Microplastics In Arteries: Longevity Doctor Exposes

Microplastics show up in coronary artery plaque. We're flooded with plastics. The way water is delivered right now in all these small single-use plastic containers, that's got to go somewhere. That doesn't just dissolve and disappear.

The rationing of care while you see these huge amounts of money being made by insurance companies, this is not health care. This is just predatory.

Now, how does a person go about finding the right provider? Find somebody that doesn't use the shiniest objects first. Find somebody that does the foundational health care first. If they're not doing that and they're prescribing peptides right out of the bat, right out of the gates, that's a red flag.

Dr. Abid Husain, welcome back to the Pathway to Peak Performance. So great to have you back, my friend. Thank you so much for coming all the way back from Boulder, Colorado to see us, man. Um, some amazing things have happened uh since we last saw you. And uh we won't get into those things today because we want people to go out and find those sources and and see other things. But uh the one thing I will say is it's really interesting to see that uh you and Dr. Yurth were a part of that entire FDA presentation to to uh help the world see the benefits of peptides.

Yeah, we were grateful to be part of that and it was exciting and yeah, scary too, but uh it was it was quite the process and I'm really grateful to have contributed to the movement of peptides.

Yeah, I mean not to take anything away from anyone, but you were the two people that really knew the most uh presenting there, and so that's just my opinion uh and I'm entitled to it.

So I can appreciate that. Thank you, Jock.

Yeah. All right. So today, listen, we talked about cardiology and just how important it is, and you know the the CLEERLY scan at the end of it, which I think is really great. We we went all the way from okay, what are the factors that you know can contribute to these situations? When should we start getting tested uh for all of the you know the panels into how do we then do diagnostic work and then uh address the issues uh that you may or may not find you know to make sure that you're going to live the the longest you can, not be the guy that keels over, you get to the uh emergency room. And that was a phenomenal episode, uh really enjoyed every minute of it. Oh, by the way, are we doing— we didn't talk about charity yet. What would you like to do this time? Would you want to do the same thing?

I'll stick with the same thing because Charity: Water, the statistic I heard was that we need— they they need $10 billion to be able to solve the globe's water problem.

Here we are in this day and age and you would think, like, fighting wars.

Yeah. Like, like what what what— that's a ridiculously low amount of money considering that we have trillionaires and we're spending billions of dollars a day on unnecessary interactions with the other countries. You know, this is an amazing charity and it's a solvable problem. So, let's— I'll do what I can to help.

Yeah, let's get the word out. Um, as I said, Scott is like a phenomenal— and he, what a speaker. I mean, just really, I mean, he definitely— talk about a guy that could tug on your heartstrings. Um, they tell you mine.

Yeah, he was— blew me away.

Um so, all right. Well, as you know, show is sponsored by uh KetoneAid and um you're familiar with ketones. Last time we did the KE4.

Yeah.

Should we try the KE2?

Let's do it.

All right. Well, you know, here's mine. And there's the uh bottle. This— this is uh I guess that's three and this is 2.5 when uh when it's all diluted down. So, there's the cap.

Mhm.

Um, nice thing about working with you is you know exactly how much to pour in without even having to use the cap. You don't have to get it all over your fingers. So, uh, I like to do mine a certain way. You do yours your own way. Cheers.

Mhm. KE2 I can— I can chug.

Yeah, it's different. Um, I think it's, you know, KE4 will always be my favorite. I don't know why, but um you know, it is what it is. Everybody has their own preference.

That's right.

Look, we've got a lot to cover. Um, this is a super exciting time and people are really waking up, but they need to know the right information.

Yeah.

They also need to understand the dangers of listening to people who don't know what they're talking about, and there are a lot of them out there. Um, so you know, when you're talking to anybody, in my opinion, if you're taking peptides, got to get them from a high-quality compounding pharmacy under the direction and care of a physician who really understands the complete picture,

yeah,

of who you are. And uh something that Leonard Pastrana always always says that I really like is this notion of, we should be like— if you're using the same dose of something, or you know the the plan should be progressing.

That's right.

Yeah. So I think at 30,000 ft, let's talk— I mean, you have a tremendous amount of peptide experience. You also practice with Dr. Elizabeth Yurth. I mean, what is— this year is the year that she celebrated 20 years of BLI.

That's right. That's right. 20 years in the industry.

Yeah. 20— unheard of.

Yeah. I mean, she's she's uh— I would never call her this, uh but I guess you you would say OG in the industry, right?

She is an amazing— just amazing speaker. I I love her. She's just something about her. She's so—

Got that energy.

Oh, yeah. She's passionate about this. This is what she eats, sleeps, and drinks. And it never ceases to amaze me how much she absorbs and then brings to the table every day. Passionate, caring. I mean, it's the— it's the— if I'm going to get sick, she's the person that's taking care of me.

Yeah. So, there's a lot to cover here, a lot to talk about. Um, first things first, um, let's talk about how patients go about uh finding the right provider. This is the key that I feel today because you see a lot of people rushing into this and you know they may or may not have uh the education. There's certainly a lot of people that are influencers and I'll say like trainers and this whole— the whole culture of people that are out there, that it'd be like me trying to like, you know— people always come to me, Dr. through saying— and they say, "Jock, you know, what should I be doing?" which— first of all, and they always ask me what supplements am I taking. Listen, I'm an appointment, whatever I'm taking doesn't matter. That doesn't— you know, there's some universal things around hydration, whatever, but you shouldn't be like judging what you're doing based on who I am. That's a bad place to start. So with that in mind, how does— how does a patient or a person go about finding the right provider? What should they— are you looking for in that provider?

Yeah, finding a provider can be a really challenging process. Uh, it's going to take some vetting because you got to get some experience with them and potentially uh it's hard to interview them, but at least get a sense of how they practice.

I would look for time in the industry. All right. The the longer somebody's been in the industry, then you know they're interested in healthcare, or they're interested in this process of optimizing health and longevity. There's just so many people that have joined this— this industry in this short period of time because it's a flash in a pan for them and they're looking for money grab, you know, or they're looking for a quick cash out. Uh, and that's not to say that practitioners are doing that, but this is rampant in the industry right now.

So get somebody that's got some experience, and then find somebody that doesn't use the shiniest objects first. Find somebody that does the foundational health care first. If they're not doing that and they're prescribing peptides right out of the bat, right out of the gates, that's a— that's a red flag, because peptides should be the last thing that a person gets prescribed. There is so much that needs to be done before they get to a point where they're using those and that they're getting full advantage of them.

That's what we do at our practice. We— the the peptides don't even— they may enter the discussion, but I don't prescribe them until three to six months into the process. Um, optimizing their biomarkers, looking for risks that they have, addressing immediate health risks, and then looking at their hormones, looking at the nutritional deficiencies, looking at vitamins, minerals, fatty acid deficiencies, and then lifestyle changes, metabolic issues — all that has to happen before we can start looking at some of the shinier peptides and some of the more, I don't know, glamorous longevity tools. Now, that's not to say you can't do, or I don't recommend doing, sauna or cold plunges earlier on. Um, or I won't recommend a GLP-1 earlier on. If it's indicated and if there's a a reason to do it, well, certainly. But if if you're coming to me with a testosterone that's suboptimal and you're complaining of low energy and and not working out, that's what we got to address first before I put you on, you know, or some sort of growth hormone agent or some performance-enhancing agent. Let's get you to perform. There's no point in giving your body signaling agents if the signal is going into— doesn't know how to receive it.

Yep. So, it makes perfect sense to me.

Mhm.

I'm going to draw sort of a a cor— like a correlation to what I saw in the cosmetic aesthetic surgery world. There's a period of time where you had these boarded plastic surgeons and uh some of these cosmetic surgeons who really— like oral and maxillofacial surgeons had really gone deep into a fellowship in cosmetic aesthetic uh surgery. And then you were seeing all of a sudden a whole bunch of other— I'm just not going to say who they are, I don't want to insult people — but a whole bunch of other people just jumping on this cosmetic bandwagon because, you know what, 99215 just wasn't paying enough money, right? So saying I want to be in the um— I want to be in the actual cosmetic game, which led to a lot of people— like, there's a reason why the show Botched is out there.

Oh yeah.

You know what I mean? So I think in some ways we can draw that right back to this. I mean, and boy oh boy, this could be way way worse. Uh, because uh you know, just like we talked about in the last episode, you don't want to be the guy that keels over in the gym.

Yeah.

At the same time, you really have got to be careful about, you know, who you're working with.

Yeah. So, so those are two things. Look at how long they've been in the field and looking at what they— how they practice, making sure they address foundational stuff first. Cuz as a customer, as a patient, you have to know what your goals are. And if your goals are just performance, sometimes getting what you want, which is the peptide, is not necessarily what's going to help you perform. Sometimes it's the hard discussion, and the practitioner you choose to do this has got to be prepared to deliver that hard uh message. Like giving you more stimulants is not going to help if you're only sleeping six hours a night, five hours a night. Maybe you need that extra three hours of sleep to help you regain all this, to recover from the stress that you've got.

So, there's that. Don't necessarily trust all the certifications out there, because certifications right now really come by— you can come by them pretty easily. Um, and in the age of AI where certification programs can come up pretty quickly, we have to really just look at clinical experience and time in the industry as opposed to how many certifications a person has. That may be controversial, but uh, I— you know, this is the direction the industry is going in. People are trying to get validity, and when I say industry I'm talking about the longevity industry. They're trying to get some sort of val— validity and standardization when uh it's really early in the field to be able to establish that.

That's a really critical point. Um, I think ultimately when you're choosing a provider of any type, it comes down to number one, how long have they been around? What success rate have they had? What do patients say about them? Because ultimately, this is truly an intimate relationship that you have with that doctor. You got to be able— or provider, because they're phenomenal.

Sure. There's practitioners out there as well.

That's right. Uh, but you've got to be able to tell the truth. You got to really be able to say this is what's going on for me, and they've got to really want to hear you. Uh, I think that's also a critical component. Goes back to the stuff we talked about in the social kind of stuff. Um, that relationship has got to be um super important. Have you ever had to discharge a patient in your practice? Have you ever decided to say to somebody like, "Hey, man, this is not a good fit"?

Yeah. Yeah, I— I've had to do that. It's rare, but every once in a while it happens. It could be from issues between— between recommendations and therapies that they— that they have not been able to implement, and we've given them multiple opportunities, and then they'll return and and say, "Well, nothing you're doing is working." You got to give it a chance. And then, you know, there's there's not really— there's no— there's no way to mend that sort of a disconnect. Um, and then if there's somebody that just continues to show up and doesn't take the recommendations, it's not really worth their time or mine. Um, and then there's people that just don't know how to treat other people well, when they don't know how to interact with the staff the right way. You know, it's rare that somebody will be rude or offensive to providers, but how you treat the staff, the back sta— and staff and the support staff is clearly uh a more better indicator of what the true true nature of somebody is. Now, yeah, everyone's got a bad day every once in a while and and there's certain grace for that, but if it's a consistent pattern, it's time to let them go.

Yeah, for sure. I think the interesting thing too is it's got to be frustrating at times where you're like, "Hey, this is clearly what you need to do, and if you're not implementing that and this— you're taking a— you're occupying a seat. So, not easy to get that seat, and there's somebody out there that really wants the seat that you're occupying. You got to go."

Mhm.

I think this is also now at a point in time where, as this— we're just, you know, the slingshot is still being pulled back. It's not even— there's nothing launched yet. I mean, it's just— we're getting ready to really go and um it's such an exciting time. And the thing that you said last time that I thought was really insightful is we've never had a better chance. It was— when I say we, just— it's just years of being in the healthcare space. The industry has an opportunity. You as providers have an opportunity to provide a level of care that previously just wasn't possible.

That's right. Yeah.

Yeah. That's because— human genome project, deciphering pathways, peptides have really been part of that educational process because we've started to understand how they work and what mechanisms they work through, pharmacy technique, new formulations, all these new technologies, stabilities, these are all converging in a in a in a time frame and allowing us to really investigate what it is that we can do for— shoot— for biology, for longevity. You know, it's not about— healthcare in the past has been about how we take care of people when they come in in an emergency or at the end of the spectrum. We've never looked at it from the other end of the spectrum. And that's what longevity science is doing. And it incorporates all of the things that looked at chronic disease management and that was ignored by conventional medicine, functional medicine, you know, uh hormonal health, all of these things where people functioned really well but just didn't feel great or had chronic conditions. We've gotten much better at identifying, testing, and treating those patients. And that's educating us on how to get people to live better longer with better healthcare.

Yeah. And I, you know, I want to stay focused on the positive and and the move forward. But I think there's also a revolution that's happening with people that are waking up and realizing, hey, this insurance is not really working out very well for me. The rationing of care while you see these huge amounts of money being made by insurance companies, that you know, it's like drugstores um owning the pharmacy benefit manager, owning the insurance company that owns the pharmacy, the kickbacks that are associated with that, how it all intertwines. It's not great for patients.

No, it isn't. And and there's even techniques now where insurance companies have decided that they're going to put roadblocks into delivering care intentionally. So, it forces you to shift your your your services to another insurance provider on a yearly basis so that every year they have a chance to either increase premiums or just let go of responsibility of— of— kick the can, kick the can. So, I mean, this is not health care. This is just— this is predatory now.

Yeah, I agree. And I think, you know, when I was early on in my career, I looked at— I'm like, why wouldn't you want to do these things that were quote unquote like alternative back then? And then it, you know, eventually it became clear that patients are transient based on, you know, you're getting your health insurance through your employer for the most part. It was before the Affordable Care Act. Uh, so you're either insured or uninsured. Um, and when you have just like this heavy duty profit motive associated with everything. Um, and now you know we're seeing hospitals close. Uh, CMS is saying look, you got to send these surgeries to ambulatory surgical centers. It's a whole new world.

Yeah. Concierge medicine is not free from its criticisms, and it is a more direct uh interaction. It's a— it's a— it's an engagement and a relationship, and there's an expectation that patients, clients have and we can meet those, and if it's not met, there— there's a dialogue. It's not like there's this— this nebulous insurance company that decides for a patient without anybody else's contribution. And yes, you know, it is a business, especially in concierge medicine, but people go into that understanding that, and if their health care needs are met, value is then— value is obtained.

Well, I think one of the main tenets of that is transparency.

Yeah.

I mean, going into that, you know what you're getting, how much it costs, and the other side of it, you have no idea. Um, especially if you wind up in a surgical situation or an ER situation.

Yeah.

You have no idea what that bill is going to look like, how it's going to show up. And when we look at the number one cause of bankruptcy in the United States, it's going to be health care bills that people just can't— they can't pay. Something's got to change there.

Yeah, it's got to give.

Yeah. That's the movement. I think that's also part of the movement of this longevity medicine uh thrust right now. People are realizing that their health care dollars in insurance are not getting them what they think. Uh, whether it comes from care, specialty care, primary care, down to uh prescription benefits. They're not getting what they think they should be or what they're paying for. And they're going outside to pay for health care that they want, even if it's coming from out of the pocket, when we get to this point in time where it's like, I'm not getting what I need. It's all sick care model.

Yeah. You're gonna treat me. I had a doctor say to me, "You're gonna have hypertension, high blood pressure, you're going to have prostate cancer. That's just the way it is." Like, come on, dude. Like, really? Is that the best news you can give me?

Yeah.

So, what I love about you is that you're always like, "Hey, I'm going to figure out how to improve your not just longevity, but health." So, how do I— how do I get you to be functional? I love what you just said, too. It's like, hey, let's start out with number one, get you on track with all the— the four pillars, right? Exercise. Uh, you're an avid exercise uh guy. Yep. You eat well, you sleep well, and you stay hydrated. Those are the things I think are just— I mean, the hydration piece um is is incredible.

Yeah, hydration's interesting. It's uh— you know, we— everybody walks around with a water bottle nowadays and it's important to get hydrated on a on a day-to-day basis. You know, we we want to put in the right types of compounds, supplements into that water so that it benefits us. Maybe we don't need as much electrolyte supplementation as we think we do, but certainly things like creatine help— that helps to get the water intracellularly. Um, you know, most electrolyte supplements have a lot of sodium in them. So, you got to be careful what your background is and if that sodium load is healthy for you or not. And just drinking a lot of free water is not necessarily healthy for you too.

So, you know, hydration— but it is important, because if our cells don't have enough fluid in them, then they won't function efficiently. Uh, if our cells don't have enough fluid, we can't buffer the acidity that we make when we're functioning normally, when we're exercising, when we're just digesting food. So, it's it's vital. I mean, if we're underhydrated, simple things like digestion and gut motility are going to be off, even mentation. So, it's important.

And also, you know, I have a personal belief that we probably don't need to be running with water all the time. You know, we are also designed to be very resilient and to allow ourselves to drain our tank every once in a while. So, go for a run without all your uh water bottles and, you know, sweat it out a little bit and then you can replace it when you're done.

You know, it's funny. I was in um Alaska in Fort Yukon. I stayed in the chief of the Athabascan uh tribe's house, and he said when they would go out on a hunt, he said, "You know how much water we would drink?" He he used his thumb, like they drink that— like a tiny amount of water and they out forever and they come back and then replace it, you know, like as they needed it. So that is interesting, that also the thing we talked about before, that we would hunt and feast and then not have anything. And uh, that's super interesting.

Wonder um, with regards to hydration, how important do you feel it is for people to know about the water that they're drinking?

Yeah, it's important now more than in the past, because there's so much more that's getting leached into our water supply. Our environment is increasingly more more filled with industrial compounds, and those compounds — some of which, many of which, thousands of which we don't even have great identification of — they get pumped into the environment, comes down into rain, into the groundwater, and then it gets into our water sources. So so there's a lot of things that we drink from tap water, and water that is there now that wasn't there before.

I know this because I do metal testing. I do what's called an environmental tox testing on a lot of my patients, and it's surprising what type of petroleum compounds, organophosphates, plastics, um pesticides and herbicides, even uh metals and radioactive compounds make its way into our water supply and sometimes show up unexpectedly depending on where you're living. So that's one aspect of it.

And then we're flooded with plastics. The the water supply, or the way water is delivered right now in all these small single-use plastic containers, that's got to go somewhere. That doesn't just— doesn't just dissolve and disappear. You know, those particles break down. Plastics remain and they basically— they diffuse into everything. I mean, we've seen plastic compounds, microplastics show up at the ocean floor. All right. Microplastics show up in coronary artery plaque, that was detected.

Yeah, that's the crazy thing. One thing we didn't talk about last time when we talked about plaque is that that's kind of a new hot topic. I don't know if it's new. It's new to me. It's probably not new to you, but that notion of microplastic or nanoplastics being a contributor in that plaque. What's that? That's like a whole new added dimension.

It is. It is an added dimension. The the microplastics uh issue is hard to tease apart. Now, we know that having microplastics embedded in our bodies, in in our ecosystem, can't be healthy. But we don't have specific data that shows that one plus one equals two, meaning microplastics plus these biomarkers tell us how much risk we have. There's an assumption that it's causing a certain amount of damage.

We also find bacteria in in plaque. All right. There was a study that came out when I was in my training that said that you could find many different types of microbes, one of which was chlamydia, in uh in atherosclerotic plaque, different types of it. So, so you know, what do we make of this? Is it causing overall inflammation? Probably. We don't know how much. Um, there was an interesting conference I went to last year, the Buck Institute, where the leader in microplastics research was saying, "Yes, it's an issue. Yes, we're detecting it, but we don't really know how much of an issue it is."

So when we look at the hierarchy of things in coronary artery disease and heart disease, it's certainly good to think about microplastics. And if I see a profile that has a lot of microplastics or plastic compounds, BPAs in them, then I'm going to start doing some sort of a detox for that, or I'll try. Um, but if it's not showing up, it's not the first thing I'm going to focus on. It's still doing the basics. It's still looking at what overall inflammatory issues do they have? What can I do for— does their cholesterol or their Apo need to be modified? What other risk factors do they have? What's their metabolic health? What does their liver look like? Those are much more hard targets that give better return on investment than chasing microplastics. Not to say that that's not something to keep in mind.

Sure. Interesting to think that we sort of have this um cacophony of things that are happening in a way that we just don't know how they're all sort of, you know— what is— the whole is greater than the sum of the parts. Like we don't really know exactly what all of these new things— so we have glyphosate that's really introduced into the food system sometime somewhere in the '90s, I think. Uh, and who knows how that's affected us. We see a rise in neurocognitive disease.

Yeah. And that's got to be something that your patients— I I I don't want to put words in your mouth, but I would imagine your patients are coming to you and saying, "Well, I'm terrified of that."

Yeah. When there's dementia in the family — and everybody's been touched by dementia in some shape or form — that's a fear. Everybody wants to prevent it. It's right up there with, you know, preventing heart disease for sure. So yeah, the the biggest movers for dementia are going to be our basic health care, the pillars that we talked about. It's going to be doing things to help prevent, whether you have buildup of amyloid plaque or vascular— or vascular dementia.

This is where we come back to the idea of, or we talk about the idea of, maybe cellular medicine. Cellular medicine is understanding what's happening in a cell and knowing that it's probably the same. All cells function very similarly. There is different sub metabolisms that may happen between, say, the brain and and and other parts of the body, muscles, but overall there are certain fundamental pathways that every cell functions in the same, and if we understand those and know how to impact those, then we can impact different organs in a different way and do it with different timing. So, you know, that's one of the things that I enjoy about cellular medicine. It's knowing— when I know really what's happening on a cellular level, then applying that to different organs is just a matter of when and how.

Yeah. Really interesting. The other day Kristi Fury— we were doing an episode on Cell to Systems about um metabolic psychiatry and the notion of, what if um— you know, some study that said that that um serotonin may not even be a factor in depression. She said, "Well, what if it's just a, you know, an issue of um energy, you know, in the brain, brain energy rather than serotonin?" And I think that's really interesting, the notion of going back to cellular medicine. We had the privilege of learning a little bit about that, and to think about like, okay, we go back to hydration. You're not hydrated. Your cells are not able to function, right? Uh, and then we need some sort of autophagy around cells to get rid of um— get rid— rid of the, you know, the dead stuff or the stuff that's ailing, right?

Okay, we've covered a bunch of stuff already and we're kind of getting all over the place.

Yeah.

When we talk about microplastics, that's one thing. Um, there are obvious ways to avoid that. Don't drink bottled water. Um, don't microwave food that's in plastic. I see people do that. I'm like, dude, are you crazy? I mean, like, what is wrong? That's insane. Stay away from stuff that's packaged in plastic.

Ideally, yes.

Yeah. I mean, almost every single bottle of everything has plastic. I mean, yeah. Plastic here.

That's right.

Um, you wonder like, okay, what's next after that? Um, and and trying to live a clean, healthy life. So, we've talked about water, we've talked about plastics. Let's talk about food. Yeah, food is one of these things where it's like you really have to pay close attention, because there's some pretty deceptive uh food tactics, like, you know, the way that people say things.

Yeah.

Uh, about the product that they've got. So for me, just as an example, I'm always looking at pasture-raised uh organic. You know, a lot of people don't have access to those types of things. And I love— one of the things that you've always said is like, hey, you don't want to freak people out. So if you have to eat conventional food,

Yeah,

how bad is that for you?

Yeah. I mean, it's better than eating packaged food. So that's the hierarchy. If you have the opportunity and the availability for the higher quality grass, pasture-raised and uh and organic, farm-raised, farm-to-table type meals, fantastic. If you don't have access to that, then you can find online which foods tend to have the most uh pesticide and herbicide burden. I think it's the Environmental Working Group.

Yeah.

They have a list of— what are they called, like the Dirty Dozen or something like that. And that's a list of the the fruits and vegetables that actually retain pesticides and herbicides the most, and the ones that need to be the clean the most, or you should maybe potentially stay away from them. But that doesn't mean you don't need other ones, because then they have a list of ones that are really safe that often don't retain a lot of that stuff. So there's there's sites out there to be able to navigate what to get at the grocery store.

By and large, that's the hierarchy. So, if you can do the organic, pasture-raised stuff, great. Continue that. Stay away from the packaged foods. If you can't do that, conventionally raised groceries, but stay on the periphery of the grocery store and stay away from packaged foods. That's really the overarching message, because once you deteriorate and get to that stuff that sits on the shelf for a longer period of time, that's where the seed oils come in. That's where things become highly palatable. They have sugar. They have sodium. They have fat. That's the trio that makes us get addicted. You know, that's what you got to stay away from. So, that's what I stay away from. When I go to the grocery store, I love walking around and seeing what's available, but I'm in the periphery. I'll get as much uh fruit and vegetable as I can fit. I'll get some protein, some lean meats of different types, and then rarely do I go in the middle.

I try to live that way. My my diet is just so basic now. And uh it's really hard to go out to eat now.

Yeah.

Um, I just— there are very few places. I mean, I do love sushi.

Sure.

But I also am really cautious about where I'm going to eat that because, you know, farm-raised salmon is not good, right? And that's a lot of the stuff that you're going to find in grocery stores. And I— I mean, I won't even eat salmon in a restaurant um unless it's 100% guar— you know, guaranteed that it's been uh— what's— wild and caught.

I mean, I try to do that. You're better than me. So, uh sometimes I'm just— I'll— I I'll eat what I need to, but uh I'll pay for it later.

Yeah. Well, you know, that's— so, so then we move on to exercise. Yes. And there's a lot of talk about— we talked about Dr. Suzanne Ferree. Yeah. Um, and she has said something to me that was like, hey, um, you probably want to periodize your exercise over— think of it more in a 10-day cycle, which I think stems out of the old Arthur Jones, Mike Mentzer way, low volume, high-intensity training versus the Arnold.

Yeah.

We use the bodybuilders because those are the easy ones to track, right? Uh, versus the high volume, uh, you know, whatever, however they're training. Do you have a sense of what you feel, or do you feel it's truly like an n-of-one thing where somebody can— they have a— they're set— if they're a phenotype, they can set up for training a certain way, and then maybe they're impacted by some of the choices that they've made, the things that they've ingested, the amount of sleep that they had? You know what I mean? As you dimensionalize this down. Or do you have like an overall thought process around exercise on a whole for everyone?

It depends on— so if we're talking about my patients and what I recommend when they come to me, depends on what their baseline is. Uh, I'll get all ranges. I have patients that love bodybuilding. They've been doing it all their lives and and they're going to stick with weightlifting till they die. And then I have patients that are triathletes and ultramarathoners. Um, so the the idea is to bring those two into the center a little bit, to bring balance to that, because neither system functions great in those extremes.

Um, and so I will make sure that the bodybuilder has some aerobic days. I'll make sure that the ultramarathoner has resistance days. If they're already sort of in the middle, or if they're starting with nothing, then it's generalized full body workouts — meaning generalized, it incorporates both. It incorporates aerobic activity and resistance exercise, because that's what we need. That's what our our vascular system really responds well to. Uh, not only is it the the aerobic activity with getting your heart rate up and and doing that for a specific amount of time, it's the vascular responsiveness that happens with resistance exercise.

So, you know, the old notion was you do cardio, right? Cardio is aerobic activity, running and biking. Well, that brings the heart rate up while you're exercising, brings the heart rate down when you're resting, and tends to give more parasympathetic response. And then it would hopefully bring about a weight loss. It was a classic idea of what heart health is. That is still relevant. But remember that that type of exercise either promotes your VO2 max or your lactate threshold, which is— the maybe better way of describing it is like your zone 2, you know, efficiency. So that's important. We need that for good heart health. But we also need the resistance exercise, which then promotes nitric oxide release and development, and that is what opens up the blood vessels, keeps them pliable. So the the combination of the two is really how we get optimal heart health.

Um, so that's what I start with as a reduct— recommendation for my patients. Two days a week of some sort of aerobic activity, two days a week of some sort of resistance activity. If they're starting from scratch, it should be whole body, nothing too aggressive, because I want to keep them motivated and keep them free from a lot of pain, a lot of soreness. If they already have that, then I will start to push them to do high intensity intervals, and then specific body types, maybe increase their resistance exercise to three times a week. And then that really depends on their goal.

So exercise, to your point, becomes a little— it becomes an n-of-one depending on what the goals are and their body type. I'm not going to make a stocky small guy that may be better suited for weightlifting run, you know, a marathon. But if that's what he wants to do, we'll work with that. Generally that's not what happens. We tend to go to the area naturally that accommodates our system the best, especially when it comes to movement. So, it's a fun discussion to have with people, because I love— I love talking about exercise and I've been an athlete my whole life and I've gone through many different phases of many different types of exercise routines.

The notion of bringing the strength training with the cardio together, um, just from where I am standing today, it's like I— I want to be mobile.

Yeah.

I I want to be able to run upstairs. I want to be able to uh lift things. I think that's super important. I saw something. It was crazy. It was a scan of um a person's leg.

Yeah.

You've seen this obviously. Um, the scan that they were talking about was like, "Okay, here's somebody, a 70-year-old man that works out," and there was very little fat mass, inner— intermuscular fat mass. Um, and then they showed somebody that was 70 years old that doesn't do anything and it's like all fat and some muscle fibers. I was like, whoa. Marbled in there like Kobe beef.

Oh man.

I mean, and and some of it was just like— I mean it was just like chunks of just— just straight white tissue, you know. Um, so it's wild. I think it's really important. I try to get a really good discipline. My my my exercise routine is uh is a little strenuous, but I like that and I need it. So for my own mental sanity, I may be taxing my CNS um a little bit more than than maybe you should.

Yeah.

Uh, and I am an admitted typical overtrainer, but uh the reality is it seems to work for me, and when I don't do it, I feel it immediately.

I can relate. That's exactly how I feel and I tend to overtrain as well and I'm guilty of not periodizing. Uh, but these are all lessons that start to get internalized with age.

Yeah. And I think eventually you get to a spot where you go, okay, I figured it out and this is what works for me and yeah, um, it is what it is.

It brings us to sleep.

Mhm.

Uh, which is like the big— I mean, for years in my career, all the things we're talking about, um, you know, all the airplane travel, uh, as I told you— shared with you that one time, uh, you know, we lived in and out of those airports just going, going. You're not eating well, you're not sleeping well, you're not uh exercising, you're not probably hydrating properly, and you're in, you know, up down, up down, all the—

Um, that's not so far from the truth though. Even though there's so much information about how to stay healthy right now, you would be amazed how many patients come to me who are CEOs who have been living that lifestyle up until maybe two years ago or maybe even just now, when their friend, their best friend had a sudden heart attack and died and they're desperately afraid of that happening all of a sudden. Um, or they've had an event and now they have to do whatever they have to do to keep another one from happening. So, it's it's surprising how the basic message still hasn't reached everybody the way it should.

Seems like it's ramping up. People are becoming more and more aware. The sleep portion is really interesting. There was a study that came out recently that talked about having more than nine hours is actually not healthy. Mhm. Um, and I wanted to ask you from a cardiovascular standpoint, why would that be true? Is that just because you're— you're laying down for too long, you're not moving the body, or what what would be the factors associated with that from your perspective?

Looking at that, I think that we probably have a sweet spot where where we get the most amount of benefit from a certain sort of biological process. You know, this is how humans work. So some people do require a higher amount, a larger amount of sleep and they will feel it. But when we start to get an excessive amount, we pro— we will start to get sluggish. We probably get an overdrive of some of our parasympathetic activity, and it maybe reduces our overall activity dur— throughout the day. It could also be a sign of an imbalanced neurotransmitter system. So if you're— if you're needing or sleeping that much on a regular basis, something's driving that that's underneath, in the undercurrent, that needs to be looked at. So maybe less about the sleep itself, but what's driving that? Is it fatigue? Is it some needs that aren't being met? Is it an underlying metabolic process?

I mean, I am a person that— I'm lucky if I can get six, seven hours. I just wake up, I have ideas, I start thinking about stuff and, sure, you know, it just is what it is. But I always go to bed super early, too. That's probably, you know— I struggle to stay up. I fall asleep really early. But sleep is absolutely critical.

Yeah. I mean, we were— physicians are just— are horribly guilty of neglecting sleep for for years. As part of our residency training, we had very little sleep. Into fellowship, same thing. And the belief was, and this was what we used to share amongst all my other colleagues, all right, I'll sleep when I'm dead, when I have to, you know. And now we know that if we don't sleep, that death will happen sooner.

So, I mean, there was a certain point in time where you took it like as a badge of honor.

That's right.

You know what I mean? It's not the case anymore.

Yeah.

Now people know and people were taking sleep really seriously and trying to like get a good sleep hygiene piece in place. I remember, you know, uh, worked on a project with uh uh Dr. Dement, the godfather of— so he discovered REM— uh, REM sleep. Didn't really work on the project, but I did have an opportunity to talk with him and be on a show with him. Um, but Jed Black and Derek Lully uh at Stanford, we worked on a project that was for transient insomnia. You know, was traveling and basically at the end of the night, you get off the airplane, you got to be up super early in the morning and you're there, it's 11:30 at night and you're staring, even though you're exhausted.

Yeah.

It's sort of a weird thing trying to get to sleep. So these were focusing tools. You listen to them. The running joke on them was that you would never hear the end of them because they distracted you enough to actually get you to go to sleep. Yeah. The sleep thing has been elusive in many ways for me and something that I think is— you have to work at it.

Yeah. And what's increasingly distressing is so many people have a problem with sleep because of the environment, the modern environment that we live in. It is constant exposure from our phones, blue light. It's uh the anxiety of the constant information. It's the responsibility of checking the emails and things that we think that we have to do when we don't really have to. Not getting enough exposure to the sun because we're inside all the time. These are all lifestyle changes that we can make to really impact our our sleep in a positive way.

And one of the things that I try to recommend for people to do is to just reduce your screen time. That by itself can do a lot. Uh, make sure you're not constantly on your phone the second you have a free moment. Give yourself some space, and especially when it gets closer to bedtime, stay away from electronic devices. Sleep at a reasonable time. Try to go to bed before 11:00, ideally at 10:00, because from 10 to 2 is when we have our best growth hormone release. And that will set us up for physical recovery. All right? And then from 2 to waking, about 2 to 6, we have our REM sleep and we have our neurologic cleaning out. You know, the glymphatic uh drainage happens. So, it's a two-step process and we can't sacrifice one and make up for sleep in the other areas, too.

Back to your question about having too much sleep — when are they sleeping? If they're doing all their sleep from 1 to 10, then that's not going to be effective. You're— you're not getting that growth hormone release. So, we have to do it on the right circadian rhythm, too. So, these are all things that we've learned over the past 10 years about sleep and how it really contributes to our health. Uh, and definitely one of the contributors to cardiovascular health.

Isn't it interesting that we're in a time where it's like— I think shift workers in some way, shape or form, probably in— I don't know, in every industry, but uh will be replaced by robots. I mean, hopefully, because shift workers have the highest incidence of some of the worst diseases: diabetes, heart disease, uh dementia. I mean, you name it, the big things shift workers have at a higher incidence. So, it's not a healthy lifestyle.

Yeah. It's uh it's scary to think, like, some people are just forced into doing work that is just, you know, wow.

Um, yeah, be careful the choices that you make, I guess.

I mean, if you're forced to do that because of necessity, uh then it's unfortunate. But if you can stay away from shift work, that's highly recommended.

And then we get to the sitting thing. So I have a standing desk.

Yeah.

I think I should move this podcast into just a standing—

Well, I mean, it's not long enough where you couldn't just move it to the gym.

That'd be perfect.

We'll compete with Arnold's podcast and then you will have some real competition.

I would love to do it over a gym. That'd be great. Be like, let's work out together and have a podcast. That'd be super cool. Um, but yeah, the standing thing versus sitting thing. It's funny. We were in the sauna the other day and I was like, you know, these benches, right? So, here you are, your blood pressure is going up.

Yeah.

You're sitting in that— what you said before was that space where like, hey, normally if we're sitting—

Yeah. Right. But now we're driving up our blood pressure.

That's right.

Shouldn't we stand in the sauna?

It's probably a good idea to get to— I mean, the blood's flowing and you don't necessarily want to be hunched over, but I don't know that there's a— it's a short period of time. Um, are you giving your body mixed messages? It's interesting. You might be, but uh I haven't really thought about the sauna in that way. Um, most people are seated in the sauna. You know, you're seated just sort of relaxing, dealing with the heat, and that's more out of comfort. Um, so it'd be curious to see what you would tolerate in a sauna as far as exercise goes. But I think that for now, don't do any exercise in the sauna. Just take it seated.

Yeah, it's funny. I see people come in and they're doing whatever they're doing, like, you know, there's— we have a policy: no stretching in the sauna.

Yes, that's— you know, for a variety of reasons.

But I also see guys bring in plastic bags full of ice and they're like icing their joints in the sauna. And it occurred to me, I'm like, that doesn't make any sense at all.

No.

Like, why would you—

No, you ice afterwards, right?

That's when you would take it out and you would ice. I guess they're just trying to be efficient or something, but why would you ice? Is there any reason why you'd want to ice a joint when you're in the sauna?

Not that I can tell. I mean, ideally then you would do a cold plunge or wait till you're out. Wait till you're outside.

Yeah, there was that um information that came out that said basically post-workout you don't want to be in cold uh for what, four to six hours or something?

Yeah, that's right. Well, it really depends more on the type of exercise. Um, you could do it after an aerobic activity.

Oh, like a bike ride.

Yeah, a bike ride. Because there is— the belief is that the cold somehow suppresses mTOR. And so you want an mTOR release after resistance exercise for sure. So if you have a heavy lifting day, that's not the day to do a cold plunge. Wait for a few hours. Uh, but if you're doing a a run, a bike, something aerobic, then it's probably okay.

So, let me give you my my protocol that I'm running right now. Uh, always subject to change, but I'm running a uh two days on — uh, full upper, then full lower — uh, then one day off. That's Wednesday, and then, uh, back to full upper, and then back to full lower. Then Saturday is going to be an arm and stair day. Mixed in that is some sort of cardio, a walk, a bike. Yeah, uh, my stationary bike and or uh stairs, which, you know, really I really do the stairs like once a week because I think that's pretty— it's pretty taxing. It's pretty intense. And then Sunday is really just like— I go for a nice easy walk. I'm not trying to break any records. Uh, and that really works for me. I really love it. And then the sauna is mixed in four days a week.

Mhm.

So it's sort of like— it's not the Finn version of where they're doing it like seven days a week at whatever. This is 190 for 15 minutes four times per week. So you're getting a total of 60 minutes.

That's reasonable. I think that's good. I wouldn't— I would uh wouldn't do too much more of the sauna. Um, once you start— I think with the load that you have, remember that sauna is— it is a strain to the system also. You're activating the system. So you combine that with your your lifting and your aerobic activity, it's going to add up.

Yeah.

So check how your recovery is. If you feel like you're recovering well, then that's okay. Your system is maintaining itself or balancing well. If you feel like your recovery is starting to wane, to reduce, it's taking longer to get better, or you're feeling fatigue in the afternoon, then you may want to dial back one of those things, maybe the sauna or uh a little bit of the aerobic activity, or reduce one of the lifting days, because that's a pretty high— there's just some good volume.

Yeah, the volume is pretty intense. And there are days when you just go, "Okay, uh, today's not going to be that day."

Yeah, that's right. And if you have that gauge, great. You don't need to push through it.

Yeah. When I feel it and I know it's like that, that's that second dimension, right? So, you can have this protocol or this— whatever you want to— it's not a protocol. It's like a schedule, right? You can have this schedule. Uh, but then when you get to that spot where you go, something didn't line up, or I had a really stressful day, something was just— it put me into a uh into a sympathetic overload. Maybe the next day is not the day to go in there and really really push it.

That's right.

So, we move on to like using— you said Environmental Working Group. Uh, there's that Think Dirty app, right? Uh, where you can scan just about everything. It was interesting because I was using uh Lubriderm. I always had dry skin. Kind of find out— you think from these commercials that Lubriderm is like phenomenal. It's the best stuff you can put on your skin. Not so much.

Oh.

Um, according to that app.

All right.

Um, and then we started to talk about um, okay, well, what is— and Kristi Fury said that's a gut microbiome issue.

Yeah.

Like that notion that your skin, um, like dry skin would be tied to something in the gut microbiome.

I agree. There's uh— when I look at psoriasis, um, in osteoarthritis or just uh not even osteo, or generalized arthritis, it's uh— especially if it's autoimmune related, I'm going to look at the gut.

What are you looking for in the gut when you're doing that?

Looking for leaky gut, looking for inflammatory compounds that are showing up in the stool that represent a more— an impaired barrier of the gut lining. Because when we see inflammatory compounds in the stool, we know that the stool and those microbiome compounds are actually getting into blood, also, that can trigger the inflammatory response in the body and then in turn aggravate areas like the joints.

Wow. So yeah, having those tight junctions really stay tight, getting your gut microbiome in place. Uh, probably eating a lot of fermented foods but not too much, right? Right. Is there— there's like a certain— there's a just right Goldilocks zone.

I think so. Yeah. I mean, it goes back to what we mentioned last time. Butyrate— butyrate's an integral part of that tight junction maintenance and and gut microbiome, or the the gut barrier. So fermented foods help to introduce different microbes for sure. Um, is there a top limit? There probably is. I don't— you know, I don't have an exact amount, but um yeah, if you have, for instance, if you have uh small intestinal— intestinal bacterial overgrowth, eating fermented foods aggravates it. So that's when you can have too many microbes, when they grow outside of the areas where they're supposed to be. And when it does that, it creates inflammation in different areas of the intestines. It's contrary to what you would think, but that's when we actually would use antibiotics in some degree to knock down where those are coming from.

Is this like H. pylori?

Not necessarily H. pylori. That's a specific infection, but this is when you have microbes that generally are supposed to be there, but they've overgrown into areas where they shouldn't be.

Done. Okay. The next topic— wanted to move on and ask you about are um scents. Scents. Yeah. Um, so phthalates— interesting. I always wondered, is this stuff, like spraying scent on your body, is this really good for you or not? And you come to find out that perfume and— the way they can hide these chemicals and these phthalates, which have serious uh ability to disrupt your endocrine system apparently. Um, and yet there's like scents in every single thing. We were in the gym this morning and these two girls— it's like, we're outside, man, and you can like— they've got perfume on and it's like, I'm trying— yeah. It's like, whoa. How disruptive do you think that actually is?

I don't know much about phthalates. Um, I can't really speak to that much detail, but if they're endocrine disruptors, if they're interfering with your ability to regulate your normal hormonal balance, then that's another potential area for significant disruption. I mean, we look at other endocrine disruptors and those are really insidious ways of people losing hormonal uh hormonal efficiency. And some believe that this is one of the reasons we are seeing increasing rates of testicular hypofunction, earlier rates of menopause, because we're flooded by different things that are endocrine disruptors.

Okay, so testicular hypofunction, what does that mean?

That means just low testosterone. We're seeing more and more men with lower testosterone, young men coming in with low testosterone when it shouldn't be happening. Uh, starting testosterone therapy because it's needed earlier on in people. Um, so it's uh it's not just a fad. It's— you know, we're seeing rates of men coming in with lower rates of testosterone. So plastic exposure with uh estrogens and the plastics that— that

phthalates,

uh, that's right, and a number of other things that are all again this sort of overall— the world has changed and we're maybe trying to catch up, or now just deal with taking away the things that are problematic.

That's right. Helping our body be able to— I mean, our body has detoxification mechanisms, but they're getting overwhelmed and so they need help.

So we can do all the things that we can do that we know of, uh, and there seems like there's always more. How does a person who wants to live at the highest level of health really— like, do you build like a checklist? What do you do? I mean, I think you really want to have a phenomenal relationship with your provider.

Yeah.

Um, and get a really solid baseline like we talked about the last time.

Yeah.

Um, which is clearly not happening for a lot of people.

No. No. You want to get a great relationship with a provider that understands uh prioritization of what you need to take. So this is what I do with my patients is I create uh three categories. There are foundational things that we need to have you do every time, every day. These are what you need to do to maintain your health. And then there are supplemental things that we do cyclically, help optimize your health. Maybe it's something that we, you know, we do on and off. They could be peptides, they can be supplements, they can be any form of treatment. It could be HBOT. It could be some sort of treatment or testing — you know, do an annual Prenuvo scan, like a full body MRI, or uh some other testing for screening. Those are cyclical or timed. And then there's goal-oriented— uh, goal-oriented testing or treatment is for a specific time period and then it stops.

So the point is not so that we just continuously start adding so many things and then it becomes this exhaustive list that we just can't manage. And that's what happens with a lot of people, and I see that, and I've been guilty of creating that for people, and I see the frustration. So this comes out of a need to help to organize their life and then really have them understand what it is that I'm trying to do in the treatment.

Yeah, that's really fascinating, right? The notion that you would actually maybe almost have to govern the amount of work that you do with a patient at any given time as to not overwhelm them. You probably have the people that come to you and they're like, "Give me everything." You're not— right, but you know that you've got to just sort of start them here, and it's a little bit and a little bit, and then you get to the point where it's like, "Man, I don't want to go— like, In-N-Out Burger used to taste great." Yeah. But I'm not doing that anymore. Right. Not my thing. It must be really interesting to— I mean, I have no idea because I'm just not— I don't do what you do. Um, I'm a patient but I don't know what it's like to do what you do. It must be a fascinating, fascinating job.

It is. It's one that is actually— it's brought me a lot of hope in medicine. And if I'm going to be, you know, transparent about my process, I almost gave up with medicine for a long time. Uh, 15 years ago I was done. I thought, this is it. I'm signing off and I'm going to figure out another way of living. Um, I went to train to become a painter and got, you know, great experience doing that, but it wasn't satisfying my scientific brain, my scientific curiosity. And I kept on practicing, and you know, I was also sort of just frustrated with medicine.

And so coming back to this type of medicine has provided me with hope that I can do something different that's not what is the standard of care — meaning not that I'm undercutting the standard of care, but I'm providing something more than that, and I'm providing something that's— there's options that are hopeful for patients and providing, you know, what is for them uh hope. You know, it's a new way of practicing it and it's a new way of understanding our bodies, how we function, and delivering and creating a patient-doctor relationship that is meaningful. So this is something that's brought me back to medicine and made me inspired to be involved in the industry again.

It made perfect sense to me, like if you're working in a world where everything's governed by reference ranges that are based on people who are unhealthy in the first place, and then you got to live within those guidelines, then secondarily everything that you want to do has to be approved by somebody that has no idea, but you know that they're there to like make it difficult to get it done. And then on top of that, uh, you've got uh formulary issues. Yeah, I want you on a specific drug um for this and it's not in your formulary. So, how do you address that? And then they have the gag order on you. So, like you go and you ask for it, you say you've got this insurance, then there's nothing. It's like it's a crazy system.

That model was an exercise in frustration, and then uh— and being free of that model is— liberated me to feel empowered for my patients. And the other exciting thing is that longevity medicine is, like you said, the slingshot is pulling back. We're at a point in time right now where all the things that we thought that were possible for humanity, for the hopes that we think are possible, they're just out of reach. But in five years, maybe 10 years, they might actually be within reach. And so there is so much interest in this industry and so much that's being researched and developed that it really is exciting to be on the leading edge of that.

Yeah. And also scary at the same time because there's some people out there that maybe aren't operating the way that you're operating. Um, and that's just my perspective. I'm not going to put words in your mouth or say anything. I'm just going to say that I think sometimes I wonder um if people really are doing everything they can to really follow— I mean, look, I guess if you're going to really be a pioneer and you're going to really push the boundaries, you're going to have to get beyond the edge at some point in time.

Yeah, right.

And you hope that what you're doing works.

Yeah. And— but we have to prioritize safety. So that's the first priority, and knowing that what we're doing is safe. Once we've got that taken care of, then we can start asking some of the other questions.

Yeah. Like the guys that um that are on our team at Stemodontics, you know, are just really big believers in a very certain way of using stem cells, and it's all model-based and really just, you know, the data has to support this and it's very, you know, very structured, where you see like a lot of people using stem cells in a way that they would not subscribe to in any way, shape or form. I don't know. I don't know. It's not for me to say one way or the other. Um, but it seems ill advised to just inject stem cells into a joint and hope that's going to somehow naturally remodel a torn meniscus, right? Um, doesn't seem reasonable.

No.

And yet that's happening every day. Um, and people are doing that. So, I don't know. Um, all right. Well, what's the one thing that we need to cover for people to understand about where this whole thing is going, uh, before we wrap up?

The discussion that I see happening in longevity spaces always comes back to the same thing, and we've talked about it. It's the— it's the pillars. Make sure that you're doing the pillars appropriately. And those are going to be sleep, diet, exercise, stress management, and community engagement or some sort of social engagement, because we're social creatures. Those are foundational and those have impacts across all of our health systems.

Once you start doing that, then it's reasonable to start going into biohacking and playing with the gadgets. But don't be distracted by those gadgets and think that those are going to take care of deficiencies in your fundamentals. You have to do the fundamentals. You have to do— like any championship team that wins the trophy, if you want to win the trophy of your life, you got to do the fundamentals, and then you can go and get those special skills. You can do those special biohacking tricks.

Um, and that's the continual message that we always get. And that's really inspiring, because everybody can do the fundamentals. It doesn't take a concierge doc to tell you to eat right, sleep well, exercise, manage your stress, engage with your loved ones. You can do all of that and not spend a dollar. In fact, you'll probably get back something. Go back to the fundamentals and then have fun playing with the biohacking stuff. Get out there and find a good practitioner that can help you, guide you through working with those tools if you really are excited to do them.

Yeah. The funny thing is, if you think about it from a population standpoint, population health being— what if the— we have like 330 million Americans, 350 million, okay, if everybody did the basics? Where we spend the most amount of money in health care is at end of life, right? Keeping people— where you're treating them and they're way past whatever you can do. You're trying to, you know, extend their life, which sounds terrible in some ways to say this, but like, you know, what kind of life is that? You know, you're taking all these different medications, you're not feeling well, or you're just trying to stay alive. If you were to go back when we were talking about those disease of decades, the disease of decades, and if everybody would just do the basics—

Mhm.

—or the pillars like you talked about, the right way, then gosh, I mean, I mean, you'd have to think by the numbers we'd have a totally different um health care system.

Yeah, and we'd have— it would be way more affordable.

So— well, you know what, always amazing to spend any time with you. Like, it's just— every time I see you I'm just like, yes— win.

Thank you. I enjoy coming here. It's a great, great visit out here.

Yeah, every time you're just like— you're a wealth of information. Um, I know it's almost impossible to get into your panel, but if a patient wanted to, how do they do it?

Just uh reach out at Boulder Longevity Institute. Uh, you can reach out online at our website, uh, boulderlongevity.com, and there's a, uh, client engagement form. Just fill that out and someone will give you a call and then we'll see what kind of availability I have. Um, I'm still seeing new patients, so there's plenty of— there's some options available right now.

Yeah, that's great. Thanks, man.

Thank you, Jock.