One of the most powerful things someone can do for their health is lab testing. Because the second you see what is going on, you become motivated to take action. You start to realize there are things going wrong that you weren't aware of.
Max Marchione, the CEO of Superpower.
There are all sorts of chemicals in our environment that never used to exist. And many of these chemicals are called endocrine disruptors. In other words, they disrupt our hormones. BPA is a classic one. I thought I avoided all BPA. And my BPA levels when I tested were in the 99th percentile.
That's crazy. For a guy who works, you said 110 hours a week,
Probably 100. Yeah, sometimes 110.
100 is still a lot. How do you manage your stress? Let's start there.
One is make sure the foundations of health are solved. If your metabolism is out of whack, your diet's out of whack, you're not sleeping, your hormones are out of balance, your health is shot, you need to solve that first.
So, you said you meditate every time you're in an elevator for 15 seconds.
I love this idea of passive optimization. And the idea is we don't actually have a lot of time to all of a sudden add 20 hours of exercise a week or an hour of meditation a day. Most of us don't have time for that. How do we take the things we're already doing and turn them into moments that are more productive?
A lot of men have very low testosterone in this country right now. Let's start with the basic question, which is why.
Let's look at what men do now compared to what men did hundreds of years ago. Men a thousand years ago used to go to war, used to fight, used to be out in nature, used to be touching grass, used to be hunting for food. Men today, wake up, watch porn.
For guys in their early to mid to late 20s, why the fuck aren't they going out and doing the thing, taking the chance?
I think it's really hard in a culture that has been structured to not facilitate that, right? This is also heavily influenced by our parents. So parents try to minimize downside. Let's get a safe job, become a doctor, become a lawyer, become some sort of corporate professional. It's very rare that parents are like, "You know what? I'm willing for you to actually risk kind of failing multiple times to maybe find something that works."
Yeah, of course. That's what we all want. Where do you start?
What do I need to understand about who you were as a teenager to understand who you are today as the CEO of Superpower?
Oh, this is such a good question. So, probably three things. One is always rule breaking and pushing the needle. I have always hated arbitrary rules. My general view of rules is that sometimes they're useful because they drive a certain outcome. A lot of the time they're kind of arbitrary. So, I would not listen to half of my teachers. I put headphones on and just did my own work. I would sneak out of class. And the reason I did this wasn't to not study, because I thought there were more effective ways of studying.
The second thing that comes to mind is always being entrepreneurial and like trying new things. I've started probably 5 to 10 businesses between the age of call it five and 15. And then maybe the third thing is grappling with health challenges. I would take three hours to get to sleep every night. I would fall asleep through a third of my high school classes. I used to sprint competitively and I'd be asleep 20 minutes before a race. And when you have health challenges and can't sleep and see doctors and have surgeries and get told to medicate for life, you start to become curious about what's going on and very frustrated that the system isn't doing much about it.
How old were you when you were dealing with the health issues?
Basically 10 to around 18.
By the way, you've come a really long way from...
Oh man, I feel way too old. Don't rub it in.
So, how's your skincare routine?
It's really funny. Like, I had never thought about skin or skin health until maybe a year ago.
Because I think until you're maybe 23, 24, you don't notice anything. No wrinkles, nothing.
And now I'm like, fuck, I'm starting to look old.
Sure. And the world's probably telling you like if you don't start this now, in 10 years, you're going to regret it.
There's a version of that. There was this article published by the SF Standard that called me babyfaced, and all the comments were saying, "What do you mean? He looks 35 years old. He's not babyfaced." Like, oh fuck, okay.
You mean babyfaced? Were you like flattered by that?
I was like, I don't know. I think this is the irony, right? Like when I was babyfaced, I was like, no, what do you mean I look old? And when people told me I look old, I'm like, what do you mean I don't look old? So I don't know, man. Maybe just never happy.
So the story that I've always latched on to with you is from 10 to 18 years old, you dealt with a bunch of health issues and you cured them yourself. Then you went to med school. Is that right?
I never went to medical school.
You didn't go to med school.
So, but this is like you're a child and you're figuring out what the heck is wrong with me. Where did you even start with that?
Yeah. Sadly I didn't have ChatGPT because that would have solved things, or Superpower, which would have solved things even more effectively.
I started by trying to read everything I could and test everything I could. I remember haggling doctors to let me test my gut microbiome, and most of them said the gut microbiome is not a real thing.
I don't even know at that age that that's a test you should run.
I was just reading online, reading forums, reading research papers, trying to read textbooks. I remember getting a gen one Oura ring. It was this big fat device at the time. I remember buying a CGM. I wasn't able to procure one because there weren't companies like Levels out there, and I had to convince the pharmacist to give me one illegally. I was like, "Oh, look, I just want to test it." And he gave me one. He didn't even charge me. Great, great guy. And I would do this with everything.
I remember a similar story trying to get the doctor to let me test mercury. All the doctors were like, "No, you don't need to test mercury." I got my test results back and I was in the 99th percentile, right? So it was this journey of reading things, having hypotheses, haggling doctors to let me test things, and being frustrated when they often said no. And I think in many respects, Superpower is kind of an antagonism to that. We say let's actually give consumers power to make choices, right? Let's not assume that consumers need to be mollycoddled. Instead, here's information and here's the ability to take action.
Mhm. Okay. So, I'd love to dig into a lot of today's conversation around stress, anxiety, all that stuff. I know you guys are moving in a direction of working with companies, helping them provide benefits to their employees. You work a lot. You grew up struggling with health. You figured it out. How do you manage your stress? Let's start there.
One is make sure the foundations of health are solved. Right? If you do not have the foundations in place, if your metabolism is out of whack, your diet's out of whack, you're not sleeping, your hormones are out of balance, no matter what you do to manage stress, it's going to be really hard, right? I see a lot of people who have anxiety or are depressed. And the modern world says meditate or take this medication. I think often the more accurate answer is fix your gut health. The number of people I've seen fix their gut who end up fixing what's going on in their brain is crazy. So the first thing is solve for the foundations of health.
The second thing is work on something that is actually meaningful and authentic to you and brings you energy.
For me, I work 110-hour weeks, but it doesn't feel like work, right? I wake up and I'm so excited to get to the office and spend time with the team and work on interesting and fun problems and push health forward and push technology forward. And then probably the third thing is knowing that the world is going to have so many exogenous stresses, right? Seeing what are the small things I can do to drive an outsized result.
Unfortunately, I don't have time to just like take a week off. I don't have time to like meditate for an hour each day. So those things aren't really options, but I ask what are the small things I can do? And the small things for me look like every time I go up and down an elevator, I meditate for 15 seconds. Small, but I'm going to go up and down that elevator anyway. Let's use that moment for something useful. A small thing is supplementing, right? L-theanine, magnesium, PharmaGABA at night reduces stress. Another small thing is when I'm in meetings, just trying to breathe 5.5 seconds in, 5.5 seconds out. That's the breathing frequency that maxes heart rate variability and that calms the nervous system. So, what are the small things I can do to reduce stress?
Yep. For the everyday guy who lives in the United States, he hears something like, "Oh yeah, just like work on something that you're passionate about or like find things. It doesn't feel like work." Yeah, of course. That's what we all want. You know, guy works 9 to 5, maybe he's blue collar, whatever it might be. Where do you start? Like, how would you make it so damn simple for this guy to understand like where do you start here?
Yeah, I think two things. One is information, right? Spend time on the internet. Spend time reading. Spend time on YouTube. Try to understand what are the set of options out there. Right? Information is education. When you have information, you can understand the set of options. When you know the set of options, you can take better action. So that's number one, get information.
Number two is just explore different things. Right? I love this idea of explore before you exploit. Try everything. Taste test everything. Try to observe your nature. So that's kind of number two. And then maybe number three is observe who you are and who you have been for a lot of your life. What are the things you like doing on the weekend? What are the rabbit holes that you go down? What did you do as a little kid? What did you want to be as a little kid? What are the kinds of things if you look at your calendar over the past year, what are the moments where you found energy? And I think those three things — get information, explore lots of things, and observe who you are — allow you to get towards this work that feels like play idea.
Sure. And I'd love to really dig into the reality of the situation, which is going out and getting tests, figuring out what's going on with you, even like being able to diagnose something that you may not even know that's going on in the first place is so hard, especially in the US right now. Obviously, enter Superpower, making it easier. But in general, what do you want someone to understand about what they think their options are versus what their options really are?
Yeah. In terms of career, in terms of health?
Health. Okay. So, one of the most powerful things someone can do for their health is lab testing because the second you see what is going on, you become motivated to take action.
The other reason it's really powerful is you start to realize there are things going wrong that you weren't aware of, right? Maybe you're feeling a little bit tired. That often shows up in your blood biomarkers. Maybe you're putting on weight, often shows up in your blood biomarkers. Maybe feeling a little bit depressed or down shows up in your blood biomarkers.
What are the super common things that are showing up in people's blood biomarkers today that are just like we're like, ah, it's just like where we're at in America, but they're actually a problem? What are you seeing a lot?
Over 90% of our members are vitamin D deficient.
The modern lifestyle is indoors all day behind laptops, right?
The modern diet is very vitamin D depleted compared to our ancestors who are out in nature.
The second thing we see a lot of is high lipid burden. So high ApoB and Lp(a). These are two biomarkers that are way better than cholesterol to give you a sense of your risk of heart disease. Heart disease is the number one killer in the US and I would contend no one should die of heart disease. We can genuinely take steps early to prevent it. The third thing we see a lot of is around a quarter of our members are pre-diabetic, and honestly that makes a lot of sense.
One, they know it. They're coming to you and they're like...
And something like 80% don't. Probably 80 to 90% do not know it.
Because they have no symptoms or they just never went to go figure out.
They just don't realize that even if they seem healthy and exercise, they could be pre-diabetic. I was pre-diabetic, right? I exercised often. I ate healthily, but the modern lifestyle is really, really hard metabolically. And they might have symptoms, but they're not aware of those symptoms. They might say, "Oh, at 2 p.m. I get really tired. I eat a meal and I feel fatigued afterwards." That shouldn't happen. If you're metabolically healthy, that doesn't happen. If you're metabolically unhealthy, which is a lot of people — 88% of Americans are metabolically unhealthy — if you're metabolically unhealthy, then you eat a big meal and you feel kind of dead after.
At what point is it too big of a battle for you?
Never, right? Like we're here because the health system is not working.
And until that is fixed, someone has to solve that problem.
Do you think this would have worked like three, four years ago?
Yes. But not to the same extent it does today. I think we're at a real turning point in terms of consumer health. If I look three years ago, if I look six, seven years ago, people laughed at me for wearing an Oura ring. If I look three years ago, people laughed at me for taping my mouth shut to sleep at night and to nose breathe.
I was in Australia around three months ago, is where I'm from, and I was sitting at a cafe and the table next to me, there were three girls probably in their 20s and they were talking about their biomarkers. They're talking about their progesterone levels and their estrogen levels. That is where the world is at now. That would not have even happened a year and a half ago. So I do think we're at a turning point in terms of timing, but I also think that it's incumbent on founders and individuals to create that turning point as well.
Yeah. I mean, a couple years back, you know, like I've been in venture since I was 18 and startup world since about the same time. And it's always just been the topic of like, oh, health is just too hard. It's too hard. Like do something easier, lower hanging fruit. And now it's like, is it that hard anymore? It's still really hard, but it's not as impossible as it used to be. Were you receiving similar messages when you're just getting going?
Oh, yeah. I remember when I moved to the US, I was 22 at the time. I was naive. I didn't really know what I was doing. And I used to say to people, I want to start a new healthcare system and I want this new healthcare system to actually prevent disease and largely be driven via AI.
And what kind of responses would you get? And the fact that you threw the word AI in there three, four years ago.
This was pre-LLM. I was hardcore of the view that AI would replace doctors and everyone I said this to was like, no, this is never going to happen. What about the human touch in medicine? Technology is not that good. What about the risks? It's too hard to build a new healthcare system. This is naive. How do you start? There were so many naysayers and that was really hard because I think I internalized some of that. I didn't internalize it to the extent of I can't do something, but I internalized it to the extent of I can't do something that ambitious. And I think I started looking at, oh, how do I find some sort of business model arbitrage or how do I look at the history of what has worked and map what I'm doing to that, and that was the wrong decision, right? A year later when starting the company, I'd come full circle and back to where I started, which was, you know what, we can build a new healthcare system or at least one in front of the existing one. We can prevent things. People do care about prevention. People do care about optimization, and we can use AI.
I think any founder would probably understand this situation, certainly been there myself, whereas you start something, it's growing and then you get to a point where you're like, "All right, it's at a certain scale now where there's real impact, there's real consequences, there's real money, there's just realness to it." And now you have to start making either little pivots or little decisions or sometimes big decisions that could go against what you initially set out to do in small ways or big ways. Have you dealt with anything like that before with Superpower? And if so, what?
Two moments come to mind. One was in the early days, we tried doing everything, right? We started with this view of let's start by charging $10,000 per member per year.
That was the price to begin, 10k a year.
$200 a year. What's the percentage decrease on that?
A big yes, it's very big.
And I contend that what we do today is better than what we did for 10K. But when we were building the 10K product, we said we have to do everything. And it was really, really hard to do everything when we were just getting started. And there was this point maybe a year into the company where we're like, you know what, let's cut 90% of what we're doing. And we massively scoped back. And that was a tough decision to make. It's hard to kill something that you've spent a year working on. But it was a really, really important decision because then we could focus on doing the first things right, nail them, and then move to the incremental.
The second big moment for us was reducing our price from call it $500 to $199. And that was a big bet, right? But the fundamental belief here is that what we set out to do is create a membership the majority of Americans own. And the membership price that the majority of people own is like Amazon Prime $200, Netflix $200, Spotify $200. And we said, well, surely there has to be some membership for health. What is that for health? And we said, well, let's start by saying it's $200, $17 a month, right? That feels like the price someone would pay for a membership.
And the reason it was a really powerful decision for us is the second we fixed today the constraint we would have in the limit. We were forced to make decisions with that constraint in place. We were forced to hold up, we can't have humans in the loop anymore. We need to build technology and AI. Hold up, we can't do this thing we're doing. We need to do it slightly differently. We need to automate all of these processes. So that was a really big decision for us. Risky because we risked our revenue going backwards, right? We risk no longer having the contribution margin to pay back CAC. But in retrospect, one of the best decisions we made.
You clearly have balls of steel, and I'll hit you with a weird one, which is when I ask you this question, what initially comes to mind, which is what moments in your life in the moment made you question, do you have balls of steel for yourself?
I don't know if I have balls of steel. I think I just assess risk differently to other people.
I actually don't think I take much risk. I just think most people are not good at pricing risk and I think I'm slightly better at pricing risk.
I don't know. I think it's like assume this goes to the worst case situation. How bad can it actually be? It's often not that bad. I think it's also if you actually extend the time axis and we assume we've got multiple shots on goal, is it actually that risky? So I think that's part of it.
That said, can we double down for a sec? What did you have to lose?
I don't think of it that way. Like the worst case is that I would run out of money, I'd go get a job or I'd find a way to make money and then I'd try to start the same company again.
That's the worst case, right? When you look around at the world and you know, especially for guys in their early to mid to late 20s, maybe even in their early 30s, why the fuck aren't they going out and doing the thing, taking the chance, and like looking at it that way?
I think it's really hard in a culture that has been structured to not facilitate that, right? Like the culture we grow up in is you go to high school, high school is about preparing you for university, university/college, but it's about preparing you to get a professional job. That is the socialization and the culture we have around us.
This is also heavily influenced by our parents. Often our parents are not thinking how to maximize upside. They're thinking how to minimize downside. Right? And this is very biologically primitive. When parents had children back in ancestral times, we would think about how can this child not be eaten by the lion, right? So parents try to minimize downside, and the minimize downside socialization that the parents introduce onto their child is let's get a safe job, become a doctor, become a lawyer, become some sort of corporate professional. It's very rare that parents are like, you know what, I'm willing for you to actually risk kind of failing multiple times to maybe find something that works.
So we have a societal pressure with the education system. We have a nurture pressure in terms of how we're brought up. And then we have an extra cultural pressure that comes from not wanting to be a failure, right? Everyone loves to laugh at you if you fail, right? Like I'm sure if we failed, there'd be a portion of the population, yeah, they failed. I told them this wasn't going to work. And that's the society we're in. We don't celebrate failure. I think when someone fails, I remember when Forward Health failed, everyone was like, "Yeah, I knew that was going to fail from the start." My response was, "Thank God they tried, right? We need more people trying and it's fine they failed." Like they took on the right level of risk. They tried to change the world. It didn't work this time and now they can do it again.
Mhm. Mhm. So, what were your parents like? They got this 11-year-old kid who's trying to figure out his own health stuff. How did they frame everything for you?
They always gave me a lot of leeway to explore what I was interested in. They were hands off at the level of just like letting me be me and then hands-on with the small things that mattered such as being strict around in particular who my friends were. And they always exposed me. I remember when I was younger, we would have friends over for dinner and my brother and I were always invited. My family had friends over for dinner. My brother and I as little kids were invited to the dinner table.
Older or younger brother?
Yeah. And yeah, any family conversation my brother and I were involved in till we felt complicit in decision-making. So, we were empowered to actually entertain ideas bigger than what children were typically exposed to. And I think that was really powerful.
Were you guys doing family dinner regularly?
