Episode #350: Startup Series – Saad Alam, Hone Health, “40% Of Men Over 35 Have Hormone Imbalance With Testosterone”
Guest: Saad Alam is the founder & CEO of Hone Health, is the premier men’s optimization clinic that helps men get their spark back and be their best self. Hone Health fixes hormonal imbalances and low testosterone by offering at-home blood tests, 30 minute telehealth consults, and medications delivered directly to their door.
Date Recorded: 8/25/2021 | Run-Time: 48:36
Summary: In today’s episode, we’re talking men’s health! Saad walks us through how his personal experience of being told he had the hormone levels of a 70-year-old man gave him the idea for the company. We discuss the reasons for the decline in both testosterone and fertility in men. Then we walk through the process of getting your testosterone levels tested with Hone Health and later doing a visit with a doctor to help restore your levels back to normal.
As a special offer for listeners of the show, visit www.honehealth.com/saad to get 25% off your order.
Sponsor: The Idea Farm gives you access to over $100,000 worth of investing research, the kind usually read by only the world’s largest institutions, funds, and money managers. Join today and get access to quarterly CAPE ratios, an excel quant backtester and the entire research library. And best of all, there’s a 30-day free trial period.
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Links from the Episode:
- 0:40 – Sponsor: Idea Farm
- 1:25 – Intro – HoneHealth.com/saad to get 25% off your order
2:25 – Welcome to our guest, Saad Alam - 3:54- What led Saad to drop out of med school and into optimization therapy
- 6:41 – Episode #338: Startup Series – Will Mathews, Fellow
- 8:16 – Working through the initial regulatory hurdles and going from idea to launch
- 11:58 – Leading causes of testosterone depletion in middle aged males
- 14:52 – The process of being tested and treated with Hone Health
- 26:07 – Some of the insights and lessons learned from the data they’ve collected
- 30:40 – What the future looks like for Hone over the next few years
- 33:03 – Biohacking levers Saad pulls on regularly to help with longevity
- 38:02 – What a sound bath is; The Integratron
- 40:38 – The fundraising process during a pandemic
- 42:35 – Learn more about Saad; honehealth.com/saad
Transcript of Episode 350:
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Meb: Hey, friends. Today, another great show. Our guest is the founder and CEO of Hone Health, a company that helps you fix hormonal imbalances and low testosterone by offering at-home blood tests, 30-minute telehealth consults, and medications delivered directly to your door. In today’s show, we’re talking men’s health. Our guest walks us through how his personal experience of being told he has the hormone levels of a 70-year-old man gave him the idea for the company. We discussed the reasons for the decline in both testosterone and fertility in men. Then, we walked through the process of getting your testosterone levels tested with Hone Health, and later doing a visit with a doctor to help restore your levels back to normal.
As a special offer for listeners of the show, visit honehealth.com/saad to get 25% off your order. Again, that’s honehealth.com/saad to get 25% off your order.
Please enjoy this episode with Hone Health’s Saad Alam.
Meb: Saad, welcome to the show.
Saad: I’m really excited to be here. Thanks for having me on.
Meb: Let’s just start with you being a med school dropout. You know, I was an engineer, I briefly considered med school, I ended up in biomedical engineering. I volunteered, I think I got credit for it, in a wound care clinic and took one look one day of doing that in person, and I was like, “Oh, hell no, this is…oh, my God, go put me behind the computer. This is…I can’t deal with this.” What was the progression for you?
Saad: So, there is a little bit of that, by the way. My girlfriend cut her finger the other day and I ran the other way, probably a pretty good indicator. But honestly, for me, I had this guy, he was an advisor, he had two PhDs, he had an MD. All through from Columbia, graduated top of his class. The first day I came in, here I am, right, really callous 22-year-old kid, and I just, like, flat down on his desk. And he says, “You really lucky to be in the position you are,” and I said, “Why?” And he said, “Well, with my MD, I can be across the street at Presbyterian, pulling down a million dollars a year helping people with their hearts. But I’d only see 2,000 or 3,000 patients over the course of a year. And with my life, I’m working to eradicate arsenic in Bangladesh’s drinking water. And over the next 10 years, I’ll save 65 million people’s lives.” And I said, “Wow, what you’re doing is kind of where I want my life to head.” And I was in like, this dual MD/MPH program, I finished my MPH off, and I said I’m out of there. And I went to business school. And that’s a whole other question, that was the decision or not, but…
Meb: And so you started a kick-ass new startup, what was the progression? I’ve heard it, but for the audience who would love to hear a little bit of the origin story because it’s got a little bit of a personal slant to it as well, right?
Saad: Yes, this is about as personal as it gets. So, let’s see, just some background on myself. I am insanely healthy, meaning I’ve worked out 6 days for the past 25 years of my life. I eat perfectly, meditate twice a day, track my sleep with three different devices. If I turn this camera around, you’d see this massive infrared sauna in my office actually that I do a bunch of my calls from. So, health is just a really large part of my identity.
Meb: We should have done the podcast from the sauna. One of my favorite podcasts ever was, like, Rick Rubin where I think he was doing part of the podcast from the sauna or directly out of the sauna. It was great. Anyway, sorry to interrupt.
Saad: No, honestly, Meb, I feel like Rick Rubin has done things and broken so many stereotypes, the stigma. I almost feel like I’m going to step into my sauna right now and finish this off.
Meb: Yeah. Awesome.
Saad: But basically, when I turned 35, a bunch of things started happening, super worrisome. My energy was at a low, mental acuity and stamina down really hard. All of a sudden, I started gaining weight on my body, and then my libido was absolutely gone. And went to my physician, I said, “Something is dramatically wrong with me.” And he basically sent me off to get some blood work, asked me to come back, looks in my eyes, and very seriously says, “Saad, it’s all in your head.” And I said, “That’s bullshit, man.” I said, “There’s no way, I’m super in tune with my body.” I spent 6 months meeting with different hormone optimization and regenerative physicians, and they said, “Saad, you had the testosterone level of an 80-year-old man.” And I said, “That is crazy.” And then I said the T-word. Ah, it sounds so underbelly and so dirty.
And what was the most interesting thing is, I started doing all this research because they told me a large majority of their patients are these younger dudes. And basically found that 40% of men over 35 have hormonal imbalances and low testosterone. And I started kind of, like, becoming obsessed with the problem and started digging into it. And this is going to sound incredibly conspiratorial, but what you basically find is that our father’s generation had 25% more testosterone and 50% more sperm.
And so, we’re like, there are these large generational shifts that are being happened. And when you dig into that, you begin to learn that all the plastics, phthalates, PCBs, all this stuff in our drinking water and the foods that we eat, it really gets into a guy’s body and attempts our natural hormone-regulating centres in our brain to shut down androgynous production. And so, you have all these guys that are like the late 30s, early 40s, running around with low energy. They’re having fertility problems, which I don’t know about you, all my friends are exactly in that age category. And they kind of like describes all of us to a tee, no pun intended.
Meb: Yeah, I mean, we did a podcast with a sperm testing startup fellow maybe a month or two ago and talked a little bit about this. And a lot of people haven’t heard of it this, like, decline in fertility. It’s honestly like, first time you read about it, it’s pretty scary. I mean, it’s like out of the plot of “Children of Men.” This movie where you’re like, “Wait, why is this happening? What’s going on?” You definitely get the Internet, like, conspiracy theories of like all the various reasons why but…
Saad: And so, one, it’s like that. It’s just like “The Handmaid’s Tale.” And that’s why I say it sounds sort of conspiratorial. When I first read it, it felt like it was something of a science-fiction book. And basically, I ended up…let me also say this too, the psychological impact that had on me was crazy. I am the most confident, most energetic person I probably ever met, and all of a sudden, I’m wondering, how am I going to take care of my aging parents? How I’m going to take care of my family? Can I build another company? Did I see my best days already? And, like, it gets you to a really dark place and it forces you to question yourself in these ways.
And so, I went in this optimization therapy, and man, it just completely turned my life around. It was like literally not having enough energy to get out of bed on certain days to feeling like my 20-year-old self again. I don’t mean like my 20-year-old self, where I could pick up cars or had superhuman strength or, like, drink all night. Actually sounds horrible, if you ask. But more than anything, I just felt like my best self on my best day ever. And the moment I realized that that is what optimization therapy did. I said, “Okay, I know exactly what I want to spend the rest of my life doing,” which is helping other men have confidence as they actually age.
Meb: So, you touched on a couple of topics that I think are interesting, because I hadn’t really only heard about this, this wasn’t a commonly discussed topic amongst my friends. Partially, I think the education in the general population is pretty low about this topic. And to the extent people know about it, it feels sort of backroom clinic, sort of, like the only friends that I had heard that had been involved, like, it was from that sort of environment.
And there’s a little paintbrush of shame, for no reason, right? We know this, but for whatever reason, males are going to be males. And so, to think you’re not sufficient in something like your “body” should be produced, right? It’s in your head. But I think the pandemic has done so much to break down a lot of stigma for everything. I mean, like you said, you’re doing this podcast next to a sauna, if I was at home, “Paw Patrol” would be on in the background and dogs running around.
So, let’s go from idea to actually company building. So, you said, “Okay, this changed my life.” I’m sure you’re talking to friends and family about it. But what was sort of the next step about hey, this should actually be something as one of my life’s missions?
Saad: So the reality of what I do…and let me also say this before we get started, so I’m not a doctor, so anything I say is not medical advice. I just happen to know a lot about this, and I’m deeply passionate about it. At the end of the day, what we do is we run one of the most complex and sophisticated blood collection companies that have the probably deepest infrastructure across the entire country to get samples from individuals, and then prescribe them things like controlled substances, i.e. testosterone. And so, when you actually tell someone I want to go build a company that becomes the largest provider of TRT in the nation, they go, “You’re absolutely crazy.”
And to be honest with you, I had to spend…I spent seven months doing research and thinking if I, one, is the market as big as I think it is, and there are as many guys go into the problem as I actually believe they are. And the second thing was I had to make sure that I was able to go through all the appropriate legal and regulatory channels. And make sure that this thing would be as safe and conservative as possible and was doing everything according to the book, like literally right down to every single last regulation on a state-wide level.
And frankly, I did all that, I was terrified. I didn’t do anything for another three months, because I didn’t have, excuse my language, the balls to actually get myself over that next stump. But once I did, I was incredibly fortunate the way the financing came together and the way I met my team. But we basically said, “Okay, we are going to put this company together, we’re going to do it right according to the book. We’re going to bring together one of the best medical teams, one of the best early-stage healthcare startup teams.” And we went from an idea in September of 2019, to launching in March of 2020.
And then, it became one of the fastest-growing men’s health companies in the country last year. Like, it was just absolutely unbelievable how fast it went, the age demographic that we were reaching. But almost more importantly, you hit on this before, COVID is what allowed us to expand so quickly, actually. The relaxation of the telehealth regulations helped us tremendously.
And also, it was the first time I think in maybe ever in modern society, at least in America, where you had millions of men sitting at home. And for the first time, confronting themselves in the mirror every day and going, “Why do I feel like this? Is it because of COVID? Is it because of anxiety and stress? Or is there something deeper?” I always thought it was probably like depression or maybe like an ED problem. But the reality is that it’s something that is, I would say, far more nuanced than that and hits you at a much deeper level.
Meb: What is the cause for this? We mentioned a little bit potential environmental factors. Is it more genetic? Do you think it’s 50/50, 90/10 if you had to kind of talk about it? And then we’ll walk through the actual process of how you get tested and what’s the prescription.
Saad: All right. So, let’s first talk about what happens when a guy turns 30, your body stops naturally producing one to two percentage points of testosterone per year. So all of a sudden, you’ve got these Leydig cells in your testicles and your Leydig cells basically start shutting off slowly. And so that means by the time you’re 40, you’ve probably lost between 10% to 20% of your natural ability to produce testosterone.
Now, the most interesting thing is most people just think testosterone has to do with libido. That is a very small part of what it has to do with, it has to do with overall body function. So, it has to do with your ability to think. It has to do with your ability to produce red blood cells. It has to do with your ability to respond to exercise. It has to do with your sleep. It has to do with your bone mineral density.
I actually was listening to one of Andrew Huberman’s podcasts this morning on when he was on Joe Rogan about testosterone, never understood why it increases your motivation. But basically, when men have higher levels of testosterone, it impacts their amygdala and tells them that hard work feels good. And it’s really interesting that that’s the case, which is why a lot of guys when they’re younger, love athletics, because the harder they work, the better it actually feels. And it makes a lot of sense. And so, there’s that one, your body stops naturally producing testosterone.
The second one we talked about was all of a sudden, you’ve got, especially if you live in an urban area, you’ve got all these chemicals everywhere. You’ve got plastics, you’ve got PCBs, you’ve got phthalates. And they basically get into our body and they tell the hormone-regulating centres in our brain, it’s called your hypothalamus, that, “Hey, here’s a piece of estrogen here.” And there’s this interesting feedback cycle in your body, that if you have too much estrogen in your body, your actual testosterone production shuts down. And the reason being is because testosterone eventually turns into estrogen in your body. It’s almost like an internal thermostat. And so, because of that, a lot of guys are running around with lower testosterone levels.
But that isn’t the only reason. Let’s now pile lifestyle factors on top of it. If you’re not sleeping well, if you’re in front of a screen all the time, if you have a poor diet, if you’re smoking, if you’re drinking, all of these things contribute to your testosterone level, which contributes to your overall well-being. And so, generally, what we tell people is before you even look to therapy, and here’s the God’s honest truth, if you just reduce your stress, if you just sleep well, if you just move and eat relatively healthy, your life is probably going to be okay. All this other stuff we do is just for optimization’s sake. But if you do all those things and you still feel really crappy, that’s when you generally start looking for something like therapy that we do.
Meb: When you guys first came across my desk, you are known as Peak, you’re now known as Hone. I invested a little, and then in prep for this podcast, my expectation was that I probably had pretty normal testosterone as far as the symptoms. I pretty equate to just a normal 43-year-old with a child tiredness, but I went through the process. So, you can tell us what happens. But it’s pretty darn simple. So walk through what’s happened, somebody is listening to this, they say, “Okay, I want to check it out, I want to find out what my numbers look like.” They go to the website, then what? Is it Hone Health?
Saad: Yep, it’s Hone Health, honehealth.com. They’re going to buy a kit, and we’re going to send them out this kit in their house, we’ll probably get it two days from them. And in that kit, there are a couple of pieces of fancy filter paper, and there are a couple of lancets. They’re going to prick their finger with the lancets. They’re going to drop four drops of blood into each of those pieces of filter paper, there are two in the box. Then, they’re going to drop it into a prepaid envelope and send it to one of our labs, we’re then going to analyze it for eight different hormones. After we analyze those eight different hormones, we’re going to send them out a text or an email that basically says, “Hey, in order to go over your results, you should talk directly to a physician.”
So then we’re going to arrange a 30-minute telehealth consult using an audiovisual. So, it’s basically just FaceTime with your physician. This is not like your average run-of-the-mill primary care conversation. This is the kind of thing where it’s deep like you got to go in and you got to be willing to share, open up that entire kimono and talk about what are you going through in life? Who do you want to be? And you got to be really open and honest with your care provider.
And then on top of it, they’re going to say, “Okay, well, let’s go over your biomarkers, let’s educate you so you understand what’s going on in your life. And let’s give you different options if you require medication, about what you can do.” And they’re also going to give you lifestyle advice, they’re going to give you ideas on supplements, they’ll give you either pharmaceutical plans.
And then, if a pharmaceutical plan is what you decide to do, you go on a membership through us, it’s $120 per month. And then we charge you exactly the cost of medication that we get from the pharmacy, it’s illegal to actually mark it up. And so, then you pay us and we pass that money directly on to the pharmacy. And then, every month, you’re going to receive the package in the mail that has your medications.
Now, the most interesting thing is, most clinics, they basically hand you a bunch of products and they walk away for a year. That’s not the way this is done. Every 90 days, we require you to do another blood test and do another consult with a physician. Because once you start touching one hormone, a bunch of other things can happen in your body. And it really is like this six-month process that you have to go through in order to dial in and figure out how you feel the best. And I’m going to be…and it’s such a weird word I use like feel, there’s one part of the equation, which is what are your actual hormone levels?
And there’s the other part of the equation, which is how do those hormones interact with your personality and manifest changes in your life? It really is a very soft, qualitative, are you feeling like you’re completely energized? Do you feel sleepy? Do you wake up feeling like you want to just get after the day? Do you feel like you’re romantic again? Do you want to spend time with your children? Are you a little bit too… I mean, like, what’s the word? The one that comes to mind is, sometimes people think you can become too aggressive. Well, the reality is, when you look at the dosages the physicians you work with provide, it’s like a tenth of what should make you aggressive theoretically. And so, all of those different factors go into play to help us understand how to really dial in the medication or change the medications off to help you feel like your best self.
Meb: I went through the process, it’s super easy. Mine ended up being normal. My favorite part of the process though was the doctor was the nicest guy ever. And he looked exactly like Hal Holbrook, and I had to Google this because I didn’t know who this actor is, a very famous Oscar-nominated, Tony Award-winning actor. But if anyone’s ever seen the Tom Cruise movie, “The Firm” with Gene Hackman, Hal is the actor who’s in charge of the firm, looked exactly like this guy. And I couldn’t…I had a hard time paying attention because I was like, “Is Hal Holbrook also a doctor?” So, I had to Google it. Holbrook passed away like a year ago, but a great actor. Anyway, so mine ended up being normal. Walk us through what are the options on the medications? And also, are there any non-medical options you can do to boost testosterone, in general?
Saad: Yes. So let’s even start there. If you haven’t tried getting eight hours of sleep a night, if you haven’t tried figuring out how to reduce your stress, and I happen to be like, a huge proponent of meditation, if you haven’t figured out how to cut tons of sugar and carbs out of your diet, if you haven’t stopped drinking a lot, you haven’t stopped smoking, chances are you should try doing those things first before you even start thinking about how to improve your testosterone levels. Now, there is the reality, which is some people are almost in a depressive state, and they need to figure out how to get some momentum back in their life. And if you’ve kind of tried changing all those things, but none of them have improved, then I say definitely come to us.
So then, the other thing they’re going to probably suggest for some supplements, then they’ll probably look at your levels. And they’ll say something like this…and once again, I’m not a doctor, but there are certain medications that can be prescribed off label or on label that help men improve their testosterone levels naturally. There are also other medications that help men remove some of the estrogen from their body that may be causing some of the problems. And then, some of the medications are things like testosterone.
And testosterone comes in three different forms. It comes in what they call a subcutaneous injection. So, it’s like this little insulin pen that you take small doses of testosterone, inject directly into your stomach. I actually do that myself. It’s quite literally painless, and I absolutely hate needles. We also do a cream that you can use. And then, we do something called the troche, which is one of these, like…it almost is like a little Starburst that goes underneath your tongue that tastes really good. And then, we are beginning to now…we just did simple things like Viagra and Cialis. We are launching, probably, other 13 or 14 other medications over the course of the next year as well.
Meb: Is there one that tends to have the most efficacy? Or is there one…because I imagine those have different levels of compliance like you mentioned the needle for whatever people in their head, most people opt for the cream? What are the sorts of the seesaws or variables that kind of work in that decision other than the doctor’s recommendation?
Saad: All right. Well, we’re going to play this game. You tell me what percentages you think the cream, the troche, and the needle are prescribed in?
Meb: The troche is the dissolve?
Saad: Yep, goes underneath your tongue.
Meb: I would go…assuming the cream doesn’t smell like one of these cannabis CBD creams, or like Icy Hot, assuming it doesn’t smell like Icy Hot and you’re going to offend everyone in the grocery store, I’m going to go like a lozenge, subcutaneous, cream, shot.
Saad: Opposite.
Meb: Opposite?
Saad: Hold on. When we started the business, I swore that if I were betting…I did make a bet and I did lose it. I bet exactly the way that you did. Interestingly, 95% of what we prescribe is a subcutaneous injection, the most efficacious, interestingly, is the cream.
Meb: Weird.
Saad: And there’s like a couple of elements. We haven’t been able to figure it out. Part of it is I think that guys associate something that is almost afflicting like a certain element of masculinity on yourself comes in a needle, like I earned this. Also, I think that when guys go online and certainly on message boards, message boards happen to say that the needles are the most efficacious.
Meb: How often is the needle?
Saad: So that’s another interesting question. Most physicians will start someone off on once a week. The best way to actually do it with the least amount of side effects is you split that dose in two and do it twice a week.
Meb: Okay. And is the cream and the lozenge daily?
Saad: That’s correct. The cream is and the lozenge can be twice a day.
Meb: Yeah, that may be it, just appealing to the male laziness of compliance. I feel like I would probably rather take a shot once a week than cream up every day. But yeah, okay, cool. All right. Well, so you start turning the dials. And then is it pretty often that you’re going to have to kind of figure it out over the first 6, 12 months? Or is there kind of a traditional glide path that people are doing? And then, are you going needles and creams for the next 60 years, or what?
Saad: Generally, the physicians we work with, if the patient decides to go on something like testosterone, they’ll start a patient off on like 100 milligrams per week. And just to give you as a frame of reference, if you were a bodybuilder doing a cycle of steroids, technically, you’d be doing 1,000 to 2,000 per week. So, we’re giving the patient at 10% to 5% of what someone all the way at the opposite end of the spectrum would be getting.
You start feeling changes, depending upon the person and as soon as two to three weeks of testosterone, if it’s one of the other meds, it takes a little bit longer, one to two months. The reality is you have to kind of stick with it for two months to really figure out how your body is beginning to feel because you have to stabilize your blood concentration levels of testosterone. It takes a little bit of time to happen.
And then, usually at that 90-day mark, and it’s when I say 90-day mark, it’s really like 70 to 90-day mark that you meet with your physician again. You talk about, “Should I increase my dosage? Should I reduce it? Should I add something else on to maybe help my natural production increase a little bit or maybe take some estrogen out? And it usually is right around the six-month mark when people start to feel comfortable with it.
Now, the other thing that you may realize is because there are three different formulations, patients will say, “Well, I don’t really like the cream, I want to with the injection.” And then you kind of sort of start that process over again because they all have very different feelings associated with them. And you’ve got to figure out which one you like for your body type the most. The question about like, “Am I on this thing forever?” Great question.
So remember, I talked about that feedback loop in your body and you kind of have that thermostat in your brain. For some guys that are younger, let’s call them sub 40 years old, they’ll get a medication that basically increases their fertility. And it’s increase that there’s a signal that goes from your brain and your hypothalamus to your testes. And that signal is a luteinizing hormone that is sent. And there’s a medication that you can take that amplifies that signal. And so, for younger guys, very often, that’s what we give them to preserve their fertility. And once you give them that medication, they can go off it, it’s almost like a kick start to their system.
Now, the moment you start shooting testosterone or what they call exogenous testosterone, it basically takes that feedback cycle that’s going through your body, and it starts to disrupt it a little bit. And so some of your natural testosterone production actually decreases a little bit because you’re putting so much in from outside of your body. And in those instances, if you are younger, you can very often re-kick start your body by taking that same fertility medication we talked about. But if you’re older, let’s say 55, 60 years old, frankly, the engine or the motor may not be working, i.e. your testes.
And so, you may have to be on the testosterone for a prolonged period of time, which is no different than taking any other chronic medication. But you just have to make sure… And our physicians, I should say our physicians, the physicians we work with, they do a really good job of making sure that patients understand what they’re getting themselves into. But very often the guys are already feeling so crappy that this is the best alternative they have on their hands right now.
Meb: So you guys have been doing this for what? Two years now, ballpark?
Saad: Eighteen months.
Meb: Eighteen months. Talk to us a little bit about some of the insights. I imagine an eventual massive resource is that you guys are also building this huge database and platform of data inputs of all these guys that are signing up and getting treated. But has there been any general takeaways from…the shots one is a surprise to me, but anything else that having done this for 18 months other than how hard a startup is? Any other takeaways that have surprised you or have been interesting on this journey?
Saad: You actually said something that was incredibly insightful. What we built is actually probably the most sophisticated engine for longitudinal efficacy-based studies across the country bar none. That’s just a fancy way of saying because we have biomarkers over multiple time periods throughout the year, we can then start running studies on which combinations of medications for which men, and which combination of lifestyle factors end up producing the best effect. And so, the interesting numbers that we’re starting to see is, you can basically give a guy a series of medications. And depending upon which of those medications, you can increase their testosterone levels by two, two, and a half, 3x sometimes. But the quality of the change, meaning how they feel at the end of the day, is dramatically different.
So certain medications that I’ll call not controlled substances like this fertility drug, if you take it, your testosterone level may go up two and a half times. But your symptom improvement may only improve…I’m kind of using these rough numbers, 15% across 8 different quality score measures. Versus if you took something like testosterone, which is a controlled substance, your testosterone level may only increase 2x rather than 2.5x. But your quality of life measures will increase 24% rather than 15%. And so you can very quickly…and then I can start diving into, like, very specific populations event to say, for white males that are 43 years old, this is probably the best set of medications to start this particular patient on and this particular dosage.
And now that we have thousands of men that we can do that with, it’s very insightful, not only for the patients. But then we can also go back to the physicians and say, “Hey, look, the way you’re currently prescribing, it is probably either too aggressive or not in line with how to get an optimal response for a particular patient population. Why don’t you just take a look at this data?”
And so the thing the reason why this is so exciting, is when we started to build a business about testosterone, people basically said, “Hey, look, very difficult business.” And it is, without doubt, the single most difficult business to build within telehealth. What inadvertently happened because we’re doing these at-home blood tests, we’re then doing Labcorp and Quest draws, we’re also doing at-home phlebotomy. And so we have literally built the most complex infrastructure for collecting blood at anyone’s house literally across the entire country at this point in time. And then we just literally go, “Well, we’ve got testosterone, why don’t we add this next medication, this next medication?” And because we built the infrastructure, we built this engine we call the prescribeinator. And basically, any medication, any lab biomarkers at any cadence, and we automate the entire thing so you can run tens of thousands of patients at scale in, like, this very, very complex dance that you’re doing on a daily basis.
And I think the other, like, really interesting thing we’ve learned is two kinds of interesting insights. The average age of a testosterone user across the country is 53, the average age of our users is 39. So, you’re legitimately going into a much younger demo. And we only prescribe to patients that are what they call hypogonadal, so that means that they’re clinically low. We’re not just what they call this strict optimization clinic that gives it to anyone. And so, you’re actually are seeing that the age of patients is very much in line with what the research shows that the rest of the market hasn’t caught up there yet. That’s the first.
The other one that’s very interesting, too, is that patients, in general, if you were to ask them, why are they coming for this particular therapy. A lot of people would guess, like, it’s a libido problem or like a muscle problem. It’s an energy problem. The single biggest insight we get is, “I don’t have enough energy.” It’s actually a really deep statement I’m about to make, but it’s not going to sound like it. “And I don’t feel like myself. And because of that, I can’t take care of the people I love.” Like, at the end of the day, this is really about like, “How can I be a man and take care of my family?” And that’s why the customers are coming to us right now.
Meb: Yeah, I mean, it makes sense. You alluded to sort of the future a few times, as you guys scale, I imagine you have a ton of blocking and tackling just with the opportunity set in front of you. But as you look to the horizon, next year, next couple of years, I imagine there’s a lot of possibilities. I mean, clinical trials could be one on certain partnerships. I imagine just analytics research. But what sort of meds do you refer to, like what would be the natural extension? To the extend you can talk about it if you don’t want to announce it, that’s fine. But to the extent you’re willing to mention, what does the future look like for Hone?
Saad: I can’t mention the meds because I’ve got to imagine people are probably listening. But I can say this, my beliefs that we’re about the same age issue, I believe, guys our age to live until we’re 110 or 120. And I know that some people will think that’s crazy, but I actually believe it’s a foregone conclusion. And I think that barring no chronic or acute circumstances, we get to live that long. So that means, at me sitting 40 here, I may have 60 good years a good life ahead of me. Forget about life at the end, that’s kind of decrepit and probably a little bit slower.
And if you realize that you have 60 good years of life ahead of you, it fundamentally changes your understanding of the arc of our lives. I’m no longer saying, “At 65, I’m going to retire.” We’re going, “At 65, I’m going to have another whole life ahead of me.” And when you begin to shift your perspective, you begin to realize there’s no playbook that’s been rolled out to help, I’m going to say men and women, understand that your biological health is one part of the equation. You have to probably modify your behaviors to start thinking about how do you move and how do you eat appropriately. Because whatever helped you for those first 40 years is not going to help you for the next 60.
And then, there’s this other really important part of life, which is…and I bet you a lot of the guys listening to this podcast believe in it, but so much of this is about your mindset. So, what are the mental and emotional behaviors that you’re practicing on a daily basis? How are you setting goals? How are you visualizing success? How do you prioritize in your life? And if you get those three things right, you become better every day, and frankly, allows you to do the things you really care about, which are, like, spend time with the people that you love. And I know that sounds very, very soft in itself, but the reality is, like, that’s where we think the entire market is moving, which is helping people live far along.
Meb: I mean, it makes a lot of sense. I mean, it becomes part of a holistic concept, which even from the beginning of the podcast, you certainly have an interest in a deep experience with. Talk to me a little bit about that as someone who’s spent his personal life, biohacking. What have been any of the big levers that have made a huge difference for you? You mentioned you got a sauna. I don’t even know what an infrared sauna looks like. So, you crank that up to what? What’s the temperature and how long do you hang out in there?
Saad: So, a traditional sauna goes to like 181, 185. This goes to about 136 and I spent about 30 minutes in it per day.
Meb: Awesome. I thought you’re going to say, “I’m like a vampire, I sleep in there. Just set it at 130, I sleep in there.”
Saad: Listen, I’ll tell you, I do want to get a hyperbaric oxygen chamber. And I would intend to spend quite a bit of time in there.
Meb: What else? You talked about you eat healthy, is it a pretty traditional…what kind of diet? What does that mean to you?
Saad: I actually…there’s this guy named Thomas DeLauer. Have you ever heard of him?
Meb: Uh-uh.
Saad: You should take a look. So, Thomas is probably I’m going to say the world’s foremost authority on keto from the perspective that I probably care about, which is, he lost, I don’t know, 120 pounds on keto. And if you look at him, he looks like Johnny Cena. And, he is arguably the smartest person I’ve talked to about this. And so, Thomas is actually like my personal coach. So, I eat a modified keto diet, meaning like, I go three days keto, one day off, three days keto, one day off. And what that basically means is that you add a ton of Mediterranean fats. I don’t eat carbs in days that I’m keto, and I eat a ton of meat and a ton of protein. Other things I do that are really important is I sleep on an Eight Sleep mattress. Have you ever seen one of those things?
Meb: Mm-hmm. Got one.
Saad: Oh, do you? How do you like it?
Meb: I love it. There’s a caveat is I live at the beach in LA, listeners know this. And my house doesn’t have air conditioning, which used to not matter. Now that we have global warming, it used to be like one week in the summer that would be, like, unbearably hot, now it’s like half the summer. And I love sleeping cold anyway, if I go to a hotel, I’m like 66, my wife runs the opposite. So I’ve heard enough positive reviews, so I like it. I don’t know that it makes me sleep any better, but I like it.
Saad: Have you ever tried one of these? It’s a Ōura Ring.
Meb: Yeah, my problem is look I’m a sleeper, you can probably be borderline insane like narcoleptic, like I hit the pillow, two minutes, I’m out. I sleep eight, nine hours, no problem, our child is asleep or so. I have it easy, my wife is kind of the opposite. I’m going to try to get her to try to do the Ōura. The one experiment I would like to run that I’m just too lazy to do but eventually will do is to do the see how the sleep works, alcohol, no alcohol. So, a couple of glasses of wine, how does it impact, because I hear it impacts a lot. I don’t really notice. But that’s what everyone says.
Saad: I mean, I’ll tell you, I stopped drinking maybe three years ago, and, man, has it changed my life in so many ways. Not stopped drinking because I was drinking too much, I actually didn’t drink that much. I haven’t really drunk that much in my 30s, to begin with. But I just felt like the next day I just ran a little bit slower. And because of the Oura, because of the Whoop, because of the Eight Sleep, I can track everything. My deep sleep numbers have gone through the roof now. And that deep sleep, I don’t have to sleep more than six and a half hours, if I’m getting really high-quality sleep versus before. I mean, running a…this is my second company now that I built. I mean, you just don’t sleep that often. And now I prioritize the hell out of it.
And then, honestly, the single biggest thing if you don’t do this and your listeners don’t do this, if someone said you had to take away everything but you can only keep one thing, it’d be meditation. I mean, the meditation thing has changed my life in ways that I could have never thought was going to happen seven years ago when I started.
Meb: And what’s that mean to you? Did you start with any sort of teacher? Did you go with an app? Or you just kind of do it on your own? What’s the meditative because it means a lot of different things to a lot of different people?
Saad: Yep. So I started just with a plain old Headspace app. And I’ll tell you the truth, it took me six months to figure it out. I do it, my mind was racing, I was like, “Ah, feels horrible. I don’t feel energized.” And I gave it up probably a couple of times in those first six months. I just forced myself through it because I learned a read so many great things about it. And so the Headspace eventually became transcendental meditation, which I actually didn’t love, and I went back to Headspace. And then I realized actually using Headspace in the morning and Calm at night to help me go to sleep was my particular stack of what helped me keep myself calm. And then I got into…my girl basically dragged me to a sound bath one day, and once you’ve been to a sound bath you just don’t go back, man. Do you know what that is?
Meb: What does sound bath mean? I mean, so I went to sleep last night with the calm heavy rains. My meditation go to at this point has been essentially I take a nap, which for the vast majority of my life, I’ve had to get over this hurdle of nap guilt. Despite all the evidence despite everything like the guilt of taking the nap even though I know there should be no guilt still remains. Now, it’s down to like a fraction of what it used to be but it is still somewhere in my psyche.
Sound bath, the only thing I know about a sound bath is there’s a sound bath on the way to…you see it on the way to Vegas or Joshua Tree. We always see I forget what it’s called from LA. It’s called like the…oh, god, I’m blanking on the name on what the show note links. Anyway, tell me what you mean when you say sound bath.
Saad: All right, so basically like you go to…it’s like a person that has a series of different instruments. And generally like, the place I’d go to is, you go you sit down, everyone drinks, what’s the equivalent of hot chocolate. And it sounds like, almost like a therapeutic session where everyone talks about what do they want to think about where they try to improve in their life. And then lights go out, you close your eyes, you start to meditate. And they have these Tibetan bowls, and they hit the Tibetan bowls with different instruments and they move it close to your head.
And the most amazing thing is that all of a sudden if you’re in the right meditative state, the sound turns into color in front of your eyes. And then, right as the color is coming through, they’ll come through with another bowl. And then there might like be another instrument they’ll play and they may actually throw water at you at the same time. And it’s a completely different sensory experience than you’re used to. And after 45 minutes of it, you come out and then you just feel like you are literally floating in another world to a certain extent.
Meb: So this is like a place you go to do it. It’s not you just do this at home. This is, like, almost like a yoga studio-style offering. Is that accurate?
Saad: Yeah, that’s correct. There’s another really cool company called NuCalm. You ever heard of them?
Meb: How do you spell it?
Saad: N-U-C-A-L-M. And so, NuCalm makes like an $8,000 device that goes on your head, basically like it uses binaural beats. And then, you apply this gel on to your…what’s called? Not your palms, but your wrists and the inside of your neck. Usually, it’s Gabbeh and it puts you into this really deep meditative state. It’s really good when you have jet lag. And what they did, which was brilliant this guy named Mike DeWitt. He basically said, “Well, I bet you you can do this a lot easier,” and he convinced NuCalm to create an app. And then instead of using this gel on your wrist, there’s some discs you put down and they use binaural beats. And they use these little discs to kind of give you the same exact feeling. And it’s like a much lesser version of, like, the sound bath, but it kind of gives you the same-ish feeling.
Meb: Yeah. The place in Joshua Tree, that I looked it up, it’s called the Integratron. And they do like, full one day, five-day weekend things. And it books out like months in advance. It looks super awesome. I love Joshua Tree. Anyway, if anyone’s been, hit me on email or on Twitter, and let me know what the Integratron was like.
We could probably talk about this topic for hours. It’s fascinating to me. And obviously, you’re starting to see not just an explosion in the analytics and biomarkers and in technology. But also a shift from sort of decades of qualitative understanding of things that work. I mean, people obviously been talking about meditation for a really long time but also being able to tie it to actual, real, measurable outcomes. And starting to drive a wedge in the difference between the whole category of things that people claim is, you know, impactful and actual real outcomes, which is awesome to see. So, it’s going to be fun to watch what you guys are up to.
So how did you guys build this out? Was this all credit cards? I know you’ve started to do little funding rounds, can you tell us about what that process has been like? And then also, what was it like trying to do this, raise money during a pandemic?
Saad: Let’s see, we don’t talk about the funding number we’ve raised, but we will very shortly. But the punchline is we’ve raised capital from tier-one Silicon Valley VCs, we’ve also got probably 80 individual investors on our cap table as well to Better Angels. We’ve been very fortunate that raising capital has been relatively easy for us. The first company I built man it was long, I had to talk to 50 people to get my first Angel check in the door. But this one is actually every single round has been oversubscribed by 2x or 3x.
We’ve had capital come to us multiple times, we’ve had multiple acquisition offers already at this point, too. And we just focused on just growing the business. And it’s a really hard business to grow, which is great because it means it’s a tremendous amount of defensibility around it. And so we are at this point, getting ready to look at the next growth point. So we’ll probably be out in the market soon.
Meb: Cool. Congrats. I got what do you call it? Not crammed down because that sounds too negative. I was in the seed round and remember getting less than I would have liked to have gotten. That’s all I have to say. It’s a nice way of saying it. But it’s been fun to watch y’all’s journey. We ask people and so we try to tailor this to their specific personalities and histories. But we’ll ask you this just to see if it applies, too, since this is an investment show. What’s been your most memorable investment in your lifetime, as you look back? Good, it could be bad, in-between, but just the one that’s seared into your frontal lobe, anything come to mind?
Saad: Yeah. So, I’m a diehard crypto investor. I’d like to think I’m a good investor. I’m not. I’m not a good investor at all. My single best wins have been when I find something I love. And really, when I think about it deeply, it’s about a mission and a founder that I love. I dropped my money and I walk the hell away. That’s it. I don’t try to be cute. I don’t try to trade momentum. I just dropped the money and I walk away forever. They’ve all been my single best bet. I think everyone can talk about like, for me, my investment in Tesla, like years ago, has been wonderful. And it all came down to conviction around the founder.
And it’s interesting because the investors that put money into us, they take that same exact bet, we have nothing but an idea and a personality. And they say, “Well, look, I’m going to take this 7 to 10 year-long bet. And I can’t put my capital out of this thing generally, unless there’s, like, an incredibly successful secondary.” And that’s a bet they take and it works. It seems to make a lot of sense.
Meb: There’s five decades old now at this point paper that Robert Kirby wrote called “The Coffee Can” portfolio. And he’s talking specifically about stocks, but it applies to everything, like, you just mentioned. It’s actually a very…it’s not a unique insight, but it’s a critical one. And most investors in the world of Robin Hood, hyperactive trading, gloss over it. And the time horizon, you really need to compound these big winners.
Not talking about a double, like lucky double your money awesome, but we’re talking about the 10 times your money, a 100 times your money in the stock market or an Angel private startup investing often takes years, in many cases, more than 10 years. But putting it in like this “Coffee Can” modern equivalent would be like the safe deposit box and just forgetting about it, is like one of the best pieces of advice you could give someone investing. No one has the patience for it. So very thoughtful. So, this has been a blast. Where do people find more? They want to check their levels, they want to keep up with what you guys are doing, where do they go?
Saad: So go to Hone Health, honehealth.com/saad. And then on top of it, too, we actually set up something special for your listeners where they get 25% off the initial testing kit.
Meb: Sweet.
Saad: You can find me also @saad_hone on Instagram, too. You can get me on my DMs, I’m always active there as well too.
Meb: Cool. We’ll put all that in the show note links, listeners, mebfaber.com/podcasts. Saad, it’s been a blast. We’ll have to do this again as you go down your journey. Thanks so much for joining us today.
Saad: Thanks, Meb. I appreciate it a ton.
Meb: Podcast listeners, we’ll post show notes to today’s conversation at mebfaber.com/podcast. If you love the show, if you hate it, shoot us feedback at themebfabershow.com. We love to read the reviews, please review us on iTunes and subscribe to the show anywhere good podcasts are found. Thanks for listening, friends, and good investing.
