After spending 10 years as an Emergency Room doctor and feeling the impact on her overall health and wellbeing of a stressful job that kept her at work for long and unconventional hours, Dr. Amy Killen knew it was time for a change. In the process of making that change and seeing these improvements in her life, she knew that she wanted to go into an area of medicine that allowed her to change the lives of other people. She is now a preventative and regenerative physician at the Docere Medical clinic in Park City, Utah where she uses stem cells, PRP, and exosomes to help her patients with aesthetics, hormones, and sexual optimization.

In this Deep Dive, you will learn …

Who is Dr. Amy Killen and how did you get started (0:18)

• Anti-aging and regenerative physician specializing in skin and sexual function
• Was previously an ER doctor for 10 years and long stressful days led to unhealthy diet and living habits ands wanted to get herself and her patients better
• This led to more energy and healthier habits and she knew immediately it was the right choice for her
• Was driven to teach patients about this and learned before opening her own practice
• She focuses on lifestyle medicines, hormones, and regenerative medicine and starts with the lifestyle medicine component for her patients

What is the difference between stem cells, PRP, and exosomes (9:04)

• PRP – getting blood form the patient, helps heal wounds, very safe treatment, fairly inexpensive
• Stem Cells – already in your body, responsible for healing and renewing tissue, can be taken from where we do not need them and put into where we do need them
• Exosomes – serve as the messengers between cells that get them to communicate, they tell your cells what proteins to start making can be combined with PRP

Recommendations for wellness for a woman looking to spend $10,000 (22:17)

• Structuring life so there is downtime for things like meditation, yoga, or breathing
• Sleeping an adequate amount of time every night
• Stress reduction, which leads to immune system improvement, through meditation and journaling
• Low-glycemic diet
• Exercise through running, weight training, yoga
• Get basic testing done to check hormones, inflammatory markers, basic organ function, Omega 3 levels, B12 levels
• All of this only costs $300-400 and with the remainder would figure out where the problems are and look at stem cell treatment, hormones, laser treatments

Advice for men who want to live better, longer (38:18)

• Stick with the basics
• If you are doing a good job of exercising, sleeping, and managing stress, then you should not have high inflammatory markers
• You may not need to do a lot of the biohacking things like cold plunges, PEMF, infrared, light therapy
• The people who live longest go out and fish every day, spend time with their families, eat a healthy diet, have low stress
• The people who live the longest are the people who do the basic things the best

The procedures Ben Greenfield underwent (45:22)

• He did a full body stem cell makeover roughly a year ago
• It included pulling stem cells from his bone marrow and fat, pulled exosomes, pulled PRP and did injections all over the body
• Injections of stem cells in basically every major joint done by her partner Dr. Harry Adelson
• She did injections in his scalp, face, penis
• Have also done Dave Asprey and Mark Hyman who are both big players in the space
• Cost of the full body is $45,000, but there is a much lesser cost for fewer injections in fewer parts of the body

Memorable success stories (50:22)

• 50-year-old man had tried everything and they used shockwave therapy with him and he called 3-4 months later to say that he had sex with his wife
• It also impacted every other aspect of his life because he was more confident

Dr. Killen’s recent speech (52:50)

• People who have satisfying sex lives with regular sex with people that make them happy, live longer
• Sex is an important indicator of overall health
• Sex is a component of a healthy life
• People don’t talk about how common sexual dysfunction is

Full Transcript

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Dr Amy Killen: So, I’m Dr. Amy Killen and I’m a anti-aging and regenerative physician, specializing in skin and sexual function.

Saad Alam: What does that mean exactly?

Dr Amy Killen: That’s a lot of words, right? So integrated medicine, to me, means taking all different types of medicine, treatment modalities, ranging from traditional medicine to plant-based medicine, supplements, nutrition, lifestyle medicine and kind of putting them all together in a cohesive way.

Dr Amy Killen: And then I also do a regenerative medicine which is using things like stem cells or other therapies that sort of harness the healing powers of your own body to get your own body to heal itself. So basically, it’s using all different treatment modalities to try to get your own body to work at its best and heal itself.

Saad Alam: How did you get into this?

Dr Amy Killen: So I was an ER doctor for about 10 years, that’s my background. I did emergency medicine for 10 years. I worked in really busy emergency departments and it was great. It was an adrenaline rush every single day. And then I had three kids in two years. And I started kind of going a little bit crazy, sleep-deprived, lots of stress, lots of anxiety and was having health problems myself. I was drinking 100 ounces of coke every day, monster energy drinks, just multiple every day just to get through my 10 hour shift and then I would go home and I would just crash and be this zombie person.

Dr Amy Killen: And I was also seeing the effects of chronic stress and health on my patients, the chronic diseases. They’re coming in over and over again for things that really we should have been able to treat, whether it was thyroid problems or obesity or diabetes. And they’re just coming back every month, I would see the same patients over and over again and I would just give them some medicine and I would say, “Try this or try this.” And nothing was helping.

Dr Amy Killen: And so what I realized was that I needed to be able to do something to help my patients get better and get myself better. And so I started reading a lot about preventative medicine which is really what medicine should be, preventing the illness and using the things that we already know about nutrition and stress and sleep and exercise and all of these things that seem so simple. But using all of those in a way to heal my patients and myself. So that’s kind of how I got into it.

Saad Alam: So you basically said, “I’m going to heal myself.”

Dr Amy Killen: Yeah.

Saad Alam: What were the first steps that you took?

Dr Amy Killen: So the first steps I took were learning how to … Well, first of all, I quit the emergency department which was a big step. I’d spent 10 years, that was my identity, that’s who I was. I was an ER doctor and I didn’t know what I was going to do next but I realized that the shift work, the getting up at 3 AM every day to go to work, the sleeping for three or four hours a night, the constant stress of it was a big part of my problem.

Dr Amy Killen: So what I did was I just basically had kind of a game plan but not really. But I just quit the emergency department one day and I was like, “I think I’m done.” And I just walked away. And then I started sleeping which was amazing, sleeping for eight hours a night was something that I hadn’t done in 10 years. And like going to bed at a normal time, getting up at a normal time, having like a morning ritual was something that I’d never got to do because I just go straight to work and then all of a sudden it was like crazy town. So just some simple steps like that.

Dr Amy Killen: And then that led me to have more energy to exercise and eat better and it kind of all fell into place after the sleep component was there.

Saad Alam: How long did that process take?

Dr Amy Killen: I would say a couple of years. But you know, even from the first few weeks, I knew that this was the right choice for me. I already could feel the difference just in a few weeks of sleeping well. And then the stress part is huge, too. When people talk about stress and how it’s so bad for you, but it’s not just bad for you. It actually destroys your body.

Dr Amy Killen: High cortisol levels over time, we know that the chemical is essentially eating away at all different things, whether it’s your hippocampus in your brain affecting your memory, it’s basically destroying all kinds of things including your hormone levels and including your skin and just everything. And so getting the stress down to a level that I could actually deal with it was amazing.

Saad Alam: All right. So you got your sleep under control, you started exercising a little bit, what’s the next thing you said to yourself?

Dr Amy Killen: So the next thing I said was, “What else can I do? And how can I teach patients about this?” And so I learned a lot. I went through several different fellowship programs and training programs and just watched a ton of videos and attended conferences and all of this where I was just kind of self-educating for several years.

Dr Amy Killen: I knew I wanted to have my own practice doing this but you know, I didn’t really know how to do that. So there was a lot of education time spent in that time. And eventually, I opened my own practice, just moved out of state, opened a practice in Portland, Oregon and started doing the basic [inaudible 00:05:06] hormones, exercise, fitness, kind of the basic things. And then from there, I grew into doing regenerative medicine and that’s what I do a lot of today, both of those things. The hormones, the lifestyle medicine, the regenerative medicine.

Saad Alam: And explain to me, what’s the difference between lifestyle medicines, hormones and regenerative medicine?

Dr Amy Killen: So, lifestyle medicine is traditional basically things that you can do as a patient on your own to help your body to heal. So things like making sure that you’re eating the right types of foods whether that’s just low-glycemic foods, low sugar foods or whether it’s certain types of fats or you know, there’s different diets out there.

Dr Amy Killen: But essentially, it’s eating a healthy diet and then using exercise as that part of the puzzle. You know, the sleep part of that, that’s the stress commander. All the things that you can do on your own to heal yourself is considered to me lifestyle medicine.

Dr Amy Killen: And then there’s some other therapies that you have to go get someone to help you with and that’s the regenerative medicine which is like the stem cells, the platelet-rich plasma, the shockwave therapy, the lasers, whatever else you are doing to try to help your body to be better. That’s sort of a second piece or a next level of that health pyramid if you will.

Saad Alam: And then what about the hormones? Does that fit into regenerative medicine or is that something completely different?

Dr Amy Killen: I consider it to be something different. But very important, also, you know, you have to get a doctor to help you with the hormones. Well, yes and no. So you have to have a doctor to give you prescriptions, obviously, and maybe to give you information but sometimes you don’t need prescriptions, maybe you just need information about how to change your lifestyle to make your hormones better.

Dr Amy Killen: For instance, sleeping, one of the big things that happens as you sleep is you make growth hormone, you make testosterone. So if you are a man and you’re not sleeping, you’re probably also not making testosterone, you’re not making growth hormone which are both very important and you can increase both of those just by getting better sleep. So there are a lot of things with hormones that can be tweaked and changed and improved, just from a lifestyle standpoint.

Dr Amy Killen: But then there are some patients who are doing everything right and they still have messed up hormones and that’s where someone like me or one of the other physicians who do this can basically get some testing done and then help them further with whether it’s supplemental recommendations or actual prescription medications.

Saad Alam: And would you say it goes first let’s aim at your lifestyle, after we do your lifestyle, then let’s make sure your hormones are in line and then after that, let’s do regenerative stuff or can the regenerative stuff and the hormones come at the same time?

Dr Amy Killen: It can all come together. I do like to first focus on the lifestyle piece because I think that empowering the patient to heal themselves is really important. And yeah, the information part of it and giving patients information is a lot of what I do. So we’ll have these long sessions, long meetings at the beginning because it’s important to teach patients what they can do to make themselves healthier because they don’t want to rely on doctors all the time because that’s lame.

Dr Amy Killen: But if you can figure it out yourself with my help, then you’re good to go on your own. And then after that, I would say the hormones probably are the next piece, depending on the problem. But regenerative medicine and hormones can come together for certain things. For instance, I have a lot of patients who will come in with erectile dysfunction or sexual dysfunction and we’ll work on all the things kind of at one time. We’ll work on their lifestyle but maybe they also need some testosterone or maybe they also need some stem cell or PRP or shockwave therapy and we can do all of it together for this sort of maximal impact.

Saad Alam: And so when you say you have … Let me take a step back here. Tell me the difference between stem cells, PRP, exosomes. I think right now, people throw them into a sentence very casually.

Dr Amy Killen: Like I just did.

Saad Alam: But you know them. But I think a lot of people just hear it and go, “Well, we can do this and this and this,” and they’re like, “Yeah, I guess that sounds like it’s the right thing to do.” What’s the difference and when do you pull each one out?

Dr Amy Killen: That’s a great question. Also the short version of that question is, we don’t always know what the best modality is or how much better it is than other treatment modalities when it comes to these things. But I’ll give you the short version of what those are.

Dr Amy Killen: So PRP, platelet-rich plasma, is basically getting blood from you and then spinning it, centrifuging it and getting the platelets from your blood which have all these growth factors in them because if you think about if you cut your arm for instance, you start bleeding, right? And the platelets come in and they cause you to have a clot which is the first thing that happens. And then after that, they send out growth factors that are already inside of them to all of the cells around there, to the stem cells that are already in your arm.

Dr Amy Killen: And they say, “Hey, guys, we need some more blood flow to heal this wound, so we need more blood vessels, we need more collagen to heal the skin, we need more …” Like essentially, it sends out signals to all the cells that are already there to say, “Hey, let’s heal this wound.” So that’s platelet, starting that whole cascade.

Dr Amy Killen: So we can use those platelets, the PRP, for all different things in the body. It’s commonly been used for joint pain, for dental problems, I mean it’s been used for years for just kind of improving your own stem cells’ activity. So, I use PRP for some of my procedures. I focus on skin, hair and sexual function. And so I use PRP as a way to kind of communicate or fertilize the cells, the stem cells and other cells that are already in that area to make them more active.

Dr Amy Killen: So they’re kind of like the first level, I would say. Super safe, been around for 30 years, just use the patient’s blood, fairly inexpensive. We can put them almost anywhere.

Saad Alam: When you say inexpensive, what’s inexpensive?

Dr Amy Killen: It depends on where you go and what you’re getting but I would say 500 to 1,000, 1,500 is about average for a PRP treatment, depending a lot on what kind of kits the doctor is using and whether they’re expensive or not, how much blood you’re getting drawn, where the injection is taking place. But somewhere in that range. So not totally inexpensive but less than some of these other therapies.

Saad Alam: All right. And that was an amazing description, by the way. [inaudible 00:11:10] perfect.

Dr Amy Killen: Thank you, thank you.

Saad Alam: All right. So then you got PRP. Then what’s the next step above that?

Dr Amy Killen: So, the next step above that is a hazy step.

Saad Alam: Okay.

Dr Amy Killen: Because it depends on who you talk to. There are a whole bunch of different types of stem cells that can be potentially be used for a whole bunch of different types of treatment. So, stem cells are the cells that are already in your body, they’re in every tissue of your body from your brain to tour heart to your knees that are responsible for healing that tissue, for renewing that tissue.

Dr Amy Killen: So when you mess up your knee, the cells are in there that essentially make more of themselves so that you can heal that tissue. So we have them everywhere. And what happens, as you get older, is you start to have fewer stem cells in certain parts of the body and those stem cells also become less active in certain parts of the body which makes sense, right?

Dr Amy Killen: You think about now if you’re like a 80 year old and you cut yourself, the process to heal is much slower, you’re more prone to get scarring, it’s like this long process, your skin is all crepey. And part of that is because you don’t have as many stem cells that are in there that are able to replicate themselves and repair that tissue. So that’s kind of what’s happening with age.

Dr Amy Killen: What we can do is we can take stem cells from a part of your body where they’re just being stored or not really being used like for instance your fat. You have fat, most people have some fat on their skin, in their body, that are storing a bunch of stem cells that we can take those stem cells and then we can put them somewhere else to make use of them. So that stem cells, that’s a part of how we use stem cells.

Dr Amy Killen: We can also take stem cells from other people so like umbilical cord stem cells or placental stem cells which are younger, healthier stem cells that we may be able to use. With all of these stem cells, the most important thing to remember is that what’s happening is the stem cells are actually still communicating with your own stem cells which is a little bit confusing.

Dr Amy Killen: We used to think that you take stem cells from you fat for instance and put it in your skin and then all of a sudden those stem cells from fat turn into skin. Right? That’s what we kind of through about stem cells. But, what we know now is it’s actually for the most part, it’s not turning into your skin. It’s just talking to the stem cells again that are already in your skin and saying, “Hey, let’s make better skin. Let’s make more collagen, let’s make more elastin, let’s make healthier skin.”

Dr Amy Killen: So it’s all about communicating with the stem cells, with the cells that are already in your body. So whether we’re taking stem cells from umbilical cords, stem cells from your fat, from your bone marrow, from XYZ, all of them, the way they work is they talk to the cells that are already in that part of your body.

Saad Alam: So you’re not increasing the total number of stem cells you have, it’s just telling what you have to work better.

Dr Amy Killen: You might be increasing the number for a while, for a period of time. But at least, with most of the common treatment modalities right now, those cells are not ingrafting into the tissue. So they’re not becoming that tissue if that makes sense which is interesting because one of the things we like about stem cells is that we know that they can turn into all different types of tissue. So it’s like, “Oh, that’s so cool.” I can put them on my knee and they can become cartilage in my knee. And they do have that ability in culture, in Petri dishes to turn into different types of tissue.

Dr Amy Killen: But what’s actually happening in people is, for the most part, it’s signaling your own stem cells and not turning into the tissue.

Saad Alam: So, why do you choose to do fat versus umbilical cord versus something else?

Dr Amy Killen: Oh, it’s a fantastic question. I will tell you that the answer varies depending on who you talk to. Basically, people are just doing what they’re most comfortable with at this point because there are not a lot of studies that are comparing fat-derived stem cells versus bone marrow-derived stem cells versus umbilical cord stem cells versus exosomes versus this. Like essentially, we know that they all seem to work pretty well for different things. But no one has really done a lot of comparisons.

Dr Amy Killen: And part of that’s because these are expensive. It’s expensive to do trials on drugs or on anything and with stem cells, especially if they’re coming from your own body, who’s going to pay for that trial? Right? In the normal drug trials … In order to get a drug all the way through the FDA approval process from the very beginning, all the way through approval is about a two to 2.5 billion dollar experience. Right?

Dr Amy Killen: And that’s great. You get a lot of information, you get a lot of patients, it’s a big trial, it’s randomized, it’s controlled, it’s all these things. But when we’re talking about stem cells derived from your own body, who’s going to pay for that trial? I mean, are you going to pay for it?

Saad Alam: What’s the point even? You pay for it, but would I want to take my stem cells and give them to 30 other people and follow them over the course of two years?

Dr Amy Killen: So yeah. It’s just a lot less information available right now when it comes to regenerative medicine because we don’t have the pharmaceutical money or the device manufacturers’ money to put into the doing of research. So, in answer to your question, I don’t think anyone knows yet what the best types of cells are. Certainly, for instance for erectile dysfunction in men, there are studies that have shown that bone marrow-derived stem cells are helpful. Same thing with fat-derived stem cells, same thing with placental-derived stem cells, same thing with PRP.

Dr Amy Killen: So any of those things can be used. It just depends on sort of what the comfort level and also the regulatory environment.

Saad Alam: What are you reaching for more often than not and why?

Dr Amy Killen: I’ve actually been reaching for exosomes and PRP together and exosomes, which I haven’t talked about yet, I knew you would ask, exosomes are … I call them these little sort of messenger bubbles that you have the whole stem cell and then part of the way it communicates with the other cells, which I told you, is the whole point of getting stem cell therapy is that communication. Part of the way it does that is these little, tiny messenger bubbles of information come off the main stem cell and they float around and they attach to other cells that are already in your body. And then they essentially can get engulfed by your own stem cells and they can program your stem cells to do certain things.

Dr Amy Killen: So, for instance, in the skin, if you take exosomes and you inject it into the skin, what happens is that your own skin cells, your own fibroblast which live there, they soak up those exosomes and then the exosomes which have like the blueprint for DNA, they don’t have actual DNA but they have micro-RNA which is like a blueprint for making proteins.

Dr Amy Killen: The exosomes then tell your own cells what proteins to start making. So it’s like programming your own cells with these other exosomes.

Saad Alam: And so do you need different kinds of exosomes for different messages? Or do you just take one kind of exosome from one cell, multiply it multiple times over and just give it to someone?

Dr Amy Killen: So right now, for the most part, it’s kind of one type of exosome. Just from mesenchymal stem cells derived usually from healthy umbilical cord cells. In the future, and it’s already happening but just not clinically, there will be different types of exosomes for different treatments. Just like we have different stem cells for different treatments.

Saad Alam: And so now, why are you reaching for PRP and exosomes in combinations over a stem cell?

Dr Amy Killen: I do stem cells as well but it’s a little bit more invasive to get stem cells, right? We have to do a liposuction or a bone marrow aspiration and so the person’s going to have a little bit more downtime or pain involved. So I still do stem cells, especially when I’m doing multiple treatments. I feel like if I’m going to be treating multiple things, let’s go ahead and get those stem cells and we’ll use them.

Dr Amy Killen: But if I’m just treating one thing, sometimes I’ll do exosomes because they’re a lot easier and they seem to have the same type of activity and end result as some of the stem cell treatments. We don’t know for sure.

Dr Amy Killen: PRP I use because it’s sort of tried and true. It’s super safe, it’s been well studied, well documented for everything from improving your skin to improving your hair, hair thickness and regrowing hair to improving sexual function in both men and women. So, PRP I just use as sort of my base and then I add things to it.

Saad Alam: All right. And then you use the exosomes on top because-

Dr Amy Killen: I used the exosomes because they are easy and they seem to be very effective. They’re coming from young cells but they don’t DNA in them. So I’m not giving you someone else’s DNA but I am still giving you sort of the power of someone else’s stem cells.

Saad Alam: Okay, all right, that was super clear. And I have to ask you this question because you look wonderful, what are you doing?

Dr Amy Killen: Oh, I do a lot of things. Thank you first of all. You know, everything from sort of the basics, the foundational stuff, the diet and exercise and sleep. Again, I’m a big fan of sleep. I do PRP treatments on myself with microneedling and injections usually a couple of times a year, maybe twice a year. I try to do microneedling just by itself which is like a small little device that has little needles that just go up and down really quickly and it induces collage production.

Saad Alam: Like a Vivace?

Dr Amy Killen: It’s a little different. But, like dermapen, skinpen, you can at a men’s spa, it’s very easy. But I do that, maybe, again two or three times a year. I do exosomes now, injections and microneedling with exosomes at least … I’ve done it once or twice. They are pretty new. Exosomes have only been out for a year in the United States. I’ve done stem cells on myself. These are all things that I’m kind of experimenting on myself but I also do other things.

Dr Amy Killen: I’ve used lasers, I’ve done IPLs to get rid of pigments or I’ve done some fillers. There is a lot of different things that you want to combine or I mean, at least, if you want to have the best result, combining multiple different treatment modalities is the most effective in addition to doing these sort of core cutting edge things like stem cells, maybe just do some basic things as well.

Saad Alam: Now, if you had to choose one thing, you’ve been saving up for the entire year, you’ve got $10,000 in your pocket. How would you spend that $10,000?

Dr Amy Killen: What am I treating? For skin?

Saad Alam: Let’s say you have a 45 year old female that’s a corporate executive that has three kids at home that are between three and seven years old.

Dr Amy Killen: This is quite a story.

Saad Alam: Assume from there. And just a demanding life and she comes to you and she says, “Hey, Doctor Killen, I just want to be better.”

Dr Amy Killen: Just better in general?

Saad Alam: Better, I want to be able to continue running harder, I want to be there for my kids, I want to live longer to see my kids’ kids but I only have $10,000 and I can only come this one time because I’m so busy.

Dr Amy Killen: Okay. Wow. I mean I would probably … Most of the things that I would start with would be free for her. Again, working on structuring her life so that she has some time to herself, making sure that she has some downtime where she can do some meditation or yoga or breathing, some of these things that seem like sort of hocus pocus medicine but are actually legitimate ways to heal yourself.

Saad Alam: So important.

Dr Amy Killen: Yeah.

Saad Alam: I’m so on the same page with you. But, the things you really need to do cost you nothing.

Dr Amy Killen: They don’t cost anything. And I mean, honestly, if you do all those things right, everything else is just like a little bit of bonus. You can still do it, and that’s great and it will help you. But, if you are doing the basics, the free stuff, it’s the most important thing.

Dr Amy Killen: I found with weight and losing weight, for a lot of people, they try so hard, they do all the things, they do all the diets, they do all of this and that. And nothing happens. But, then they stop trying and maybe just start working on their mind, they meditate, they sleep, they work on their relationships, kind of the things that don’t seem like they’re that important. And then all of a sudden, they’re losing weight or they’re feeling better.

Dr Amy Killen: And that happened to me too. I felt whenever I was going through all the stress, nonsense stuff, I was a good 15 pounds heavier than I am now and I mean, I wasn’t eating very much at all. I was just drinking energy drinks all day. And I was exercising. But once I got rid of that and started really focusing on what’s important to me? It’s spending time with my kids, it’s spending time meditating, it’s spending time doing yoga. I love hiking, I go on three or four hour walks sometimes and I just walk around. I call them my walk abouts and I love them.

Dr Amy Killen: Just spending time on those things, sleeping. That part of it, for me, was much more important than what I was eating. The eating was still important but the rest of it was way more important.

Saad Alam: People don’t get it that there is so much stress put on your body and the second you give your mind a little bit room to breathe the right way, everything changes. My father has kidney disease, he’s had it for the past 15 years and he’s like the toughest son of a bitch I’ve ever met. Literally, he should have died, I say knock on wood, 20 times over with how many complications he’s had. And the thing that brought it on, and we saw it, was stress from work.

Saad Alam: And we’re like, “Dad, you got to let it go.” And it was just one thing after another after another. The second he retired, all of a sudden his body has started going a very different direction.

Dr Amy Killen: Yeah. It’s amazing because you know, when you’re in that sort of fight or flight mode, when you have the chronically high stress, the chronically high cortisol levels, you know, cortisol is balancing out with your immune system. So when you have high stress, high cortisol, then your immune system is down here. So it’s low which means that you can’t fight anything. You’re just a total wimp. You can’t fight infections, you can’t fight pneumonias, sinus infections, cancer, heart disease. You can’t fight anything.

Dr Amy Killen: But, when your stress comes down, then your immune system is back up to where it needs to be. So it’s like an elevator and so you got to figure out where you want to be on that. And you know, think about stressors. Part of it, obviously, is what’s happening in the world around you. And some of it you can’t control. But stress is actually the way you react to that. So, you know, what is my reaction to what’s happening to the world around me?

Dr Amy Killen: I can’t control a lot of it but I can control my reaction to it. And so it’s everything from, you know, if I’m sitting in traffic and everything is going crazy, people are honking, what’s my reaction? Is it that I’m going to get super pissed off or is it that I’m like, “You know what? I can’t do anything about this.” And so I think a lot of it is learning to say, “I can’t change the situation, so I’m just going to go with it, just ride it.” And that sort of change in mindset, which I’m still working on, you know, I think we all are, I think is really important for dealing with the things that you can’t actually change around you.

Saad Alam: I never used to meditate and there was one point where I had to let 40 people go, we did like a mass firing and the stress of it was just so much for me to bear, because it sucked taking that many people’s jobs away and I started meditating and I promised myself I wouldn’t. I was like, “Oh, it’s just some foofy, hocus pocus, kind of soft. I’m too manly for this.”

Dr Amy Killen: Totally.

Saad Alam: And then six months in, you’re in, “Man, I feel amazing. Nothing gets to me at all.” And there’s this stomach that you develop which is no matter how … And especially the gratitude journaling as well on top of that.

Dr Amy Killen: Yes, yes.

Saad Alam: Just get up in the morning, you set your mind into the right place and then no matter what gets thrown at you, it’s all right, it’s life. And if you just reframe your perspective time and time again, nothing gets under your skin now. Stressed a little bit [inaudible 00:27:15]. I’m like, “Obviously, things happen, you kind of probably bubble up more than you probably should.” But, generally, once you figure out what that feeling of inner peace feels like and you can figure out how to constantly grow it, I would say that’s like the single most important thing. I couldn’t agree more with you.

Dr Amy Killen: Totally. Yeah, the gratitude journaling is fantastic. It’s actually helpful to just write it out and have it to look back at and just be like, “Oh yeah, last week, the Lyft driver was super nice to me and that was awesome and that made me happy.” Or whatever it is. It’s nice to have that written down. But even if you don’t write it down, I still, throughout the day, I’ll just tell myself, “That was awesome, I’m happy about that. That trash looks really cool in the street, that’s beautiful right there.”

Dr Amy Killen: You know, reminding yourself that, yeah, there is actually a lot of beauty out there that we don’t see because our head is down in our phone and we’re dealing with all the stress of this and the email and this and that. But I think that if we give ourselves the chance to actually look around ourselves, we’ll see that it’s a pretty amazing place and we’re really lucky to be here.

Saad Alam: Yeah, when I started doing the gratitude journal in the morning, for me, my family is the single most important thing and I’m insanely close with them and I started thinking about it. I’m just so fucking grateful for my mom, my dad, my brother, my girl, my puppy, [inaudible 00:28:39] whatever it is. And then I started reading about the psychology behind it and how it fundamentally goes into your subconscious and starts telling you to be grateful for things. And I remember, would have been like 7 o’clock or 8 o’clock and I’ll be working, I’m like, “Man, I’m so fucking lucky that this is what I get to do every day.”

Dr Amy Killen: Right, that’s how I feel.

Saad Alam: You’re sitting here and you’re like, “Fuck, I’m so grateful.” Some people give us a bunch of money to go do this. This is work. Are you joking?

Dr Amy Killen: I know.

Saad Alam: And people don’t get it. They’re like, “It’s fake.” I’m like, “No, no, no. It’s actually not fake.”

Dr Amy Killen: It’s not fake.

Saad Alam: Because once you believe in it, all these other things start happening in your life and they’re like, “Well, then why are you spending so much time on all these other things you’re putting in your body?” I was like, “Well, I just still want to be even better.” And it just becomes this act of being … If you understand that there is no real limit to your happiness and what you can get out of yourself, then you just constantly expand the circle of who you are and then you can rub off on other people.

Saad Alam: These guys were just talking about how they’ve lost … Zac lost 20 pounds since working with us because he started taking care of his health. Zac lost-

Speaker 4: Pretty close to 20, 25. I was over like 220.

Saad Alam: Yeah, it’s really cool once you welcome it into your life. I’m sorry, I took us off [inaudible 00:29:52].

Dr Amy Killen: No, I love that, I love it. It’s important and I think that that’s … I do think that those foundational kinds of things, they can’t be overstated. You know, all the cool technology and science stuff that we have out there that we can use, the stem cells and the nanotechnology and the AI and the big data and al the things that people are talking about in the medical space are going to be the things that change the future. They will. And I think that they’re really cool. But, I still think we have to start with sort of the things that we can do on a daily basis in our own homes, in our own families, in our own communities.

Dr Amy Killen: Because that’s where it starts. And then you add in the rest of this cool stuff.

Saad Alam: Well, we’ll tell you a bit more afterwards. So we interviewed 100 men face to face, then we did 4,000 men, using surveys. And the single biggest differentiator between the guys that looked young and acted young was they thought they were young. And because they thought they were young since they were 20, that same exact mindset followed them and you look at them and it’s just like they look 20 years younger than everyone else. And they had this different way of carrying themselves around life and they didn’t see bounds on the things they could do.

Saad Alam: And you just realized, “Shit, if you just have that when you’re 20 or 30 years old and you make that part of your philosophical approach to life and how you approach stress, it kind of manifests itself into this amazing person at 70 …” We met these 80 year olds and we’re like, “Jesus, they look like they’re just [inaudible 00:31:21] right now.”

Saad Alam: All right. So I’m sorry, so the lady who has $10,000.

Dr Amy Killen: Oh my gosh, yeah. Okay, so, I would start with the sort of self-talk, the gratitude, the meditation, the relationships, have her focusing on those kind of things. Just spending time by herself and with people she cares about is step one. And then I would add in the food. My main focus with food is just a low-glycemic diet however you can get there.

Dr Amy Killen: So, that means low sugar. So low in the things that are simple. The simple carbohydrate low in sugar which … We know sugar is the root of most evil, right? So, some good fats, lots of plants and vegetables and fruits and those kind of things and then low sugar. And then whatever else your sort of idea is.

Dr Amy Killen: And then you know, I think obviously exercise can’t be overstated and whether it’s cardiovascular, getting out and running or weight training or yoga or all of the above hopefully, that’s really key. And then, probably I would have her get some basic testing done to check things like hormones, inflammatory markers, just basic organ function as well as some of the fancier tests that look at things like Omega 3 levels and B12 levels and some of the things that maybe aren’t always done on regular blood tests.

Dr Amy Killen: And see if there is something that needs to be changed in their blood test, that can be easily done. Whether, again, it’s through lifestyle or supplementation or medications. And that’s not going to cost that much. We’re only now at about $300, $400. We still have a lot of money left.

Dr Amy Killen: But then I would use that money to sort of figure out what her actual main problem area is. You know, if she’s got bad knees and that’s causing her to not be able to exercise, then let’s work on the knees and maybe that means she needs some stem cell injections into her knees and that will eat up a lot of your 10,000, depending on what you get done.

Dr Amy Killen: Or, if her concern is that she’s not as close to her husband sexually as she would like to be, then let’s focus on that and let’s focus on hormones and maybe some laser treatments like some vaginal lasers or maybe some stem cells and do like an O-shot and work on that piece of it.

Dr Amy Killen: So I think start big and then kind of zero in to what’s the thing that is causing her right now to not be able to get over that next hurdle and then deal with that.

Saad Alam: I’m so happy you said that because I think that so many people, when we’re talking to them, they just look at this as, well, I’ll do this and this and this and this and this and you’re like, “No, you have to think about what is your real outcome or goal that you’re chasing after.” Because if you can actually fix what that outcome is and actually I would say improve it, change it, make it go away, then everything else improves. And I think there is another step after that happens and people have to understand this continuous journey they’re going down.

Dr Amy Killen: Right, yeah. There is always something that you can improve. But finding out what’s the thing that will make the most difference right now is important and then once you do that, there’ll be something else that comes along. And you can tackle that. But you know, it’s the same thing with supplements for instance. I have a lot of patients who ask me, “What supplements should I be on?” And I always tell them, “It depends on what’s going on with you.” I don’t think everyone should be on 15 different supplements because not everyone needs the same things and a lot of people can get those things from diet.

Dr Amy Killen: So it’s really about taking a personalized approach, whether it’s with your supplements or your hormones or your stem cell treatments. Figuring out what your body needs right now which will not be the same thing it needs in a year or two. And dealing with that one thing as you’re continuing to work on this sort of foundational stuff that’s really important for everybody.

Saad Alam: So tell me, so your kids are how old?

Dr Amy Killen: I have twin daughters who are 10 and a boy who is nine.

Saad Alam: Okay, so your kids, they’re active, they’re running around, in the next 15 years, they’ll be in that age where probably their bodies will start to see just maybe the first effects of aging, maybe it’s 20 years from now. And you want your kids to be around as long as possible and you want them to be the best versions of themselves. What do you take that’s in your bag and you tell your kids, “Hey, I want you to do this from a preventative perspective,” in order to keep them alive long, knowing that they’re probably going to live until they’re 120 or 130.

Dr Amy Killen: Yeah, they’re going to live a long time. For them, it’s the same thing as it is for anybody else. I feel like I have my kids doing gratitude journals. And I have my kids doing … We do breathing exercises before bed and they’ll do body scans and they’ll come in and say, “Hey, mom, can we do a meditation with you.” And then all of us, all five of us will lay in bed and listen to a meditation. And you know, knowing what they’re putting in their bodies.

Dr Amy Killen: I had my kids … We’re watching some Mark Hyman video about sugar and you know, we watch this whole film and I’ve been, of course, telling them for years about sugar and how it’s bad and all these things and they didn’t really listen to me. And then they watch this video and they’re like, “Mom, sugar is really bad for you.” And I was like, “I know.” And then they knew maybe other things are also sugar, maybe pasta is kind of like sugar, maybe granola is kind of like sugar and it all gets made into sugar.

Dr Amy Killen: And the next morning for breakfast, my son was pouring himself a bowl of cereal and he was like, “Hey, mom, I’m pouring myself a bowl of sugar.” And you know, he still eats cereal but the point is, he now knows what it is and I think that that education is really important and should start as soon as kids can understand. You know, start giving them information, maybe don’t make it … Make it fun and maybe they won’t use it right now but hopefully that they will and will be healthier because of it.

Saad Alam: So, it’s really interesting, we talk to so many people and I’d say people that are in our-ish age range, I’d say between 35 and 50, because they’ve seen their parents go through chronic conditions and they’ve been like, “That’s not going to be me,” they’ve started incorporating all these things into their lives which then means their kids grow up with all these different things.

Saad Alam: And that should theoretically mean that your kids will be healthier and live longer or maybe not live longer but be healthier as they age. What about for someone like me, I’m 36, I had super high inflammatory markers, I had test levels, I was at 228 nanograms for [inaudible 00:37:55].

Dr Amy Killen: Wow.

Saad Alam: That’s crazy. My free test levels were even more ridiculous. [inaudible 00:37:58] was gone.

Dr Amy Killen: That’s low for someone that age, for sure.

Saad Alam: What do you tell someone like us, someone like me specifically, to come in and to do if I legitimately feel, look … Maybe not look but feel like this until I’m 80 or 90 years old. And let’s say I have perfect diet, perfect sleep.

Dr Amy Killen: I was going to say, start with all the basics again.

Saad Alam: I meditate perfectly, I’ve done six different genetic tests, three different gut biome tests, I’ve done four, including the day before yesterday, bile blood draws of 20 vials or 30 vials a piece. And I’ve optimized for everything other than probably the stuff that you do, the high end stuff that you do. What do you think someone like me should do in order to just completely be a super version of myself.

Dr Amy Killen: I think that you don’t have to necessarily do anything else. I mean, if you do the basic things that you’re doing perfectly, then I think you will be the best version of yourself. Now, certainly, you can add in all of the sort of bio hacker things that might help you go up a little bit more. Whether it’s the cold water plunges or the PEMF therapies or the infrared this or the low level light therapy, kind of all these sort of gadgety things which I think are great and I think could have utility.

Dr Amy Killen: But, if you are doing everything, if you have a perfect diet and you’re exercising, your stress is managed and you’re doing all the other things really, really well, then you’re not going to have high inflammatory markers. They’re already going to be zero or very low. So, maybe you don’t need to do other things that are going to work on those markers.

Dr Amy Killen: You can and it’s great if you do. But I sometimes think that people get so caught up in sort of the technology of it that they don’t focus on the basics. It’s almost like they use the idea that they can do other things as a justification for not doing the basics.

Dr Amy Killen: And, I’m guilty of that, too. Everything new that comes out, I’m like, “I’m going to do that, I’m going to do that.” And I do all those things. But, you don’t necessarily have to do all of those things if you’re taking care of yourself properly. Some of the people who live in the blue zones which are the places of the world where people live the longest, what do they do? They go out and they fish every day, they spend time with their families, they eat a healthy diet, they have low stress. That’s pretty much it.

Saad Alam: Spend time with their loved ones.

Dr Amy Killen: Yeah, I mean, it’s really for longevity purposes. I think all of these sort of bio-hacks are amazing and I love the idea of them and I’m going to get a sauna for my house when I have the money. However, the data, the global data shows us that people who live the longest are the ones who do the basic things the best. And I think that’s what’s the most important thing.

Saad Alam: But wouldn’t you argue that the people in blue zones, and let’s even say that the ones that are features in the human longevity project, they haven’t had access to a lot of the different technologies out there.

Dr Amy Killen: That’s true.

Saad Alam: But if you were to take someone from a blue zone that practices all of those different things and lives very healthy, a stress free life and then you were to also give them all the different technologies out there, that they should theoretically not only be able to live longer but also be able to live differently within that period of time.

Dr Amy Killen: Yeah, they absolutely could. And they probably will. You know, I think between all of the things we can do to increase mitochondrial function, increasing the numbers and activity of stem cells, increasing telomere length. There is all of this cool stuff that’s out there that we can use. And I think it’s all really important and I love all of it. I go to conferences all the time and I hear about it every day and it’s fantastic.

Dr Amy Killen: So yes, I think that probably it could be helpful for those people. But i also think that stressing about it is not helpful. If it’s too much. I feel like we need to know about these things and maybe adopt a couple of them but maybe not spend your entire day doing the bio-hacking because then you’re giving up something, you’re giving up your connections, your family or you’re giving up your … Something has to give.

Dr Amy Killen: So, yes, I think having some of these good practices, whether it’s taking cold showers or doing cold plunges or laying out in the sun for a little while and soaking up the Vitamin D or avoiding EMFs or the list of things that you can do to help yourself, I think, is quite long, avoiding being on social media for 10 hours a day and the sort of digital dimension that comes with it. There is so many things that are out there that we can do and I think they are all important. It’s just because there are so many things, it becomes overwhelming and that’s stress.

Dr Amy Killen: And what you don’t want to do is add stress. So if you can do it in a way that is relaxing and it makes you feel good … Like, I do a meditation, one of my meditations, I call them meditation, it probably isn’t is that I have a low level light therapy, like a red light therapy like mask chamber thing that I just go lay on my bed and put the light therapy on and I have big waterfall sounds. And my kids know that when I’m in there with my light that they should just leave me alone.

Dr Amy Killen: And I do it for like 20 or 30 minutes, whenever I can. And you know, it feels amazing. I come out and I just feel happy, I feel like I’ve been out in the sun for 30 minutes and I feel like my skin is glowing, I’m not sure if it really is. But so I do that. And it feels great. And it makes me feel really happy. And I feel like when there are so many things that are out there that you’re not doing, if you feel stressed out about that, then that’s counterproductive. So adopt the things that make you happy, that make sense but don’t feel like you have to do all the things, all the time, that’s what I would say.

Saad Alam: And when you think about your current stack of things that you do, how long did it take you to come to that?

Dr Amy Killen: I mean, I’m learning more every day. I started, I think, it’s about six years since I left the emergency department and I started the focusing on what I could do to make myself healthier. And so every day, I learn new things whether it’s coming to talks like last night or going to conferences. But it’s just kind of building. And there are certain things that I listen to and I’m like, “Yeah, I’m not ever going to do that.” Just because it wouldn’t make me happy. And if it doesn’t make me happy, it’s just not going to make the cut. I have a high level that you got to be above that level to make me do it and some of these things just don’t.

Dr Amy Killen: But like stem cells, I love. They make me very happy because I think they’re amazing. And so I will do a stem cell infusion or an exosome infusion or stem cell therapy which just doesn’t mean that everyone can do at this point because it can be expensive. But because I have access to them and I believe in them, then that’s something that I would do.

Dr Amy Killen: But I think it’s different for every person, figuring out what’s accessible and what makes you happy and what makes sense from a scientific standpoint and then what makes sense in my life. And putting all those things together.

Saad Alam: So I’m just going to quickly change this real quick to talk about one thing that I think people will absolutely love. They loved watching what Ben Greenfield did in your office. I bet you hear about this all the time.

Dr Amy Killen: Yeah, so Ben Greenfield came in for what we call the full body stem cell makeover, I don’t know, about a year ago, I guess, it’s been a little while where my partner, Dr. Harry Adelson and I did this procedure where we got stem cells from bone marrow, stem cells from fat as well as exosomes as well as PRP and we did injections all over the body. So my partner, Dr. Adelson, who treats muscular skeletal pain, he did injections on basically every major joint. So all down the neck, all down the back, every single point, both sides, both shoulders, both elbows, both wrists, knees, hips, all the major joints. He injected all of those things with all these stem cells.

Dr Amy Killen: And then I went in afterwards and did injections in the scalp, the face, the penis and then we did IV. We did the kind of everything to try to give him a superdose of stem cells in all different areas. And the idea for him is that maybe it helps prevent problems long-term, whether it’s in the joints or the skin, we know that with the skin, which is where I work in, stem cells in the skin can help protect your skin from some of the effects of photoaging, from UV radiation and it increases your collagen production which, as we know, goes down over time.

Dr Amy Killen: So if you can keep that production up with these types of therapies, then you look natural because it’s just your own skin for longer. So that’s the kind of thing … So we did that for him. We’ve done Dave Asprey, similar kind of thing, we’ve done Mark Hyman, we’ve done a lot of the sort of big players in this space with similar types of treatments because all of them are looking at themselves, saying, “I want to be the best possible version of myself. I want to be healthy, I want to be able to run, I want to be able to do spartan races,” or whatever. And so they come to see us and we do the whole thing.

Saad Alam: Do you mind me asking how much something like that costs?

Dr Amy Killen: So the full full body stem cell makeover is about $45,000. That’s with all those injections that I just talked about. But there are a lot lower versions of that where we’re just treating specifically, you know, if you have elbow pain, we treat the elbow pain or if you want to have better skin, then we do the skin. You know, you can do any variation for a lot lower price point but that’s sort of the big package with all of the things.

Saad Alam: And what kind of time requirement do you think is required that you need for something like that?

Dr Amy Killen: Most of our patients come from out of town, so out of state, out of the country and we have them come into town for a couple of days, usually. If they’re coming from a low altitude, we have them come in at least a couple of days ahead of time because we’re about 7,000 feet above sea water so we like to have them acclimate a little bit. But for the most part, people are there for two or three days total and the actual procedure is less than three hours.

Dr Amy Killen: And we do have an anesthesiologist, we put you to sleep because we don’t want you to … It’s so much more relaxing if you’re asleep. Have you go to sleep but you’re still breathing on your own but you’re sedated and then you wake up three hours later and you’ve had a full body tune up.

Dr Amy Killen: People are sore for a couple of days, mostly from the sites of the fat aspiration and you know, they look a little crazy for a day or two because of my injections. But for the most part, people are good after just a couple of days, they go back home, go back to work and the over the next few months, start to see improvements whether it’s in their back pain. Dave Asprey talks about that his sleep, his circadian rhythm reset for some reason after this procedure and that he was able to start going to bed earlier and getting up earlier and it made a big difference in that. So some people don’t necessarily have problems but they still find that it had improvements in different things afterwards.

Saad Alam: We saw Ben maybe like four months after.

Speaker 4: September.

Saad Alam: October.

Speaker 4: Yeah, October. Late October.

Saad Alam: And his skin was ridiculous. And I saw his face and I was like, “Wow, man.”

Dr Amy Killen: Yeah, I mean, he’s got baby skin anyways. He’s got great skin. But I wouldn’t do these things if I didn’t believe in them and I think that what I like about the skin procedures are that it’s completely natural in that it’s your own skin. So it’s not like filler where you have maybe your lips look funny or you got duck lips or Botox. I use filler and Botox also, but, you know, some of those things make people look a little bit crazy, depending on who’s doing the injecting.

Dr Amy Killen: But, what I like about the regenerative techniques are that it’s really just your own skin. It’s just more youthful looking.

Saad Alam: Sorry, the last question, promise.

Dr Amy Killen: Yeah, no, it’s fine. As you can tell, I like to talk.

Saad Alam: No, you’re good at it. You make it so easy, actually. Some people, it’s like-

Dr Amy Killen: You’re like, “Shut up, be quiet.”

Saad Alam: No, no, it’s the opposite. This is great. I could actually go for another hour. All right, then I’m going to ask you two questions.

Saad Alam: So, tell me about you do this all the time. And tell me about the time that you felt best about what you do. Not who’s the person. What do they want done? What did you do? What was the outcome? Why was it so impactful?

Dr Amy Killen: That’s a good question. So, one of my favorite stories, and I’ve had other similar patients but the first one that happened was I had about a 50 year [inaudible 00:50:30] guy who came in who had severe erectile dysfunction. He had prostrate cancer three or four years previous and ever since having surgery on his prostrate, he’d had no ability to have erections. And he was young, he is like 50 something, married, super healthy guy and had gone to various urologists. Nothing worked for him, the medications didn’t work, Viagra didn’t work, the injections didn’t work, nothing worked.

Dr Amy Killen: And his doctors basically told him either be okay with nothing working or you can get like an implant, a penile implant and he was like, “I don’t really want to do either one of those things.” So, he came to see me as kind of like a last ditch effort. And we did a series of things but we did stem cell injections, stem cell and PRP injections into the penis, the P-shot, we did a whole series of the GAINSWave, the low intensity shockwave therapy, worked on this testosterone, got his nitric oxide levels up, worked on some lifestyle stuff. You know, some sort of basic stuff.

Dr Amy Killen: And about three or four months later, he called me and he told me that he had had just had sex with his wife for the first time in four years. And you know, he was so excited. But, beyond that, he said it certainly had brought him closer to his wife but he also felt like it had given him back this confidence and this vitality that he didn’t even realized he’d lost.

Dr Amy Killen: He said it affected the way that he was interacting with his people in his work, in the business. Like all of a sudden, he was more confident and he was making better decisions. And you know, it basically affected the way that he saw the rest of the world which is something that I thought was really interesting because people think about sex as sort of this thing that happens in the bedroom. And it does, a lot of times.

Dr Amy Killen: But, it also really affects the way that we interact with the people around us and how we view ourselves and how we come across. And so anyway, he’d had these therapies done and he had a really good response and since then, I’ve seen this happen multiple times to varying degrees. But every time it happens, I get kind of a warm, fuzzy feeling because it really does change people’s lives in a really profound way.

Saad Alam: Now, you actually gave a talk about how it is probably one of the most important factors for living a happy, long life.

Dr Amy Killen: I did, yes.

Saad Alam: Can you talk about that just very quickly?

Dr Amy Killen: Yeah, sex is … We know that people who have satisfying sex lives, that are having regular sex with partners that make them happy, they tend to live longer. And there could be a lot of reasons for that, maybe it’s the exercise, maybe it’s the intimate relationship, maybe it’s all the hormones that you release during sex. It’s probably not just one thing. But it is the case.

Dr Amy Killen: And it’s really important from a lot of different standpoints. We know that in order to have good sexual function, you have to be healthy in general. You know? you have to have good open blood vessels, you can’t have atherosclerosis and cardiovascular disease, you have to have a good working brain, you can’t have a lot of stress, it has to be able to send the signals. Basically, having good sexual function is one indication that the rest of you is also working pretty well.

Dr Amy Killen: And so when you stop having that sexual function, it’s often an indicator, it’s like a canary in a coalmine where maybe you have atherosclerosis and you’re not getting good blood flow to your penis but you’re also not getting good blood flow to your heart or to your brain and that could be a problem later on.

Dr Amy Killen: So I think that sex is an important indicator of other problems going on. But it’s also a way to stay closer in relationships as a way to sort of express yourself, it can be a meditation for some people. It’s just part of sort of one of these pillars of health that make us who we are and make us healthy, so there’s the diet piece and the exercise piece, the meditation piece and the sex piece. And it’s more than one thing. But that’s part of what makes us human.

Dr Amy Killen: And I think that people are afraid to talk about it. And people, certainly to their friends or to other doctors, oftentimes don’t talk about it. I have to ask my patients, specifically, what’s going on with them and a lot of times, I’ll ask them questions and they’ll deny, deny, everything is fine, I’m good, it’s great. And then I ask specifically and they’re like, “Oh yeah, no. Yeah, things are really bad, I haven’t had an erection in this long.” Or for women, “I don’t get orgasms anymore.” Or whatever it is.

Dr Amy Killen: And I think that there is sort of a stigma around talking about sex, even with the advent of Viagra and all of the media around it. I feel like people still don’t talk about how common sexual dysfunction is, it’s really common.

Saad Alam: I feel like we’re right at this interesting place where so many of these stigmas that we have in place are starting to get broken and there are people that are just coming out and they’re almost saying, “Fuck it.” I was previously taught to believe something is wrong with me when the reality is that every single person is dramatically different and every person has their own bag of things. Doesn’t mean it’s a problem, it just means my body operates differently. I remember first it was mental health, right? Mental health has started to change. Now, all of a sudden men are going through what I’ll call a feminization a little bit right now in the country where they’re starting to talk about their feelings. And that in itself is changing things.

Saad Alam: And we have this group of elder men that are kind of the old guard. And then you have these newer younger, I’ll even say touching the millennials where they’re like, “Look, who cares? I want to talk about my feelings, I’m going to approach all these other things, why not? It just makes life better.”

Saad Alam: I’m assuming that your sexual practice in terms of how you help your patients is a big part of the identity that you’ve actually created. Who are the people that you are helping really? What’s the age category?

Dr Amy Killen: It’s all different ages. Mostly about 35 up to 80. It’s all different ranges. But, you know, it’s people who have noticed some kind of change. And in younger men and women, oftentimes the problems are due to something that’s not physiologic. Maybe it’s porn problems, porn addiction, compulsion, it’s something I see quite a bit of. Or it’s just problems with the relationship or stress, or something, other things that we talk about, sort of lifestyle problems that affect the brain.

Dr Amy Killen: And then as people get older, then maybe it’s a blood flow problem or it’s a neurologic problem or it’s a hormonal problem. So the cause of the dysfunction, for both men and women, changes obviously as we age. But, it can happen at any time. Most of my patients are at least 35 or so.

Saad Alam: That’s interesting. Well, I promised that was going to be the last question.

Dr Amy Killen: Yeah, you did say that.

Saad Alam: Listen, you are wonderful. Thank you so much. I appreciate this.

Dr Amy Killen: Thank you, this has been fun.