Latest / The Driven Athlete / Dr. Faryal Farooqi - The Fusion of Functional Medicine & Aesthetics | Ep 76

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Dr. Faryal Farooqi - The Fusion of Functional Medicine & Aesthetics | Ep 76 · The Driven Athlete

• 0:00
  Speaker 1: If you're a driven, active person who wants to reach and pursue a higher quality life with some ambition, then guess what this podcast is for you.
• 0:07
  Speaker 1: This is the Driven Athlete Podcast.
• 0:10
  Speaker 1: What's up?
• 0:12
  Speaker 1: Y'all?
• 0:12
  Speaker 1: It's your man, dr Kyle.
• 0:13
  Speaker 1: Welcome back to the Driven Athlete Podcast.
• 0:15
  Speaker 1: We got a really cool special guest with us, dr Faryal Faruqi.
• 0:21
  Speaker 2: You got it.
• 0:21
  Speaker 2: Wow, that's pretty good.
• 0:22
  Speaker 2: You said it.
• 0:23
  Speaker 1: Wow, that's pretty pretty good, you said it really well, okay, good.
• 0:25
  Speaker 1: I was practicing, I was making sure.
• 0:27
  Speaker 1: So Dr Faruqi is a local internal med doc, family doc, right.
• 0:32
  Speaker 2: Internal medicine.
• 0:33
  Speaker 1: Internal medicine.
• 0:34
  Speaker 1: But yeah, but anyway, thanks for coming on Of course my pleasure.
• 0:37
  Speaker 1: Share with people about where you're at, what you do.
• 0:40
  Speaker 2: Yeah, so I have a practice in downtown city city place and we are called the stay young health and wellness Institute and I have a concierge medicine practice.
• 0:50
  Speaker 2: We do aesthetic medicine and also functional medicine as well.
• 0:53
  Speaker 1: Cool.
• 0:54
  Speaker 2: So it's an amalgamation of all three.
• 0:56
  Speaker 1: Yeah, I know that, like with aesthetics, right and functional med usually goes hand in hand, people usually find interest in the same same thing as a little blend.
• 1:06
  Speaker 1: Yeah, what led you to that?
• 1:09
  Speaker 2: So what's unique is, you know, after I graduated medical school, you know, I went to Rutgers for undergrad and then I went to med school it's a five-year program with FIU in the Dominican Republic and I came out and then I my family's like okay, you're, you're a doctor now.
• 1:23
  Speaker 2: So, like you can answer all of our questions.
• 1:25
  Speaker 2: And the first couple of questions were like my mom has seven sisters, so all her, all her sisters, yeah, all they had.
• 1:32
  Speaker 2: All they did was have babies apparently.
• 1:34
  Speaker 1: Seven sisters one brother.
• 1:36
  Speaker 2: So female health was the utmost importance.
• 1:39
  Speaker 2: And they're like okay, hormone replacement therapy, let's talk about it.
• 1:42
  Speaker 2: And I knew nothing.
• 1:43
  Speaker 2: I couldn't answer basic hormone questions and I felt such a deficiency from the nutritional aspect in medicine and also the hormonal aspect.
• 1:52
  Speaker 2: So I kind of furthered myself.
• 1:54
  Speaker 2: I did a functional medicine fellowship with A4M and focused on women's hormones and then, as I was going through my specialty training, I realized that I just was procedurally very good.
• 2:07
  Speaker 2: I trained with Dr Shino Bay during my residency as well, so I kind of developed an interest in procedural medicine.
• 2:14
  Speaker 2: I wanted to be an ER doctor for a long time because I was so procedurally savvy, but I would have aged exponentially if I did that.
• 2:21
  Speaker 1: Yeah, it's pretty stressful.
• 2:23
  Speaker 2: It is very stressful and my mom was an ER nurse my whole life, so for 20 years I was constantly exposed to that and I would see how that impacted her sleep quality and you know just daily functioning, long shifts and obviously high stress.
• 2:37
  Speaker 2: So I think for me, realizing that in medicine you never stop learning and you just have to constantly be on that pursuit for more information because we're evolving right Constantly.
• 2:49
  Speaker 2: So going into that field is really that's why I did that, because of my personal family needs.
• 2:56
  Speaker 1: Yeah, that's really interesting.
• 2:58
  Speaker 1: Yeah, so your functional medicine fellowship, that was where again.
• 3:01
  Speaker 2: Yes, with the American Academy of Anti-Aging and Regenerative Medicine, also known as A4M.
• 3:07
  Speaker 1: Oh, I see Where's that located.
• 3:09
  Speaker 2: So they're, they're kind of online everywhere, but they hold national conferences, so sometimes they're in Vegas.
• 3:15
  Speaker 2: They're actually coming in April in West Palm, so that'll be fun yeah.
• 3:18
  Speaker 1: That's really cool, yeah.
• 3:19
  Speaker 1: So then you got.
• 3:21
  Speaker 1: You got all that information able to help out your seven aunts with all of their hormonal replacement questions.
• 3:28
  Speaker 1: That's cool.
• 3:29
  Speaker 1: And then what about aesthetics?
• 3:31
  Speaker 1: Where did that come into play?
• 3:32
  Speaker 2: So you know, learning the aesthetic side of things.
• 3:35
  Speaker 2: I think people want to feel good but they also want to look good and seeing that in my training being a part of the dermatology training part and I did a dermatology fellowship in the Caribbean as well it was a year of just aesthetics and laser training after medical school.
• 3:50
  Speaker 2: So I kind of had that knowledge but didn't really put it into practice.
• 3:54
  Speaker 2: And once I started seeing that I was good at it, I started taking additional training courses.
• 3:59
  Speaker 2: I did some with Shino Bay.
• 4:00
  Speaker 2: I did some with Julie Horn, who's known for specific parts of the face, and just realized that I had.
• 4:06
  Speaker 2: It's an art, so I had a way that I would just look at the face and I could restore features that people had lost from years ago and just it came very natural to me.
• 4:17
  Speaker 2: I've been educator.
• 4:18
  Speaker 2: I've been an educator my whole life so I started a training program for the boards and started really getting into the educational side of aesthetics.
• 4:26
  Speaker 2: I started teaching for aesthetics.
• 4:28
  Speaker 2: I did some teaching with Empire Medical and they were really excellent in terms of really allowing me the platform to do so.
• 4:36
  Speaker 2: And then Benev is a big company.
• 4:38
  Speaker 2: They have exosomes and they have devices and they kind of gave me a platform as well to kind of speak as a national and international speaker.
• 4:46
  Speaker 2: So I think just learning and kind of applying as I was practicing it grew naturally over the last six years and I just love that I could combine all of those skills and, you know, apply internal and external beauty.
• 5:00
  Speaker 1: Yeah, yeah, that's really cool.
• 5:02
  Speaker 1: What kind of things do people usually ask the most Like people come to see you?
• 5:05
  Speaker 1: Right, yeah, yeah, that's really cool.
• 5:05
  Speaker 1: Um, what kind of things do people usually ask the most Like people come to see you?
• 5:07
  Speaker 2: right, yeah, yeah.
• 5:08
  Speaker 1: What do they usually ask for?
• 5:09
  Speaker 2: So there are trends in aesthetics, right?
• 5:12
  Speaker 2: So, um, people will ask for a lot of things.
• 5:15
  Speaker 2: Hormone replacement therapy is a big part of my practice, but, uh, body contouring services and, of course, facial contouring services and hair restoration.
• 5:24
  Speaker 2: Uh, since the semi-glutide glp1 era, where everybody's been on weight loss, nutritional deficiencies have started to develop.
• 5:33
  Speaker 2: So now people are actually losing a lot of hair, hair is falling out rapidly and people want to either go through the hair transplant route or look for non-invasive ways to grow hair.
• 5:43
  Speaker 2: So I have a I work inside of a salon known as the Anushka Spa.
• 5:48
  Speaker 2: This year we rebranded and I bought the practice, so now it's known as the Stay Young Health and Wellness Institute.
• 5:54
  Speaker 2: So we're kind of connected to a spa salon.
• 5:57
  Speaker 2: So we get a lot of referrals for hair thinning and hair falling out, post-pregnancy hair fallout and we do a lot of.
• 6:04
  Speaker 2: We use a lot of stem cells or exosomes, along with microneedling and PRP for hair restoration.
• 6:10
  Speaker 1: Oh, interesting.
• 6:11
  Speaker 2: Yeah.
• 6:11
  Speaker 1: So you just do a bunch of injections.
• 6:13
  Speaker 2: Really well, yeah, yeah.
• 6:14
  Speaker 1: Wow, when would a person?
• 6:15
  Speaker 1: What does that treatment look like Like?
• 6:17
  Speaker 1: When would a person expect to see results and how many?
• 6:19
  Speaker 1: How many visits?
• 6:20
  Speaker 2: Yeah, so traditionally we do it in a set of three.
• 6:23
  Speaker 2: So every four to six weeks somebody would come in.
• 6:26
  Speaker 2: The treatment itself is pretty much like an hour and I can do a block.
• 6:31
  Speaker 2: So we do a numbing block to make you comfortable.
• 6:33
  Speaker 2: We also give you Pronox so you get like a ring block around your head with lidocaine, and then we would microneedle and we apply the stem cells so they get kind of infused into the scalp where the follicle is.
• 6:48
  Speaker 2: Yeah, and we get a lot of really good results.
• 6:50
  Speaker 2: I like to pair it and I know NAD is a fad right now.
• 6:53
  Speaker 2: A lot of people are doing these NAD IVs.
• 6:55
  Speaker 2: Nad is just like a molecule that goes into your cell, into one of the phases of the cell, and it powers the cell, powers the mitochondria of the cell, which makes ATP.
• 7:06
  Speaker 2: So if you have an energized cell, all of your cellular processes just optimize.
• 7:12
  Speaker 2: So we like to pair it with four NAD IVs and we get excellent results.
• 7:17
  Speaker 2: The issue with hair is you have to throw the kitchen sink at it because the origin is basically inflammation but can be hormonal issues, can be nutritional deficiencies.
• 7:27
  Speaker 2: So we really just we supplementize, we do the procedure, we correct your nutritional deficiencies and we get great results.
• 7:35
  Speaker 1: That's really cool With hair loss.
• 7:37
  Speaker 1: I was hearing it was related to a test, a variant of testosterone, dht.
• 7:44
  Speaker 2: DHT actually acts on the follicle and that's why the hair falls out.
• 7:49
  Speaker 2: Especially with male testosterone replacement, the thing that you have to remember is we're not replacing bodybuilding levels of testosterone, like we're not bringing your test up to 2000, 3000.
• 8:00
  Speaker 2: We know, we know, we have some data that shows that in the biohacking world, bringing it up to a thousand, as close to a thousand, keeping it in the nine hundreds, is really where you want to bring somebody.
• 8:11
  Speaker 2: But there's also this concept of lock and key where the receptor site for some patients can be a little bit more sensitive.
• 8:19
  Speaker 2: So when we do hormone replacement, we really look at how you feel we don't really look at what the levels are, and just the numbers, yeah, interesting.
• 8:27
  Speaker 1: And then NAD what does that stand for?
• 8:30
  Speaker 2: It stands for oh, you're testing me now.
• 8:32
  Speaker 1: Sorry.
• 8:35
  Speaker 2: Nicotinamide, adenosine deaminase, I believe, but correct me if I'm wrong.
• 8:38
  Speaker 2: Okay, yeah, but it's a molecule that goes into the cell, it just energizes your mitochondria.
• 8:45
  Speaker 2: You've got like five phases within a cell and it energizes your mitochondria.
• 8:50
  Speaker 1: It's very effective, I would assume.
• 8:51
  Speaker 2: Very effective even for sleep quality.
• 8:54
  Speaker 1: Yeah, what do people seek that out for?
• 8:57
  Speaker 2: A lot of athletes will come in just for energy or just to optimize whole body.
• 9:04
  Speaker 2: I mean, I don't really get somebody coming in for one purpose, but they're like we've heard NAD is good and on the cellular level it's excellent, but you can't overdo it right.
• 9:13
  Speaker 2: As we age after 40, everything kind of plummets hormonally, so we're kind of repleting the cells of what's deficient.
• 9:20
  Speaker 2: So usually people feel really good.
• 9:22
  Speaker 2: Some patients will say I got a couple ivs.
• 9:25
  Speaker 2: I didn't really feel a difference.
• 9:27
  Speaker 2: So that could also mean that you're very deplete so and that nothing happens.
• 9:31
  Speaker 2: So over time, when you get it and I would recommend once a month you don't have to be aggressive.
• 9:36
  Speaker 2: But with our hair protocol we're aggressive for a reason because we want to just make sure that the cellular health is perfect yeah.
• 9:43
  Speaker 2: And there's no such thing as perfect.
• 9:44
  Speaker 2: I shouldn't say that.
• 9:45
  Speaker 2: We can optimize right, Get it to the best shape as possible, and there isn't much data that says using NAD or without NAD you're going to have a difference, but with hair we, just we do it all just to get the best result.
• 9:58
  Speaker 1: Interesting, yeah.
• 9:59
  Speaker 1: What have you found more with your aesthetics?
• 10:03
  Speaker 1: You said body contouring to body contouring.
• 10:06
  Speaker 2: So I do have a device in my practice called the M sculpt Neo.
• 10:09
  Speaker 2: It's a muscle building, fat burning device.
• 10:12
  Speaker 2: Um, I brought it onto the practice as an internist because I read some you know some papers that said that it actually killed visceral fat.
• 10:20
  Speaker 2: So visceral fat is the fat that surrounds your organs and if you diminish that fat you improve your cardiac health.
• 10:26
  Speaker 2: And I saw that the results were really excellent the before and after pictures.
• 10:30
  Speaker 2: But I was still skeptical and brought it onto my practice, started doing Emsculpt.
• 10:35
  Speaker 2: So it's a 30 minute treatment.
• 10:36
  Speaker 2: You can treat abs, you could treat the buttocks, you could treat the arms, biceps, triceps.
• 10:41
  Speaker 2: There's different applicators on the device.
• 10:43
  Speaker 2: They also have a flank applicator.
• 10:46
  Speaker 2: What's really cool is it uses radiofrequency and high FEM, which is high intensity, high frequency, electromagnetic stimulation.
• 10:55
  Speaker 2: So the more hydrated you are, the concept is we have skin, then we have fat and then we have muscle.
• 11:03
  Speaker 2: If you're hydrated, the water stays in the skin and the muscle and the radio frequency kind of ping pongs between it stresses the fat, the fat clumps and it's released through your lymphatics.
• 11:16
  Speaker 1: Interesting.
• 11:16
  Speaker 2: I personally started doing it and noticed a difference in my plank strength, so I went from a three minute plank to an eight and a half minute plank with this device and I've done like 25 M sculpts now, because I have it in the practice and I just throw it on when I when I get a chance to.
• 11:32
  Speaker 2: But you really feel stronger.
• 11:33
  Speaker 2: It improves back pain.
• 11:35
  Speaker 2: It really does strengthen your core.
• 11:37
  Speaker 1: Cool.
• 11:37
  Speaker 1: Um, what got you in a med school to begin with?
• 11:42
  Speaker 2: So I have um, we've been surrounded by medicine my whole life.
• 11:46
  Speaker 2: As I said, my mom was an ER nurse and now she's a doctor.
• 11:50
  Speaker 2: It runs a very successful psychiatry practice in New Jersey.
• 11:53
  Speaker 2: But I have two brothers with special needs.
• 11:55
  Speaker 2: They don't walk or talk and they were just born that way.
• 11:59
  Speaker 2: They are we call them developmentally delayed, but they have severe mental retardation and they're full care.
• 12:06
  Speaker 2: So at a very young age I realized that we were in and out of doctor's offices and I realized that a good doctor would take the time to sit and comfort my family and my family would be happy when, in those moments of comfort and encouragement with two boys that can't walk, talk and are diaper ridden Right.
• 12:28
  Speaker 2: So I realized the importance of a good doctor at that point.
• 12:32
  Speaker 2: So, and then, of course, my mom being a nurse every great doctor there's a greater nurse behind them and I truly believe that even in residency training, all of the nurses would catch our errors and help us with things.
• 12:46
  Speaker 2: So I've always had a tremendous respect for nursing as well and I was kind of like nursing or medicine.
• 12:52
  Speaker 2: And then I just wanted independence.
• 12:55
  Speaker 2: I wanted to be able to practice in the way that I wanted to practice and kind of do this.
• 13:00
  Speaker 2: This was always a dream of mine to have a concierge practice, and now concierge is so popular because of COVID.
• 13:06
  Speaker 2: But before COVID not many people knew about concierge medicine.
• 13:10
  Speaker 1: Yeah, so the functional medicine integrative medicine is definitely.
• 13:15
  Speaker 1: It seems like the route healthcare is going.
• 13:17
  Speaker 2: Absolutely.
• 13:18
  Speaker 2: I think COVID did a lot of good things because it created a lot of skepticism in the medical space where we were like how do we, how did doctors not even know the answers to things.
• 13:29
  Speaker 2: So patients kind of took their health into their own hands and started doing some research.
• 13:33
  Speaker 2: And during that time, as I was, I was medical director at dedicated in green acres we were challenged by patients, not only for vaccines, but we were challenged for basic, you know, treatments like antibiotics and why, why?
• 13:49
  Speaker 2: Which I love because I've always been an educator, so I like to teach my patients.
• 13:52
  Speaker 2: But a lot of my physicians that were working in the practice were doctors don't like to be questioned.
• 14:00
  Speaker 1: Defensive.
• 14:00
  Speaker 2: So, yeah, like they would get defensive and frustrated, and I always looked at it as an educational opportunity and I never took it personally because I don't know everything, even though I am a doctor and I've done school forever.
• 14:11
  Speaker 2: But I've always wanted to build that collaborative network.
• 14:15
  Speaker 2: So I think it's a good thing.
• 14:17
  Speaker 2: I think we should strive to have our patients to know just as much as we know.
• 14:22
  Speaker 2: It doesn't have to be the same jargon, but they should understand what medications they're on.
• 14:26
  Speaker 2: I can't even tell you how many patients come to me.
• 14:28
  Speaker 2: They're like I don't know.
• 14:29
  Speaker 2: I've been taking this PPI for 20 years.
• 14:31
  Speaker 2: I'm like what are you taking a PPI for?
• 14:33
  Speaker 2: Oh, I had GERD once, I had reflux once and my doctor put me on it and I never stopped it and now they have osteoporosis because of it worsened.
• 14:47
  Speaker 2: Maybe at baseline they had a predisposition to develop it, but accelerated osteoporosis in certain areas.
• 14:50
  Speaker 2: So polypharmacy is a big thing and we're kind of getting sidetracked and going on the polypharmacy route.
• 14:57
  Speaker 2: But I think it's really important.
• 14:59
  Speaker 2: We're in a time where patients knowing more than us is actually beneficial to us too.
• 15:05
  Speaker 1: I mean, you're not, we're not being.
• 15:07
  Speaker 1: Polypharmacy is definitely.
• 15:08
  Speaker 1: It seems like it'd be an issue.
• 15:09
  Speaker 1: Yeah, Definitely.
• 15:12
  Speaker 1: Seems to be a lot more skepticism of the pharmaceutical companies and just like the medical relationship and health insurance and all that stuff of like just creating root, you know, lifelong customers, versus like selling us, bringing a solution.
• 15:30
  Speaker 2: And even for hormone replacement, like when I realized that women that are depressed in their early fifties and they're going through menopause they're depressed because they're lacking the basic hormones that are now depleting and we are treating them with antidepressants, and then realizing that the antidepressant world is big pharma, is, you know, backing it and there's a lot of money, not to say that we don't need them.
• 15:57
  Speaker 2: I think there is a need, but there's also a big need for educating on usage.
• 16:02
  Speaker 2: We like to overprescribe those types of medications.
• 16:07
  Speaker 1: What are your thoughts on antidepressants?
• 16:09
  Speaker 1: Do you have some of that in your practice?
• 16:11
  Speaker 2: Yeah, absolutely, absolutely.
• 16:13
  Speaker 2: Obviously, I'm not a psychiatrist, but every internist is always faced with screening a patient and knowing that they're depressed, and depression is one of those things that has many faces and not everybody's depression is the same and just like you have functional alcoholics, you have functional depressed people and I think being really compassionate and connecting with people gets them to open up to you truly.
• 16:38
  Speaker 2: I think there's room for usage with other types of mental illness and mental disorders, but there is a lot that we could do to improve baseline depression.
• 16:50
  Speaker 2: I was depressed, so a little bit about my personal story.
• 16:52
  Speaker 2: I divorced in my training.
• 16:54
  Speaker 2: I was married from 19 to 29, got a divorce during the most pivotal time in my life and used patient care and my passion for medicine, exercise and improving my sleep quality to come out of that depression and building a sense of community with my friends during that time was essential to not feeling depressed.
• 17:16
  Speaker 2: So I think there are a lot of resources to not feeling that way, but not everybody reaches out right or has the tools to know what they need to do.
• 17:26
  Speaker 2: I was lucky enough to be in medicine and know that there is a dark path that I could follow and I didn't want to go down that path.
• 17:33
  Speaker 2: But I had that knowledge and that control and, depending on the degree and the stage of depression you're in, you might not be able to control that.
• 17:40
  Speaker 2: So I think there's a time and a place for medicating, but this long-term medication use we have to cease that.
• 17:47
  Speaker 1: Yeah, I mean I totally would be on that boat where it's like, is my goal to be on this medication for life forever, like nonstop?
• 17:55
  Speaker 1: I mean there's gotta be a way out of dependency, right.
• 17:59
  Speaker 2: There is, and a lot of people are asking those questions Like do I have to be on this forever, which I think is a great thing, because people don't want to be dependent on things.
• 18:08
  Speaker 2: But you know, speaking on the functional side of things, optimizing your sleep quality is critical.
• 18:15
  Speaker 2: Like if there's one thing I recommend and try to do with my patients when they come in for a functional assessment is how are you sleeping?
• 18:22
  Speaker 2: Are you getting optimal sleep?
• 18:25
  Speaker 2: Are you and not?
• 18:26
  Speaker 2: Everybody's optimal is the same and I love things like, obviously, your watch and the aura ring.
• 18:31
  Speaker 2: We're seeing everybody's wearing one.
• 18:32
  Speaker 2: But how are you using that data?
• 18:34
  Speaker 2: These are just data points that we're collecting.
• 18:36
  Speaker 2: How are you modifying?
• 18:38
  Speaker 2: You know whether you're drinking at night and you're seeing that your your temperature goes up and you have a rest, restless night of sleep.
• 18:45
  Speaker 1: We have to do things about the data we're going to be screened user before, or intense conversations, intense TV shows, whatever all that stuff.
• 18:53
  Speaker 2: All of that makes sense.
• 18:54
  Speaker 1: I've heard very similar things from other sources where um same same message.
• 18:58
  Speaker 1: So you either start somewhere, start with like sleep quality and um whatever duration is appropriate, and then set up the environment to be as optimal for you as possible, and then routine, because that's what they suggested.
• 19:13
  Speaker 1: Like routine as in like absolutely just like this way we sleep, train our kids.
• 19:17
  Speaker 1: You know babies and stuff like sleep, train yourself yeah it's like it prepares your body to know like, oh, now it's time for sleep yeah, you're an expert at this now.
• 19:25
  Speaker 1: I mean three.
• 19:26
  Speaker 1: Oh yeah, exactly.
• 19:27
  Speaker 1: Yeah, we haven't sleep trained our youngest yet.
• 19:29
  Speaker 1: Ok, but it's rough man.
• 19:31
  Speaker 1: Last night was rough.
• 19:32
  Speaker 1: We were up.
• 19:32
  Speaker 1: My kid got up, I think three times, and then my, my baby got up.
• 19:37
  Speaker 1: He's up every two hours.
• 19:38
  Speaker 1: Oh so I usually help with the big kids at night.
• 19:43
  Speaker 2: Oh, that's awesome.
• 19:44
  Speaker 1: But unless they're screaming for mommy, then I'm like what do you want me to do?
• 19:49
  Speaker 2: Then you go to the baby, right, yeah, so I did.
• 19:51
  Speaker 1: Okay, and then I was up with him twice.
• 19:54
  Speaker 1: It was rough.
• 19:55
  Speaker 2: That's tough, that's so tough.
• 19:57
  Speaker 1: It's just a grind.
• 19:58
  Speaker 2: Yeah.
• 19:58
  Speaker 1: But anyway, my wife is managing 95% of the night stuff.
• 20:03
  Speaker 1: Yeah, managing okay 95 of the night stuff.
• 20:08
  Speaker 2: yeah, because usually the big kids cry for mommy, yeah, and then she's also feeding, still at night.
• 20:11
  Speaker 2: You know, how are you caring?
• 20:12
  Speaker 1: for her during the day?
• 20:12
  Speaker 1: Yeah, I'm usually here doing my thing, you know, I know I'm out hunting and killing and she's at home with the kids so sweet, you know it'll pass it'll be right, it'll be a phase, and then we'll look when I've told from wiser people myself they're well that, and then also like enjoy it, because you're going to look back and be like I wish I could just hold my little kid one more time.
• 20:31
  Speaker 1: I've heard that plenty of times from you.
• 20:33
  Speaker 1: Know patients that are empty nesters now.
• 20:34
  Speaker 2: Yeah.
• 20:35
  Speaker 1: I'm always trying to get their advice, you know, yeah, and they.
• 20:39
  Speaker 1: If I could go back and just give him one more hug, that's all I would want to do.
• 20:43
  Speaker 2: Absolutely so.
• 20:44
  Speaker 2: My fiance has two kids.
• 20:46
  Speaker 1: Oh yeah.
• 20:46
  Speaker 2: Well, he has three, but one's older, One's 25.
• 20:49
  Speaker 2: So she lives in New York, but the 10 and 12 year olds he's already thinking like when they go to college.
• 20:54
  Speaker 2: What am I going to do?
• 20:55
  Speaker 1: Yeah.
• 20:55
  Speaker 2: We're going to have 17 that are sitting on ice.
• 20:58
  Speaker 1: Yeah Right, exactly, we don't have to worry Right?
• 21:01
  Speaker 1: I'm always threatening him with that he's like we'll have plenty of.
• 21:04
  Speaker 2: Yeah, Don't worry honey.
• 21:06
  Speaker 1: Oh boy, he's like well, 17.
• 21:09
  Speaker 2: He's always like what?
• 21:10
  Speaker 2: What do you mean?
• 21:10
  Speaker 1: Yeah, that's funny, but but anyway.
• 21:13
  Speaker 1: But yeah, so I hear from experts.
• 21:16
  Speaker 1: Yeah.
• 21:27
  Speaker 2: You know that do a lot of research in this stuff, suggesting that that sleep is like the first thing to go after when.
• 21:30
  Speaker 2: I learned that melatonin right.
• 21:31
  Speaker 2: Melatonin will peak between two to 3 AM.
• 21:32
  Speaker 2: Okay, similarly to growth hormone, when it kind of peaks at night, in the middle of the night, it actually melatonin release will go into your liver and stimulate clock genes and those clock genes are directly correlated to your immune health.
• 21:43
  Speaker 2: And those clock genes are directly correlated to your immune health.
• 21:49
  Speaker 2: When I learned those facts and I was like whoa, so melatonin is not just essential for sleep, and deep sleep, but so directly related to your immune health that you can think of that as like why am I getting sick so often, you know, why do I not have enough energy?
• 22:00
  Speaker 2: All of that is tied to your immune system too.
• 22:03
  Speaker 1: Interesting I also.
• 22:04
  Speaker 1: That's, that makes, I mean, I mean, it makes total sense.
• 22:06
  Speaker 2: Yeah.
• 22:07
  Speaker 1: Cause I've heard that before sleep, quality sleep as it relates to immune health, um, but just linking that with I mean physical health, um, always feeling fatigued, physical exercise, um, I think, in order to get quality sleep, I feel like there has to be a lot of factors that come together to allow that to happen, where, if somebody is under a lot of emotional turmoil, right Mental health usually they're not going to sleep that well, Right.
• 22:36
  Speaker 1: And then their escapism.
• 22:37
  Speaker 1: Or just distracting themselves with shows or screen time scrolling, doing whatever Alcohol substance.
• 22:43
  Speaker 1: It's just like compounds, you know.
• 22:45
  Speaker 1: Yeah, it makes total sense.
• 22:48
  Speaker 1: So I'm like man.
• 22:49
  Speaker 1: If somebody can achieve really good quality sleep, they usually have to tap into some kind of mental health aspect as well, Right.
• 22:57
  Speaker 2: Yeah, like you have to shut off whatever that, whatever you require for that.
• 23:02
  Speaker 2: You have to kind of figure that out.
• 23:03
  Speaker 2: For some people it's just kind of sitting quietly in a space for 10 minutes.
• 23:08
  Speaker 2: It doesn't have to be a long period of time, but there needs to be a shutoff point, whether it's listening to music or calming music or meditation.
• 23:18
  Speaker 1: Yeah, I've heard.
• 23:18
  Speaker 1: Meditation is really helpful.
• 23:20
  Speaker 2: Big time.
• 23:20
  Speaker 1: I haven't done it.
• 23:21
  Speaker 1: I really haven't done much meditation I want to get into.
• 23:23
  Speaker 1: I mean, from what I've been hearing, I think it's like it makes a lot of sense the times I've done things similar.
• 23:29
  Speaker 1: It's always really interesting you know.
• 23:32
  Speaker 2: I think it's interesting.
• 23:33
  Speaker 2: I think for high functioning people like yourself, it's hard to turn off because in that quiet moment we're still creative and thinking.
• 23:40
  Speaker 1: Yeah, things pop up.
• 23:46
  Speaker 2: Yeah, things pop up.
• 23:46
  Speaker 2: Yeah, but you need to.
• 23:47
  Speaker 2: Kind of the advice I give my patients is get involved in that meditative practice.
• 23:49
  Speaker 2: So don't lay there.
• 23:50
  Speaker 2: If, like, you're on a yoga mat and you're listening to sound bowl, don't start thinking about well, the next week I got you know, these meetings and this, this patient or something to take care of.
• 24:00
  Speaker 2: Really try to focus in on that sound and try to take a moment to shut your brain off, because that's the hardest thing to do.
• 24:07
  Speaker 2: Yeah, for sure, to master.
• 24:09
  Speaker 1: I have a, uh, a guy that I would call a mentor.
• 24:11
  Speaker 1: He he's, you know, spiritual guy.
• 24:13
  Speaker 1: He he recommends like deep focus, meditation, practice and stuff, and he said the same thing.
• 24:20
  Speaker 1: It's like thoughts are just going to pop up yeah as like oh, I gotta send that email.
• 24:24
  Speaker 1: Yeah, oh, what about this?
• 24:25
  Speaker 1: What's my marketing?
• 24:25
  Speaker 1: What's like, what's my patient strategy?
• 24:27
  Speaker 1: Well, how am I gonna rehire this person?
• 24:29
  Speaker 1: Like oh, this email I gotta send that.
• 24:30
  Speaker 1: Oh, these things pop up right and my spouse, like all the kids, right um, he was just like that's fine, like you would expect that to happen, yeah, so when it does, you can just like bring it in, take it and then literally just throw it away go yeah and then acknowledge it.
• 24:44
  Speaker 2: Yeah, don't freak out about it right.
• 24:47
  Speaker 1: I think when I would first first attempts of doing stuff like that, I would be like stop, you're supposed to be, you know yeah, no no, you're not supposed to do that.
• 24:54
  Speaker 1: Yeah, wait, don't think you know.
• 24:56
  Speaker 1: I'm like I'm just effing everything up.
• 24:57
  Speaker 1: Yeah, it's like, oh, it's totally fine, you would skip meditating.
• 25:01
  Speaker 1: Exactly, I suck.
• 25:02
  Speaker 1: Um, it's like you should expect that to happen and then, when it does, you're not going to like freak out, don't freak out, and then like upset at yourself and frustrated.
• 25:11
  Speaker 2: Yeah.
• 25:11
  Speaker 1: And just like, oh, I was expected to happen.
• 25:12
  Speaker 1: And then like, oh, throw it away.
• 25:14
  Speaker 1: Next one comes up.
• 25:15
  Speaker 1: Oh, that's fine.
• 25:16
  Speaker 2: And over time to practice.
• 25:17
  Speaker 1: It just gets less and less, and then you just that's how you practice, Exactly.
• 25:20
  Speaker 1: And I was like oh, that makes total sense.
• 25:21
  Speaker 2: Exactly, Even if that full first time you tried to meditate you've been thinking about business.
• 25:26
  Speaker 2: It's okay to give yourself that you know leeway.
• 25:29
  Speaker 1: Totally, I think, and I think just even that with, like I mean even healthcare, just managing expectations is a, is a massive.
• 25:37
  Speaker 1: I think is probably one of the most important things, because it's like I don't get results immediately, Then things get frustrating.
• 25:44
  Speaker 2: Yeah.
• 25:44
  Speaker 1: Right.
• 25:45
  Speaker 1: Well, I'm sure you see your patients say the same thing.
• 25:49
  Speaker 2: Yeah, big time.
• 25:50
  Speaker 2: I mean, we're in the business of serving people, right?
• 25:54
  Speaker 2: So a lot of what we do is based on what we get back from our patients.
• 25:58
  Speaker 2: So I think it's we do is based on what we get back from our patients.
• 26:01
  Speaker 2: So I think it's just being kinder to yourself, I think I now I kind of look at every day and every opportunity is like that, and then if it was bad and it didn't go the way I wanted it to, learning how to let it go and not taking it with me through the rest of the day, which is what I used to do, because we're so hard on ourself and we don't really allow that to pass.
• 26:18
  Speaker 2: But you just every interaction is an opportunity and just try to make yourself better and not hold on to something that you did wrong.
• 26:26
  Speaker 2: Or, if you know, the patient expected something and something went another way.
• 26:30
  Speaker 1: I love that.
• 26:31
  Speaker 1: Yeah, you mentioned semi-glutide.
• 26:33
  Speaker 1: Yes, right, ozempic.
• 26:35
  Speaker 2: Oh yeah.
• 26:36
  Speaker 1: What are your thoughts on that?
• 26:38
  Speaker 2: I think it's an excellent drug Ozempic Manjaro Wagovi.
• 26:48
  Speaker 2: I think the future of obesity in this country.
• 26:49
  Speaker 2: There's a solution and I think people became so fixated like that's a diabetic drug.
• 26:51
  Speaker 2: I've been using these drugs in my medical practice for the last decade and Hollywood, thank you, has now made it popular because if you want to lose five, six pounds, you can go on it.
• 27:02
  Speaker 2: The issue with that?
• 27:03
  Speaker 2: Obviously there's good and bad with everything right.
• 27:06
  Speaker 2: So the issue is those patients that now have been on it long-term how do you wean them off right and how do you get them off of it and not to gain the weight back?
• 27:15
  Speaker 1: What would long-term?
• 27:16
  Speaker 1: What's that timeframe look like?
• 27:18
  Speaker 2: So so you know, we we have different patients.
• 27:20
  Speaker 2: We have patients that go on it for six month period.
• 27:22
  Speaker 2: It depends on where you are cardio metabolically, how much weight you have to lose.
• 27:26
  Speaker 2: I've helped people lose 80 pounds on it and then really we've had a micro dosing protocol, um, where we will keep you on it and then, as you're coming off of it, we will do one week on, one week off and we will switch the dose up based on response.
• 27:40
  Speaker 2: It's excellent for creating behavioral change in people.
• 27:44
  Speaker 2: So we have an addiction to food, we have an addiction to alcohol.
• 27:48
  Speaker 2: Obviously, I think there's like a socially accepted things.
• 27:51
  Speaker 2: One of the most socially accepted one is alcohol, and we have a lot of functional alcoholics, like people that can drink and function like they don't have a drinking problem and you start seeing it in their blood work.
• 28:03
  Speaker 2: But they don't act like they have a problem because they're able to go through life, drink at night and still be functional.
• 28:10
  Speaker 2: But there will be a point where that'll stop happening.
• 28:13
  Speaker 1: Yeah, it'll catch up Before you continue, what things in the blood work would show up.
• 28:19
  Speaker 2: So we look at liver enzymes.
• 28:20
  Speaker 2: We look at GGT, specifically your AST and ALT, which are specific to the liver, but you can start seeing protein deficiencies.
• 28:29
  Speaker 2: You can look at other vitamin deficiencies, like folic acid and B12 deficiency, so like a malnutrition picture.
• 28:36
  Speaker 1: Got it.
• 28:36
  Speaker 1: So you see that stuff Absolutely With increased liver enzyme, you're like alcohol.
• 28:41
  Speaker 2: That's worrisome, obviously, and your AST is the one that is usually higher in proportion to the ALT for alcoholism or for an alcohol-related problem.
• 28:51
  Speaker 2: I remembered it in medical school we always create mnemonics for things.
• 28:55
  Speaker 2: So a scotch and tonic AST, so that ratio is a little bit higher.
• 29:00
  Speaker 2: And there's obviously other things and other factors.
• 29:03
  Speaker 2: You might not necessarily see anything on blood work because a lot of that is genetics too how your body is resilient, how your cells, your liver enzymes and your liver cells are resilient to that stress.
• 29:15
  Speaker 2: And then of course we have this over supplementing world.
• 29:19
  Speaker 2: Right, we over supplement the most expensive urine in the in the world, they say, because we pee out everything excess.
• 29:26
  Speaker 2: So sometimes you can mask those deficiencies by taking supplements too.
• 29:31
  Speaker 2: So I've seen people that drink five, six drinks a night and you don't see anything in their blood work.
• 29:36
  Speaker 2: And it's middle-aged Caucasian females who have an amazing social life and they don't even realize it.
• 29:45
  Speaker 2: They're just drinking that much.
• 29:47
  Speaker 2: So I think it's an excellent drug the semaglutides.
• 29:52
  Speaker 2: Going back to that is an excellent way to get people off of it.
• 29:55
  Speaker 2: It's being used in addiction medicine, for opiates, for marijuana and for alcohol as well, and of course obesity is a huge problem in this country.
• 30:04
  Speaker 2: So I think it's allowing people to finally feel good about themselves.
• 30:08
  Speaker 2: I think it's great because there's abuse for everything right.
• 30:12
  Speaker 2: So, yes, we could take it to the extreme and lose way too much weight, and I think the biggest problem we're seeing now and why I love kind of medicine with aesthetics is we're seeing the ozempic faces where the deep facial fat pads are dropping and accelerating to drop.
• 30:27
  Speaker 2: The skin is not stretching back because you're losing the fat so quickly, so you're getting more hanging of the skin, which is why patients come in and I can see right away when I look at their belly.
• 30:37
  Speaker 2: When they get on the Emsculpt I'm like you've lost a lot of weight, did you lose more than two to three pounds a week?
• 30:43
  Speaker 2: And they're like oh, I was losing six to seven pounds because I went to you know a Liquivita and I bought you know a semaglutide bottle and nobody told me how to use it and I was just kind of doing it on my own.
• 30:56
  Speaker 2: So my program is very tailored.
• 30:58
  Speaker 2: We provide nutritional support, we give an exercise regimen and patients follow up with me weekly and we dose them weekly based on the response.
• 31:08
  Speaker 1: What's the mechanism with semaglutide?
• 31:10
  Speaker 2: So there's two ways.
• 31:12
  Speaker 2: So it works neurohormonally and chemically, and then mechanically as well.
• 31:17
  Speaker 2: The first thing it does is it's going to alter two hormones in the brain called ghrelin and leptin.
• 31:23
  Speaker 2: Ghrelin elevate when you're hungry think grr hunger so ghrelin goes up.
• 31:28
  Speaker 2: Leptin goes down.
• 31:29
  Speaker 2: When you're full, leptin goes high.
• 31:31
  Speaker 2: So it will elevate leptin and reduce ghrelin.
• 31:34
  Speaker 2: And secondarily it will create a mechanical slowing of the motility of the gut, so food will sit in the stomach.
• 31:42
  Speaker 2: That's why they say it's like a bypass surgery.
• 31:44
  Speaker 2: Food sits in the stomach a little bit longer and isn't propelled forward as quickly.
• 31:50
  Speaker 2: So if it's sitting there then you're going to feel fuller longer.
• 31:53
  Speaker 2: So those two mechanisms obviously are the main ones.
• 31:55
  Speaker 2: Those two mechanisms obviously are the main ones.
• 31:57
  Speaker 2: But metabolically a lot of shifts happen in the pathway, in the GLP-1 pathway, that allow you to lose the weight really quickly, with the fat cells Interesting, and that's why people have the side effects of constipation.
• 32:11
  Speaker 2: That makes sense, right?
• 32:12
  Speaker 2: Because if you're not moving your bowels forward you're going to get backed up.
• 32:15
  Speaker 2: But the terzepatide has a less side effect of constipation, the ozempic.
• 32:21
  Speaker 2: So manjaro less side effects, ozempic higher side effect profile.
• 32:27
  Speaker 1: Interesting.
• 32:27
  Speaker 1: So imagine if you stack semaglutide NAD to get like mitochondrial metabolic excitation, like a heightened sense, and then peptides in addition to that oh yeah would that be like?
• 32:43
  Speaker 1: What's like?
• 32:43
  Speaker 1: Is that like the weight loss stack?
• 32:45
  Speaker 2: so we do a lot.
• 32:46
  Speaker 2: Um, we I love putting peptides on with weight loss because the semaglutides the way you lose the fat, you can also lose muscle mass.
• 32:55
  Speaker 2: So we do in-body assessments to make sure we're preserving your muscle mass.
• 32:59
  Speaker 2: And when you stimulate growth hormone with peptides like samoralin and hexarelin and PDA and BPC, these peptides are going to stimulate growth hormone.
• 33:09
  Speaker 2: So you're going to stimulate more muscle growth.
• 33:12
  Speaker 2: Therefore you don't lose the muscle mass.
• 33:14
  Speaker 2: So those are great peptide stacks to do with the weight loss.
• 33:18
  Speaker 1: Interesting, yeah.
• 33:20
  Speaker 1: Peptides, yeah.
• 33:21
  Speaker 1: So you just mentioned three.
• 33:23
  Speaker 1: What are the most common ones that you use in your practice?
• 33:27
  Speaker 2: Those are pretty common.
• 33:28
  Speaker 2: I mean, um, they're pretty regulated and the pharmacies have had to do a lot to change, uh, their formulations because of not having clinical studies for these peptides.
• 33:40
  Speaker 2: Obviously you want to make sure they're coming from a pharmacy.
• 33:42
  Speaker 2: You're not buying them from a black market.
• 33:44
  Speaker 2: They're available everywhere.
• 33:46
  Speaker 2: But if they're made in factories and they're not made in sterile environments in a pharmacy, you can actually increase inflammation in the system.
• 33:55
  Speaker 2: So you want to make sure you're getting it from a 503A pharmacy that can legally make these.
• 34:02
  Speaker 2: So we work with a great pharmacy in Florida that does that.
• 34:05
  Speaker 2: And you also want to make sure that you're using them appropriately.
• 34:11
  Speaker 2: So it's important to alternate days on and off with these peptides.
• 34:15
  Speaker 2: Peptides so when the receptor sites become too saturated, kind of like a lock and key, they stop working.
• 34:24
  Speaker 2: So you need kind of like a washout period to allow for that peptide to kind of rework again.
• 34:28
  Speaker 2: So our patients will usually do their stack at night because you want the growth hormone to peak in the middle of the night.
• 34:34
  Speaker 2: So they'll inject before bed two to three peptides and we like to cycle different ones.
• 34:39
  Speaker 2: My favorite, favorite one which I personally use, is the samoralin, hexarelin and the PDA, so it will help optimize your sleep quality.
• 34:47
  Speaker 2: Your muscle growth everything that growth hormone does it will function better.
• 34:52
  Speaker 2: So muscle growth metabolism.
• 34:56
  Speaker 1: You give patients like do they inject themselves?
• 34:58
  Speaker 2: Yes, it's a tiny little insulin needle we teach them how to inject and it's painless.
• 35:04
  Speaker 1: You don't even bleed from the site that you inject it in and they do it every day, and the washout period is every other day.
• 35:08
  Speaker 2: Two, three days off, so not injecting, and then you start injecting again.
• 35:13
  Speaker 2: So either Monday through Friday, and then the people that are like, no, I feel the difference, I want to do the Friday.
• 35:18
  Speaker 2: We'll include Friday, but sometimes Monday through Thursday because they can get expensive.
• 35:23
  Speaker 2: So you want to preserve as many days as you can.
• 35:26
  Speaker 2: Yeah, so there's a lot of misinformation, a lot of negativity surrounding peptides and I'll tell you, I have a lot of patients with autoimmune disease, rheumatoid arthritis, joint issues, aches and pains.
• 35:39
  Speaker 2: It's been life-changing for these patients, along with hormone replacement therapy.
• 35:47
  Speaker 1: What's that?
• 35:47
  Speaker 1: Look like hormone replacement therapy, Because you mentioned we're not going to just get a guy coming in.
• 35:51
  Speaker 1: That's going to be like anabolic steroids with like 3,000 bodybuilding.
• 35:56
  Speaker 2: No, first of all, anybody in their 20s and 30s.
• 35:58
  Speaker 2: We want to preserve that testosterone.
• 36:00
  Speaker 2: We don't want to do testosterone replacement unless we absolutely have to, because it can affect male fertility.
• 36:05
  Speaker 2: But I'm seeing a lot more men in their late 20s even like on testosterone and you're like well, why?
• 36:13
  Speaker 2: Because access right, you can easily get it.
• 36:15
  Speaker 2: Everybody wants to look jacked and built and nobody's patient to work for it, so it can easily help you obviously look better, but there are a lot of harmful effects in terms of fertility and obviously side effect profile if you're not being monitored by I would imagine long-term, yeah, dysfunction absolutely not just like infertility, yeah, but yeah, accelerating the the process in the 40s and 50s.
• 36:40
  Speaker 2: And cardiac right.
• 36:41
  Speaker 2: You want to think it's an anabolic hormone.
• 36:43
  Speaker 2: It is a controlled substance and if you have any type of cardiac risk factors that haven't been worked up and you're not being treated high cholesterol, or you know we have early cardiovascular disease in the family you could be predisposing yourself to a coronary event or a cardiac event without even knowing that you are.
• 37:02
  Speaker 1: Peptides that help stimulate growth hormone?
• 37:05
  Speaker 1: Yeah, they don't.
• 37:06
  Speaker 1: It's not HRT, it's not HRT Exactly.
• 37:10
  Speaker 2: That's a good question.
• 37:10
  Speaker 2: I get asked that a lot.
• 37:12
  Speaker 1: Yeah, Is there like a risk of like I've been doing peptides for 10, I'm not saying me, let's say someone's like I've been doing peptides on and off for 10 years.
• 37:18
  Speaker 1: What does that look like?
• 37:20
  Speaker 2: We don't have the data to show that it causes anything.
• 37:23
  Speaker 2: There is some information out there that says that they can stimulate cancer.
• 37:28
  Speaker 2: Obviously, if anybody has an active cancer, we don't do a lot of these therapies, right?
• 37:33
  Speaker 2: You want to make sure we treat the cancer and we get rid of that issue first.
• 37:37
  Speaker 1: Right.
• 37:41
  Speaker 2: But even with let's go to hormones real quick, because I think this is spoken more about in the hormone world Correlation does not mean causation.
• 37:46
  Speaker 2: So like, if I don't go on hormone replacement therapy, god forbid, and I get breast cancer, did my hormones cause my breast cancer that I naturally have?
• 37:56
  Speaker 2: So I think we have to become better at looking at studies and I've noticed that even my colleagues, some of my friends, will look at studies and, based on the headline of the study, make a decision on what that study is.
• 38:08
  Speaker 2: And we have to really become statisticians and look at what type of quality of study it was.
• 38:14
  Speaker 2: What are the confounding variables?
• 38:16
  Speaker 2: Is this a good quality study and is it insinuating that this is a causative effect of a hormone?
• 38:23
  Speaker 2: And bioidentical hormones do not cause cancer?
• 38:26
  Speaker 2: Synthetic hormones cause cancer.
• 38:29
  Speaker 2: So I think what a lot of women when I sit and I go over hormones with them, they're like they think progestin is the same thing as progesterone.
• 38:37
  Speaker 2: So synthetic progestin is very different from bioidentical progesterone.
• 38:44
  Speaker 2: Premarin, a synthetic horse estrogen, is very different from bioidentical estradiol.
• 38:50
  Speaker 2: So I think the overview of hormones scares people because they think cancer right.
• 38:57
  Speaker 2: Since the Women's Health Initiative in 2012, we have a lot of data that shows us that synthetic hormones cause cancer.
• 39:03
  Speaker 2: Bioidentical hormone replacement therapy means chemically the structure is bioidentical to our natural hormones does not cause cancer.
• 39:12
  Speaker 2: But obviously if I have a hormone responsive breast cancer, that's responding to estrogen.
• 39:17
  Speaker 2: If it's there, yes, it's going to make that cancer grow.
• 39:21
  Speaker 1: It would be wise.
• 39:22
  Speaker 1: It's going to proliferate that.
• 39:23
  Speaker 2: But what I tell patients is this is not a surrogate for screening.
• 39:27
  Speaker 2: We still aggressively screen and if you are somebody that's conscious enough to feel good and want to take bioidentical hormones, you're going to be good with the rest of your screenings.
• 39:36
  Speaker 2: You're going to get your pap smears, your colonoscopies, your annual mammograms.
• 39:41
  Speaker 2: I have patients at baseline.
• 39:43
  Speaker 2: Make sure that all my patients are up to date with their screenings.
• 39:45
  Speaker 2: I kind of end up acting as their primary care doctor or reinforcing all their primary care to make sure that they're a good candidate.
• 39:53
  Speaker 1: Yeah, which is good.
• 39:54
  Speaker 1: Yeah, I mean I'm sure they would appreciate.
• 39:57
  Speaker 1: You know, patients appreciate that.
• 39:59
  Speaker 2: Yeah.
• 40:00
  Speaker 1: So what would you say like what's, what's the, the, the main type of clientele you all work with?
• 40:04
  Speaker 1: I think, what's your wheelhouse?
• 40:07
  Speaker 2: Yeah, so my, my practice is really diverse.
• 40:09
  Speaker 2: You know, I have that concierge side and then I have the aesthetics, and then I have the functional side, and I do a little bit of all of it with all of my patients, and I think that's what makes it really fun that I get to the.
• 40:27
  Speaker 2: The um theme of my practice is making people beautiful from inside out.
• 40:29
  Speaker 2: So, um, my favorite I don't think I have like a favorite thing I do, but I think the reward is really making people feel overall better and well, whether it's the patient that'll come in and I get tons of patients that come in and they're like I don't want the Botox or the fillers, and I get that too and I don't ever go that route with those patients.
• 40:46
  Speaker 2: But feeling beautiful is not always about doing aesthetic invasive treatments.
• 40:51
  Speaker 2: It could just be improving skin quality, having the good skincare regimen using sunscreen, vitamin C and a good retinol, maybe getting some microneedling or peels.
• 41:01
  Speaker 2: It doesn't have to be invasive injectables.
• 41:03
  Speaker 2: We're actually getting into the phase where people don't want to look like they're overdone and they want to look kind of like the best injectable is undetectable.
• 41:12
  Speaker 2: Look where I have patients that bring in pictures of themselves and we really try to mimic a youthful you instead of changing face shapes.
• 41:20
  Speaker 1: Yeah, I like that.
• 41:21
  Speaker 1: I've never heard it before.
• 41:22
  Speaker 1: The best injectable is undetectable.
• 41:23
  Speaker 1: Yeah, yeah, that's cool.
• 41:24
  Speaker 2: So all the people that you're seeing with the bad work.
• 41:26
  Speaker 2: That's the bad work, that's noticeable, but everybody that's beautiful and they look good and they look super symmetric.
• 41:33
  Speaker 2: It's all about creating symmetry.
• 41:34
  Speaker 2: They have good work done and I think some women will openly talk about it.
• 41:39
  Speaker 2: Some women don't.
• 41:40
  Speaker 2: I mean, I do all my work on myself, I do everything, so I have a little bit of lip filler in my lower lip.
• 41:46
  Speaker 2: I don't have facial failure because I've naturally been blessed with high cheeks, but I do all my Botox myself, from my forehead down to my neck, and I think it's all the little treatments that just keep you looking youthful, but not overdone.
• 41:59
  Speaker 1: Yeah, you know.
• 42:01
  Speaker 1: So what would be like a success story that was impactful for your practice that you can think about?
• 42:09
  Speaker 2: Yeah, I've got so many.
• 42:12
  Speaker 2: I mean, the weight loss is really life-changing.
• 42:14
  Speaker 2: So my patient that lost 80 pounds.
• 42:16
  Speaker 1: Yeah, how long does that take?
• 42:18
  Speaker 2: Looks like a brand new person.
• 42:19
  Speaker 2: A year and a brand new person a year and a half year and a half.
• 42:22
  Speaker 1: And uh, which is good for me 50 weeks a year, like you wouldn't want.
• 42:26
  Speaker 2: that's not we do it very slow.
• 42:27
  Speaker 1: Right.
• 42:27
  Speaker 2: We do it very slow.
• 42:28
  Speaker 2: You want to allow the collagen and elastin in your stomach to kind of retract and pull back, and when you lose that much weight you are going to get hanging skin.
• 42:35
  Speaker 2: But it's about getting less of it Right.
• 42:38
  Speaker 2: So you want to do it in the safest way possible and metabolically you want your body to catch up cellularly to your weight loss and then not gain it back.
• 42:49
  Speaker 2: So it's creating that lifestyle change.
• 42:51
  Speaker 2: I think for me is really transforming someone's life.
• 42:53
  Speaker 2: Obviously there's great stories where we found cancer and we've treated it and gotten them the help.
• 43:00
  Speaker 2: And my autoimmune patients where they have lupus and they have rheumatoid arthritis and their joints ache all the time and they're hormonally completely thrown off.
• 43:10
  Speaker 2: They can't even get out of bed.
• 43:11
  Speaker 2: And now they're on hormone replacement therapy, a great peptide stack and we've done a little aesthetic work and they just can't stop raving enough about how good they feel and that really drives work into my practice.
• 43:26
  Speaker 1: RA is.
• 43:26
  Speaker 1: I have a couple people that I can think about that have battling that, but what's the protocol?
• 43:33
  Speaker 1: What's the treatment look like for RA?
• 43:35
  Speaker 2: So we have obviously your disease modifying agents right.
• 43:39
  Speaker 2: So some patients, when it's really debilitating, deforming joint disease, we do have to go towards those medications, like you know, certain biologic medications.
• 43:48
  Speaker 2: But we try to really use more of peptides because I think there is a lot of research that's showing that this will improve your joint health.
• 43:58
  Speaker 2: We do a lot of PRP knowing that this will improve your joint health.
• 44:02
  Speaker 2: We do a lot of PRP.
• 44:02
  Speaker 2: You can do stem cells into certain joints which can help make your joints feel better.
• 44:05
  Speaker 2: But I've noticed with certain peptide stacks like thymus and beta or PDA, which can help in a little bit of growth hormone boosting, sometimes direct growth hormone therapy there are candidates for it too when they don't respond to the peptides and we measure that.
• 44:21
  Speaker 2: We do all of our blood work in-house and we can actually measure that.
• 44:25
  Speaker 2: But I've noticed within 30 days of using a certain peptide stack a little bit higher dose than a normal person the joint aches go away.
• 44:35
  Speaker 2: Testosterone what women don't know a lot of even for normal women, just postmenopausal women is that testosterone is your energy.
• 44:44
  Speaker 2: It's not just sexual health for women, it's your mental clarity.
• 44:47
  Speaker 2: So females think estrogen.
• 44:49
  Speaker 2: I'm low in estrogen and that's the only hormone they'll worry about.
• 44:52
  Speaker 2: Your test is your motivation, your mental clarity, your bone health.
• 44:59
  Speaker 2: If you're incontinent and you're peeing yourself after entering menopause and having multiple babies, the sphincter health, the testosterone will help and the estrogen, but right away women go on this and they stop having incontinence.
• 45:13
  Speaker 2: So I think the hormone replacement, also for the joint health, is essential.
• 45:19
  Speaker 2: So for a lot of my rheumatoid patients who've gone, let's say they they don't have a, they don't have joint deformities yet they've gone on hormone replacement and their joint aches will feel better, along with peptides that's cool so we test, obviously, and make sure that your growth hormone's low, and then we come up with the best peptide stack for you.
• 45:38
  Speaker 2: And sometimes it's trial and error and it takes us a few weeks to do, but we get there.
• 45:43
  Speaker 1: Right, what about Crohn's?
• 45:47
  Speaker 2: Inflammatory bowel disease.
• 45:48
  Speaker 2: Yeah, oral peptides high dose, bpc-157 and PDA have been essential in treating that.
• 45:56
  Speaker 2: Yeah, obviously, if you're bleeding and you're having chronic diarrhea, you have to control the disease first.
• 46:01
  Speaker 2: So we have to use the big gun medications to control it, and sometimes that includes medications like acetylcholine or misalamine or steroids.
• 46:10
  Speaker 2: But I have a patient in particular that I'm thinking of.
• 46:15
  Speaker 2: We did high dose of BPC orally.
• 46:18
  Speaker 2: We did about 2000 milligrams and we cycled it over four weeks and he stopped having bouts of Crohn's.
• 46:26
  Speaker 2: But obviously your diet is essential.
• 46:29
  Speaker 2: So food is medicine and we have to really start treating nutrition as a form of medicine.
• 46:36
  Speaker 2: And I know we don't look at it that way.
• 46:38
  Speaker 2: Um, and it's hard.
• 46:39
  Speaker 2: Even I indulge sometimes, knowing all this data right, I love a burger and fries and I'll sit and have truffle fries all day with a glass of wine.
• 46:46
  Speaker 2: But I think it's about following up with really good habits that can undo the inflammatory burden.
• 46:53
  Speaker 2: And if you have an inflammatory bowel disease, everything is your diet because everything is being processed through there so we come up with and it isn't a one one size fits all approach because, for example, I have patients that have had chronic diarrhea all their life and they have irritable bowel syndrome and they realize that I've been eating healthy my whole life.
• 47:16
  Speaker 2: I eat salads all the time.
• 47:17
  Speaker 2: The salads, the foliage is creating the diarrhea, so sometimes people just don't do well with certain foods.
• 47:27
  Speaker 2: So we find that out by doing an elimination diet.
• 47:30
  Speaker 2: We do gut testing.
• 47:31
  Speaker 2: There's a lot you can test.
• 47:32
  Speaker 2: There are a lot of tests that are fads, also in the functional world.
• 47:37
  Speaker 2: So we have to kind of gear it towards basic testing and see where that leads us to.
• 47:42
  Speaker 1: What are some of those tests for the fad tests?
• 47:46
  Speaker 2: Um, you know there are some companies out there that will tout, like you know, lots of inflammatory markers.
• 47:53
  Speaker 2: You know not to like put anybody on blast, but I've just kind of to bring on things to my practice.
• 48:00
  Speaker 2: I've done some research and sometimes knowing all of that and not being able to do anything about it can also be unnecessary.
• 48:10
  Speaker 2: We can go down $50,000 worth of testing and it doesn't truly give us the information we need.
• 48:16
  Speaker 2: So, for example, if I'm reactive to cilantro and I test and I find out I'm reactive to cilantro, you can avoid cilantro for a little bit and then become unreactive to it and reintroduce it back into your diet.
• 48:28
  Speaker 2: So it's not something lifelong that your gut will react to.
• 48:31
  Speaker 2: Our gut is changing constantly.
• 48:33
  Speaker 1: Interesting yeah.
• 48:34
  Speaker 2: And now there's some data which I attended.
• 48:37
  Speaker 2: This Women's Jupiter Medical Center held this amazing women's conference last month and Dr Amy Shaw came and spoke, and she's a doctor in California.
• 48:47
  Speaker 2: She spoke about how we are the gut of the people we spent the most time with.
• 48:53
  Speaker 2: So you become the gut, your microbiome becomes very much similar to the people that you're around the most.
• 49:02
  Speaker 2: Um, so I think there's a lot of just by eating the same stuff eating the same stuff.
• 49:08
  Speaker 2: Eating the same stuff?
• 49:09
  Speaker 2: Yeah it, that's one of it.
• 49:11
  Speaker 2: I mean, I can't imagine transplanting gut, you know, microbiome just being next to each other, but it has to probably do with lifestyle related things, right, like if you're in the same space you're probably eating the same stuff.
• 49:23
  Speaker 2: But there was an interesting study that was done that there was an overweight mouse and they transplanted from a thin uh, mouse or mice, right, yeah, mouse.
• 49:34
  Speaker 2: They took the fecal matter and they transplanted, like a fecal transplant, into the obese mouse and that obese mouse ended up losing weight.
• 49:45
  Speaker 2: So your microbiome and your gut bacteria can also determine your propensity to lose and gain weight.
• 49:54
  Speaker 1: Interesting.
• 49:55
  Speaker 1: So how do you?
• 49:56
  Speaker 1: Is there a way to retrain your microbiome?
• 49:58
  Speaker 2: There is, yeah, so we know when we go on vacation, when you go to Europe, which you're going to do sometime in the near future.
• 50:06
  Speaker 2: I remember when I went to Italy I I ate pasta and pizza and I didn't feel bloated, and I, you know, I drank wine there too, but pasta, pizza and walked around and I didn't gain any weight.
• 50:18
  Speaker 2: If I eat pasta and pizza in the United States for a week, I will be 10 pounds over by the end of my first week.
• 50:25
  Speaker 2: So there's something to say about the farm to table lifestyle and the way that they process their foods that makes a difference.
• 50:35
  Speaker 1: Interesting.
• 50:36
  Speaker 2: Yeah.
• 50:36
  Speaker 1: What is the difference?
• 50:37
  Speaker 1: Have you done your research on that?
• 50:40
  Speaker 2: Why is?
• 50:41
  Speaker 1: it that Because you're not the only person I've heard say the exact same thing about the food in Italy, as an example.
• 50:46
  Speaker 2: It's the processing of the food, right.
• 50:48
  Speaker 2: So our food, before it gets to our table, goes through lots of chemicals, lots of spraying of pesticides, and a lot of that gets absorbed into the food even if you wash it.
• 51:00
  Speaker 2: So, I think, the processing and denaturing of the nutritious aspect of the food.
• 51:06
  Speaker 2: We know that if we want to eat a diet that's the most healthy, it should be very colorful and it should be raw, as raw as it can be, because the moment you heat the vegetable or the fruit you denature the nutrients in it.
• 51:23
  Speaker 1: So microwaving frozen vegetables is not a good idea.
• 51:26
  Speaker 1: It's not a good idea.
• 51:27
  Speaker 1: Interesting it's not a good idea.
• 51:28
  Speaker 2: I mean it's not the best idea.
• 51:29
  Speaker 2: Is it better than having pizza?
• 51:33
  Speaker 1: Yes, but you're not gaining all the nutrients you could.
• 51:36
  Speaker 2: You're not gaining all the nutrients you could not gaining all the nutrients.
• 51:39
  Speaker 1: So what you're suggesting is like just straight off the bush um like washing it broccoli or yeah.
• 51:45
  Speaker 1: Out of the dirt green beans, washing it and just eating it like that it's hard to.
• 51:49
  Speaker 2: it's hard to cause.
• 51:49
  Speaker 2: I don't even like eating it like that, Right, but implementing a little bit of it and not having fully like blasted cooked meals all the time, I think is the best way to.
• 52:00
  Speaker 1: Interesting.
• 52:00
  Speaker 1: Yeah, I mean there's sometimes where I've, you know, have fresh raw vegetables crunchy.
• 52:06
  Speaker 1: You know it's good.
• 52:07
  Speaker 1: Yeah, I'm like man, this is good.
• 52:09
  Speaker 2: Delicious, yeah, yeah, and I think that's the lifestyle that they've really cultivated.
• 52:14
  Speaker 1: So how do we do that here?
• 52:15
  Speaker 1: Just have our own gardens in the backyard.
• 52:18
  Speaker 2: We to start high, yeah, like hydroponic gardens in our backyard, yeah, and even the oils, right, like there's so much information about, um, avocado oil and coconut oils being best because they have higher denaturing, higher melting points.
• 52:34
  Speaker 2: Um, so you can heat them a little bit more without creating the bad substances in them.
• 52:38
  Speaker 2: And if you have olive oil, it should be extra virgin olive oil and you should sprinkle it, without heating, on your salad.
• 52:44
  Speaker 2: I think, doing all of those little things, they have additive effects?
• 52:49
  Speaker 1: Yeah, big time.
• 52:50
  Speaker 1: One other thing that I've heard uh, and we'll wrap it up, but is the uh, the microplastics?
• 52:56
  Speaker 2: Oh man, don't even get me started on that, don't even get me.
• 52:59
  Speaker 2: We could do a whole hour on microplastics.
• 53:01
  Speaker 2: So I started buying.
• 53:04
  Speaker 2: I threw away all the plastic in my home.
• 53:06
  Speaker 2: Even when I met Tony, my fiance, we threw away all the plastic because the kids would microwave everything in plastic.
• 53:13
  Speaker 2: Then I started really thinking like before the water gets put into the water bottle, that's glass.
• 53:19
  Speaker 2: Is it sitting in a big plastic tank somewhere?
• 53:22
  Speaker 2: Right there's no way to 100 eliminate it.
• 53:25
  Speaker 2: There's plastic in everything.
• 53:27
  Speaker 1: Everything it's just decreasing the burden yeah that's all you can do are you familiar with the like, the home water filter systems?
• 53:34
  Speaker 1: I am what you're I'm not, so I'm not familiar.
• 53:37
  Speaker 2: I have to actually do some research because we're renovating a home and we're planning on getting one, but I'm a big advocate of them it's one of my do you know about them?
• 53:44
  Speaker 1: I mean probably much as you do.
• 53:45
  Speaker 1: I haven't really done much research on them of like the effectiveness and you know, but I know this is interesting as I'm getting a lot of instagram ads for water filter systems.
• 53:54
  Speaker 1: I'll tell you it's definitely listening to us because, like for sure, I've mentioned it a couple times at home.
• 53:59
  Speaker 2: This we're always being listened to.
• 54:01
  Speaker 2: You're carrying around the biggest I got a tracking device.
• 54:04
  Speaker 1: My wife at home, like I'm thinking about getting your water system.
• 54:07
  Speaker 2: Turn your phones off when you're talking um.
• 54:10
  Speaker 2: But no, even skin quality like putting a filter on your shower head um makes a big difference because there's a lot of heavy elements.
• 54:19
  Speaker 2: Even if it's not harmful overall water, you know, it's still basically clean to shower in.
• 54:25
  Speaker 2: There's a lot of heavy heavy elements in the water and the piping that's coming through.
• 54:29
  Speaker 1: Right.
• 54:30
  Speaker 2: And filtering that out is only beneficial.
• 54:32
  Speaker 1: We had a minor leak in one of our bathrooms and we got the you know plumbing fixed and all that great work was done.
• 54:39
  Speaker 1: I really appreciate it.
• 54:40
  Speaker 1: And they were fixing the pipes with copper pipes and just going straight in there and then that's the main filter, the pipe that goes to the sink, and we get a glass of water from the bathroom like in the sink or whatever, and I was like they just attached the pipe.
• 54:55
  Speaker 1: The water just goes straight through the pipe.
• 54:56
  Speaker 1: Could you imagine taking that pipe and just drinking water out of it like a straw right now and my wife's like, no, that'd be nasty.
• 55:03
  Speaker 1: Never, that's what we're doing.
• 55:04
  Speaker 1: Yeah, wait a minute, I didn't even think.
• 55:07
  Speaker 1: Like up to that point, I didn't even think about that.
• 55:09
  Speaker 2: Yeah.
• 55:13
  Speaker 1: I was like there's like a copper pipe.
• 55:15
  Speaker 1: You know that the plumbers just used to replace pipes in the wall and I was, like, could you imagine just like drinking out of a, out of a hose, like a straw, like, yeah, just that right now?
• 55:23
  Speaker 1: Yeah that would, then that's what our kids are drinking yeah, then there's what do we do, you know?
• 55:28
  Speaker 2: there's a lot of uh data in terms of deposition of plastics into the brain and how it's, you know, creating dementia and alz, alzheimer's and stuff like that.
• 55:38
  Speaker 2: So I think we need to start thinking bigger in terms of how to preserve things.
• 55:42
  Speaker 2: It's tough.
• 55:43
  Speaker 2: It's a tough global issue.
• 55:46
  Speaker 1: So you don't use plastic Tupperware, I don't Plastic Ziploc bags.
• 55:51
  Speaker 2: Ziploc bags?
• 55:52
  Speaker 2: I have to admit I do.
• 55:53
  Speaker 2: I do because I have not found.
• 55:55
  Speaker 2: I do have little glass jars that I try to keep and I try to put things away in.
• 56:01
  Speaker 2: But if I'm taking a snack to work and if I have like raspberries or blueberries, I do put them in in.
• 56:06
  Speaker 2: I'm not going to lie.
• 56:08
  Speaker 1: Um, what would be what's worse?
• 56:11
  Speaker 1: A Ziploc bag or a plastic Tupperware?
• 56:14
  Speaker 2: I would say plastic Tupperware, because you're heating it.
• 56:17
  Speaker 1: Oh, I see, Right, like you don't want to heat.
• 56:19
  Speaker 2: That's the issue.
• 56:20
  Speaker 2: Even your pans, the BPA coating and all that stuff on your pans yeah, the plastic pan, it's the daily use, like the cutting boards that you're cutting on, You're creating micro injuries into the plastic and that's going into your food.
• 56:34
  Speaker 2: So it's about eliminating that daily stuff, the once in a while stuff, it's okay to get away with.
• 56:40
  Speaker 1: Well, we'll have to get you back on and dive deeper into microplastics.
• 56:43
  Speaker 2: Thank you so much for having me this was a pleasure.
• 56:45
  Speaker 2: This was fun.
• 56:46
  Speaker 1: Cool.
• 56:46
  Speaker 1: Well, I'm glad and I'll have to come in and check out your spot.
• 56:49
  Speaker 2: Please anytime.
• 56:51
  Speaker 2: I'd love for you to come by.
• 56:52
  Speaker 1: How can people reach out to you if they want to reach out?
• 56:56
  Speaker 2: So you can follow us.
• 56:57
  Speaker 2: It's Stay Young Health and Wellness.
• 56:58
  Speaker 2: We're the Stay Young Health and Wellness Institute.
• 57:01
  Speaker 2: I have an Instagram and I go by DrStayYoung, and our website is launching next week DrStayYoungcom.
• 57:08
  Speaker 1: Cool, Awesome.
• 57:09
  Speaker 1: Thanks for having me.
• 57:09
  Speaker 1: Well, yeah, everybody reach out if you have any questions on how to stay youthful and aesthetically and internally beautiful and healthy, and if you have any questions for us.
• 57:17
  Speaker 1: We're always open to comments, questions concerns suggestions or battling any orthopedic sports pain that you think as a sports physio, we can help you all.
• 57:25
  Speaker 1: We're always open to helping.
• 57:26
  Speaker 1: So at least give us a call, we can chat and we'll catch you all next time.