How Chamath Optimized His Health

I have so many of my friends that just literally have everything except their health. And I just don't want that. You know, there's a limited amount of time. I'm not trying to live forever. I'm just trying to live well. So this week I'm going to explore some questions that I have about my health and I suspect that many people out there have about theirs. It has great, so far. My father lived a really unhealthy life. He struggled with alcoholism for decades. He was diabetic. He had heart issues. And in the end, he died of a cardiac arrest. We were expecting his death, but he still left my mom, my siblings, and me honestly to pick up the pieces. When my friend Dave died of a heart attack, I wasn't expecting it. To me, he seemed perfectly healthy and that was my real wake-up call. We were in Mexico and he had a heart attack. And it was a real tragedy to be totally honest. But on the heels of that, his wife asked his four best friends just to really try to take care of ourselves better and specifically to start going and seeing a cardiologist.

我有很多朋友，几乎拥有一切，但就是没有健康。而我不想成为那样的人。你知道的，时间是有限的，我并不是想永远活着，而是想活得更好。所以这周我会对自己的健康提出一些疑问，我怀疑很多人也有同样的问题。目前为止，这一切都很棒。我的父亲过着极不健康的生活，多年来与酗酒斗争。他有糖尿病和心脏问题，最后因心脏骤停去世。虽然我们对他的去世有心理准备，但他仍然让我的妈妈、兄弟姐妹和我不得不继续面对生活。当我朋友戴夫因心脏病去世时，我完全没料到。在我看来，他看起来很健康，这真正提醒了我。我们当时在墨西哥，他突发心脏病，这真的是个悲剧。随后，他的妻子请他的四个好朋友一定要更好地照顾自己，特别是开始去看心脏科医生。

Hey, welcome back. Thanks, Jonathan. Great to see you. It's great to see you. Online, on X, we saw some interest about statins. So with Dr. Karlsberg, he is the best interventional cardiologist in the United States. When he discovered some plaque in my arteries, he put me on statins. They're supposed to lower bad LDL cholesterol, reduce the risk of heart attack and stabilize plaque. But to some, they are controversial. Well, you posted basically trying to do something for cardiac health across all of America and you tagged me and Bobby. But the amount of commentary in Twitter or in X-Rather was all about the whether or not I should be honest at. And whether or not it was just completely pseudoscience. Look, what I've learned in my career is I could talk about anything. I could say the sky is blue and there will be opinions that say it's not. So to be honest with you, I kind of ignored most of it except to say that the few people who are very thoughtful in there brought up, I thought a very legitimate question.

嗨，欢迎回来。谢谢你，Jonathan。很高兴见到你。在网上，我们看到了一些关于他汀类药物的关注。与美国顶尖的介入心脏病专家Dr. Karlsberg一起，当他发现我的动脉中有一些斑块时，他让我开始服用他汀类药物。这些药物应该可以降低不良LDL胆固醇，减少心脏病发作的风险，并稳定斑块。但是，对某些人来说，这些药物具有争议。你发帖基本上是想为全美的心脏健康做点什么，并标记了我和Bobby。然而，推特或X平台上评论的重点全在于我是否应该诚实，以及这是否完全是伪科学。我的职业生涯中学到的一点是，无论我说什么，比如说天空是蓝色的，总会有人有不同的意见。所以，老实说，我基本上忽略了大多数评论，除了那些非常有见地的人提出的问题，我认为那是个非常合理的问题。

A lot of my followers feel like statins might help them in some areas but also hurt them in others. That's one of the reasons why I've been coming to Dr. Karlsbergs for regularly to help me figure all of this out. What's the most difficult part of doing all this testing? What do you say? But to be honest with you, it's the cognitive load before you start it because I think there's so many incentives, there's little voices inside of many people says it says don't even start because of what you could find. And I do this test every four or five years called the CT&G-Grammeth contrast. It's basically a way of injecting a dye into your veins and then imaging your heart so that you can see all the arteries. Three, two, hold your breath. What it's also able to do now is image it in such a way where you can take that corpus of data and send it into a machine learning model. And then now you can start to extract an even more detailed sense of what's happening. That young lady is a perfect study. Absolutely beautiful.

很多我的关注者觉得他汀类药物可能在某些方面对他们有帮助，但在其他方面可能有害。这就是为什么我经常去找卡尔斯伯格医生帮我理清这些问题的原因之一。做这些测试的最困难部分是什么呢？你怎么看？老实说，最困难的部分是测试前的心理负担，因为我觉得有很多诱因，很多人的内心会有个小声音说不要开始，因为你可能会发现一些不好的结果。我每四五年就做一次叫作CT&G-Gra​​mmeth对比的测试，这基本上是一种将造影剂注入静脉，然后对心脏进行成像的方式，这样你就能看到所有的动脉。三、二，屏住呼吸。现在它还能用一种方式成像，使你可以把这些数据传输到机器学习模型中，然后你就能开始提取更详细的信息。那位年轻女士是一个完美的研究对象，绝对美丽。

I mean it's weird when the contrast goes in your body. Yeah, I've had it done a couple times before obviously. But I really, I forget each time. The heart is important but it's only part of the story. If you want a more complete sense of your overall health, you really need a pre-new boss game. Good morning. How are you? Good, thanks. So I reached out to Tremeth when we had just opened a clinic in Silicon Valley during COVID. And I thought I knew he was a bit of a hacker or bi-hacker and I really wanted him to experience what we were doing. He was nice enough to come in. We developed the friendship and he's been in for several scans. Can you accept right there? In the five years since I met Tremeth, we've now imaged about 150,000 people. We've saved or made about 4,000 life-saving diagnoses and every day we get stories from folks where we might have saved their life or gave them clarity or a dilute piece of mind. So it's really great to be building a company and at the same time having positive impact.

我觉得当对比剂进入身体时，会有一种奇怪的感觉。 是的，我以前做过几次这样的检查，但每次之后我都会忘记具体的感受。心脏固然重要，但它只是健康状况的一部分。如果你想更全面地了解自己的整体健康，你确实需要一次全身体检。 早上好，你好吗？ 我很好，谢谢。所以当我们在硅谷开设一家诊所时，我就联系了Tremeth，那时候正值疫情期间。我知道他有点像个黑客或生物黑客，所以我很希望他能体验我们的项目。他很友好地来了。我们建立了友谊，他也做了好几次扫描。在这五年里，自从我认识Tremeth之后，我们已经为大约15万人进行了成像扫描，做出或挽救了大约4000个生命攸关的诊断。每天我们都会收到一些故事，有的人说我们可能挽救了他们的生命，或者给了他们清晰的认知或安心。所以，在建立公司的同时能够产生积极影响，真的很棒。

Okay, let's do it. So what makes us unique compared to others is we operate our custom built research grade MRI hardware. We have AI that enables us to enhance image quality and then we have this incredible team of radiologists and medical professionals now over a hundred that deliver and Tremeth stand-up care for our patients. So I just did a full body advanced MRI scan. It took like an hour and 15 minutes but it really didn't feel that way because I just was lying in the machine watching Netflix. So it's actually like a really it's really great actually.

好的，我们来做吧。相比其他人，我们的独特之处在于我们使用专门定制的研究级MRI设备。此外，我们的人工智能技术使我们能够提升影像质量，并且我们拥有一支由超过100名放射科医师和医疗专业人员组成的优秀团队，为我们的病人提供卓越的护理。我刚刚进行了一个全身高级MRI扫描，花了大约一个小时又十五分钟。但实际上并没有感觉那么久，因为我躺在机器里看Netflix。总的来说，这真是一次很不错的体验。

Okay, yeah, so we just got in the car. We are headed to Toronto Techweek. Our first stop is at the Shopify headquarters for a fireside chat with my friend Farhan Thor. Good. How is that? What's up? Being on stage is something I like because it allows me to tell people what I think is going on right now and what will go on. I hate to say this way but like the more success that you can have the easier it is to detach yourself from real life and then you start to miss out on people. And if enough people you know find that truth credible some subset of those people will self-select and say hey I want to work with you on this and then I you know feed them into those businesses. It's a great opportunity for them but it's also how we get one step closer to achieving average dreams.

好的，是的，我们刚刚上车，正前往多伦多科技周。我们的第一站是去Shopify总部，与我的朋友Farhan Thor进行炉边谈话。挺好，这样如何？站在舞台上是我喜欢的，因为这让我可以告诉大家我认为当前发生了什么，以及未来会发生什么。虽然不太想这样说，但取得的成功越多，越容易让自己脱离现实生活，然后开始错过与人的交流。如果有足够多的人觉得这个观点可信，其中的一部分人会自愿加入并说“嘿，我想和你一起合作”，然后我会把他们引入这些业务中。这对他们来说是一个很好的机会，但这也是我们一步步接近实现平凡梦想的方式。

Now we're going to jump in the car and go to the 89B office in that lunch. Yeah. I just want to show this right to you. How are you? I just see you. I'm going to get you. Okay let's talk because I don't want to have time so what do we have to do for it? What I found is that early on especially when you're trying to do something extremely ambitious like the 80-90 team is trying to do the biggest problem is drift meaning you just kind of drift away. Everybody just drifts away. They lose an understanding and I think the responsibility of the CEO in that early phase when you're in the build cycle is to minimize the drift. The way that I think a good CEO can do that is just reminding people of what they're there to do. And so you know in Toronto is just a chance to just take everybody and sit them down, wipeboard something, just talk to them so that they could feel a sense of what was happening. It's one thing to hear it on a Zoom or see it in slides but it's another to just be in the room and feel that connection.

现在我们要跳上车，去89B办公室吃午饭。是的，我只是想直接向你展示这一点。你好吗？我刚看到你，我会去找你。好吧，我们来谈谈，因为我不想浪费时间，所以我们需要为此做些什么呢？我发现，特别是在你尝试做一些非常雄心勃勃的事情的时候，比如80-90团队正在尝试做的事情，最大的问题是走偏，也就是说，每个人会慢慢偏离方向。他们失去了一些理解，我认为在早期的建设阶段，CEO的责任就是尽量减少这种偏离。我觉得一个优秀的CEO可以通过提醒人们他们在那里做什么来实现这一点。因此，在多伦多有一个机会，可以让大家坐下来，用白板展示一些东西，与他们交谈，让他们感受到正在发生的事情。在Zoom会议上或通过幻灯片了解是一回事，但亲身在房间里感受到那种联系是另一回事。

Okay so what's the plan today? We're going to go and get a little readout of the pre-new vote scan and hopefully everything is in a relatively straightforward there. These health tests may seem a bit like overkill but I feel strongly that people need to advocate for their health and ask a lot of questions. What we know is that you lose about 3% of your brain volume every decade on average. Is that right? Yeah. And so the question is how do you compare? Honestly my stomach felt a little bit when Andrew mentioned brain volume loss because I knew the FDA label on statins warns about memory loss. Sean over to you tell me the good news or the bad news.

好的，那么今天的计划是什么？我们要去获取一下投票前扫描的初步结果，希望一切相对简单。这些健康测试看起来可能有点过于谨慎，但我坚信人们需要为自己的健康倡导，并多问问题。据我们所知，平均每十年大脑体积会减少大约3%。是这样吗？是的。所以问题是你和这个数据相比如何？老实说，当安德鲁提到大脑体积减少时，我心里有点不安，因为我知道美国食品药品监督管理局在他汀类药物的标签上警告过记忆力减退。肖恩，到你了，告诉我们好消息还是坏消息。

So this is the enhanced scan now and so what what we're looking at here is just blood flow throughout all the higher functioning brain tissue and this is all very symmetric and normal. Well I think what Dr. Lennon is saying is you're on a normal curve here. What suck at people all the haters out there? Nothing worries him. No change when it comes to my brain. I'm really relieved. But something that did confound me is that I have some muscle loss which is concerning. This is the main thing I wanted you to focus on and to highlight with the muscle muscle mass because we know how important maintaining muscle mass is particularly for brain health too over time and it's harder to maintain as we get older. Plus the internet thinks that I don't work out of I should be doing more like that. So this is going to really feed the whole conspiracy. Take everything with the greatest self too. They're going to love it.

这是增强扫描的结果，我们看到的是大脑高级功能区域的血流。这些血流都很对称而且正常。我想伦农医生的意思是，你的状况在正常范围内。那些讨厌的人有什么好说的？他不担心，我的大脑没有变化，我感到很欣慰。但让我困惑的是，我有一些肌肉流失，这让我感到担忧。这是我希望你们关注和强调的主要问题，因为我们知道，维持肌肉量对大脑健康也很重要，尤其是随着年龄增长，维持肌肉量变得更加困难。此外，网上有人认为我不锻炼，说我应该多锻炼，这无疑会助长这些阴谋论。一定要谨慎看待所有事情，他们会喜欢这样的消息的。

I mean it's not like a terribly concerning decrease. Yeah. It was just more notable than the other fluctuation. The trolls are going to love it. Like I told you you know workout and it's not true guys. I'm just tall. I mean every time I comment just get say you're doing a better and better job building this thing. It's so great. I love being a guinea pig for stuff like this. Yeah. And it's been really valuable for me. The next like 10-11-12 years I really want to make sure I pack as much muscle as possible. Insulate myself going into my 60s and 70s seems like the right goal. Thank you very much. Thanks for visiting. Right to see you.

我的意思是，这并不是一个非常让人担忧的下降，对吧。只是比其他波动更明显而已。那些喷子会喜欢的，他们会说：“我告诉过你们健身没用。”但这不是真的，我只是个子高而已。我每次评论，人们都会说你做得越来越好，这个项目真的很棒。我很喜欢成为这种东西的试验品。这对我来说真的很有价值。在接下来的10到12年里，我真的很想尽可能多增肌，让我到了六七十岁时能有足够的“隔热层”，这似乎是个不错的目标。非常感谢您。谢谢您的到访。能见到您真好。

Now it's time to check back in with Dr. Krollsberg and face the music on my heart. Welcome back. Thank you. Good to see you. You had a really busy day yesterday. Busy day. Yeah. But a good day. What I'm going to do now is present something that's quite astonishing. You have a zero calcium score and you still have a zero calcium score. Let's get out of here. Not so fast. We see that over the 10 years you had a 370 percent increase in that material, which means that you are on a pathway to atherosclerosis. But you're one of the few people on the planet that have this kind of information. And you're going to take advantage of it.

现在是时候去见Dr. Krollsberg，认真面对我心脏的问题了。欢迎回来。谢谢你，见到你很高兴。昨天你过得很忙。一整天都挺忙的，但也是不错的一天。现在我要告诉你一个非常惊人的事情。你的钙化评分是零，并且仍然保持为零。但是，别急着走。在过去的十年里，你的这种物质增加了370%，这意味着你正在走向动脉粥样硬化的道路上。不过，你是地球上少数能获得这种信息的人之一，你将好好利用这个信息。

And so what we're looking at here was a percent change that went from total plaque volume fell from 24 percent a year to 10 percent a year, which is consistent with what we found in much bigger studies. Now, given the first level of tears, which is listen to your audience and come off the drugs because they're dangerous or stay on the drugs, the first level of decision on your part based on what you heard is going to be one. Obviously, we're going to stay on the drug. Okay. That's your decision. Yeah. Okay.

我们在这里看到的是，总斑块体积的年下降百分比从24%降低到10%，这与我们在更大规模的研究中所发现的结果一致。现在，在风险的第一层级下，你应该根据听众的反馈决定，是要因为药物的危险性而停药，还是继续服用。显然，你的决定是继续服用药物。好的，这就是你的决定。

I think what I'm hearing from you is we started this statin a decade ago. It seems to have had a pretty meaningful impact. We, it's all of these other things that we never would have known to look for had this stuff not existed. Exactly. So what I'm learning from you actually is a big deal. You've done some good stuff and that was actually pretty preventative and good. But there's now an even better leading edge for you because you're fighting against a genetic trend that will eventually catch up with you.

我觉得，我从你的话中听到的意思是，十年前我们开始使用这种他汀类药物，这似乎产生了相当有意义的影响。正是因为这些事情的存在，我们才发现了其他一些我们本不会注意到的问题。确实如此。所以，我从你这里学到了很多，这意义重大。你做了一些很不错的预防性工作，那真的很好。但现在有一条更好的前沿道路，因为你正在对抗一种最终可能会影响你的遗传趋势。

That's a secret. That's fantastic. I want to know the secret. I want to know the answer now. There are no standard treatments for you. I think that you could choose to wait. Your calcium score is zero. Your outcome is going to be fine for the next five, ten years. Chances of you having a cardiac event are very, very close to zero. No risk of a cardiac event in the next five years. Hopefully ten. That's my prediction.

那是个秘密。太棒了！我想知道这个秘密。我现在就想知道答案。对你来说，没有标准的治疗方案。我认为你可以选择等待。你的钙化评分是零。在接下来的五到十年里，你的情况会很好。你发生心脏事件的几率非常、非常接近于零。在未来五年内没有心脏事件的风险，希望是十年。这是我的预测。

All right. You're doing a great service. Thank you. Thank you. Thank you. See you soon. Have a great summer. Bye. Bye. You know, if there's one thing I've learned through this process, it's that there's no finish line. Honestly, optimal health isn't a destination. It's a journey. But at the end of the day, we all face the same choice. Do we wait until something breaks? Or do we start listening now?

好的。你做了很棒的工作。谢谢你。谢谢你。谢谢你。很快再见。祝你有个愉快的夏天。再见。再见。你知道，通过这个过程我学到的一件事是，没有所谓的终点线。坦白说，最佳的健康不是一个目的地，而是一段旅程。但最终，我们都会面临同样的选择：我们是等到问题出现，还是现在就开始倾听自己的身体呢？

Starting the health journey can be scary, but in my opinion, I think it's worth it because living while is the best return there is. Well, we're home. It's been a lot week. I hope you enjoy following me around. But now it's time to get the fuck outta here.

开始健康之旅可能会让人感到害怕，但在我看来，这是值得的，因为健康生活是最好的回报。好了，我们到家了。这真是忙碌的一周。我希望你喜欢跟随我的步伐。但现在是时候离开了。