Steve Martocci

@bryan_johnson Thank you for sharing, I’ve had declining Ferritin levels for years, this has inspired me to get to the root of it.

Bad news #1: I have an autoimmune disease. My stomach is eating itself. Bad news #2: 2–5% of people have this, too. Likely more, because it hides. Good news: I'm going to try and solve it. Will share all. As a kid, I ate sugar cereal, drank sugary soda, and gobbled down fast food. I had a few healthy years in my early 20s but then became a young father of three and began building a business. Juggling that stress and grind, I let my health slip and gained 40 lbs. Within a few years I’d fallen into a deep, chronic depression. Somewhere in that timeline, my body began developing an autoimmune process affecting my thyroid and then my stomach lining. It’s called Autoimmune Gastritis (AIG). My hypothyroidism got diagnosed when I was 21 years old with a routine blood draw. That enabled me to begin proactive management, supplementing levothyroxine and Armour Thyroid. They are the hormones my body should be producing on its own but wasn’t. By taking these pills daily, my body was able to operate as though my thyroid was functioning properly. What I didn’t know was that something else was going on inside my body: my stomach had begun attacking itself. But there was no routine test to find out and I didn’t have any symptoms. I just discovered it in May. I'm unsure how long I've had it. AIG causes irreversible damage: nutritional deficiency, anemia, and over a long horizon, elevated cancer risk. When AIG is discovered today, standard medical care concedes defeat, stating that nothing can be done except managing the condition, no matter how awful or lethal the effects. Looking back over the past few years, I can now see the early signals we were picking up in measurement but hadn’t connected the dots. For 11 years, I’ve had low ferritin, without anemia. We continually tried to raise my iron levels with food and supplementation but nothing would work. We chased the obvious solutions first. A plant-based diet means all my iron is the hard-to-absorb, non-heme kind. Hard training, sauna, and hyperbaric oxygen all raise the body's demand for iron. But none of them explained the core failure: despite me taking iron orally, trialing every formulation, and using every timing trick, none of the iron would stick. What I didn’t fully appreciate until recently is how many stones my previous providers had left unturned. The low ferritin kept getting explained away but not fixed. I overhauled my medical team earlier this year. It was the rebuild to lay the groundwork for Immortals Care, our $1M a year protocol. With greater capacity, we revisited everything. On the surface, my low ferritin was easy to dismiss by most standards of care. My hemoglobin and hematocrit were normal. Ferritin measures stored iron, while hemoglobin measures circulating iron, and because the body drains its reserves first to keep hemoglobin normal, you can be fully iron deficient with a perfectly normal hemoglobin and hematocrit. This is why my low ferritin kept getting dismissed: the numbers that define anemia looked fine, so no one asked why my iron reserves wouldn't refill. My team pressed on that question. They first turned to a colonoscopy. I was 48 years old and overdue. It was good health hygiene to have while also serving a specific purpose of searching for a hidden source of blood loss such as a polyp or even cancer in my bowels. Either one of those would be an explanation of why the iron kept disappearing. At the same time, they began connecting the dots. Iron absorption depends on stomach acid, so one theory was that my stomach acid was disrupted. They also knew that thyroid and stomach autoimmunity often travel together, so often that the pairing has a name: thyrogastric syndrome. Put against my 27+ year history of autoimmune thyroid disease, the pieces pointed to a single hypothesis: my own immune system was attacking my stomach. To our surprise, my colonoscopy came back clean. A perfectly healthy colon, better than 95% of colonoscopies of men, according to the gastroenterologist. That ruled out the first concern and worst possible outcome: slow continuous bleeding from colon cancer, or pre-cancerous polyp. My team had exercised great foresight though, anticipating this possible outcome. In addition to a colonoscopy, they’d ordered an upper endoscopy to be performed at the same time. The combined procedure is a bi-directional endoscopy. Probes would look at my entire intestinal tract, up from below and down the throat. Additionally, we had several blood biomarkers measured ahead of the procedure to try and pick up on any signals that would give the gastroenterologist guidance for what to look for while doing visual inspections. Fifteen minutes before the procedure, my blood results returned, finding elevated levels of anti-parietal-cells-antibodies (APCA). They came back at roughly five times the upper limit of normal (103, against a ceiling of 20 Units/mL). It was a positive result confirming the suspicion of AIG being the culprit behind my low ferritin, the other type of gastritis, driven by a bacterial infection, was already ruled out, as we knew I am negative to H. pylori. Even before this finding, my team had ordered five biopsies to be taken from three regions of my stomach. The biopsies were the critical piece. Had they not been ordered, the bi-directional endoscopy would have been completed and AIG remained undiagnosed as there were no visual signatures of the condition in my intestines. Two days later, the results of biopsies came in, showing clear signs of early autoimmune gastritis: early atrophy confined to the acid-producing lining, with the rest of the stomach still spared. My team had anticipated this, methodically tracing every line of evidence. We now had a formal diagnosis. I have autoimmune gastritis AIG. My stomach is eating itself. So this was never one problem. It was three, linked to one another: the iron deficiency, the autoimmune gastritis driving it, and the autoimmune thyroid disease alongside it. Iron and thyroid feed each other both ways, low iron impairs the conversion of thyroid hormone into its active form, and an under active thyroid impairs how the body uses iron. Each made the other harder to fix. Autoimmune gastritis affects an estimated 2–5% of people, and likely more, because it hides and is challenging to diagnose. It's usually silent for years, surfacing only once the stomach has atrophied enough to do real damage: iron deficiency first, then B12 deficiency, then anemia from both, and over a long horizon, raised stomach-cancer risk. In one study of people with precancerous gastric lesions, roughly 18% carried the autoimmune antibodies, and only about 1% had ever been diagnosed. And the earliest clue, low ferritin, is the one standard medicine waves through. Low iron stores get normalized and rarely investigated at all when anemia hasn't shown up yet. That blind spot is what hid mine for a decade. The good news: the iron deficiency is now corrected. I received a 1,000 mg Monoferric iron infusion. This was chosen for two reasons after considering multiple formulations. First, it can safely deliver a full dose of iron in a single infusion (1,000 mg), while older options like Venofer require several separate appointments to reach the same total. Second, certain other IV iron formulations can cause a drop in blood phosphate levels, an important mineral for bones and energy. Monoferric is much less likely to do this, which matters given how closely we track long-term metabolic and bone health parameters. As mentioned earlier, current medical standards treat AIG as something to be managed, not resolved. It's worth noting that many of you give me a hard time, inviting me to "live life" and engage in self-destructive behaviors like a "normal person". I'm cool with the playful ribbing. Also, had I not taken care of my health during the past five years, my situation could potentially be very serious. You too may have a lurking health issue that is undiagnosed and could increase in severity from unhealthy life choices, without your knowing. The absence of symptoms is not the presence of health. A gentle nudge that minding your health, no matter your situation in life, is good decision making. My team and I are going to try and solve my AIG. This is how we’re approaching it: First, routine monitoring keeps the disease in view: ferritin and iron, B12, the pepsinogen I/II ratio, gastrin, and chromogranin A. Gastrin is the dial to watch. If it climbs, the disease is advancing, and the risk of gastric neuroendocrine tumors climbs with it. Second, we’re doing advanced characterization of the disease. We’ll do a repeat biopsy to read the immune infiltrate, deep cytokine profiling, and T-cell subset analysis, to see which pathways are actually firing. That testing drives the intervention plan, including the experimental approaches we intend to develop. + If gastrin and chromogranin rise: damp the gastrin drive (netazepide) and tighten endoscopic surveillance. If the profile is Th1 / interferon-driven: target JAK/STAT. + If it's Th17 / IL-17-driven: target IL-17 and STAT3. + If regulatory T cells are failing: rebuild them (low-dose IL-2, induced Tregs). + If it's antibody- and B-cell-driven and antigen-specific: engineered cell therapy (CAAR-T). Which organizes into four tiers, from available today to frontier: Tier 1, now: protect and support; zinc-L-carnosine, and acid replacement (betaine HCl with pepsin) under physician supervision. This is specific to my case and not something to self-prescribe, especially given the cancer-surveillance considerations above. Tier 2, target the signaling , JAK/STAT, GSK-3, IL-17, and damp the gastrin drive (netazepide). Tier 3, reset the cells, induced regulatory T cells (iTregs). Tier 4, frontier: engineered T-cell therapy (CAR-T / CAAR-T), custom AI-designed antibodies, or synthetic proteins, that can specifically seek out inactivate or destroy the rogue immune cells attacking my stomach lining. To be clear: there's no approved cure for autoimmune gastritis today. Medicine treats it as something to manage, not solve. Tiers 2 through 4 are investigational preclinical evidence at best, and in several cases therapies that still have to be built. If you're working on autoimmune gastritis, antigen-specific tolerance, regulatory T cells, or CAAR-T for organ-specific autoimmunity, please reach out. Modern medicine has normalized too many conditions that erode our health, function, and comfort, shrinking the goal to monitoring and management while a cure is rarely even attempted. Most of these verdicts were handed down decades ago, in an era that predates nearly all of our current tech and science, and they have gone largely unchallenged. We want to change that. In the age of AI, multiomics, and custom-built DNA, proteins, and cells, no condition should be presumed incurable simply because no one has yet tried to cure it with today's stack. I’ll end on a personal note. We fill our days mostly on things that are trivial next to what we ultimately care about. We know, deep down, however, that in the noise of it all, health is easily forgotten until it’s the only thing that matters. We spend a fraction of our lives truly sober to the preciousness of life. We feel it when someone we love dies, when a child is born, when we come close to death ourselves, or when a diagnosis marks our limit. In those moments, we are sobered, and the rarity of it all becomes self evident. Imagine the existence we’d build together if that clarity didn’t fade. I wish all of you the very best. Care for yourself, care for others, care for the planet and care for our animal friends. Care for life as it’s the most precious gift there is.

@emigal Devin +100

Really great points from Brian. After going Cursor > Claude > Codex at Ezra we're now back to Cursor + Devin so we can better manage token usage. Cursor remains the undisputed leader in DX when developing locally, Devin has absolutely nailed cloud agents.

@alexkaplan0 I love the tag line but good is a major undersell.

Devin is Actually Good Now ™

Tragic, @JoshuaBaer was a friend and mentor. He will be missed.

@mattbergland 4.8 + Devin is already so absurdly good at solving really complicated multi step tasks. I can’t even comprehend how this will improve with Fable.

First Mythos-class model is here. Let Devin rip 😈

@ericzakariasson Got @smart but broke an 82 day streak yesterday!

introducing cursor profiles! go claim your handle at cursor.com/profile

@mattbergland Took this one this morning

love getting these texts

@RonConway THANK YOU FOR ALL THE SUPPORT YOU AND SV ANGEL HAVE GIVEN ME. SENDING YOU ALL MY LOVE.

I want to share some difficult news. I was recently diagnosed with a rare form of cancer and I want you to hear it directly from me. Treatment is starting immediately and will include multiple strategies over the course of about a year. While I will be stepping back from some of my usual activities, I will continue to support SV Angel founders, who I love with a passion. SV Angel remains unchanged. Topher has made all of our investment decisions for the better part of the last decade, and Ronny joined as Managing Partner in 2024. They bring experience from nearly every major technology cycle in Silicon Valley and are now focused on partnering with founders building the future of AI. SV Angel has a deep, experienced team that remains fully focused on supporting exceptional founders. With a more focused and balanced schedule, I can prioritize treatments while helping SV Angel founders at inflection points like we always do! I’ve chosen not to share the specific type of cancer since I don't want speculation about my prognosis. I appreciate your understanding and respect for this. I am optimistic about my prognosis. I am fortunate to have the best/amazing team of UCSF doctors in San Francisco, and as you know, I never back down from a fight. Thank you for your support, it means a great deal to me.

@nickbilton Incredible, so happy for you. Will be watching.

It's the honor of my career to become the executive producer of 60 Minutes. I just shared the note below with the incredible staff and can't wait to get started.

@ScottWu46 Huge fan, incredible to watch the progress of the product over the last year. I should have reached out to invest when I became a daily user in March last year!

Grateful for our customers, investors, partners, and most of all for our incredible team. Hard to believe it's only been two years. Still a long way to go to build the future of software engineering - we are hard at work every day on making Devin even better! If you haven’t tried it in a bit, check it out and let us know what you think: devin.ai

@jack Truth supp.co/products/thorn…

best and only thorne.com/products/dp/bu…

@Jovkicks @pepfessions Agree, my BP is luckily fine at 117/78 but still the RHR is still freaking me out. I am a carrier of the CASQ2 gene mutation, been wondering if that could play into it, would be open to sharing my genetics in a study to try to find out.

@smart @pepfessions I will say everyone different on them. That’s why when people ask me about it I say what happen to me for me may not happen to you but keep a BP cuff watch your heart and get blood work. Lucky for me I take BP meds which counter the effects of the HR increase who knows.

Switched from tirzepatide to retatrutide expecting magic. Got the same weight loss but my resting heart rate climbed from 62 to 84 and stayed there for 3 months. Reta is not tirz plus. It's a different beast and nobody talks about the cardiovascular load.

@Jovkicks @pepfessions I would not put me in that category, I've had no weight to lose with GLPs. They have had this effect on me even in my peak physical shape, which included plenty of cardio and strength training.

@smart @pepfessions 58-60 before 58-60 at 4mg a week. I say people should pop Reta without at lease preparing their bodies with 60 days of cardio and good work out system. Lots of people are popping 4-8mg have horrible cardiovascular health already due to being out of shape and to high a dose.

@ScottHickle @oasishealthapp 👋 @joinsuppco

The @oasishealthapp has lost every shred of credibility in my book. I’ve watched them make baseless accusations and delete them *multiple* times now. If you’re going to be a third party standard, you have to be excellent What we have here is incompetent fear mongering for profit.

We're thrilled to share @truniagen is now TESTED by SuppCo. This category-defining supplement just earned our TESTED by SuppCo seal. We anonymously purchased their products and sent them to an accredited lab... and they passed. 🏆 When a brand with 45+ clinical studies and 60+ patents still chooses independent verification, that says something. — TESTED by SuppCo is an independent verification program that anonymously purchases supplements through normal retail channels and sends them to accredited labs, where active ingredients are tested for identity and potency against label claims. Only products that meet or exceed 95% of their label claims earn the certification. Brands pay to participate and this post is sponsored as part of the program. Results cannot be influenced and are published transparently pass or fail.

I use Devin a lot from my phone, when an idea hits, I write a prompt and get a fully working shareable feature branch deployed. Better than maintaining a todo list, it’s more of a “maybe done list”

I’m in the top 200 @cognition / Devin users. At $400m+ ARR,the enterprise contracts must be large and concentrated. I’m a huge fan of the pace of innovation, the multi repo support, automations, Devin review, wiki tools, computer use and now it can run and test android apps. The pace we can move at with @joinsuppco is unmatched so far. Check it out.

Automations are set up for nightly accessibility checks, test coverage, security and SEO improvements.

Having the backend and frontend fully configured (2 repos) in the cloud environment lets it work on end to end features, write tests and even do screen recordings of the whole feature.