Darren: Yeah, sure, Andrew. For us, it’s really built off the back of naturopathy 101. It’s all root cause-based. But of recent times, there’s really been an explosion of tech advances, and it’s really providing, like in so many other industries, a real disruptive opportunity for naturopathy. And being sort of our bent, we like playing with toys and things in the clinic, and Brett’s really got us onto with this pretty early. So, we really, as well as your traditional base of naturopathic therapies, we’re drawing on emerging fields in biohacking, in functional diagnostics. The wearables are really…many clients now are coming in with untapped data on their wrists. And then we’ve got AI really coming to the fore, and available to everybody now. So, there’s really, there’s a lot going on in the space, and a lot of it’s pretty well understood by praccies, you know. Nootropics and, you know, nutrigenomics, and diet, and lifestyle, and all that sort of core or key naturopathic tools. But then we’ve got stuff that’s maybe not so quite well-understood around hyperbarics, and the use of these sort of things in wellness centers and clinics that are popping up, you know. So, there’s, you know, PEM, pulsed electromagnetic field devices, and there’s hyperthermia, and there’s low-level laser therapies, and, you know, intermittent hypoxic and hyperoxic therapies. There’s all sorts of stuff coming around in, for people to choose, and to assist in their, you know, health journeys. And, you know, our concept of adaptive medicine is looking to pull all of those things together into a coherent, usable form, if you like.

Andrew: Brett, can I follow on with you? So, Darren just mentioned this untapped data that we have at our fingertips, or our wrists. And I totally agree with you. People are using it personally, but what you’re doing is taking that data to help them, basically, in a formed framework. Is that correct?

Brett: Yeah. And so, it’s recording people when they come into the clinics in very simple activities. It might be, you know, we’re using heart rate variability, we’re using heart monitors, we’re taking baselines, we’re working out shifts. So, I guess that’s where the idea about adaptive medicine comes from, because what we could see is, if people could adapt more efficiently, they tend to get better results. It gives that traction and momentum out of that chronic state. So, I guess the key to it is, I guess the disease is that lack of adaptability. If we can use, you know, herbs, nutrition, devices, to create a shift, even if it’s an artificial shift, then the body then starts to relearn this capacity of adaptation. And I think that’s what we’re seeing, just in, even with the data, we’re seeing this, as we’re seeing people’s symptoms improve, we’re seeing that data, that adaptability improve alongside it. And that’s been over the last 15 years.

Andrew: Gotcha. Can I follow on with you, then, as well? How is adaptive medicine different from, say, functional medicine?

Brett: Yeah, I guess it was looking for a term that we could sort of redefine, I guess, the biohacking model. I guess, you know, we’ve been doing this for 15 years, pre the term “biohacking.” So, we really wanted to show that there was a very functional way that this strategy, this biohacking can be used, and to define it in a very clinical model. And so, we were looking for what we were noticing with people’s health. And it wasn’t a way that we thought. The system was then creating plasticity. And so, as we create more plasticity, we see the body’s capacity to adapt. And I guess that’s what, I guess, the measurements are actually showing, where functional medicine, you’re actually looking at what’s out, what’s not working, and supplementing or supporting that process, we’re able to add in equipment, herbs, nutritionals, any device that we can use, and actually see this plasticity start to come back in to the framework for people. If you’re not in a position of recovery, the body won’t put any resources towards it. So, what we’re noticing is, is you may have all the best intention with the client, and they may have, trying all the devices and everything possible. But if the system can’t allocate that as a resource, it doesn’t tend to be effective.

Andrew: I love the way that you guys talk about the framework, like, “if the system,” as in, the system of the patient’s resources. So, it’s sort of like, and I’m not sort of saying that you’re taking the personability out of it, but you’re looking at it as a system, so that you can address certain points along that framework. I think it’s a really interesting way to work. Darren, can I ask you, you mentioned before, hyperbaric, and then hypoxic therapy as well. This is obviously a stressor, to help the person cope with adaptation. Can I ask you firstly to explain those, but also to go a little bit into how you assess whether a patient is able, ready, to cope with that stressor of hypoxia?

Darren: Yeah. So, we’re very keen or big on measuring. We don’t like to guess too much in the clinic. So, part of the system that we’ve developed is looking at the person when they come in, from the perspective of balance or homeostasis, more than just the pathology or the set of symptoms that they’re coming in with. So, we’re looking and we’re measuring urine and saliva and parameters from those. And we utilize bioimpedance, and we utilize microscopes. There’s a whole range of tests that you can go deep with, with your different organic acid profiles and your genetic profiles and stool, etc. So, when people are coming in, we wanna get a little snapshot or a fingerprint of who they are biochemically. And that’s giving us an assessment of how far from balanced they are, if you like. So, we know, from the tools that we have, what balance or homeostasis looks like. And we’re measuring clients when they’re coming in against that. You know, how far from balance are they? And then, part of the clinical aspects or skills there is, okay, well, what do you need? How much of it? How often, and how long, to assist in moving them back to balance. So, more to your question there with the hyperbarics and the hypoxic training, those two are very interesting assists, where one, in the form of hyperbarics, will directly make available oxygen available to a cell, if it’s become unable to transport or utilize. So, that mild pressure just allows oxygen, for example, to get to the mitochondria, so that then they can make energy. And then the cell’s got half a chance of getting on with whatever it was supposed to be doing. The hypoxic training’s a little bit different, where it’s teaching the body how to utilize oxygen better. So, one provides, and one teaches.

Andrew: So, I love that simple explanation there. But basically, you’re talking about, as you say, provide, and then teach. But with the teaching bit, you’re stressing, if you wanna go right down to the biochemistry, you’re stressing the mitochondria, to come back to aerobic metabolism from anaerobic metabolism. Is that correct?

Darren: Yes. Yeah. It upregulates all the enzyme systems and things here. So, it assists. So, when we’re assessing for individuals, that’s why we utilize both technologies. If the load we perceive would be too much using the hypoxic therapy, then we’ll use the hyperbarics. And to assist until we say, okay, well, given the set of data that we’re looking at, yeah, now we think that you’re in a position that the body can adapt to that stressor.

Andrew: Right. Brett, anything to add there?

Brett: I guess, yeah, again, it’s about that adaptation. And I guess it’s, what we’re really looking at is always how we affect the mitochondria. So, really, you touched on that point. And really, what our science is, is always focus on that mitochondrial capacity, and how effective it’s able to produce ATP, and create the capacity to form energy potential. And then, so, really, when you’re looking at hypoxic training, it’s really trying to re-educate the system. So, it’s saying, well, the nervous system, in particular, you can exist with reduced oxygen, and the nervous system can respond effectively. And then that has an overriding effect of creating this adaptive potential. And right down to the cellular level. It’s not just a physical, mental level.

Andrew: Can I ask as well, is this, forgive me if I’m wrong, correct me if I’m wrong, but is this indeed what breathing techniques teach us, like box breathing and things like that? Is that teaching us to handle a small level of, we say hypoxia, hypercapnia, whatever, so that our bodies can adapt to that?

Brett: Yeah. And if you look at what someone like Wim Hof is actually trying to explain, when he looks, when he teaches his theory, or his practicality, he’s actually saying, “This improves adaptability.” So, that’s what it does, is it allows your system to relax when it needs to relax, and fire up when it needs to fire up, and have that adaptability when either one is needed. But as long as the brain and the body is, you know, I guess at the whim of the mind, then they’re just responding to what they perceive as the risk. So, the mind fantasizes, the brain and the body just responds as if it’s real, and then you can lock yourself into a system of survival. And so, what you actually wanna do is create some adaptability out of that. Once you’re in survival, all the resources will go into that survival capacity. It’s not meant to last very long. It’ll sacrifice all the work it’s meant to be doing. So, all the recovery work will be put on hold until the body and the brain knows that it’s safe again. But, and then we know now, in modern life, that that’s becoming much more difficult, for the system to sort of self-regulate. And that’s all that this breath work is actually doing.

Andrew: It’s interesting that, you know, archaeologically, human’s main job was to survive. And once you got over that, it was like, you know, go out, hunt, don’t be eaten, come back and eat, and rest and play and procreate, whatever. Now we’ve got so many fingers in so many pies, stressors attacking us from so many points. You know, not just emotional stress, but physical stressors. You’ve got, you know, the COVIDs and the RSVs and the, you know, the seasonal infections, and then you’ve got the emotional stressors, and then you’ve got pollutants and blah, blah, blah. So, can I ask, how does this look, this adaptive medicine picture, how does it look in the clinic, to tease apart what is the main assault on the patient facing you? What are the main things throwing the system out of balance, if you like? Darren, how about I start with you again?

Darren: Yeah, thanks, Andrew. That comes back to the set of diagnostics or screening tools that we use. So, we’re looking at, I guess, to make it real simple, you’re looking at, okay, well, what are the inflammatory drivers, if any? Is that what predominates for people? Is it oxidative? Is it an immunological issue? Is it detoxing? What’s, where’s the block? What’s overwhelmed or under-resourced? And then if you’re looking at the autonomic nervous system, well, then we’re using heart rate variability. We’re measuring that. So, that gives you a direct insight. And then we’re going, okay, so, for the individual, who are they biochemically? What resources do they have? How can we help them to modify the load? And then the tools that we have is all about assisting the body to move back towards balance, where it’s been pushed out.

Andrew: Yeah. Brett, continuing on?

Brett: Yeah, it’s a really simple naturopathic philosophy. We all know about homeostasis. And so, really, what we’re doing is we’re, the baselines are really just measuring how far someone is from homeostasis. And then it’s like, okay, then, what can we measure? Then, if we remove what we can measure, what we can see, then the body will self-regulate. So, we’re just reducing load, as Darren said. It’s not looking for a diagnosis. And I guess this is what, I guess, is the great thing about naturopathy, is we say we can’t diagnose, but we don’t have to, because, based on homeostasis, all we need to do is reduce and remove roadblocks, and the body’ll do itself. The system will do itself, and it’ll go into this recovery process. So, we’re looking for roadblocks. We might have a limited capacity, but if we can remove the roadblocks we can see, then the body will recover. And that’s what we see over and over again. Some people need diet, lifestyle, really simple indications. Other people need really complex pieces of equipment, and time, and effort, and money need to go into it. But we can measure that over time, and we can provide that capacity to remove the roadblock. That’s what we’re really looking at.

Andrew: So, take us through some of the conditions you treat. I mean, one thing that’s just pinging in my head with this, forgive me, the hyperbaric/hypoxic sort of therapy is long COVID. I have a picture in my head from this YouTuber, you know, Dianna Cowern, who’s just been through the wringer with this condition, from such a vital human being, teaching, you know, her whole thing was about helping women, young girls, to explore science. And it was more than that. She helped humans. But just to see what this poor woman has gone through is devastating. It’s heartbreaking to me. Can you take us through… Forgive me for harping on about long COVID, but can you take us through, like, an entry, an assessment, and then a treatment phase, maybe, with a patient or, with that or a similar condition? Brett, could I start with you?

Brett: Yeah. So, we start off with our basic testing. And then, you know, I guess what we’re…I guess we’ve got some really fascinating tools to measure with. And I think when you’re looking at blood, you can actually start to see some of the drivers. You can see sort of what white blood cells are doing. You know that there’s an upregulation of some of these systems. You can see inflammation. So, we know inflammation is the biggest driver, if you can see it and identify it. And after seeing, like, hundreds and hundreds and hundreds of clients around, you know, potential long COVID, or COVID impacts, then you can get to see what’s actually happening that’s consistent. And so, again, you’re identifying what you can see, that’s outside of homeostasis and you’re working on removing that. So, I guess the great thing that we were doing five years ago, when we’re looking at COVID, is we could see this increased production of fibrin. And so, we didn’t know the science of what was happening, but we could see fibrin. We knew that was part of an inflammatory cascade. We knew that was generated from, you know, the liver, because of viral load. If we remove that type of inflammation, what actually happens? And so, then, you get now, for long COVID, you get the classic nattokinase, you know, bromelain, turmeric, you know, these are the classic kind of treatments. But we were seeing that and addressing that with our simple, you know, indicators five years ago. And so, really, again, it’s just removing what we can see, and seeing what those impacts are. And we’re in a really lucky position to just to be able to see this cascade of events that we could just see as naturopaths, and we just had techniques to use. And we know now that the protocol that we were using five years ago is the standardized protocol today. We could only see it because we were just, from a naturopath’s point of view, because we’re removing roadblocks. Really simple.

Andrew: Right. But you’re also capturing the data anonymously, so that you can then say, okay, this therapy works and that therapy doesn’t. Is that right?

Brett: Yeah. So, each client, we’re measuring again and again over time. So, we’re not just saying, okay, this is what we’re gonna do. We’re going to, you know, some clients, we might measure weekly, daily, fortnightly, monthly, depending on, you know, how much data we need to capture. And so, we’re using, again, maybe one or many of these baseline tests. So, before, when they first come in, we’re measuring baseline. What do they look like before they go under treatment? Then, what happens if they have treatment for a week? Do we see any change in that? If they go for a fortnight, do we see any change in that? Do the month, six months. You know, we go for years now. So we’ve got data right back to 2012, 2011. So, we can get a client coming in, and we can look at them. We can compare their data to when they’re, you know, 2012. So we can look at this progression over time and strategize. So, it’s just measuring the data. And if the data improves, then we know we’re on the right track. If it doesn’t, then why not? Then that’s when we start that intuitive mind, is kind of like, okay, what do we need? What does this person need to help them get over the line, to get that traction and momentum, to actually start to see these parameters start to shift? And then that’s where this consistent measuring actually occurs. And that’s, I guess, when we develop the confidence to know that the strategies that we’re using are actually effective, because we see it in multiple cases, not just singular cases, and we can compare that data.

Andrew: Darren, this is gonna be a bit of a list I’m gonna ask you, but can you run off a few of the types of conditions that you’ve seen in clinic that have most benefited from this approach?

Darren: Well, I guess where we’re looking at the individual and their presentation and what they bring, we’re not so interested in the label. So, we’ll treat all comers, if you like. So, how we sort of got to this position, a bit of background for us, and why we sort of moved in the direction we have is because we were finding, for some clients, that, if you like, were having catastrophic problems with self-regulation, how the tools that we were traditionally working with weren’t getting us that traction and momentum. Right, we weren’t getting them back. We couldn’t shift them in that, couldn’t assist in shifting. So we went looking for other tools, and that’s where we started to adapt pulsed electromagnetic field therapies, and the hyperbarics, and the hypothermia, and different ways of helping initiate change for people. And, you know, we can see, and it’s well understood, that if you can’t get something in and out of a cell, well, you can provide whatever you like, but if the body’s not signaling, or it can’t transport, or it can’t absorb, or it can’t eliminate toxins, or there’s some other barrier or it’s otherwise occupied, thinking it’s needing to fight a tiger, or on a battlefield somewhere, unless you’re having them come back to a position of ease, and the autonomic nervous system is signaling the rest, repair, recover, digest, hormones, neurotransmitters, immune function, etc., then you can have the best of everything, or the best of anything, but the body’s not using it. So, many of the tools we’re covering, based on client need, and what we can see and measure for them. Is it a cell transport issue? And if it is, well, why is that? Is it inflammatory? Is it oxidative? Is it a toxin load? Is it an endotoxin? What’s going on for that person? So, without needing or looking for a diagnosis, or a label, which is a descriptor, obviously, we unpack that. We try and reverse engineer the process for people.

Andrew: Right. I gotta say, I love the words you used, the initiate change, because we all want change for our patients, to move away from a disease model to a wellness model. But compliance is the big elephant in the room that we don’t like to address. And I think your approach seems to basically, passive isn’t the right word, but it’s almost like a nudge, to help initiate that change, using these machines and things like that, and the therapies, like hyperbaric versus hypoxic. Darren and Brett, you have both embraced artificial intelligence, AI. And we often think about AI about being useful for writing a story, and helping  with a framework for an article we might want to write, or something like that. There have been issues that have been pulled out from AI, though, about being able to trick AI, for instance, how many, if it takes two hours to dry two towels, how many hours does it take to dry four towels? So, you can, and the AI will say four hours. But you’re not using it in that way, I understand. Can you take us through, Brett, could you take us through how you’re using AI to benefit your patients? What sort of data are you collecting? What are you coming up with?

Brett: Yeah. So, I guess we’re in that unique position that, really early on, we decided to keep all our data. And so, the unique, then, position we’re in is that one day, it’ll be useful. We don’t know how that’s gonna look. And now we’ve got something called AI. And so, we put that data through this system. And really, it’s just a chip that has greater capacity to sort through information. And then we can bring much more clear indicators about what’s happening. So, the problem is, is that all our tests and our equipment don’t actually talk with each other. They’re all very separate, kind of individual tests and individual processes. But what happens when you bring those all together, and then there’s an individual way to pull the information, and to categorize it for an individual? So, AI, for us, and firstly, the beautiful thing about the AI that we’re going to be using is it’s a closed system. So it’s not accessing, at this point, a massive database. It’s not accessing Google. It’s actually accessing the information within the clinic, and it’s bringing up far better results. And that will then increase. So, then we have more practitioners using the same system, and so we’re all sharing the data. So, you might have someone that’s, you know, an individual practitioner using the system, and they’re accessing a clinic that’s on a larger scale or an integrative practice, using the same technology. And they’re able to access the same information or database that we can, and bringing that information much more holistic, as far as the data that we’re choosing. So, it’ll bring in pathology, and it’ll bring in functional testing, and it’ll bring in the values of equipment, and it’ll bring in the client’s individual, you know, information that they’re recording. They can punch in their data around what they’re eating, and it’ll start to then organize the information, to produce best outcomes. And I guess that’s what we’re all looking for, is this outcome-based sort of treatment strategy.

Andrew: Yeah. I love that. Outcome-based rather than treatment-based. I also am very reassured, by the way, that it’s a closed system. So that it’s this true anonymity for the patient data, patient protection. So, I love that. But how, then, is the invitation going to be to other practitioners? How are you going to maintain a closed system with that?

Brett: Well, I guess what you’ve got is a provider who’s providing that AI technology, and then they can add data in. So, they can then input information. So, they may put in a later study. So, there may be new findings, and they have been clarified, and that’ll go into the system. Again, it’s about the practitioner’s discretion as well. So, it’s a guide. You’re not taking the practitioner out of the decision-making. You’re actually bringing a much more coherent system together, to work out strategies, primarily for the client. So, you’re looking for outcomes for the client. So, the system won’t be, like, a closed-door process. It’s actually being able to screen it. So, it’s not accessing the World Wide Web to work out solutions. It’s actually looking at the participants, working out solutions, adding information that’s relevant, and then having that in the mix. That information may change over time. We’ll see. So, it’s dynamic. It’s not two-dimensional. It’s actually three-dimensional. So, it’s much more like a world that you can access, rather than this kind of flat screen, kind of dashboard kind of idea. It’s much more dynamic for the practitioner and for the client, as far as how they can use it and interface with it.

Andrew: Darren, I need to ask you. So, this has obviously got to do with data capture, and you’ve obviously done that from the very get-go. But when we’re doing that, and then you’re transferring it over to an AI system, who has to do the legwork with regards to data transfer? Or is it something that just draws? Or do you guys just sit there typing all night?

Darren: Thankfully not. The team that’s sort of behind the development of the AI platform is, they’ve been deep into it. They’re affiliated with one of the universities in New South Wales, and the guys that are in the background are deep into it with Amazon, I believe, if I, I think that’s right. Or Google was one of them, but, so, they’re bringing a wealth of experience and knowledge of how to frame it all, but then bringing it to, and applying it for, a holistic medicine model. So, yeah. I’m just great and keen using it. I don’t know how they put it together in the background. I don’t know how the phone works. I just use it.

Andrew: But with regards to you using that data to help your patients, what springs out at you? How is it presented to you, so that you can then go, “This is our direction of therapy?”

Darren: Okay, yeah. So, myself and Brett and practitioners, we’ve been around for a little while. Previously, we’ve had to do it, bring in 25 years of knowledge and expertise. We can read a genetic profile, we can read omics, we can do genome maps, but new practitioners don’t, and new functional practitioners in the space don’t have that experience. And so, it’s being able, at your fingertips, to bring hints or guides, or what does all this information mean? Because your clients are bringing in folders full of data that they’ve collected over the years. And if this is already in the system, it’s been uploaded, and the tool or the system can read that for you, it can extract what you need from it, based on when we’re looking at the blocks and the resources, and so, is it inflammatory? Is it oxidating? Is it detoxing or is it And it’s helping to rapidly and accurately pull together that data, and then it’s just at your fingertips.

Andrew: Brett, anything to follow on from there?

Brett: Yeah, so, it’s really looking at, again, creating that baseline, and then seeing it shift, and seeing if it’s shifting in the right direction, based on the information that’s being provided. We’re getting clients that are all individuals, they’ll all bring that uniqueness into their profiling, and it’s just collaborating with multiple different sources, to really narrow the strategy down. So, it’s, as Darren was saying, there’s a lot of work that goes into thinking about a client and how to navigate for them. So, I describe really what we do now is we manage people’s health. Once upon a time, we had all the information. You can get the information. Information, not a problem about any kind of disorder. It’s how you manage that. So, how do you get from a person who’s at point A, and getting them to point B? And then, what this does is it allows that transition, it allows that journey, it allows for better road mapping, it allows for better signaling, to get to that ideal map for that particular client. And that data will allow people to just navigate more effectively. Don’t forget, we’ve got the client who has access to this the whole time. So, it’s not a closed system, just for practitioners. It’s an interaction between the practitioner and the client. And so, there’s these discussions that will go ahead, talking about, well, what about this way? Well, I can see this. Well, how about if I change that? Well, in actual fact, you can see then, when there was a drop, I actually didn’t eat all day. And so therefore, you see these sort of stress response, my HRV shoot through the roof. So, for me, one of the indicators, maybe I need to eat a little bit more regularly. These are things that they’re learning, that they’re learning that roadmap as well, along with the practitioner. So, it’s an integrated system between the two.

Andrew: Beautiful. And what’s the end game to this approach, this adaptive medicine approach? Brett, I’ll start with you.

Brett: I guess we’re, for some reason, we’ve constantly been thrown into this. In actual fact, we’re not geeky. We don’t like machines, and we don’t like gadgets. True. But, each step that we go, we see a necessity for the client. So, we’re always driven by what the client needs, and what I guess our industry needs as a whole, to be much more efficient in what we actually do. And the end game is always to shake that client’s hand when they say thank you very much. And that’s where the reward is. When you get people to the destination that they’re looking for, that’s the end goal. So, all we do is providing roadmaps for people. And really, having that handshake, there’s nothing better than someone saying thank you very much. And that’s really the end goal. It’s really quite simple.

Andrew: Darren, anything to add?

Darren: Yeah, no. It’s a joy. And it’s why, you know, myself and Brett do what we do. We like to think we’re useful in some…you know? So, we’ve just found ourselves being pushed and challenged with the clients that have been coming to see us. Well, how do we facilitate this for you? And we come to a roadblock and we go, well, how do we get around it? And it’s been a steep learning curve for us. And it’s continuing. You know, this AI stuff’s a really steep learning curve. But, we’ve managed to, you know, have some really clever people and some fantastic people come into our orbit, and assist us to pull it all together. And we think it’s, you know, we’re sort of flying a little bit, you know, outside our comfort zone at some time, but we keep getting reinforced and we keep getting, “Yeah, keep going boys.” So, while ever we’re still getting outcomes, which is the end goal for us all, then we’re happy to continue while everyone’s happy with us.

Andrew: Darren Sassall and Brett O’Brien, I can’t thank you enough for sharing. Just, I’m getting that this is the tip of the iceberg for what you guys do. But thank you so much for sharing a little bit of adaptive medicine and your approach, because, I gotta say, I love this, what you’re saying, you know, initiating change, and it’s all for outcome. It’s not about input. It’s all about, at the end, you want them to shake your hand and say thank you. And that, to me, is sacrosanct, the patient care. I thank you so much for taking us through this model of adaptive medicine and how you function in this space. Thank you so much for joining us today on “Wellness by Designs.”

Brett: Wonderful. Thanks, Andrew.

Andrew: And thank you, everyone, for joining us. Remember, you can catch up on this and the other podcasts on the Designs for Health website. I’m Andrew Whitfield-Cook. This is “Wellness by Designs.”