alexander

@bryan_johnson Godspeed. If you happen to take a side quest to solve Crohn’s I’ll be forever grateful @bryan_johnson 🫡

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.

@bryan_johnson This guy

Who would you trust to run the world?

@typesfast Nibble maybe

Is Rippling going to eat every SaaS category?

@typesfast @huskies20001 I agree and I’m glad I got to reap the rewards! Best sales/recruiting spend for sure

@typesfast @huskies20001 Bro your corporation bought a box for the Warriors a decade ago.

Olympic swimming tickets for LA 2028 going for $4500 each. Where do people get this kind of money? I didn’t even know swimming was popular.

@_clem What if I like notion and cloudflare..?

Do you like Notion Workers? Do you like Vercel? Do you want to follow along as I build a mini-Notion Workers using Vercel? Well then have I got a Vercel Ship workshop for you! 6/30 vercel.com/ship/nyc

@guinnesschen I hand edit prompts more for myself than for codex tbh. Writing (even prompts) helps me sharpen my own thinking!

Bro it’s June 2026. Stop hand editing your prompts. Hold down the dictation button and ramble for 10 minutes. Give the model every fragment, caveat, example, and vibe in your head. It is literally a large language model. If it’s superhuman at anything, it’s reconstructing latent intent from language.

@thsottiaux Symlinks don’t show up in file explorer

What should we improve in the Codex app. What's not delightful?

@elonmusk @t_blom Pothole avoidance is my primary reason

Upcoming releases of FSD will remember your parking preferences, so that the car goes to the right location at your home, office, school drop off, etc. Destination parking is by far the biggest reason people now intervene with FSD. Critical safety interventions are extremely rare.

I’m astonished more people aren’t raving about Tesla’s full self driving. I no longer need to drive my car. The only time I take control is to back into my garage because it’s down an awkward ramp.

@andrewqu If just given random prompt and response probably not but in my own repos with the same harness? Definitely could.

Hot take: a lot of people wouldn’t be able to tell the difference if they were randomly routed between gpt-5.5, opus-4.8, or fable-5 for their day to day work

@OfficialLoganK @mark_k @GoogleAIStudio Just feels like Conways law in action.

@mark_k @GoogleAIStudio it’s a good question, do you see the products as the same? do you use them in the same way? curious to hear

Our long term goal for @GoogleAIStudio is to eliminate the friction to build with AI, then do the same for your own business, and ultimately unlock economic opportunity for everyone. Feels like early innings but I keep getting more excited about this.

@bscholl @Andercot Agreed. In fact we should eliminate w2 withholdings and have every American submit quarterly payments. That way it feels more real

@Andercot Terrible idea. We need everyone who votes to have some skin in the game, even if it’s small.

We should actually just not tax people who earn less than $100k per year Every single socialist politician should be in favor of this

@ClaudeDevs Limit resets?? Model switching mid session is closely.

As a result of a US government directive, we are suspending access to Claude Fable 5 for all users. You can continue to use all other Claude models. Here’s what this means for you: Across Claude products, new sessions will run on your selected default model or Opus 4.8, and existing Fable 5 sessions will end with an error. On the Claude Platform, requests to Fable 5 will also return an error. Please update your integrations to other Claude models. We know this is a disruption to your workflows; we appreciate your patience and support.

@jxnlco Huge browser fan. Wishlist item is an easier way to recreate scribe.com using it. Right now I cobble together AI meeting notes, codex browser, and screenshots.

codex users! how have you found codex'x ability to use (correctly) computer use / chrome extension / in app browser? if you want to give us feedback leave a comment and I'll organize it for the team!

@Yuchenj_UW Asian mamba mentality 🫡

Elon becoming the first trillionaire means one thing: I’m now officially closer to Jeff Bezos than Jeff Bezos is to Elon.

@Jason @Apple Bring back the AirPort Extreme!

Given token economics, we really need @apple’s new ceo to go all in on workstations that can run local, open source models Ideally, with a router that can flip between local models and frontier models when the former gets stuck. And America needs an open source champion — we really should not be comfortable with the Chinese owning the open source LLM market to the extent they do

@Cloudflare Orange really is the new black

Cloudflare 🤝 Mastercard

@clairevo Clocks ticking folks you got like 11 days to do this

oh ok i get it. imagine you have a staff engineer working on a basic CRUD saas. and they complain year after year you're not working on enough tech debt and nothing is ever prioritized right. and then they propose the most opaque, overwrought example of backend performance issues, and try to convince your ceo that you should stop all product development and put 100% of your engineers on fixing your flaming dumpster fire of a monorepo. and every year you say no, because their proposals are intractable, completely untied to business metrics, and "no customer will care." now pretend you can put that person in a back room and ignore them for a few days, and they come back and secretly ship everything that was wrong in your repo. your app is now blazing fast and you are at bug zero. that is how you should use fable. (just don't put him in a meeting, and don't let anyone read his docs)

@jxnlco I literally just had a septoplasty (and turbinate reduction). Godspeed. Took me 10 days to feel like myself again.

First, I’m going under general anesthesia and taking opioids as pain killers. Going to be a interesting rest of the week after surgery…

@zachtratar @kevinrose @craftdocs On mobile so probably not the best answer but I remember how when meetings was being push (no offense) I struggled to move it “out of the way”. Same for when I wanted to back to old home view. Would be great to just ask notion to do that for me eg with a screenshot!

@alexleesf @kevinrose @craftdocs Any specific settings you think this would be important for? I think the hard part w/ settings is users don't often intuitively know what is available. So they won't know what to ask for?

Notion feels bloated these days, Obsidian is great but I don't have time for all the configuration/extensions. Been loving the latest from @craftdocs - less complexity but native BYO AI keys + mcp support.