Written by Christopher Kelly
Nov. 15, 2019
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Chris: Well, Tim, thank you so much for joining me at the West Coast regional headquarters of not Nourish Balance Thrive and also the international recording studio,—
Tim: Absolutely, Chris. Great to be here.
Chris: …which currently stood under the owning of my VW Eurovan that is my makeshift office since I figured out I can do much deeper coding work whilst out of the house and away from the small children. That was Cal Newport’s Deep Work. It’s had a huge impact on my productivity as a coder.
Tim: Beautiful view too.
Chris: Yeah. It’s great. It’s good. I love Bonny Doon. It’s a little bit quiet, but maybe that’s a good thing. I’m here with our lead performance client, Tim Harsch. And we’ve just got back from the beach. Tim, I think we’re gonna have to start calling you Eagle Eye Tim. I just spotted my 5-year-old daughter lost her ring on the beach and I thought there’s no way that’s ever coming back. You spotted it right away. What the heck?
Tim: Good thing I had my contacts in there.
Chris: Oh, you wear contacts. I didn't know that. That's awesome. Well, I wanted to start by talking about your experience as a founder. Tim is a type 1 diabetic and he's learned a ton about how to manage that condition, but we’ll get into that a little bit later. Let’s start by talking about Owler. What problem does Owler solve?
Tim: So, Owler solves the problem of information on private businesses around the world and solves that problem via crowdsourcing. So, crowdsourcing information so you know more about the businesses that you're either working with or working for and all the other companies in the industry and their competitors.
Chris: Okay. And why is it helpful to know something about another business?
Tim: Obviously, if you're investing in a company, it’s important to know, you know, what's going on in that business. But also, if you’re partnering with a company, you wanna know how much can I trust them, how much can I rely on them as well as potentially if you're selling into a company. Those are kind of our three big use cases.
Chris: Does anyone ever getting pissed off? Do you ever get people saying, “I think that's not right about my company? Can you take that down?”
Tim: We do especially in the earlier days we did a lot. You know, these days most people understand that it is a great place for them to make their company more well-known. And so, they view it as somewhat of a marketing tool for their company, but we still occasionally get some complaints of “Hey, that's our exact revenue number and they're all estimates, but how do you get that? That’s inside information.”
Chris: Oh really?
Tim: Yeah.
Chris: How interesting. So, the wisdom of the crowd is the term I’m looking for there and it's working for you in this particular space.
Tim: It is. It's been great. I'm sure you could go on there and find companies that are like “Oh, I know for a fact that's not quite right. But you know, the beauty is the community input and people are generally pretty close on their estimate.”
Chris: Okay. Okay. And how do you go about verifying what people tell about a company?
Tim: So, there’s a combination of manual verification. We have a data team that works on that and then there’s also the trust that we build up in users over time. So, users come in and we'll see how closely they’re voting to other users in the community. And based on that, we’ll actually build up trust in you over time. So, day 1, we don’t know who Chris is. So, we may not trust you that much. But 6 months in if you've agreed with lots of others in the community, we’ll have a lot more trust in every vote you make.
Chris: Okay. Interesting. Do you ever try to use supervised machine learning to doing this stuff?
Tim: We actually haven't. It's a great idea. We should talk more about it.
Chris: It does seem doable though, isn’t it? Like if I can find another company a bit like this one, can I say anything about the revenue?
Tim: Yeah.
Chris: Or at least the anomaly detection. Right? Like if somebody just gave me some information about this company.
Tim: Yeah. I think—
Chris: Oh no, that’s not right.
Tim: There are a lot of applications.
Chris: Yeah. If you noticed how good the credit card fraud thing is now. It’s like they just text you right away the moment somebody places a fraudulent— I mean, it’s that sort of thing in it so you just send me the revenue number for this company. There’s no way like the algorithm says no. It could be interesting if you’ve got a big enough dataset that is.
Tim: Right. Yeah. We should set that up.
Chris: Talk about life as a founder. What’s it like? You know, obviously, it’s a world I’m interested in. I’ve been spending a lot of time online especially recently watching videos from companies like— Y Combinator got some really good resources online. And Allison Lance is a personal trainer I met at Bryan Walsh’s Blood Chemistry Interpretation weekend seminar, which is still ongoing by the way. And Lance came for dinner and he spent a while talking to me. And then afterward, he sent me a link to Seth Godin’s Startup School, which is a part cost series from 2011. And it was amazing. I absolutely loved it. So, I've been thinking about founders a lot recently. And they even use these words like the startups are like the Olympics. And so, you need to treat yourself like an athlete. You know, you’re gonna be working some long odd hours. And you’re a cognitive athlete. Right? You’re using your brain. You’re a knowledge worker. You need to look after that. But yeah, I’m not really sure how much detail and depth they go into. But what’s it like for you as a founder? Is it as crazy as some people would have you believe?
Tim: It's definitely, you know, a roller coaster of you're kinda—
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One day, you're conquering the world and, you know, at the tiptop. And then the next day, it's a house of cards. It's all gonna fall apart. And you know, that definitely takes a toll over time. I mean, Owler now has been around for 8 years. So, you know, a lot of movement in that time. And you know, throughout all of that trying to maintain good health, good sleep, good kinda fitness overall. That’s definitely a challenge throughout all that.
Chris: Is it your job to hide that emotion from your employees, or colleagues, or whatever you call them, you know? Like you’ve got all this pressure that you shoulder and then you don't really want everyone else to know that because it might be bad for morale. Is that a thing or am I making that up?
Tim: No. I think that's definitely a thing. You kind of have to look into this vast uncertainty in front of you and then, you know, turn around and kind of talk to the team and say “okay, here's definitively where we're going” and, you know, have that certainty. And you know, that's definitely a big challenge as well.
Chris: Uh-huh. I've had people talk about how one of the things that makes a good founder is they operate very well in uncertain environments. Would you say that's true and how do you cope? What mechanisms do you use to cope in uncertain environments?
Tim: It's a great question. I think I try to kind of bring as much certainty in with data as much as possible for making decisions and for kind of moving in the direction that we think is best. I mean, we do a lot of AB testing, a lot of multivariate testing, but there are certainly sometimes you just have to go with your gut and kinda trust that. And it’s something that honestly over time I think I’ve just gotten more comfortable with. I think it just takes those reps of going through that cycle and learning, you know, “Okay, this is really uncertain, but gonna go with our best guess and move forward and then kinda see what happens.”
Chris: That's tells me that you might have a certain amount of traffic then if you can these AB test like I don’t know I can do that. I don’t even have enough traffic to do that. I go these data science conferences and there’s engineers at Google. And they’re talking about these things called multi-armed bandits, which is like a clinical trial on steroids, you know, that has like many different arms. And then as the experiment goes on, you cull the arms that obviously aren’t going to work. And I’m thinking “Hmm… You’ve got quite a lot of traffic coming here like to make that work.” But it’s just an interesting idea. I wondered what would happen if we did real clinical trials using multi-armed bandits like how many drugs would be left at the end of the multi-armed bandit. Hopefully none.
Tim: That would be very interesting in the health space.
Chris: Uh-huh. There’s some things that you do to cope with the stress. You know, we've talked about this offline and I’m not sure if Simon has ever talked about this on the podcast actually. Oh, yeah, we have. Of course, we have. We talked about stress audit. Right? So, this is the idea that the true stress ninja has things that are both kind of coping mechanisms, right, like they tackle the stress at me, the target, and then also what you might call avoid it. Right? Like I'm just gonna cut this thing out my life and that will of course reduce the stress levels and the true stress ninja has coping strategies or tools on both sides of the equation, right, like I'm not discounting things out. I'm not just coping. I do both. Is that like the stress audit? Can you think of things that you do to cope with the stress of being a founder that fall into both of those 2 categories?
Tim: You know, I think Simon was very helpful to me in that regard of, you know, one of the things was setting up the green light, yellow light, red light system and deciding “okay, if it’s really stressful, if this is a yellow light or red light, I’m not gonna do this” and I guess that will be your voice.
Chris: Yeah, yeah, yeah. That’s the strategy, isn’t it?
Tim: Yeah. That's been incredible for me personally. I think, you know, the other side of it of kind of getting ahead of the curve, you know, big one is just sleep and consistency there is what I found.
Chris: Yeah. Absolutely. Good luck trying to get anything done when you choose to shortchange yourself on sleep. Yean. I sometimes forget like how epically terrible it feels when you don’t get enough sleep. We had a couple days when we’re traveling. My goodness, the next day, you feel like you got a hangover even though you didn't drink anything. It’s awful. Yeah, don’t do that, kids. Get enough sleep. It’s a good idea. I guess just for a little bit more background for people listening, Simon’s traffic light system is an extension of his SEEDS method that I have yet to implement in the general software implementation of his method that I created recently. The goal is to build these health-promoting behaviors. Tiny health promoting behaviors that stack up and flourish like a garden every time. So, SEEDS is both an acronym and a metaphor. SEEDS stands for sleep, exercise, eating, drinking, and stress management. And so, the idea is you plant these tiny seeds under each pillar of health and then gradually over time then flourish into a garden. But of course, life gets in the way. Right? You need to give yourself permission to suck at adulating sometimes. That’s Simon’s words, which I very much enjoy. So, yes, the founder like shit like that’s gonna happen all the time. Oh, my God, I’ve got to go to a business trip to New York or whatever like there's no way I'm gonna be able to get all these things done.
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Rather than saying “oh, fuck, I’m gonna do nothing”, I’m like “Okay, so what are my red light SEEDS? What are the core things that must happen in order for me to keep my shit together today?” And it prevents— not prevents— but it helps people get away from all or nothing thinking and catastrophizing an awfulizing all these lovely words that psychologists use. Super helpful. You can find that stuff over at seedsjournal.net if you’re interested. That’s great. Great to hear. I’m really excited about that. Let’s talk about type 1 then because you know way more about type 1 than I do. So, I'm very curious to learn what you've learned about type 1 diabetes. Tell us the story of the diagnosis.
Tim: Yes. So, it’s kind of a funny story. One of our cats growing had been diagnosed with type 1 diabetes about 6 months before.
Chris: Where is this going?
Tim: Yeah. And it seems like there might have been something environmental. But a few months later, I started getting really ill, really sick. I was drinking gallons and gallons of water, gallons of milk. Always thirsty. And you know, the doctors gave me MRI scans, CT scans. They thought I had nasal infections, lots of antibiotics. Nothing helped. And I started to lose my vision. Everything was just really blurry because all the water I was retaining. And you know, ultimately, as a joke at that time, my mom came to me and said, “Hey, here's a urine test strip from the cat. Why don't you go pee on this and see what happens?” So, I did.
Chris: It was literally for the cat. It wasn’t even—
Tim: Well, it’s the same thing.
Chris: It’s the same thing.
Tim: It’s just measuring glucose in a liquid. You know, lo and behold I did. It's super high and that was how we found out. So, I went to the hospital and learned about the other early type 1 diabetes treatment at that point.
Chris: And so, how old were you at this point?
Tim: I was 17 at that point.
Chris: Okay. And how many doctors did you see before you figured that out?
Tim: We had just been going to kind of my primary care physician at that time. But actually, I forgot in there I also had my tonsils removed because those were inflamed during all this. So, probably 3 or 4 total.
Chris: So, you went in and you had a surgery and never once did they check your glucose.
Tim: No.
Chris: That's amazing. Isn’t it? So, where would you have been if your dear mom had not told you to pee on a glucose strip?
Tim: I don’t know.
Chris: How long had it been going on?
Tim: Think about that. It's crazy. Funny—
Chris: Completely bonkers.
Tim: Yeah.
Chris: You went back. Did the primary care physician refer you to an endocrinologist or did you just get the diagnosis right there and then in the PCP doctor?
Tim: So, the PCP had me pee on one of their test strips.
Chris: Oh, ‘cause yours might not be quite—
Tim: Right. Yeah. They were like “Oh, let’s double check this.”
Chris: To confirm that you’re not a liar. You’re not a raving loon.
Tim: And they confirmed it and then they sent me to the ER because my blood sugar at that time was I think 1,100.
Chris: Holy shit, that’s a record. I heard of someone in the 100s, but yeah that’s— Wow.
Tim: That was up there. So, sent me straight to the ER. I was in the hospital for 3 days. I mean, now, I think protocol’s a day, but they kind of got my blood sugar under control and then trained me for a couple days on treatment.
Chris: Right. How long did it take before you started feeling better?
Tim: Once I was taking insulin, it happened pretty quickly. I mean, I was feeling better, you know, within kind of a couple days really.
Chris: Wow.
Tim: Yeah.
Chris: That is quite incredible, isn't it?
Tim: Yeah. Insulin's powerful.
Chris: Yeah. It does some useful stuff.
Tim: It does.
Chris: People talk about the war on insulin, but, yeah, I think it does some useful stuff. That's fascinating. As an engineer, I always wanna understand the process that led to the problem before I try and remediate it. That seems like a pretty reasonable thing to do anywhere in your life. Right? If you ripped up some carpet towels and you found a bunch of mold underneath, I probably wanna know where the moisture is coming from before I slap down some new carpet tiles, right? And so, I think maybe the same should be true in medicine, but rarely happens. You know, people like doctors tend to shrug and they say, “Oh, these things happen and we did everything we could.” But what happens for you? Did they make any attempt to understand the process that led to—
Tim: No. Not really. I mean, you know, the prevailing theory at that time was that there was a virus that triggered it ‘cause, you know, usually diagnoses happen relatively early in life. I mean, today, autoimmune is becoming more and more common later in life especially type 1 diabetes. But you know, it’s largely been juvenile diabetes as the main—
Chris: Yeah. They don’t call it that anymore. Do they?
Tim: No. No. And so, they didn't really do anything else, but say that of, you know, likely you caught a virus that triggered it in you.
Chris: Wow. Interesting.
Tim: Yeah.
Chris: Did this happen in a vacuum? Were there any other? I mean, it’s hard to say whether they were unrelated because they most certainly weren’t, but did you have any other issues? Did you notice any food sensitivity? Any other GI problems or anything else? It was just that, nothing else?
Tim: Yeah. No. You know, for me at that time when I was in high school, that was during the winter when I was less active.
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So, you know, I was a 2-sport athlete and I had the winter off. You know, soccer in the fall and then lacrosse in the spring. And so, you know, I think there was that. I was much less active all of a sudden. And you know, I also wasn't sleeping that well at that time I remember. So, you know, I think there were some other things possibly going on, but that could've kind of accelerated that maybe, but hard to say.
Chris: Do you still play those sports now? Again, tell us about lacrosse now. I’m British and lacrosse is a game they play in posh schools for girls. I don’t think I’ve ever seen it played.
Tim: It's a fun sport. I do not play anymore. It's quite a fun sport. Relatively popular here in the States now.
Chris: What about rugby as well?
Tim: So, I wasn't good enough to play division 1 lacrosse, which led me to rugby in college. And you know, I fell in love with rugby. It’s just such a fun great sport. You know, I had a lot of fun playing that, but don't do that anymore after a few concussions.
Chris: Oh really?
Tim: Yeah. That led me to endurance and ultimately led me to NBT.
Chris: Awesome. Awesome. So, you guys used to have the cauliflower ears thing. Have you ever noticed that?
Tim: I avoided that. I taped up my ears.
Chris: Oh, is that what you have to do to stop that from happening.
Tim: Yeah. It’s impact and kinda pulling and all of that. It happens when you're rocking. So, yeah, if you tape your ears, you can avoid that.
Chris: Uh-huh. My goodness, I never knew that. I just thought that was like part and parcel of the sport. That’s amazing. So, talk about those early days then after you initially got the diagnosis of type 1. Did they send you home with some way to measure your glucose and then some glucose tabs and some insulin to inject of some sort and any dietary recommendations or—
Tim: So, dietary recommendations were eat like you were always eating. Don’t change anything. I was eating relatively high carb at that time. The protocol was measuring all carbohydrates. I mean, my mom was great in that she made sure that we were weighing all the food I was eating and calculating the exact amount of carbohydrates and then injecting exactly for that. And you know, over time, I kinda got a very good sense of actually what number of carbs was in what food. But you know, early on, I was literally looking it up in a book. I mean, this was before smartphones. This was before MyFitnessPal or anything out there on the internet that shows number of carbs. So, you know, that side of it and then the other side was blood glucose meters where you’re pricking your finger all the time. And I always wanted to know what my blood sugar was. So, I was checking, you know, 12 times a day and it was just always checking before meal, after every meal, in between, before sports, during sports, after sports. And you know, that’s why today CGMs are amazing to be able to have hundreds of measurements everyday as opposed to just 12 and see more directionality. And we can talk more about that, but I know you already know all the benefits of CGM. But back then, you know, CGMs don’t exist.
Chris: Not for type 1. I mean, I thought about that. Actually, I walking the dogs around the block here and somebody's garbage slightly knocked over by a raccoon or something. And there were all these used finger stick test. I mean, I’ve done like hundreds of them as well, but it’s just different when you see like hundreds of it all just falling out someone's trash. You’re thinking “Blimey, somebody's invested a significant amount of life force into checking their glucose and what a difference CGM would make to that person, you know.”
Tim: No kidding. And there’s so much better data to actually see trends because, you know, with finger sticks, you're just looking at one point in time. It’s so hard to know, you know, am I going up, am I going down. What do I do as a result?
Chris: And then did you track anything else that might give you an idea about how you’re doing over the longer term? So, hemoglobin A1c for example.
Tim: We were tracking hemoglobin A1c and I still do every 6 months. I don't think mine is particularly accurate especially now that I have a CGM. I think my A1c measures kind of lower than it should.
Chris: What is it?
Tim: My last was I think 5.2, which based on my CGM I think I should be a little bit higher than that, but I don't know what would cause that.
Chris: Well, it depends how long the red blood cells stick around for. Right? So, H A1c test is normalized for red blood cells living for 90 days. And if they live any longer or shorter, then that would affect the hemoglobin A1c. And there’s an equation that I can cite in the show notes the measure of reticulocytes. I mean, you’re on our program. We measure reticulocytes for you.
Tim: I'm not sure.
Chris: We should look to that. We should definitely look into that. I mean, I suppose it’s an intellectual curiosity to some degree, but you can measure reticulocytes, which are baby red blood cells. It’s a 5-dollar blood test. And then you can plug the reticulocyte since it is count formula and it will tell you how long your red blood cells live and then from there—
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I’m not sure there’s an exact equation to correct the hemoglobin A1c, but it would at least give you some sense of whether they’re living longer. It will tell you the lifespan in days and then that would tell you—
Tim: Interesting.
Chris: I mean, that's incredible though for a type 1 to achieve a hemoglobin A1c that low. Was that true from the beginning? Did you always—
Tim: It always was. I mean, you know, early on, you still have some of your islet cells producing insulin. So, there’s this period they call the honeymoon period where it’s just easier because you still have more support from your body. So, I certainly don't think I should anymore, but I think I may still because it seems like balancing glucose for me is a little bit easier than it may be for others. So, I don't know if that's because my body is still producing insulin or not, but it's always kind of been in that range. I mean, I'm also very particular about even today, you know, knowing exactly what I eat, how many carbs are in it, and calculating everything. So, that's been something that I think was a result of me being diagnosed, you know, when I was in high school and wanting to go become an engineer where I could actually view it as a systems problem and tackle it as, okay, if I have all these inputs, I can calculate exactly what I need to do to optimize it.
Chris: Oh yeah. Well, that’s a good place to ask you. So, tell us about your education. What is your background?
Tim: So, I ended up studying electrical engineering and computer science. And so, you know, I actually have written some programs to kind of analyze all my old data and looked at all of that over time to kind of pull out trends and different things to optimize for. That's just always kind of a curiosity for me.
Chris: That’s great. That’s awesome. So, what was it like then? You think there's a difference with you being diagnosed later in life versus as a kid?
Tim: You know, I think so. I think that’s been one of my observations in, you know, now interacting within the type 1 diabetes community and knowing lots of other folks who have type 1 diabetes where, you know, if you're diagnosed early, it's more of just this is the way life is. And you know, for me and some others that I know who are diagnosed later, it's like “Okay. How do we go crack this? How do we solve this and make it such that we can live the way we were as much as possible before and not let this impact our lives?” You know, I’m speaking a lot from my own experience, but I think age of diagnosis definitely had a fair amount to do with that.
Chris: It does seem. I mean, if the goal is near normal blood sugar, then it does seem like a solvable problem now. Believe it or not, we’ve had a couple of type 1s on the podcast already. Keith Runyon was one and he was doing a really great job of managing. In fact, I think he's still blogging about this now about managing his blood sugar with a combination of a low carbohydrate ketogenic diet and Olympic lifting. I remember that was like a big thing for him. You probably noticed that too, haven’t you? Like the what is it? 75% of glucose is disposed in skeletal muscle independent of insulin. You know, that's gonna be a big lever for you to pull right there.
Tim: It is. Yeah. I've always noticed when I’m doing weight training, it’s much easier to reduce glucose variability—
Chris: Oh, interesting. Okay.
Tim: …and maintain blood sugars in a range just because I am much more insulin sensitive.
Chris: Yeah. You just made a big hole and like somebody wants to fill it. Right?
Tim: Yeah.
Chris: That's the way to think of it. So, tell me about your approach to carbohydrate content. I mean, you just quoted a spectacular hemoglobin A1c that anybody should be proud of assuming that there’s not some weird pathology that you don’t understand that your red blood cells don't stick around for long enough to get glycated. I mean, I don't think so. I think this is just a number that you should be proud of. So, how does carbohydrate intake— Like can you just eat as many carbs as you want and still get that number or is it—
Tim: Theoretically, I think you could as long as you're injecting the right amount of insulin. You know, I view having diabetes as kind of a roller coaster ride where you're the driver and the ups that you get with glucose are controlled with insulin. And you know, typically in your body, someone without type 1 diabetes, you’re automatically regulating both ends of those. The biggest challenge for me and I think type 1 diabetics in general is just staying within that core range, which naturally if you're not raising yourself up as much and having to inject as much insulin, there's much lower variability. So, for me, low carbohydrate has been a huge, huge component of that to be able to, you know, not have to inject as much insulin. And therefore, even if I'm wrong on a certain dose or I miscalculated something, the error is going to be smaller. And so, you're just keeping it within tighter bound. And so, as a result of that, I've eaten low carb for years, you know, more recently. You know, thanks to NBT experimenting with AIP, which has been great, and identified some other kind of food sensitivities.
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But yeah, low carbohydrate I think really, really helps.
Chris: You know, the reason why I think type 1 is so interesting to everyone is you’re forced to do the self-monitoring bit. Right? Like most people like me can just eat all the stuff they want. Literally, I can eat anything now. In terms of like the glycemic variability, this doesn’t seem to have any impact on me at all in the way that I feel. And that wasn’t always the case. At one point, I couldn’t even make it through the night without eating breakfast. I used to get up at 2 in the morning to eat cereal because I couldn't make it through the night. But now, it doesn't seem to make any difference, but I'm pretty sure it does like inside. I think it does. We know that semi-fasting glucose is a predictor of mortality and glycemic variability is generally not a good thing. I've seen some nice micrograph images of high glucose stripping away the glycocalyx, which is this glycoprotein layer that lines the endothelial cells. So, you know, if I choose to have that gluten-free cupcake, do I need my glycocalyx? Quite possibly if I were to do that 3 times a day, well, I’ve then just removed the first line of defense that’s protecting those endothelial cells. If too many endothelial cells get stripped away, well, that’s atherosclerosis. Right? You really don't want that. It’s the #1 killer in the U.S. Now, the reason why I think type 1 is so interesting is because you are forced to do the self-monitoring bit. Right? Several times in the podcast before, I’ve talked about Simon always says that self-monitoring is the cornerstone of behavior change. It just doesn't happen unless you're paying attention. And this is true in others areas of our life. As a founder, you know. I’m sure you’ve got a dashboard with some core metrics that you know are valuable. And recently, I was visiting my mom in Scotland and she's got this fancy meter on the side of a wall that tells her how much electricity she’s using at any one time. I don't have that where I live in California. But right here in Silicon Valley, I don’t have that. So, how am I supposed to improve my electricity consumption assuming that less is better? Maybe [0:26:55][Inaudible] would disagree with that. They generally [0:26:57][Inaudible] less, which is paradoxical, but I guess they have their reasons about how am I supposed to do that if I don't know how much electricity I’m using like how do I know I’m winning?
Tim: Exactly.
Chris: You just can’t. So, that’s why I think that the type 1s are so interesting because you’re forced to play that game. And you’ve rejected the insulin pump for this reason. Right? Can you talk about that?
Tim: You know, I wore a pump for 2 years, which was good. I mean, it was good to kind of try it. What I found was my A1c actually increased during that time. And you know, largely, I think that was the impact of it was just easier to inject. And therefore, I would find myself eating that cupcake or something else because “Oh, I can just click a few buttons and, you know, no problem.” I will have injected for it versus, you know, the small amount of friction of having to take out the insulin pen, and dial it, and inject that amount made me think about it just enough where I wouldn't actually eat that cupcake. You know, I don’t need that. It’s just gonna make this more difficult after all. And so, you know, that led to worse control during that time. And you know, ultimately, I also didn't love having something attached to me, but it was that control that really got me.
Chris: That’s interesting. So, you somehow made this connection that more insulin was worse. This kind of implied that really, but somehow you figured that out, right, that maybe you didn't want to use so much of this. I mean, it’s a medicine. Maybe that's the thing that makes you decide that maybe less is better. How did you make that decision that less was better?
Tim: It was exactly what you were just talking about with the feedback loop of I actually saw the, you know, increase in A1c and said, “Hey, wait a minute. What's going on?” I think I saw that the first time and said, “Oh, maybe this is just an outlier.” But you know, I think my A1c went up to low 6s—
Chris: Oh wow. That’s a huge increase.
Tim: …which was a big jump. And I was like “Hey, wait a minute. You know, it must just have been an outlier.” And then it happened a couple times. And you know, at that point, I kind of made the connection. I realized I was just doing a lot worse with it.
Chris: Does the technology exist now? I really don’t know that much about it? You would think that they can’t just measure and administrate the insulin from the same device so that you don't even need to get involved.
Tim: So, they do have closed loop systems now, which are— You know, I think the first one came on the market last year and I think there are two more this year and, you know, a few more in the pipeline from all the various pump companies. The challenge is the lag because when you're measuring in the subcutaneous fluid, you have a 15-minute delay from your actual blood glucose. And then further because of the time it takes for insulin, even the latest synthetic insulins to act in your system, you have at least an hour before the insulin's really hitting its peak and impacting your blood sugar. So, you have an hour and 15 minutes in the best case scenario. And so, the systems are pretty good. The best impact to those systems is overnight because you don't have any outside variables. You’re not eating anything and there's no exercise.
[0:30:00]
You’re just laying there. I was actually in a study at Stanford for one of the early devices a few years ago and I did love that about it, but it's not as if you can just not tell it when you eat or anything during the day and have it solve for that because of those delays.
Chris: You can’t just take a picture of what you're about to eat with your cellphone.
Tim: They haven't done that yet.
Chris: They can’t measure. There’s this increase in hormones that change almost immediately when you start eating like GLP1 and others. I wonder if they can measure those in the subcutaneous fluid like that would be cool.
Tim: That would be.
Chris: Yeah. So, tell me about what’s the meter the CGM used now.
Tim: So, I use the Dexcom G6.
Chris: Okay. How is it? I actually wore the G5 for a while.
Tim: It’s same thing. Just slightly smaller profile. And you don't have to calibrate it anymore, which is nice. So, you put it on. 2 hours later, you have a reading. And you know, it lasts for 10 days and it's incredible. I mean, the accuracy is really good. Just because I think I've built up that habit over time, I still do finger sticks occasionally just to kind of check in on it hopefully just—
Chris: How does it match up?
Tim: Usually spot on.
Chris: Okay.
Tim: If you're changing really rapidly, I've seen, you know, some discrepancies. But in general, it's impressively accurate.
Chris: That’s really great. Talk about some of the other variables. Right? So, we talked a little bit about sleep and we talked about carbohydrate consumption. Is there anything else that you found that has a big impact on what you see on the CGM?
Tim: So, the other big ones for me with regard to insulin sensitivity are certainly sleep, but also stress is big especially any like infection or you get the flu or cold. You know, much more insulin resistant during those times. You know, the inverse of that is actually the recency of exercise, so kind of consistent exercise within kind of a 36-hour window I've found to be really important for me because once I cross somewhat even a 24-hour window, but especially 36 hours from my last time exercising, I need a lot more insulin for things. And so, there seems to be that kind of critical period where I am much more insulin sensitive and also hydration is the other one that— You know, surprisingly, if I get dehydrated and then drink a ton of water, my blood sugar will just drop very quickly. And so, that's another thing I focus on.
Chris: Is that just an artifact or is it— ‘cause you’re not actually measuring blood, are you? You’re measuring the— It’s a fluid. I have to look into that.
Tim: I’m not sure.
Chris: That’s kind of an interesting thing.
Tim: I think it is a real change, but I'm not sure what the mechanism is.
Chris: Okay. So, when you first signed up for the program, I think you identified more strongly as the endurance athlete.
Tim: I did.
Chris: I think we got this kind of business where we— you know, like Zach— I’m gonna pin this on Zach. Zach Moore. He sits in a confession booth with a little curtain. And the triathletes, they walk in with their jersey with the cutoff sleeves and one of those aero helmets, you know. And they walk in to the confession both and then Zach gives them permission to get rid of the aero helmet and pick up the barbell. And then 6 months later, they’re on the podcast giving us a testimonial about how great it feels to live in this body with all this muscle mass.
Tim: That is true. I blame it on Zach as well. I give Zach all the credit. He's been great in putting together an awesome program for me that, you know, I was I think overtraining significantly for triathlons and trying to squeeze that it to everything else that was going on.
Chris: It’s kind of interesting to me. I mean, you’re a founder. You obviously don’t have a lot of spare time to play around with stuff. Like what is the appeal of triathlon at that point? I mean, I have trouble being good, even a little bit good at just 1 sport. I just can’t imagine trying to be good at 3 sports at once.
Tim: I think it actually goes back to what you said at the start about uncertainty because you have so much certainty in triathlons of “Hey, if I put in this effort and I do this, I can increase my results by this.” It's very clearly measured of your time.
Chris: Yeah. I see that.
Tim: And you know, you contrast that with—
Chris: It’s the antidote.
Tim: …sort of life. Exactly.
Chris: Yeah. That’s interesting.
Tim: I think that was a large part of what drew me to it.
Chris: That’s interesting. Yeah. Mountain biking is highly stochastic and you can’t predict anything, you know. It’s like what might be the winning formula for one race could be useless in another because there’s a bunch of wet roots and some— You know what I mean. It’s like it’s very hard to predict unlike triathlon where you know like if you can hold however many watts per kilo for whatever duration like you pretty much know what time that’s gonna get you and what time you need in order to do well at that stage. Yeah. It’s very deterministic. So, talk about the transition in just— I mean, so obviously, you have a history as what I would call a strength athlete, right, rugby.
[0:35:02]
It’s surely a strength athlete. And so, it just wasn’t a hard decision to make that “Yeah. You’re right. I can see that this triathlon thing isn’t really working for me at this time and perhaps a more strength-based approach will be more consistent with the goal.” Do you think rationally like that or what else went on?
Tim: Well, I think a big part of it was I was just totally depleted and seriously over trained where I had no energy. I mean, walking up, our office is up a couple flight of stairs. Like walking up those was really hard. And I was like “This is crazy. I'm still a young guy. Like this should not be this hard.” So, that was a big part of it. And you know, the other was really focusing on health span and all the research out there about, you know, the importance of strength or longevity and health span, which, you know, having been a rugby player and having much more strength and muscle mass and then going to endurance and losing a lot of that—
Chris: Oh, did you actually lose? I mean, you look great now. You look like you’re carrying a ton of muscle mass.
Tim: I lost a bunch.
Chris: Oh really?
Tim: Yeah. I mean, I’m still not the typical triathlete build because of that. But you know, I lost probably 25 pounds of muscle mass.
Chris: You know, I was listening to Ben Houses’s podcast, which has been very good. He’s had some excellent guests including Tommy actually recently. I forget what the exact numbers were. But you know, he’s got to the point where he’s just so close to his genetic potential, you know, even just any amount of muscle gain is good news for him. And so, yeah, I’m sure if you were to hear that 25 pounds of muscle gain, it’d like make you cry. It’s like a lifetime of achievement. So, how much have you put back on?
Tim: I think I’ve put back on about 10 at this point working with Zach, so pretty quick gains. But you know, I think I was helped by that program a lot.
Chris: Okay. And what sort of movements?
Tim: You know, a lot of kind of the core of deadlift, bench, and squats.
Chris: And what are those movements that you already knew how to do or you’re competent with those before?
Tim: Squats and bench, yes. I wasn’t with deadlifts. I’m still working up in kind of the more advanced deadlifts and doing the full one. But you know, everything else I was relatively familiar with already.
Chris: Okay. And how have you been learning to deadlift? I’ve been lifting weights and since I was 17. Yeah, I was exactly the same. The deadlift is kind of scary ‘cause you think your back is going to explode or something and, yeah, it’s even more scary when a bunch of people are watching you do it. So, how did you learn to do it? I mean, you’ve never met Zach in person, right? Like did you do it remotely?
Tim: All remotely. So, some great initial videos that Zach shared that really helped to kind of get me to this point. And you know, I'm excited to kind of keep going and keep optimizing that.
Chris: There’s so many videos online now. It's really hard to find a good one. I don't even know if this like a good video or not. And so, having Zach say “oh, yeah, this is the video I like to teach you how to deadlift” is just insanely valuable.
Tim: Really is.
Chris: Really good. Yeah. And then, so did you exchange a bunch of cellphone videos where he like looks at you from the side?
Tim: I actually haven't done that yet.
Chris: Oh, my goodness.
Tim: That's the next phase.
Chris: This is not the lean startup approach to deadlifting, is it? It’s like the builds measure— If you don’t measure, how are you gonna— Yeah. Zach was really good at that. Like I don’t know. I feel like people feel something. It doesn’t feel right like if it’s not working.
Tim: Yeah. I workout in a very small gym. So, I haven’t set that up yet, but I need to.
Chris: Yeah. I don’t know. Maybe I’m making a false assumption. I should get Zach on to talk about this. But certainly, when he fixed something for me, like it was noticeable in the way that I felt like it was quite— I had a lot of weird muscle soreness the next day until I talked to Zach about exactly where the bar should be with respect to my legs. It sounds like a crude thing, but it really did help. So, talk about some of the work you’ve done with Clay. This is like genuine inquisition by the way. I’ve seen some of Tim’s results for sure because I look at all the results, but sometimes it’s quite hard for me to connect the person with the lab results, you know. And we’ve reached the point where I do work with clients on a regular basis especially with the blood chemistry side of things since I wrote the software, but it’s really somebody else that’s doing most of the heavy lifting at NBT. And the main thing I do is the podcast, which is great. I’m quite happy with that. And so, talk about what it was like to work with Clay.
Tim: It’s been great to with Clay. You know, I came in also with some gut issues that he, you know, helped resolve and kind of bring to light and then a couple protocols to, you know, work on those over time.
Chris: Okay. Do you mind talking about the symptoms?
Tim: Yeah. This was another reason. I left triathlon. I was gonna try and avoid the stress. I guess we’ll go there.
Chris: I mean, you don’t wanna talk about poop then you’re listening to the wrong podcast right at this point.
Tim: There you go. Yeah. I mean, I would make it a couple miles and do a run and just have to go find a bathroom—
Chris: Oh shit.
Tim: …immediately.
[0:40:01]
And it was literally. And it was just, you know, really bad. And you know, all of that is gone now thankfully.
Chris: Yeah. I mean, that’s like a game changer right now. You know, you’re looking for 5% performance improvement. If I can keep you out the porta potties, then there’s it right there. You don’t need to do any additional training.
Tim: Yeah.
Chris: Did you notice like was there any food triggers with that? I mean, it’s obviously like a stress— It’s like you’re type 1. Right? It’s obviously not just the thing that I put in my mouth that’s leading to the number of I see on the CGM. It's a lot more complicated than that. And I think it's true with exercise-induced diarrhea as well. It’s obviously not just what you had for breakfast. It’s a bit more complicated than that.
Tim: Right. I think one of the things that Clay immediately suggests they go off of is bulletproof coffee.
Chris: Oh shit, yeah.
Tim: I think that had a big impact on it. The other that I actually found in, you know, later in the program doing AIP, you know, at Clay's recommendation was sensitivity to dairy. And so, I was still putting cream in my coffee and all of that at that point. And that I think was the final piece that really, really put the nail in it.
Chris: Okay. Interesting. Yeah. I don’t think we got anything against bulletproof coffee in general, though you might argue it’s kind of a nutrient poor source of calories, isn’t it? Like as a dude in my mid-40s, I kind of want all of my food to have nutrients in it. And you can’t really say that about bulletproof coffee. It’s also an excellent way to deliver endotoxins. Right? So, liquids, fats are really good at translocating endotoxins from a cell wall of Gram-negative bacteria. And so, that combination might not be a good one for some people. It does make you feel fucking awesome though. I went to a conference once and they were serving bulletproof coffee and I’ve been off coffee for a long time. So, I was completely naive to caffeine. Well, not completely because I still drank a bit of tea, but it just doesn’t do the same thing to me. So, I’ve not had coffee for a long time and they had bulletproof coffee. So, the combination of, you know, like the grass fed butter with the C8 MCT oil and really good coffee I felt like I’ve been like taking some sort of crazy drug or something. It’s amazing. It makes you feel great. It’s easy to see why people continue that.
Tim: Oh, it’s great. It is amazing.
Chris: And do you still use it? Is it like your nootropic of choice as a founder?
Tim: I do drink probably too much coffee more than I should, but I don't do bulletproof anymore, although I have at a conference here and there.
Chris: Okay. I mean, you do the AIP and you got results with that. But as everyone listening knows that it’s not forever and the point of the diet is the reintroduction. Right? So, you’re eliminating foods and you give your gut a chance to heal and then you do the reintroductions and hopefully they go well, but there’s a really good chance you discover something that you’re not able to reintroduce and that’s okay. So, for you, it’s dairy, but you have obviously been able to successfully reintroduce coffee.
Tim: I have. Yeah. Yeah, I’ve been kind of working through those and yeah. AIP was an eye opener of like “Oh, okay, this actually does, you know, impact me.”
Chris: Yeah. That’s awesome. Like I remember seeing your GI map results were kind of funky. So, you did a stool test and there were some stuff going on there. I remember seeing elevated secretory IGA I believe. So, your immune system was responding— I mean, it tells me that maybe your immune system is responding to something in the gut. The question then becomes what. Is it a food sensitivity? Is it something else? And you can look at something else on the stool test, but you don't really ever know for sure, but you found— Like you did some botanical herbs and that was helpful.
Tim: That was very helpful.
Chris: Excellent. Or is it just that you stopped doing triathlon and that’s what fixed your gut? It’s possible.
Tim: Hard to say I know, but no. You know, I still enjoy long runs and long bike ride and all of that. Not quite the same frequency, but I attribute it to all the herbs and the protocol.
Chris: That’s awesome. That’s awesome. And so, you still ride on the road then?
Tim: I do, although experimenting with mountain biking.
Chris: Okay. You know, I’m gonna have to convert you. Well, Santa Cruz is definitely the place to come to ride bike. I mean, I think for you it would probably would be the easiest and best place no matter what. Right? And
Tim: Right.
Chris: And I think it’s one of the best places on the West Coast to ride bikes. So, you have to come down and we’ll have to do some— I do take that for granted now actually like how— It’s just like problems that you just don’t notice them until they’re gone, you know. I can remember like having so many rides ruined by bloating. It was like my thing. It did happen occasionally that I’d have to like run into the bushes and might evacuate. But for the most part, it was just terrible bloating. You know, it feels like you need to like fart for 45 seconds and the pain will go away and sometimes that did happen, but mostly didn’t. So, you’d just be riding around with this bowling ball. You know, that really ruined the ride, you know. It really sucks. And I forget all the time. You know, I road my bike today and I never thought about that. And sometimes I feel guilty for not thinking about that, you know. It’s such a tremendous relief to have that go away and how quickly we forget.
[0:45:03]
But yeah, when I looked at your blood chemistry calculator report this morning, I was like “Wow, that’s pretty amazing. This guy has a metabolic health score that is at the top end of the interquartile range for all blood chemistry calculator uses. So, you know who’s using this. It’s just like the people who are the most motivated to improve their health. So, as a type 1 to have a metabolic health score of 89, I think that’s quite extraordinary. What the hell? I mean, that’s what I think when I look at this. It’s like this guy has got normal fasting glucose as in normal within the optimal reference range. 82 to 88 mg/dL. Most nondiabetics can’t hit that and you have done it, the low GlycoMark. That might be right. GlycoMark predicts glycemic variability and then otherwise the free fatty acids. I sort of believe that prediction too. That is quite incredible. You talked to many other types 1 and like is there any difference between what you’re doing and what they’re doing?
Tim: I talk to a bunch. There’s kind of a group that we’ve put together that, you know, we chat about the latest technologies and kind of what to use and what kinda tips and tricks we’re using these days. You know, I think the biggest thing for me is low carb. Not everyone wants to do that. And you know, it is doable with more insulin to eat more carbohydrates, but it just creates so much more variability. I think that’s still relatively not fringed. But you know, obviously, it’s becoming more popular, but lesser known. Aside from that though, no. Pretty much all the same.
Chris: That’s extraordinary. I mean, I know you couldn’t technically. But if you could give advice to parents— Let’s say my kid turns out to be type 1. Like Bower is 18 months old. It’s still possible. Like what advice— Imagine I was completely naïve still doing what I was doing 10 years ago. Cereal for breakfast, sandwich for lunch, pasta for dinner. As far as I’m concerned, this problem has nothing to do with diet. I’m just gonna go ahead and keep eating that diet and then use the insulin to cover it. Would you ever give advice to parents like could you do that you think?
Tim: I don't know if I'm qualified to, but I would say—
Chris: Yeah. And also technical—
Tim: Right. Yes. Yeah.
Chris: …licensing stuff aside. These are hypothetical thoughts.
Tim: Hypothetically would be shift to low carb. I mean, eggs in the morning or other low carb options and throughout the day.
Chris: Yeah. Has it ever come up by the way? Like have you ever met parents that have just got a newly diagnosed type 1 and they ask you this?
Tim: Quite a lot actually. It’s terrifying. Like you have no knowledge of this. Your child is diagnosed. You're reaching out for help.
Chris: Right. It’s not at all experiment then. Like it really has happened.
Tim: Right. No. It has happened. You know, low carb is a big shift especially if your family doesn't do that. But you know, the other thing I usually suggest as well is get a CGM as soon as possible. You know, fortunately, due to insurance, not everyone can because of the coverage, but it helps so much. It's just a game changer to be able to see all the trends and have those tight feedback loops.
Chris: So, do you know anyone that's done this without someone younger and gotten good results?
Tim:&nbsnbsp; There are some families I know that actually have children on ketogenic diets and they have better glucose control than I do. It’s absurd. I mean, literally—
Chris: I mean, that really is extraordinary—
Tim: …like perfection.
Chris: …’cause you have excellent glucose control, but yeah, I mean better than a normal person.
Tim: Yeah. Right. Exactly. It’s amazing.
Chris: And what are the resources like if you could link in— So, I know about the type 1 group on Facebook, is excellent, and I should link to them. Is there any other resources online that you found useful?
Tim: There's a great nonprofit out of San Francisco called Diatribe that puts out a newsletter and one of their editors, Adam Brown, has written this book, Bright Spots in Landmines, which talks a lot about, you know, best practices and pitfalls to avoid within type 1 diabetes. I mean, a lot of it applies to the general public as well. But you know, it's specifically geared towards type 1 that is incredibly helpful. So, I'd recommend that as well.
Chris: So, do you have an online presence where people can find you, your LinkedIn? Can people find you on Owler or anywhere else?
Tim: I am on LinkedIn. I’m also on Owler. You know, best place to connect is probably LinkedIn or via email. And I can give you that to put in the show notes.
Chris: Yeah. And thank you so much, Clay.
Tim: Yeah. Thank you, Clay.
Chris: We very much appreciate you doing all the hard work and then I don't mind I’ll just wrap you up in doing the podcast. Would you recommend the program?
Tim: I would. I was telling Clay this the other day and I told you this earlier. You know, it's been a game changer for me. I mean, this last year has been an absolute whirlwind. And you know, throughout all of that, I've continually felt better and better.
[0:50:01]
And I’m now feeling better than I have in years really in recent memory and I attribute that to the program—
Chris: That’s amazing.
Tim: …and, you know, working with NBT. So, very much so.
Chris: That's amazing. Thank you so much and thank you to Clay, and Zach, and Simon, and Tammy, and Elaine, and everyone else involved. There’s all these people behind the scenes that do the hard work. So, yeah, I appreciate all those people. Well, Tim, thank you so much. I very much appreciate you.
Tim: Absolutely. Thank you, Chris.
[0:50:27] End of Audio
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