How scientist Michael Snyder might save healthcare

There is more data on Michael Snyder than any human ever. The Stanford genomicist might just reshape healthcare, and has advice for you to save yourself.

The scientist Michael Snyder with his health monitors at Stanford University, California. Picture: Steve Fisch

When Michael Snyder’s two daughters were little he asked his wife: could he just take near-constant measurements of their blood, heart rate, glucose, microbiome and epigenetic profile, and maybe throw in some regular full-body scans to boot? It was a no. “My wife was not so keen on it,” he tells me.

This, in miniature, is the problem facing Snyder, the scientist and visionary tech guru at Stanford University, California, who cannot get the medical establishment to listen, let alone change. When he talks of modern healthcare he uses words like “wrong” and “broken”, and says that it is long overdue a “revolution” that according to him won’t just save lives but money too.

I’m now going to describe the ways in which you might at first suspect Snyder to be a Californian nutjob. He didn’t want to track his daughters’ every heartbeat out of some mad scientist project, but out of love. And, also, company. His is the first body to be tracked as fully as we know how – we have more data on Snyder than any human who ever existed. For over a decade an intense monitoring regime has accumulated two petabytes of data on his every cranny, equivalent to 40 million tall filing cabinets’ worth of scans and readings. His colleagues nicknamed this collection the “Snyderome”.

“And I’m going to keep adding until I die, and after that I hope someone can still make use of it,” he says.

He would argue he is not a freak, just the first. That annoying “optimising” tech bro you know, obsessing over his smartwatch readings? He is not a self-indulgent hypochondriac, but a new standard for every British adult – in this vision of the future our readings would be integrated into an ultra-modernised, ultra-preventive NHS (for reasons we will come to, he thinks the NHS is an ideal early adopter).

I ask him, on a Zoom call to his office at the university, for his party trick: to hold up his wrists for the camera. He has four smartwatches lined up his forearm like a crazy Inspector Gadget, plus he wears a glucose monitor on the back of his arm and carries a widget of his own team’s invention, a phone-sized black “exposometer” that records the pollution in the air he breathes – a relatively new addition to his set-up and one he believes increasingly important. While we talk machines are constantly eavesdropping on the internal chatter of his organs. I stare down at my ignored arms, which haven’t had a blood test in years and sport only a Casio watch. I feel distinctly underdressed, if not underdiagnosed. So, that out of the way, now let me show you the ways in which he might just save healthcare, as well as his advice for you right now to save yourself.

On meeting him he seems the opposite of a tech messiah: he’s a lean, dark-haired 67-year-old who speaks with the modesty of his rural Pennsylvania upbringing. He is chairman of the genetics department at Stanford University and his lab of more than 100 scientists has broken new ground in medicine, genomics and biotechnology. All his life he has spanned these specialisms – “I will explore anything that seems kind of cool,” he says – but when he was recruited to Stanford from Yale in 2009 he had the epiphany that united them to become his mission.

“I went for a health check when starting at Stanford and they did a blood draw and gave me a report on 15 things,” he says. Most laypeople are boggled by even this level of information but for Snyder it was embarrassingly basic. The typical doctor’s set-up for the most part hasn’t changed in 40 years, he says, and still waits far too long and passively for illness to blow up. For Snyder, the thought of relying on a blood test every few years is like trying to predict the oncoming weather by sticking your finger in the wind biennially. Instead he set up a system that was like daily – or hourly – satellite monitoring. Never, he promised himself, would he be surprised by illness. If he sees illness “rain” coming, he takes preventive action rather than waiting to get drenched.

“I thought, ‘This is ridiculous, why aren’t doctors using the technologies we’re routinely using in our lab?’ That launched it. We started on me, not because I thought I was anything special, but because I was there.”

In the grand tradition of scientist self-experimentation, he tests himself the most, and I don’t have the space here to describe how exhaustive that process is. But what he has discovered is that long testing is far more valuable than deep. “Longitudinal” data, ie regular self-testing over a lifetime, is the key. The example he likes to give is body temperature. Healthy body temperature actually varies from person to person by about a degree. A temperature could be dismissed as nothing by a doctor, when in fact in that individual it could be raised and thus a warning sign. Subtle trends in his blood glucose predicted Snyder’s prediabetes; subtle trends in his blood oxygen predicted his Lyme disease. However, his doctors “do not know what to make of” his reams of data and “mostly ignore what I tell them”, he says with good humour. He has had 15 full-body MRI scans in the past six years. Would he advise people to pay for preventive MRIs?

“My answer to that is yes. Every physician will 100 per cent tell you no. And the reason is you’ll find nodules. Everyone does, and they’re little and doctors say patients will worry about nothing. And my retort is, that’s not the point. The issue is, do you have any growing? I have nine. I know exactly where they are. One on my spine, one in my brain. They’re not growing. I’m glad I know that and the only way I know that is through longitudinal sampling.

“I’m not saying you need to have that many MRIs, though the cost will come down. The point is not the nodules, but setting a baseline for change. We have to change our mindset. It’s retraining doctors and retraining us.”

For the past nine years he has run his ideal testing regime on 100 volunteers. “Almost right away they started catching serious illnesses. Ovarian, prostate cancer, even pancreatic cancer, which is almost never found early. They were all found presymptomatically. In the first few years there were 49 major health discoveries.”

Then in January this year Snyder’s team published in the journal Nature Biomedical Engineering another significant invention. This is his “micro-sampling” system where a finger-prick drop of blood taken at home can provide a treasure trove of insight, from stress levels to immunity or inflammation. Keen followers of this field may be reminded of the doomed Californian tech company Theranos, which famously promised a similar kind of blood analysis but was founded on quack science. His micro-sampling is like Theranos, Snyder says, “but it works”. It sounds interesting, I say, but what’s the practical use?

“Oh, it’s going to change the way we do medicine. You’re not going to go to the doctor for routine stuff. You’ll do finger-prick blood tests at home and you’ll be able to do many more of them and see any changes that occur without waiting two years for a check-up.

“We think that’s a big deal because it alerts you when things shift. A friend of mine was in our [micro-sampling] study, he was in the normal range for an enzyme for liver function. And then it doubled. He said, ‘Mike, what’s going on here? I’m still in the normal range.’ ” His doctors didn’t “say a word” because he was still healthy. Snyder continued the tests until, soon, “he was out of range. Nobody follows these trajectories, it’s not part of our medical psyche. And it’s so, so important.

“That case shows the power of longitudinal tracking,” he adds. “Now imagine he was operating by current medical practice. He might not have known anything about it for two years. Who knows what damage it would have done by then?”

One of his lab’s most surprising revelations is the most low-tech: the importance of heart rate. The pulse has been measured by doctors at least as far back as ancient Greece. Now millions of us wear smartwatches, Snyder’s team have proved that small rises in resting heart rate are a great early warning sign. His study of 5,000 people wearing smartwatches during the pandemic found that heart-rate increases were a good predictor of Covid a median of four days before symptoms.

The extra pulse is small, between two and seven additional beats per minute: easily picked up by a smartwatch but totally ignored by doctors. In fact Snyder ignored it himself: he was part of a trial of an app that gave users a “red light” on days when their heart rate suggested they were fighting infection. He got a red light, tested for Covid, found it was negative, felt well and went on a trip to New York. The next day he tested positive and had to isolate in a hotel for a week. Pulse is still a blunt instrument: it alerts for extra stress, which could come from infection or deteriorating mental health. Still, either way it is useful.

Much of this data is already gathered on smartwatches: Snyder himself wears so many to compare the accuracy of leading brands. Also glucose monitors, which are now being marketed at the nondiabetic mainstream by fashionable companies such as the British Zoe app or the American SuperSapiens.

Genetic analysis for inheritable disease risk is on the rise. What’s new is the exposometer, which Snyder devised himself because the commercial brands only measure fumes from traffic or smoke. His also measures a whole array of nasties, from bacteria to household chemicals.

His team have tracked how his inflammatory markers go up when he is exposed to certain plastics, and pesticides correlate with inflammation in his kidneys and liver. “Pro-inflammatory things on the outside are associated with pro-inflammatory things on the inside.”

“This is very understudied, I think it’s going to be huge,” Snyder says. “The heritability of medical traits varies a lot. Let’s say it’s 10 to 35 per cent of your clinical markers that are due to genetics. The rest is environment. And what does that mean? It’s food, exercise, stress. But I’d be awfully surprised if airborne exposures aren’t a big deal. And we think about biological exposures as evil things. But if you think about humans in history, we have been living in habitats that were good for us, right?”

Does he mean how good it feels to breathe in lungfuls of forest or sea air? “Correct.” And these could be prescribed as part of the preventive vision he has mapped out. I ask him to picture my morning routine of the future. The bathroom mirror would, by the time I wake up, display any yellow or red warning signs for worrying trends based on my smartwatch. “It would be just like your car dashboard.” A finger-prick of blood would be analysed “probably once a month”. Early course corrections via the diet and exercise that work specifically for me would be easily tracked. From all his data, what does he believe is the healthiest habit you can make? “Exercise,” he says. If only I could see, as he does, the positive impact it has on almost every bodily marker I would do it more.

His vision will come to pass, he fervently hopes, for his teenage daughters’ sake. “But in the US the financial incentives aren’t aligned. There is no reason for doctors to keep you healthy. But with the NHS you guys are better positioned, you have an opportunity.”

Come over, I say. We need you. Tempting, he replies, but he loves “sunny” California. Where no one would dream of calling him a nutjob.

The Times