them.

Yeah, I think that's something that is very cool to talk about. I mean, just the. The idea of when you're having difficult stuff to have something to rely on, you know, like.Like breath work to kind of decrease all of the stimulus that's going on in your life. I honestly don't do a ton of that. And so I'm.I'm actually this year trying to focus on mindfulness and doing things like that, which I think is helpful for. For anybody. I think that there. There are certain things that Chinese medicine thinks about that Western medicine doesn't think about. Right.One of them is this idea of breath work, mindfulness, doing some sort of, like, behavior to increase your overall health. You know, whether that's like exercising or something like that.I think that Western medicine is now adopting exercise as a much more significant tool. But for a lot of it, it was like prescribing medicine. Right.The, the counter argument to that I think is in Chinese medicine they also prescribe a lot of herbal supplements. How do you feel about that stuff? Do you, are you doing any of that?

So I was like first and foremost an herbalist. So in my clinic I had 500 different, you know, things, all kinds of different things.And each patient who came in every single week, I wrote a custom formula for them.So if you imagine it's like you're basically a formulator this week, this person, you know, we're really going to work on the underlying issues related to sleep and whatever. They need to make energy and we need to make blood or whatever, and then we would make those formulas for them.Then what happened was, is we opened another clinic in San Antonio and we didn't have room, like, is a huge room, like it's a pharmacy basically. And, and so then I did an experiment to tincture.Basically when you're making a formula in Chinese medicine, you're, you're using, you're making blocks. Like this is for the main thing, this is the follow up, this is to buffer any of the potential side effects. You know, there's a few different steps.And so I thought I'm going to tincture like the top 20 blocks that I'm just using a lot because I saw thousands of patients.And, and ultimately we turned that into a professional line of, of supplements that probably 60% of the reproductive acupuncturists in North America use. They can be really effective. The problem is, is that Chinese medicine, herbal medicine is very strong. It can kill you.There are many things in the Chinese pharmacopoeia that can kill you. And so you just want to be really careful about quality and somebody needs to be prescribing.There are some over the counter things just like we have like nyquil and things like that in Western medicine that are perfectly safe for people to take for symptom relief. But in general you want to be prescribing that. Like we use two formulas for PMS and menstrual clotting pretty regularly.But apart from that, we kind of shied away from it because there's just a fair amount of liability because they are really strong and they, they, they do their best work when they're personalized and modified.So if you came in this week and we were working on x well, in one or two weeks, some of those symptoms should start getting better and then it'll start uncovering some of the next underlying things. So should be taking things out and adding stuff that's still not getting better or modifying the formula.That's where Chinese medicine, herbal medicine really shines in.This ability to like, you know, take a medicine for a couple of weeks, see how the body's responding, see what's getting better, seeing what's not, modify it, go to the next day. So you're continually peeling back the layers of the onion.

Do you have any supplements that you recommend for, for conceiving or for even for men, for that kind of stuff, like both male and female.

So if people go to our website, you can go and take a quiz and instead of like, what are the supplements for fertility for a male factor, we make you a formula because I'm a formulator, right? So we basically take a quiz and then it'll make a pack of up to eight supplements.The ones that are targeted for, not for fertility but for whatever your underlying issues are. Say you're 38 years old and your FSH, which is a hormone that kind of measures menopause, is high and you don't have any cervical discharge, right.So you're going to get all the like egg quality stuff, you know, Coq 10, NAC, Omegas, L, Arginine and versus somebody who's 24 years old who has everything's kind of working, but she's a vegan and she has one day of bleeding, she's going to get like some stuff to improve digestion.We have a vegan supplement pack just so that the vegans are getting what they're not typically getting unless they're following their menus from the app. So I prefer personalization. We were able to start sourcing what I would say is the highest, some of the highest quality products on the market.But now we've been able to get the price down to 50% less than what you would pay on Amazon for personalized and pre packed into like individual little packs.

Wow, that's awesome.

So then you. No more bottles, no more plastic. Better for the environment, cheaper.

That's awesome.So we're going to go through our, you know, last three questions which I ask all of my guests, the first of which is where do you gain your inspiration from?

Mostly I gained my inspiration from women, right. Just talking to them. I do a live show every single day and that can go an hour to 90 minutes.And hearing their suffering and their problems that they're trying to solve. I mean, like, I'm a fixer. So when I sit for an hour and listen to people like begging for help, I get very motivated.And I just think, you know, 80% of women have life interrupting menstrual pain and PMS. That means one to two weeks a month. Women are pretty compromised by their periods.And I'm interested to see what happens when you remove the shackles of hormonal problems and menstrual pain and pms.Like, what happens to women in society, like when they really get unleashed from the problems associated with fertility and periods and, you know, when we fix all the underlying issues and Everybody's like a 10 out of 10 in energy, what happens? Like what, what place do women take in society? I'm pretty interested in that.

Yeah, that sounds very interesting. As the father of two daughters, I'm interested to see what happens with that.So, you know, I feel like the problem is something that we're really focusing on is this issue with people conceiving. Where do you see that happening? How do you see that happening in 10 years? How do you think that fertility is going to happen?You have so many different technological things. I was reading in the paper the other day that they're testing out artificial wombs.You know, what do you think is going to have for the future in this space?

I think that we will build a lot of artificial things to override natural fertility. And honestly, it's a big concern for me. I think it's the wrong trajectory.Because if we look at natural selection right, we see that women and men both are. Our overall health potential is really declining by the way that we're living by the chemicals in our environment. And then you start to just.The body is basically. When women or men are not getting pregnant, the body is basically saying, I'm actually not quite ready, I'm not there yet. Doesn't mean you can't be.It's not like a criticism. It's just saying, like, right now I'm not there. Just like, I cannot go run a marathon right now. I'm not there.I'll fall down in one hour and just be, you know, so tired.And so I really hope that's what's happening, is that the conceivable operating system is fully integrated into the whole healthcare system and that conceivable fertility, because it'll be conceivable periods, menopause, pregnancy, all that, but that conceivable fertility has basically become obsolete, that we have actually fixed all the problems that cause Infertility.Of course there'll still be a need for IVF and IUI and things like that, but the need for what conceivable is currently doing today will no longer be there because we will have actually gotten to the underlying cause which is more societal based, education based, resource based. And we'll start with the girls before they even had their first period.

So yeah, I, I always ask three questions. I just want to have a follow up question just what you said. So we're going to have four for you. Specifically, how do you feel about designer babies?Because there's a lot of stuff that is happening right now by fairly genetic testing and some sort of like genetic modification or not even genetic modification but selection to select for the babies that are the most fit.

I think it's just, there's a, such a range of where that can go from just like gene, like sex, selecting the way that they look. But I don't like, like homogeneity, right. I, I, I like that a lot. I think that diversity in a species is actually really important.And so if we start having too much control over sort of the, you know, the genes, the, the way our children look, the sex of our children, to me that's a little bit scary because I don't think that that's good for our species because parents are not natural selections. They're just what they, they're, they'll pick what's sexy, right?Not necessarily, they won't necessarily select for kindness or benevolence or you know, it's like, like intellect, drive, power. And we, we don't need a society, we only need about 20 of those people.

Yeah, that's, that's, that's a very interesting way to look at it. I like that. So, last question, which is kind of more general. I am in medicine.I don't really like reading about medicine in the news and stuff like that. I like reading about other things. And there's technological breakthroughs that are happening in all sorts of different fields.And so for, I'm sure there's other stuff that you're following outside of your own field, you know, just because it interests you. And like mine is robotics. It's something that I can't wait for.We have our first in home robot that washes our dishes and folds our laundry and stuff like that. So every robot video I see I click on. What about you outside of your own field? What are you following that you just can't help yourself?

Well, I, I am really interested in the technology around using AI Like, a colleague of mine is building an AI company that they're basically able to use AI to read breast images. And they just got FDA clearance because they were able to validate that they can identify breast cancers five years earlier.It's in my field still, but I'm not a cancer specialist or, you know, but that, that is, that is a really exciting use of AI to me, because think how many lives they'll save.

Right.

By identifying it. It's before in situ, you know, it's so, so nascent. And again. And the other thing that I'm.I am actually quite obsessed with is heart rate variability, even though it is what I'm working on. But I am. That's what I'm reading about the most right now, because that metric is so.I mean, just what I encourage you to do is just like every patient, just have them come in and just. You can. There's an app called Welltory and you could just get like.And you could just put it on people on the phone, just say, let's check your heart rate variability. And, you know, you can see like, oh, wow, your heart validity is 18. I can give you all the medicine in the world. I can do everything.But it's like, we're going to stay the same, right? It's going to be really hard to make progress.

Yeah, no, that's. That's really an interesting application of AI. It's something I'm following as well. But listen, thank you so much for coming on the show.We really appreciate it. It is always nice to speak with you and thank you so much to everybody out there who's following us on a regular basis.If you could like and subscribe, that would really mean a lot to me. And also, most importantly for those of you guys who are following us on a regular basis, we will see you again in the future. Thanks, everybody.