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Biohacking: Fad or Future?
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It sounds very 21st century, doesn’t it? BIOHACKING. While the word itself may be modern, the practice of self-experimentation is not. History is actually replete with examples of individuals who decided to cross boundaries and explore the outer limits of innovation. The relatively recent convergence of certain powerful concepts and factors—personal data, affordable technology, a flowing tap of information resources—has propelled us into a new era of citizen science. Is it here to stay? Listen now!
James Maskell: 00:07 Hello and welcome back to the Big Bold Health Podcast, making health personal in a world of disease. We have been talking over the last few episodes about this shift from a disease-centric health model to a focus on health. And, if you were to sort of step back and think, “How have I come across this idea before?” you may have come across it through the guise of biohacking. Now, we wanted to spend a little bit of time talking about biohacking in this episode. Jeff, is biohacking, it’s sort of this N equals one experiment. It sounds a lot like what we’ve been talking about, and I guess I’d love to ask you, is this the future, the beginning of the future of early adoption of the future of this health system, or is this just a passing fad?
Jeffrey Bland: 00:53 Well James, I think the question you’re asking is a very important question about where innovation and discovery emerges and how it gains stickiness and ultimately grows up to become the standard of identity. And, we’re witnessing that transformation right now in healthcare. It’s an unbelievably dynamic time where ideas that would have been just rejected out of hand 10 years ago are now being seriously considered, because we’re actually seeing some of these ideas being less ridiculous and more actually the future of where we’re going. So, where does this all start and how does it relate to the process, the discovery? And I would take our Big Bold Health concept back in my examples of which we could probably find many, but one I would like to talk about are the Goldbergers, the husband and wife team that worked for the Public Health Service back at the turn of the last century, in which they were infectious disease specialists.
Jeffrey Bland: 01:44 And so, they were asked if they would go down to southern United States, the Appalachian area, and they would try to understand the origin, the infectious organism that produced this disease called pellagra, which was thought to be caused by an infectious organism. And, it was centered every fall people would go into the mental institutions with this disease because its three symptoms where the three Ds of dermatitis, diarrhea, and dementia—three Ds. And, it was thought that some infection caused these three Ds to occur. So, with their training and they went down there to find the organism, and after studying it for a year or two, they came to the conclusion that it didn’t seem like it was actually an infectious disease at all. It seemed like it was something else related to a nutrition problem. Because, the nutrition of these people living in Appalachia; they were very poor and it was rural, and so their foods would change based on what they could grow on the land. So, in the fall when they had kind of lost some of their foodstuffs and they were a more deprived diet, this condition would start to appear.
Jeffrey Bland: 02:54 So, they became so convinced that this was a nutrition problem—and I won’t go through the whole history, let’s just cut to the chase—that as biohackers, and I’m using that term advisedly because they were not probably called biohackers in the 1920s or ’15, they decided they would actually go themselves on a nutritionally deprived diet, or they would even take the blood and the skin scrapings from pellagra victims and inject and ingest them in their own bodies to show that they would not produce the disease. And lo and behold, they could, first of all, be exposed to these materials from other pellagra victims and not to get sick, but if they went on nutritional deprivation, they would get sick with the three Ds.
Jeffrey Bland: 03:39 And, they then did a study with a variety of inmates in the Illinois penitentiary system back then, that were able to show that when they were put on a deprived diet, they would get these conditions. They would then take liver, beef liver, and squeeze it through cheesecloth to make a liver juic, and they would feed it to the individuals and they would get cured.
Jeffrey Bland: 03:57 So this, this biohacking concept, which no one had thought was reasonable, that was completely thrown out… In fact, in 1936 our own government had the Pellagra 2 report, this is some 15 years after they made these discoveries about pellagra as a nutritional deficiency disorder and it could be treated with liver, in the 1936 report of our own government, they only had a small italicized reference to the Goldbergers’ work, and they said it was an infectious organism that was in certain families based upon their genetic susceptibility—15 years later. So, old ideas die hard, don’t they?
James Maskell: 04:33 They do.
Jeffrey Bland: 04:33 So let’s move forward to today. So, as we move forward to today, we can see examples, this H pylori infection, and esophageal ulcers, and gastric ulcers were also associated with stress. And so, people were on these anti-stress diets, and milk diets, and taking antacids, and the H2-blocker drugs. And then, this family physician in Australia said, “No, I don’t think it’s caused by stress and by erosion from stomach acid. I think it’s caused by an infection with an organism.”
Jeffrey Bland: 05:03 And, he and his buddy who was a pathologist put together a lab in his garage, and they started looking at the microscope and they concluded there were these little organisms that later to be called Helicobacter pylori, which they felt was the cause of this epidemic of gastric ulceration.
Jeffrey Bland: 05:19 And, the drug companies didn’t like this because they had developed all these drugs to treat hyper-acidity, the Tagamets of the world. And so, he was just kind of ridiculed and said no, so he was so committed as a biohacker to that idea, that he cultured up these organisms, and he ingested them, and produced in himself gastric ulceration. But then, the problem is that there was no known treatment for the condition. Now he’s sick. So then, he had to develop a treatment, and he used what was later to be called a triple therapy of antibiotics to treat it.
Jeffrey Bland: 05:48 So, this is another example of how a fugitive idea—that didn’t come from normal standard linear sequence research, and was a fugitive outside—and people that are willing to can really biologically hack, biologically experiment, sometimes at their own peril, I might add, to see what worked.
Jeffrey Bland: 06:07 Now, does this mean everything should be tried by anybody? Well, I wouldn’t necessarily recommend it because some things can be pretty life threatening, but what it does say is that we’re into an early stage of looking at the human being from a different position. This is what you call is n-of-1 experiment, which is each of us is an individual experiment of life, which there’s no placebo. And, even if we have an identical twin, it’s not necessarily an exact placebo to us, because that twin will engage in other things that we might not do. And therefore, we are our own experiment against ourselves.
Jeffrey Bland: 06:39 And so, how do we respond against what we select to do or are exposed to us over time? That leads us into being able to ask the right questions. How do we measure how we respond to what we’re doing? And that leads into a whole new age of biometrics and analysis. So, I think biohacking is the front edge of how we discover certain things that would not necessarily, through standard research methods come about that we would later see as well, there’s an island of opportunity. We’ve got to really populate that island.
James Maskell: 07:13 So, there’s obviously a range of stories that need to die, right?
Jeffrey Bland: 07:16 Yes.
James Maskell: 07:16 Through this next era, and there’s a range of sort of innovators who are doing this kind of experimentation at this exact moment in history, in this sort of big, bold new era that we’re jumping into. What are some of the most exciting green shoots that you see for the ending of stories that have done us harm as a population?
Jeffrey Bland: 07:37 Well, I think right now the story that has really caught fashion, and I think for good reason, which was a kind of a sidebar for decades—I remember first talking about this in some of my seminars for doctors 30 years ago—which is the so-called ketogenic diet. And it’s been known for oh gee, more than 30 years, that individuals that go on this so called ketogenic diet, which is a lower calorie, higher fat, lower carbohydrate diet that induces in their blood the production of these fat byproducts, these metabolic byproducts, I call them fat debris, called ketones. They have names like acetoacetate and acetone and beta-hydroxybutyrate are examples, that when they built up in the body, they seem to have a favorable effect on brain chemistry. And, this was known in really looking at disorders that related to epilepsy and to seizures, that there seemed to be something beneficial about ketogenic diets.
Jeffrey Bland: 08:36 And it was a sidebar, and when I say sidebar, I mean the major field of neurology did not accept this, and of course, they were as far away from diet intervention as you can probably imagine, but it remained as a viable concept that certain people were researching over the last 30 years. And for again, I think really interesting reasons of the spreading effect of nutrition and its influence on function, and biohackers that are willing to kind of dig in as what are called citizen scientists… Isn’t that an interesting title? Citizen scientists who are individuals that are not necessarily scientists—they don’t have degrees, they don’t have institutional backgrounds—but they’re willing to try things in their own body and they’re pretty good at recording information—because that’s where all discoveries come is good information and recording—that they found when they started to go on these ketogenic diets, that they had favorable effects, and it was producing outcomes that were viable in terms of their health, improving insulin sensitivity, reducing inflammation, improving mental clarity.
Jeffrey Bland: 09:35 So, now we’re moving away from kind of just biohacking frontier with a few scientists that have been keeping this idea alive for 30 years to where it’s now become kind of in the mainstream. And now we’re seeing, okay, who are ketogenic diets really best for? Under what conditions could they be implemented? How do we make them safe and effective? Now we get people recruited into it from all sorts of different disciplines starting to study it, and many of these people saying, “Oh, I always believed in ketogenic diets,” but now suddenly it’s really favorable to study it.
James Maskell: 10:04 It seems like maybe where the biohacking thing goes wrong is that when a biohacker discovers something new in themselves, then the next step from there is to shout it from the rooftops that this is a new truth for everyone, as opposed to the biohacker going through a process for themselves, finding out something interesting about themselves, and encouraging everyone else to go through that process for themselves.
Jeffrey Bland: 10:30 Yeah, and I think that that’s a really important watchword for our Big Bold Health Podcast listeners, is that because it is truthful for one, doesn’t mean that it’s truthful for all. Because of the nature of this personalization concept that we’re focusing on, I’ve often said when I’ve been to seminars over the years—medical seminars, and I’ve been to probably thousands of them over the last 40 years—that I will generally trust and believe that any speaker who’s giving an experience of their own background, that they’re being truthful. I try to accept that as being truthful. That doesn’t necessarily mean, however, that I accept all that they’ve said is available and applicable to everyone. And, science really is valuable for one thing, and one thing only, I think. It’s not a religion, it’s not the reason for being of a person’s life, but it is a standard by which we can evaluate the transferability of an idea.
Jeffrey Bland: 11:27 So, let’s say that you came up with a discovery, you biohacked and came up with a discovery, and you told me and a group of other people about this and the assumption was that it would be good for all of us to do the same thing that you just had observed. The scientific method allows us to see what its applicability would be to the rest of it. In other words, how transferrable, what probability would be that your observation could be transferred to me if I did it in myself or others and I would get the same results.
Jeffrey Bland: 11:53 So, it’s a tool for evaluating transferability. I’m always reminded of this when I think of the development of penicillin, really the first kind of major pharmaceutical in the American pharmaceutical world that transformed all of pharmaceutical science. So, penicillin really, as you know, came about through a whole series of interesting investigations, not necessarily related to drug therapy at all, about mold on bread. And then, eventually it led to the possibility that this was a potential drug. But, if you think about administering by injection, a mold metabolite to a person when mold has always been considered to be a toxin, that mold produces toxins, it’s a pretty dangerous thing to think of injecting this potentially in a person’s blood.
Jeffrey Bland: 12:39 So, how did that actually happen, that penicillin became approved? Because they eventually got an approval for one woman who was suffering from infections of her blood, from just giving birth to a baby, called postpartum sepsis, and that they gave her then this one dose of penicillin, and had it not worked, we would have seen the whole change in the pharmaceutical world, but because it did work and she survived to see her baby grow up, suddenly the birthing of the concept came about.
Jeffrey Bland: 13:09 Now today, could we have done that, what was done in the ’30s, could we have done that experiment today based upon ethics and studies? It would’ve been very difficult to do that. So, what I’m saying is that sometimes when people take risks and they explore the frontiers, it reminds me of kind of technical mountain climbing—from those early adopters came technologies that made available other people able to do technical climbing, that would’ve never taken the risk of the first climbers or the first developers of that sport.
Jeffrey Bland: 13:38 So, I think we’re seeing that right now in, in biology and in health, that there are new things that are being developed that the early adopters are then putting into the scientific method to see if they are replicable and safe for others.
James Maskell: 13:50 Well, that brings up a question, is that, does it matter if it’s replicable and safe for others, if it’s valuable for the person that it happened to and other people can do it? I mean it gets into an interesting argument because you’re talking about what we’ve been talking about all the way along, which is the value of the group, the average versus the individual. And, it seems as though, in certain way, biohacking is antithetical to the old way of facilitating science. But, where does the medium sit for the future and how will we know what is truth?
Jeffrey Bland: 14:24 Well, just a second, I want to play a little exception to what you’re saying. Every bit of new knowledge that has led to revolutionary thoughts, be it the sphygmomanometer for measuring blood pressure, or the stethoscope for measuring heart, or washing your hands as Semmelweiss did as a surgeon to prevent infection in the operating room. All of those came from observation of one person. They were all, in some sense, biological hacking that some person who is a heretic to the standard of identity at the time.
Jeffrey Bland: 14:57 But, the difference was that the way that might’ve been communicated is to say, “Here is an observation I made that seems, in my experience, to be replicable, that when I do this it, I can see it happen in others.” Then it opens the door for other people to see, is it replicable in their hands? And, that is where the rub really occurs. Now, how much do you need to prove something before it’s ultimately adopted, and that relates to its safety. If something is really unsafe, like giving a toxic drug to a person to kill a cancer, you want to be very cautious that you’re going to be getting a good effect on some individuals and not just say, “Well, let’s give it to everybody.”
Jeffrey Bland: 15:38 If it’s however, at worst, going to do no harm, then your standards of evidentiary proof would be much lower, right? So, I think it has to do with assessing relative safety versus risk, and relative value versus just something that sounds attractive to do but doesn’t have a big outcome.
James Maskell: 15:55 Yeah. Yeah. It’s an interesting process of developing new knowledge and yeah, ultimately I’d love to get your perspective on the way that biohacking, as a concept itself, as a way of people sort of entering into these things—the growth of the citizen scientists—how that can be best harnessed for rapidly increasing the knowledge of how we create human health.
Jeffrey Bland: 16:28 Well, I think you just said it and that’s probably the most important takeaway from this discussion, and I would encourage all of our listeners to really see themselves part of this new community of engagement in health enterprise, personal engagement—and we talked about citizen scientists. Any individual who does something that changes the way that they’re treating their body, that gives an outcome that they can measure and they can track it, is involved in a form of science. Science comes from the word scio, to know, right? So, they are learning how to know something.
Jeffrey Bland: 17:06 And, if they’re a citizen, meaning not necessarily a scientist at an academic institution or a doctor or something, they are part of this citizen science community, and it is a citizen science community that is changing the scope of healthcare.
Jeffrey Bland: 17:23 Let me give you an example: we’re associated with a person at Harvard Med school and at Mass General Hospital. He was at one time the chief of staff at Mass General Hospital who was involved with his group in developing the diabetes app for the Apple Watch. And, he made a comment to us at one of our meetings that I thought was extraordinarily insightful. He said, that in one year of people collecting their blood sugar—their information related to their diet and their effects that that had on their function—that there would be more information collected around diet and diabetes than had been collected in all studies that had ever been done in the history of science, by one engagement of citizen scientists with their own bodies and reporting that information.
Jeffrey Bland: 18:08 This is being harnessed right now in all sorts of ways in different types of studies in which people are taking their wearable device information, putting it in the cloud, and then giving it over to big data sets that allow aggregation to produce new discoveries that weren’t before known. This is not part of standard randomized clinical control trials, this is a whole new way of gaining information, and it’s revolutionizing our ability to compress time to make discoveries that are going to improve people’s health. So, that is part of this age in which we live. We are all, in this context, biohackers that are wearing devices and tracking things about our body.
James Maskell: 18:44 And, what kind of data science does it take to really understand that? Because those numbers could be incomprehensible to anyone who’s just looking at it with a brain, whereas maybe to an AI bot, that could be something that could be a very easily turned into actionable information.
Jeffrey Bland: 19:05 You’ve just said it, and that’s the other part of this equation that’s happening simultaneously is the emergence of informatics in handling complex data clouds of biological information or health information. It used to be in my early days as a researcher in the ’60s, we were always trying to make conclusions from too little information. We always wished we could do more experiments and bigger experiments to get more data. Now, the challenge is not having enough data, it’s having too much data, and how do you handle the huge amounts of information that are remaining available through these new types of information gathering technologies. And, that is fortunately we’re seeing the emergence of this informatics where our data can be silently set up to the cloud. The cloud, if we give our permission for our data to be de-personalized—so it takes our name off of it—can be sent over to another cloud to be combined into an artificial intelligence interrogation in which it comes back to us eventually as operative actionable information that makes it very simple, saying, “You should, following this information, do the following.”
Jeffrey Bland: 20:12 That is the revolution of our time, is to have this connection between others in a similar space whose information is being aggregated, that information systems are analyzing, for which then the simplicity—I call it simplexity—comes back to us as actionable information that is meaningful and doesn’t require a sophisticated science degree to understand.
Jeffrey Bland: 20:35 We are witnessing that today. It’s just fascinating to see how fast this is changing. And so, the whole nature of how we create new data and how we understand how to work, operate our body at a personal level is… Well, actually the doubling time is less than three years. So, that means every three years we accumulate as much new information as has been accumulated from time memoriam to today—every three years, doubling.
James Maskell: 21:01 Wow. I’m sure there’s things happening for all kinds of disease risk, but also health creation, many different ways in which people can get involved to participate in one way or another and be part of this next year of knowledge creation.
Jeffrey Bland: 21:32 Well, and I would say the area that you didn’t mention, that I know is very important to you because it is very important, is behavior science. Now, when I say that term behavior science, that might seem like an oxymoron to some people because they think behavior is not scientific, but there are ways of studying behavior using these methods that we’re talking about to develop patterns of understanding, that will help us all to understand how to support behavior changes that are going to be to our benefit, that will make them more easily complied with and more sticky. And, that’s the other part of this research, citizen sciences, understanding the diversity of human behavior, how we can motivate, and support, and ultimately reinforce individuals making positive behavior changes so it’s not giving up those things they love, but rather doing that which really pays dividends to them.
James Maskell: 22:25 Absolutely. Well, getting to the crux of what really makes people tick, finding those things, and facilitating that is where this is going. We’re excited for you to come and participate in whichever way that you see fit. Thank you for another great episode of the Big Bold Health Podcast. I’m your host James Maskell, we’ve been here with Dr. Jeffrey Bland. Thanks so much for listening and we’ll see you next time.
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