The Future Of Longevity Medicine, Leonard Pastrana's PharmD

The one big problem that I see in the longevity industry right now is that so many companies—telemedicine companies, diagnostic companies, supplement companies—are trying to bypass the medical practitioner and go directly to the patient, and it’s dangerous. Where are we headed? The days of waiting for something to happen or waiting for some dysfunction to happen to intervene are over. With the technology, the diagnostics, and the things that we have now, we can identify the smallest little biological shift into dysfunction.

If I can be healthy, if I can talk about all the right things, if I can be a good example of starting successful businesses and having good relationships, then I can prepare my daughters for the future and be a good example for them. That, for me, was what I wanted to do in life. Leonard Pastrana, welcome to the pathway to peak performance. You are a doctor of pharmacy and wow, you are a peak performer, my friend. It is great to have you in all the way from West Palm Beach, Florida. That’s a trip; you definitely put the miles in to get out here for this one. I’m getting those Delta points for sure. I think I increased my status just on this trip alone.

I don’t think you could take a farther trip across the country than South Florida to San Francisco. This is almost as far as it can get. The only thing you could do is go to Seattle or Anchorage. Well, it’s so great to have you in. We have a lot to cover, but first things first, what’s your charity? St. Jude’s. Yeah, that’s special to us. My wife had a sister that passed away early on and I just couldn’t imagine a better charity. The impact they make in people’s lives when it really matters, when it really counts, is incredible.

It’s a shared charity for years and I really believe in it. Matter of fact, I’m on the board of the USS Potomac. The USS Potomac was actually gifted by Elvis to Danny Thomas and St. Jude’s way back in the day. Then they figured out that they didn’t want the actual Potomac, which is a crazy story, but it's a phenomenal organization that does so many great things for so many people. All of the proceeds from the views that we get will go to that. We’re also going to link St. Jude’s in the show notes so that anyone can go there and just learn why their mission is so important.

We always start with the origin story. Let’s go all the way back to try to understand where you came from and how we got to this place where you've achieved such a peak performance position. I actually grew up in Miami. I was born in Oklahoma while my dad was in the army on a hospital base. We went to Germany for a year and then we went to Miami, which is basically where I grew up, and then later we moved to West Palm Beach. I’m Cuban; my mom, grandmother, and grandfather were all born in Cuba.

I think that had a big impact early on because I saw what my family went through to get here and how much they struggled. I didn’t realize it until later on in life, but your success really depends on how much stress you can handle. I never felt like I had much stress just because I knew the history of what they went through starting over with nothing. Working so hard just seemed normal. I thought everybody’s mom worked two and three jobs and everybody’s grandmother worked 15 hours. That stuck with me.

I grew up in a great family with a lot of love, but I did have a little bit of ADD. It was hard for me to focus, so school was kind of difficult and I barely got by. It wasn't until it was time to decide what I wanted to do with my life that I realized I wasn't going to play professional sports. I looked at the prerequisites for pharmacy school and thought it was something really interesting and difficult to achieve. I had that sports mentality around it because it was a challenge. I went to pharmacy school at Palm Beach Atlantic University and it was a great experience. I fell in love with it early on.

I graduated and went to work for a big retail pharmacy chain. I realized pretty quickly that you have this goal of getting your doctorate and you think once you hit that six-figure salary, you’ve made it. But I quickly realized I didn't like being a pharmacist in a retail setting, filling prescriptions as fast as you can. There was no growth to it; you get a 5% raise and that's it for the next 30 years. I felt almost dead inside. I felt fooled by school because you get prepared to make a big difference, but when you get into traditional medicine, it’s a misincentivized system.

I was just pumping out medications as fast as I could—giving bandaids while no one was really getting better. Later, I worked in a hospital and I was shocked that clinical conversations were about what was cheapest for the hospital rather than what worked best. In school, you learn first-line therapy based on evidence, but in the real world, the protocols are based on cost. At the same time, I was getting very unhealthy. I remember leaving the night shift one day and being so out of breath walking up the stairs that I couldn't even talk to my wife on the phone.

I sat in the car and realized I was going to be one of those people on the computer screen taking 17 different medications. That’s when I started being disgusted with healthcare. I started looking to entrepreneurs and inspiring people who talked about how much stock they put into their own health and performance. I realized if I wanted to invest in my family’s future, I had to take myself seriously. I started learning about intermittent fasting, nutrition, and exercise—things that weren't part of the lifestyle identity within the hospital.

I decided I didn't want to be part of traditional medicine anymore. I started learning marketing and tried different businesses. My first business was around prescription discount cards. I realized the system was stealing from patients; medications that cost two dollars were being sold for over a hundred. In the traditional pharmacy world, Pharmacy Benefit Managers (PBMs) have a gag order on you, and if someone uses insurance, they might pay a $25 copay for a drug that has a $13 cash price. They’re double-dipping on people on fixed incomes.

The traditional pharmacy model is ripe for disruption by AI and robotics. You see these big chains closing stores and firing pharmacists because they didn't evolve. Amazon is taking over because people want their regular medications delivered via Prime. The role of the pharmacist is evolving fast, but I am scared for the profession because automation is taking over the traditional role. It used to be that you had a relationship with your pharmacist—they were the most accessible healthcare professional. Now, if you look into a retail pharmacist's eyes, their soul has been sucked out because they are just managed by metrics on a screen.

They want to spend time with the patient, but their job depends on how fast they can get prescriptions out the door with the least amount of help. I call the current shift the evolution of medicine. Traditional medicine is population-based and guideline-driven, which is necessary, but the next step is personalization. We know more about the patient now through diagnostics than ever before. We can identify risk earlier. This is why practitioners like ER doctors and pediatricians are leaving the insurance model for cash-based longevity practices. They want to provide care without an insurance company dictating what they can give their patients.

The best investment you can ever make is in your health. For years, people made sacrifices around health to achieve success, but the incentives are misaligned in insurance. There’s no incentive for them to keep you healthy early on because they don’t know if you’ll be insured by them later. Where we are headed is clinical longevity medicine: assessing risk earlier and earlier. The future is about understanding your own genomics and personalized data, working with a medical professional who has the experience to interpret what that data really means for you.

We are all an "n of one." Genetic testing is going to play a huge role because we don't have to guess as much anymore. This is where technology often gets it wrong—companies try to bypass practitioners with AI algorithms and 45-page handouts. But only a few of those pages are actually accurate and actionable. True value comes from the expertise of a practitioner saying, "Here is what this data means for you personally." Take GLP-1s, for example. The question isn't just whether to use them, but what type of nutrition, resistance training, or synergistic supplements should go with them.

I’m trying to bring the best minds together to ask these questions. My ADD and obsessiveness have become superpowers. I went from barely getting by in school to absorbing every book and mentor I could find. I stopped listening to the radio and started listening to Audible on my commute, getting through a book a week. I learned that if I combine pharmacy with marketing, I’m in the top 1% of my niche. Another huge unlock for me was Joe Dispenza’s guided meditations and visualization. I used to be terrified of public speaking, but I visualized the future I wanted—the company, the impact—and it all came true.

My foundation is my family. I want to be a great example for my daughters, showing them how to be healthy and start successful businesses. I created a clinical longevity ecosystem called New BioAge. We have Progress Pharmacy and a new project called NewHX, which is an assessment center in West Palm Beach. We do DEXA scans, metabolic breath analysis, and strength testing. We want to show people their $VO_2$ max and visceral adiposity to create a baseline. You can’t personalize solutions unless you identify exactly what is going wrong individually.

The danger right now is the "wild west" of research chemicals. People are buying peptides from websites that aren't for human consumption, and even some practitioners are being fooled by sales reps. Every clinic should be getting their supplies from a regulated compounding pharmacy where every batch is tested for stability and sterility. You need a professional to monitor things like Methylene Blue or NAD+ because you can actually "over-antioxidize" the system and cause negative consequences.

I want to put medical practitioners at the forefront because they have the training to see the whole picture. A pharmaceutical company selling direct-to-patient via a website doesn't know if that patient has underlying cardiovascular disease or what other drugs they are taking. We need to stop the hodgepodge approach. My advice to anyone looking for their own pathway to peak performance is to go and study the people you want to be like. Take the best pieces from different mentors—the way one person handles their business and the way another handles their family—and make it your own.

Would you like me to create a summary of the key "red flags" Leonard mentioned for choosing a longevity practitioner?