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Why Heart Disease Isn’t Just About Cholesterol Anymore with Dr. Sanjay Bhojraj · Age Defiantly with Mark Young

• 0:00
  in the medical community, that's often the most difficult thing to do, is to change our approach to things, or realize that there's new information.
• 0:08
  What if the most dangerous thing about the current medical system isn't what it does wrong, but what it never learned how to ask?
• 0:17
  What frustrates you so much about the conventional medical system is that we really have become so reliant on technology and pharmacology.
• 0:25
  And particularly when we talk about cardiovascular diseases, so much of it is lifestyle.
• 0:31
  Who's the most important person in the Rua, and who's the most important person in a treatment plan?
• 0:38
  Really the most important person on the healthcare team is...
• 0:44
  The guest today is actually a cardiologist and a good friend of mine who's done thousands of cardiac procedures.
• 0:50
  He knows what a stent feels like from the inside, which is kind of a little bit weird if you think about it.
• 0:55
  But he's also spent the last decade in functional medicine, which is a big crossover from a man who's gone from being an MD into a functional practitioner.
• 1:04
  And once upon a time he said to me, I was trying to figure out what made me different from every other functional medicine doctor.
• 1:10
  And then one day I realized, I'm actually a doctor.
• 1:14
  I thought, how amazing, because you're speaking out of topic that is somewhat controversial in the medical world.
• 1:21
  But he's earned a seat at the table and I appreciate that.
• 1:24
  The last time he was here on this show, we cracked open the gap between conventional and functional medicine.
• 1:29
  And today we want to go somewhere a little bit harder that actually takes the patient as being their primary advocate in their own house, specifically related to heart disease and other cardiovascular functions.
• 1:40
  But also because we're going to talk about the truth about keeping you alive longer.
• 1:44
  Dr. Sanjay Bozharaj, welcome back to age defiantly.
• 1:48
  Mark, thank you so much for having me here.
• 1:50
  And let's talk about getting patient selfie and how they are truly the ones in the driver's seat.
• 1:56
  Well, I love all of that because so much of what we see in our world, like I, as you know, and I'm going to say this,
• 2:03
  like when my own father ended up in the hospital, you were my first phone call.
• 2:06
  This is a guy who not only understands what he's doing from a medical perspective.
• 2:11
  You're an MD, obviously, and a cardiologist who speaks all over the country on multiple topics related to cardiovascular health.
• 2:18
  But I know that we approach medicine and approach health from the same angle.
• 2:23
  And it is its upstream issues.
• 2:27
  It's dealing with root source problems and the functional side of cardiology.
• 2:32
  Again, the best doctor ever is the one that's there to help you never get sick.
• 2:37
  The one that's there when you're sick, right?
• 2:39
  Yeah, and I think that what frustrates you so much about the conventional medical system
• 2:44
  is that we really have become so reliant on technology and pharmacology.
• 2:50
  And particularly when we talk about cardiovascular diseases, so much of it is lifestyle.
• 2:56
  It's the diet, it's the sleep, it's the stress, it's all of these things.
• 3:00
  But we never, we were never given the tools and conventional training to deal with it.
• 3:06
  But of all the fields of medicine, I feel like cardiology is the one that could benefit the most from proper diet, proper lifestyle, proper exercise.
• 3:14
  I mean, we could probably melt away 80% of cardiovascular disease if we taught people the right things to do.
• 3:21
  And cardiology is interesting because a lot of the conditions that we have,
• 3:26
  I say, are associated with the number of birthday candles on your cake.
• 3:29
  So there are some things that are just as we get older, where into your happens, like bowel disease
• 3:34
  and aortic stenosis, paratropratiation, these things that I deal with on a regular basis.
• 3:38
  But when we talk about the bread and butter, hypertension, hyperclustralemia, right?
• 3:43
  High cholesterol, atherosclerosis.
• 3:45
  These things can, I think, are just so much better dealt with with lifestyle, diet nutrition,
• 3:53
  rather than relying on immense completely.
• 3:55
  So what, when I kind of want to go first and all of that, and then is I love the fact that I can talk to a doctor friend
• 4:04
  who's talking about cardiology and talking about lifestyle being the most important part of health,
• 4:11
  strangely, imagine that that's a controversial topic.
• 4:14
  But one step further than that, and that is, who's the most important person in the room?
• 4:19
  And who's the most important person in a treatment plan?
• 4:24
  And I believe, and anybody who listens to this podcast knows that my belief is that
• 4:30
  the medical system has taken doctors and put them on this pedestal of reverence
• 4:37
  that whatever the doctor says goes.
• 4:39
  And for a patient to defy that is, you know, it's some kind of sacrosanct.
• 4:46
  Well, kind of, I would turf against medical advice, right?
• 4:50
  And that's something that is documented in a very punitive way in the chart.
• 4:56
  In fact, there's a side-feld episode about this, right?
• 4:59
  Like, when you're not listening to the doctor's beat, they can get starkey
• 5:03
  and say, hey, you're doing this against my advice, right?
• 5:06
  And it's just insurance.
• 5:08
  But to your point, really the most important person on the healthcare team is the patient, him or herself.
• 5:15
  And because I'm not at home with them making the decision of what to eat.
• 5:21
  Right?
• 5:22
  I'm not the one there at, you know, midnight telling them to watch another Netflix video
• 5:27
  versus go to sleep or whatever it might be.
• 5:30
  And the way I do that math is that you see your doctor 15 minutes in a session, 30 minutes,
• 5:37
  let's say, tops every six months or so.
• 5:40
  So what's happening for that other 89 days, 23 hours and 30 minutes that you're not in my chair?
• 5:47
  You're not sitting across from me.
• 5:49
  And that's where the onus has to fall on the patient, right?
• 5:54
  And I would always tell patients that you are the most important person here.
• 5:59
  And what does that mean?
• 6:00
  It's not just, it is an empowerment thing, right?
• 6:03
  For sure.
• 6:04
  But as we talk about support and coming up with a plan that has to be something tactical.
• 6:09
  Right?
• 6:10
  So if I want to run a marathon, let's say, I don't just, I made that decision on Monday.
• 6:14
  I just don't just go out on Tuesday and run 26.2 miles.
• 6:17
  There's steps that need to happen.
• 6:19
  And similarly, when we look at our patients, we have to come up with treatment recommendations
• 6:25
  based on what's feasible in their lives, right?
• 6:29
  And so it's not a one-size-fits-all.
• 6:32
  You know, it is more hands-on, I guess, in the sense of what the doctor has to do.
• 6:37
  But that's where I think we have such great support from like health coaches,
• 6:41
  nutritionists, and we really have to have a much more holistic view of the health care team.
• 6:46
  But again, the most important player is the patient.
• 6:50
  I recently was in a conversation with a friend, a mutual friend of our Cindy Kennedy,
• 6:55
  with Rudy and IQ.
• 6:57
  And we were talking about that there's lenses that patients are seen through.
• 7:02
  But depending on where like a car accident, depending on what corner you were standing on,
• 7:06
  there was a very different accident.
• 7:08
  And there's a cartoon that I had sent it to,
• 7:11
  and it was a patient who had a knife in his back.
• 7:14
  But he was facing the doctor, and the doctor said,
• 7:17
  I don't see the problem.
• 7:19
  And I was like, that's exactly what it means, right?
• 7:22
  Like, and when it comes to cardiovascular health,
• 7:25
  and people who watch us know that I talk about cardiovascular health a lot
• 7:28
  because of my connections in that field.
• 7:30
  But one of the things that I see is that cardiovascular health,
• 7:34
  as you had said a moment ago, is probably one of the systems of the body
• 7:39
  that is most influenced by lifestyle and environmental factors.
• 7:43
  Absolutely.
• 7:44
  And that's everything for sleep, to exercise, to diet,
• 7:48
  to a form of health, to what you're exposed to,
• 7:51
  what you call your is strozo in your allostatic load,
• 7:54
  like so many things.
• 7:56
  And what I get frustrated with is repeatedly in the conventional world,
• 8:01
  I just want to boil it all down to LDL cholesterol.
• 8:04
  They just want to say, it's all about cholesterol.
• 8:07
  And I'm not saying it's not a part of the equation,
• 8:10
  but there's so much more there.
• 8:12
  Let me ask you, and I'm a big fan of wearables,
• 8:16
  I'm a big fan of integrated technology and healthcare.
• 8:19
  Now, when you're working with a patient,
• 8:21
  do you find wearables as being a, I'll say, a compliance metric?
• 8:27
  Because I believe wearables, for me, they work
• 8:30
  like gamifying everything in my life.
• 8:32
  And wearables help me like, I mean,
• 8:34
  I'll go to sleep and go to sleep earlier,
• 8:36
  just so that I can get about to score tomorrow.
• 8:38
  I know, it's ridiculous.
• 8:39
  I probably trigger my nervous system,
• 8:41
  just by trying to get about a nervous system.
• 8:43
  But you use these things in your practice.
• 8:45
  I do.
• 8:46
  And it really, again, it depends on the individual
• 8:49
  because I have some patients who they get absolutely worked up
• 8:53
  by the numbers.
• 8:54
  They'll see their heart rate variability is low,
• 8:56
  or their sleep scores off.
• 8:58
  And just like you said, it activates them.
• 9:00
  It does the, it has the opposite effect.
• 9:02
  You know, then you've got people who are more data driven
• 9:05
  that say, okay, like, you know, I put these folks
• 9:07
  in the, you can't have what you can't track.
• 9:09
  Kind of mindset where, okay, now I see that data.
• 9:12
  Now, let's look and see what's actionable here.
• 9:15
  So every time I have that night cap,
• 9:18
  right, I have a, like a whiskey or something before I go to bed.
• 9:22
  I see that my heart rate variability drops
• 9:24
  and my sleep score is actually worse than I thought it would be
• 9:27
  because I'm not getting that deep restorative sleep.
• 9:29
  Let me change, right?
• 9:30
  Let me, let me see what happens without it.
• 9:32
  And those are the ideal clients to use wearable devices.
• 9:36
  But we're getting information from so many different areas.
• 9:39
  I mean, there's, you know, I love body comp scales, right?
• 9:42
  Weight is no longer a metric that I think we need to worry
• 9:45
  about, but body composition is, right?
• 9:47
  So if you are very well muscled and you have,
• 9:51
  and you're lean, you know, that's a very different person.
• 9:54
  You know, as a certain weight, you know, 200 pounds,
• 9:57
  you know, but it's a lot of lean mass.
• 9:59
  It's a very different person than someone who doesn't have a lot of lean mass
• 10:02
  and carries a lot of fat adipose or visceral fat, right?
• 10:05
  Or even then, I think our concept of fat needs to change.
• 10:08
  Everyone's still worried about the pinchable muffin top kind of fat,
• 10:12
  you know, what we call adipose tissue or some king use fat.
• 10:15
  But the fat we really need to care about is that internal fat,
• 10:18
  that visceral fat that suffocates our organs.
• 10:21
  And even now in cardiology, there's a universe of data being collected
• 10:25
  about peribascular fat.
• 10:26
  So fat around our arteries and our organs and how that affects
• 10:30
  our cardiac function, our endothenial function,
• 10:33
  like how our blood vessels constricted relax.
• 10:36
  And you just realized that we were maybe right for the wrong reasons
• 10:40
  for a long period of time, but now that the science is filling in,
• 10:43
  we need to open our mind to change.
• 10:45
  And I think that, you know, in the medical community,
• 10:48
  that's often the most difficult thing to do is to change our approach to things
• 10:53
  or realize that there's new information.
• 10:56
  And it's remarkable to me how, you know, something negative happens,
• 11:00
  how quickly people respond.
• 11:02
  But when you have positive data that shows, you know,
• 11:05
  this is something that we need to optimize, sleep is more important,
• 11:08
  you know, whatever it may be from a diet and lifestyle standpoint,
• 11:11
  there just seems to be a resistance to that because it's not a pill.
• 11:15
  And it's not something, it's not an easy fix.
• 11:17
  But, you know, again, these are things that accumulate over life times.
• 11:20
  And so you're not going to rebuild room in a day or expect to take an injection.
• 11:25
  And all of a sudden, a month later, everything's going to be fine.
• 11:28
  I mean, we need to kind of unwind the biology,
• 11:31
  unwind the asymmetries and the amounts that we've created.
• 11:34
  And that, you know, it takes time.
• 11:36
  It's that untangling and not.
• 11:38
  It's so funny, you say, because you said something and that made me think.
• 11:41
  And that is, you know, what is the most important day in your healthcare journey
• 11:44
  that my answer is always today, right?
• 11:47
  Because yeah, I can't regain what happened yesterday.
• 11:50
  I can't get any kind of forgiveness for what I've done,
• 11:54
  but I can start building the future now.
• 11:57
  And there's never a today that's too late.
• 12:00
  I think that's the most apparent I think.
• 12:02
  I think that a lot of people, like I'll have a lot of being a cardiologist,
• 12:05
  a lot of patients in their 80s and they'll say,
• 12:08
  is it too late?
• 12:09
  I'm like, absolutely not, right?
• 12:10
  I mean, I'm never going to be able to make you 20 again.
• 12:13
  Nor do I think any of us would want to be, you know,
• 12:15
  go back that far in time, at least in terms of maturity.
• 12:19
  It'll be helpful for me.
• 12:20
  But, but, you know, when we talk about biological age and reversal of age
• 12:25
  and all these things, I don't think we want to think about it
• 12:28
  as making an 80-year-old functionally 50,
• 12:31
  but rather making an unhealthy 80-year-old
• 12:34
  as optimal as an 80-year-old can be.
• 12:37
  So, perfect segue, because I want to actually talk about
• 12:42
  how you're using AI in medical diagnostics.
• 12:46
  Because, again, the patient being the most important person in the room,
• 12:50
  part of what I'm a big fan of is AI has now empowered the questions.
• 12:54
  And I say clinicians, I'm watching it on a regular basis.
• 12:57
  Clinicians are getting freaked out by AI a little bit,
• 13:00
  because practitioners used to get the, you know,
• 13:05
  the patient who came into the room and had a bunch of questions
• 13:08
  because they had heard things and the doctor could easily dismiss it.
• 13:11
  And then came Dr. Google, maybe everybody goes in searches,
• 13:15
  finds WebMD, and they're dying,
• 13:17
  and the doctor laughed all of that stuff off.
• 13:19
  But right now, patients who are, who are real advocates with their own health
• 13:25
  have more information than you do available at their fingertips
• 13:30
  with nearly better diagnostic ability,
• 13:34
  and they're able to plug in every piece of data
• 13:37
  that you're just looking at a lab result, right?
• 13:40
  And yet the patient's the most important person in the room,
• 13:43
  I believe, is that the patient needs to use every tool available
• 13:47
  to scaffold their own house plan.
• 13:50
  What are you seeing as a clinician?
• 13:53
  Because normally I'm talking to patients
• 13:55
  and trying to help them understand that they have everything they need
• 13:58
  ready to finger tips,
• 14:00
  are you seeing this show up in your own practice
• 14:03
  and with patients that you still see
• 14:05
  where they're asking better questions?
• 14:07
  Yeah, I love, I'll say it this way,
• 14:10
  is I used to practice at the Midwest,
• 14:12
  Chicago, and then Detroit,
• 14:14
  and then I moved out to the West Coast
• 14:16
  in the practice of Orange County now.
• 14:18
  And I remember my Midwest patients
• 14:20
  at the end of every visit I always asked,
• 14:23
  any questions, or is there anything that E don't understand?
• 14:26
  And it would just be silence, right?
• 14:28
  It would just be crickets in that room,
• 14:30
  because I think the Midwestern mentality is you don't question
• 14:33
  your doctor, you just accept it as it is.
• 14:35
  And what I wanted to make sure was that they truly understood
• 14:38
  what was going on, right?
• 14:40
  Like, because if I'm speaking at you
• 14:43
  with these high-faluting terms that don't make sense,
• 14:46
  and you're not understanding what's happening,
• 14:48
  that's really a wasted visit for everybody.
• 14:50
  So in order to transfer that knowledge,
• 14:52
  I wanted to make sure people would understand,
• 14:54
  and almost never would I get a question for my Midwest,
• 14:56
  like especially in Indianapolis, my farmer patients,
• 14:59
  and said, what do you say, Doc? Like, oh good, right?
• 15:02
  And then when I moved out West,
• 15:03
  and this is before AI and all these things,
• 15:05
  people were much more engaged.
• 15:06
  And I think it's just a mindset difference.
• 15:08
  And you do see regional differences and that.
• 15:11
  And I think that the adoption of AI
• 15:14
  is probably very similar, right?
• 15:16
  Is that you have a very health conscious,
• 15:20
  technologically savvy group of people
• 15:22
  that are trying to do everything they can to be optimal.
• 15:25
  So they're going to come in with very high-level questions.
• 15:28
  And I think on the clinician side,
• 15:30
  you have to realize that,
• 15:31
  oh, there's really so many hours in the day,
• 15:33
  and I can't read every paper that there is, right?
• 15:35
  I mean, on a daily basis, I'm getting email blitzes
• 15:38
  from 10 or 15 journals about their table of contents.
• 15:40
  I don't even open half of those emails
• 15:42
  to see what's in table of contents,
• 15:44
  much less understand how that affects my patients,
• 15:47
  and what these studies are showing.
• 15:49
  So I appreciate AI as a tool to help synthesize that,
• 15:53
  because you've got the entire wealth of human knowledge
• 15:56
  available to you every time they update one of these models.
• 16:01
  And it will be able to draw inferences
• 16:04
  from papers and knowledge bases that don't have.
• 16:07
  But at the same time,
• 16:08
  you have to make sure that it maps out
• 16:11
  to the individual patient, right?
• 16:13
  That's one of the things that AI doesn't do as well,
• 16:15
  I feel like, is connecting patient-set information
• 16:19
  and that experience matters on the clinical side, right?
• 16:23
  But we call it second-year med students syndrome
• 16:25
  when you're learning all the diseases,
• 16:26
  you know, oh my god, I've got like leprosy,
• 16:28
  like when I assist all, you know,
• 16:30
  and I've got, you know, dengue fever
• 16:32
  even though I've never been to Africa, right?
• 16:34
  Because these symptoms can kind of feel never lupus.
• 16:38
  It's always lupus, but at the same time,
• 16:41
  you know, what I appreciate is that
• 16:43
  because it is looking at so many other variables,
• 16:46
  it can draw a lot of conclusions,
• 16:48
  much more rapidly and efficiently, I think, for people.
• 16:51
  In fact, as I was coming to the studio,
• 16:53
  I was talking to my Uber driver,
• 16:55
  and you know, somehow I got into what I do,
• 16:57
  I said I'm a doctor,
• 16:58
  and he told me that he had multiple myeloma,
• 17:00
  which is a tough disease.
• 17:02
  And the first thing I said was,
• 17:03
  oh, did he have bone pain or a fracture?
• 17:06
  I made you discover that made you discover it
• 17:08
  because that's what most people have as a presenting symptom.
• 17:11
  And he told me, yeah, you know,
• 17:13
  I had just a really bad back pain,
• 17:14
  and for about a year and a half or two years,
• 17:16
  they were putting me through physical therapy
• 17:18
  and list that and the other,
• 17:19
  and they didn't think that someone like me
• 17:22
  could get multiple myeloma, right?
• 17:24
  Right, right.
• 17:25
  And so that prolonged his diagnosis,
• 17:27
  and it's those inherent biases
• 17:29
  that we have as dogs, as clinicians,
• 17:31
  that I think AI does a great job of wiping out
• 17:34
  because it can just look at things objectively
• 17:36
  and say, hey, you have a gentleman like this,
• 17:38
  there's a globulin gap here of, you know,
• 17:41
  of greater than four.
• 17:43
  You know, maybe you should consider myeloma
• 17:45
  and get a S-PAP and a U-PAP or whatever test it might be.
• 17:49
  So some of those cognitive biases get brushed aside
• 17:52
  because, you know, again,
• 17:54
  ultimately getting back to AI and all these things,
• 17:56
  the true healer, all they care about,
• 17:58
  is healing their patient, right?
• 18:00
  Not, I did it my way or I did it your way.
• 18:02
  It's just, all right, we'll get us to that answer faster.
• 18:05
  And then part of that is that relationship
• 18:06
  that you have with patients,
• 18:07
  but I think AI is a fantastic tool.
• 18:10
  I think it's hilarious that doctors are worried
• 18:12
  that it's going to replace them
• 18:13
  because if you're worried that you're going to be replaced by AI,
• 18:16
  maybe you should be replaced by AI.
• 18:19
  Like, maybe that's something that needs to happen
• 18:22
  because maybe you're not,
• 18:23
  you're just not using all the tools.
• 18:25
  It's like saying, you know, I know my car can turn right
• 18:27
  and left, but I'm going to only go places
• 18:28
  where I can turn right
• 18:29
  because I'm more comfortable to right hand turn.
• 18:31
  And that would make them sense in that regard.
• 18:33
  Well, here's what I want to,
• 18:34
  when I kind of fair it out there a little bit
• 18:36
  because what I love about AI in the medical practice
• 18:39
  is not, I'm going to outsmart the doctor, right?
• 18:42
  What I believe in the multiple myeloma one being an example, right?
• 18:45
  Like this is a person whose that diagnosis probably
• 18:47
  would have never come out of the patient doing everything in AI.
• 18:50
  But here's what does happen.
• 18:52
  And that is, I'll give you an example.
• 18:54
  Say a friend of mine called me not too long ago.
• 18:56
  In fact, when we were out in Scottsdale, Phoenix, JJ,
• 19:01
  I'd gotten a phone call that exact weekend
• 19:04
  from a friend that said his dad had multiple myeloma.
• 19:07
  And he's like, what are your thoughts?
• 19:09
  And he's like, I'm coming to you
• 19:10
  because of a functional background.
• 19:12
  What are your thoughts?
• 19:14
  And I'm like, well, myeloma was serious.
• 19:16
  And it turns out, you know,
• 19:17
  there's a lot of great immunotherapies out there
• 19:19
  that are doing good things with that.
• 19:20
  But what I love about AI
• 19:23
  from a patient advocacy standpoint is
• 19:26
  I don't want patients to try to outsmart the doctor.
• 19:30
  What I love, and I want to go somewhere else with that too.
• 19:33
  But I love when people are knowing
• 19:35
  what lifestyle changes can I be making
• 19:38
  because the doctor may be focused on high level treatment plans.
• 19:42
  But most doctors are not telling you to cut carbs
• 19:46
  out or enter diet.
• 19:47
  You know, and most doctors are not telling you
• 19:50
  that, you know, ketogenic diets
• 19:52
  is a great way to deal with multiple myeloma.
• 19:54
  Most doctors are not telling you
• 19:56
  that it's probably good for you to go see a therapist
• 19:59
  at some point because a lot of cancers are rooted in trauma.
• 20:02
  Yeah.
• 20:03
  Like all of these types of things,
• 20:05
  like those are not things
• 20:06
  that the average clinician is talking about.
• 20:08
  And it's just the system is kind of stacked against the dog
• 20:11
  because we are inundated with so many treatment protocols
• 20:14
  that that's never part of our training on the knives in the back.
• 20:17
  And you're acting, I mean, for you're just, you know,
• 20:19
  when you're when you're taught 300 different chemotherapy regimens
• 20:22
  and every week there's 10 new articles coming
• 20:25
  about a new chemotherapy or something new.
• 20:27
  You just, you don't have the time.
• 20:28
  But yeah, I think that's a great use case for AI.
• 20:31
  You know, I also want to mention too that we have to be cognizant
• 20:34
  of the fact checking that these happen with AI
• 20:37
  and all these things.
• 20:39
  And I feel that, you know, when I have patients
• 20:41
  who are just going straight to AI
• 20:44
  for interpretation of labs,
• 20:47
  you know, as it's sometimes they can get themselves
• 20:49
  in a little bit of trouble.
• 20:50
  And that's where, again, I think that that,
• 20:52
  you know, you need a child a little bit on top of AI human intelligence,
• 20:55
  right on top of artificial intelligence
• 20:57
  and realize that, okay, you know, if you're 20 years old
• 21:01
  and you've got these this version of labs,
• 21:03
  it's a very different situation than if you're 80 years old
• 21:05
  and have a similar set of labs, right?
• 21:07
  Well, I'll just say that because here again, I say I'm 50.
• 21:11
  But when I run my labs through AI platforms that I use
• 21:15
  because I do my labs every six months
• 21:17
  and if I don't like the results, I make some very drastic changes
• 21:20
  and get a redone, which I just had recently interesting.
• 21:23
  But one of the things that I do is like when I run my labs,
• 21:27
  I don't want to be baseline against a 50-year-old.
• 21:30
  Because baseline for a 50-year-old
• 21:32
  is comparing me to every other 50-year-old in the country
• 21:34
  and by and large, that standard of care 50-year-old is unhealthy.
• 21:38
  Well, and that gets in the normal versus optimal,
• 21:42
  versus optimal, right?
• 21:43
  And so I think that's exactly right.
• 21:45
  But again, I think that's where the relationship
• 21:48
  and you mentioned kind of trauma in all these things,
• 21:50
  but I think one of the great things about being in doc
• 21:52
  is the relationship that you get to create with somebody over time
• 21:56
  and even just that relationship
• 21:57
  is therapeutic in and of itself, right?
• 21:59
  So, you know, you can use AI
• 22:01
  do 80% of the things and the other 20% needs to be that conversation.
• 22:06
  And, you know, I know there are people out there
• 22:08
  that are using AI as a therapist
• 22:10
  or, you know, or even a best friend
• 22:12
  or there's a TV show I was watching
• 22:14
  where they turned into a romantic partner
• 22:16
  and that was the setup for the show.
• 22:18
  So, you know, we still need that human connection, I think, right?
• 22:22
  And so, I think, again, I think it's great.
• 22:25
  It's like a research assistant, right?
• 22:27
  That is really kind of helping you out,
• 22:29
  learning new things that you could never learn
• 22:31
  or helping you with things that are very difficult
• 22:33
  or takes time to learn.
• 22:34
  But again, I think that the context
• 22:36
  becomes very important for a lot of that stuff.
• 22:38
  We're at my office, we call it the 108010.
• 22:41
  And 108010 is the first 10% of the entire project
• 22:44
  needs to be input correctly.
• 22:46
  Like, the humans need to make sure
• 22:48
  that all the correct inputs are in there
• 22:50
  because one decimal place
• 22:52
  and the AI is going to give you completely wrong information, right?
• 22:55
  So, the first 10% is the accuracy of the input
• 22:59
  that 80% of the heavy lifting
• 23:01
  is the AI can go do that research.
• 23:03
  Like, for instance, any time that I'll do that,
• 23:06
  I will tell my AI, I want you to interpret these labs
• 23:08
  but I want you to give me citations
• 23:09
  for where you got that information
• 23:11
  because now I've actually went and vetted the accuracy
• 23:13
  of the output.
• 23:15
  But that last 10% is still, I'm a human, right?
• 23:19
  And I'm reading the report and saying,
• 23:21
  that doesn't make sense to me, right?
• 23:22
  Like, I still need to be that educated
• 23:24
  and I think where doctors play a huge role in patient care
• 23:29
  is I believe that AI can be a huge assist for the patient.
• 23:32
  But you are the initial 10% of the diagnostics
• 23:36
  and you're also the 10% of the vetting all the information
• 23:39
  at the end of being the expert in that field
• 23:41
  that says, I know this is what AI told you by it
• 23:44
  or what great insight now I have more actionable steps
• 23:48
  that I can take.
• 23:50
  And I think that becomes a huge thing.
• 23:52
  And I want to pivot us just a little bit
• 23:54
  because we mentioned in the introduction that you're an MDE
• 23:58
  and then we'd completely flipped into this, you know,
• 24:02
  functional world there.
• 24:03
  Then you became this big IFM guy.
• 24:06
  And in the IFM world, you said to me once
• 24:10
  that, you know, here I am practicing the functional medicine world
• 24:13
  and trying to kind of make my space in a function medicine world
• 24:15
  and I'm trying to talk to patients
• 24:17
  and so one day I realized what's the one thing
• 24:19
  that I have that's different from every functional doctor
• 24:21
  I'm talking about, I actually have an MDE, yeah.
• 24:24
  But I was like, well, that's kind of a profound reality
• 24:27
  because it, and societally, I'll say like MDE's
• 24:31
  are treated very different from functional doctors.
• 24:33
  And I'd say as a functional doctor compared to an MDE,
• 24:37
  like there's a chip that exists on many functional shoulders
• 24:41
  because you're not a real doctor, right?
• 24:44
  Or a prescriber now there calls, right?
• 24:46
  And the MDE's tend to have a bit of an arrogance about them
• 24:49
  because they're the real experts in the field.
• 24:52
  And the truth is I've met some kind of dumb MDE's
• 24:55
  to be honest with you.
• 24:56
  And I've met some amazing functional doctors
• 24:58
  and vice versa, right?
• 25:00
  You're spanning both of those worlds
• 25:02
  and I'm curious particularly from the patient perspective,
• 25:07
  how does that change the way you're dealing with patients?
• 25:10
  And how would you address?
• 25:13
  I mean, so our listeners are more patients than doctors.
• 25:17
  And to a patient who's dealing with an MDE,
• 25:21
  so you've got the credential, you've got the expertise,
• 25:23
  you certainly have the experience,
• 25:25
  but you function in a functional world,
• 25:28
  meaning that functional, just meaning root cause,
• 25:31
  type things, right?
• 25:33
  Like, yes, you have this blood pressure problem.
• 25:35
  We're going to deal with your blood pressure problem.
• 25:37
  But hey, let's talk about what you eat on a daily basis
• 25:40
  and let's talk about the stress in your life
• 25:42
  and let's talk about family history
• 25:43
  and let's talk about history of trauma
• 25:45
  and let's talk about your exercise regimen.
• 25:48
  It's not a do me a favor and use less salt, right?
• 25:51
  It's literally getting into that kind of stuff.
• 25:54
  Like, how do you span that world
• 25:56
  and how does your patient experience look that much different?
• 25:59
  Well, the most important thing I did was left the insurance system
• 26:09
  and now kind of function in the cash pay world,
• 26:12
  which in a sense is a little bit liberating
• 26:14
  because now we're not beholden to the rules of insurance companies.
• 26:17
  I can't tell you how frustrated it is
• 26:20
  to have a medical license but not be able to make decisions
• 26:24
  because someone without a medical license
• 26:26
  who has economics in mind is really, you know, determining care, right?
• 26:31
  So I think the first thing was stepping out of that system.
• 26:34
  But to your point, you know, I think it just makes me a more complete healer, right?
• 26:38
  Being able to be on both sides of the equation.
• 26:41
  I think one of the frustrations that conventional dogs have
• 26:44
  with kind of the more, let's call them naturopaths
• 26:47
  or sorry, conventional doctors have with the naturopathic world
• 26:50
  a functional medicine world,
• 26:52
  is that they are also disjointed and disconnected
• 26:54
  and nobody really understands the other side that well.
• 26:56
  So there's a lot of animosity.
• 26:58
  Like I've had patients in my own practice
• 27:00
  when I was doing interventional like conventional cardiology
• 27:03
  that they would see a naturopath
• 27:04
  and their naturopath was that you need to be off of all these medications
• 27:07
  so you can't be on any of these things.
• 27:09
  And I'm, you know, and I would call them and say,
• 27:11
  hey, I just put a stent in this guy two weeks ago.
• 27:14
  I'm sorry, but they need their aspirin
• 27:15
  and their antiplatelet agents and all these things.
• 27:18
  Again, because they're just seeing, oh, you're a statin,
• 27:20
  which is bad for you and you're on its blood thinner
• 27:22
  which can cause all these issues.
• 27:24
  You should be a nano kinase or whatever it may be.
• 27:26
  And because I bridge these worlds,
• 27:29
  I get, you know, I understand, okay, look, I get it.
• 27:32
  You know, I see that there's a natural option for this.
• 27:34
  Acutely though, because we had a commercial treatment,
• 27:36
  we have to use standard of care for the commercial treatment.
• 27:39
  And then we can start to layer these things in later, right?
• 27:42
  And with it,
• 27:43
  we're often when it gets to a medical intervention.
• 27:45
  Yeah, it's too late.
• 27:47
  It's what have to deal with in the medical way,
• 27:49
  exactly, because the lifestyle options
• 27:51
  expired.
• 27:52
  Well, they didn't expire about what,
• 27:53
  but we have to layer it in correctly, right?
• 27:55
  I think.
• 27:56
  And so, you know, as, so now on the patient experience
• 28:00
  is very different because how many cardiologists
• 28:02
  are asking you what you're, you know,
• 28:04
  where you are in terms of your perimenopause journey,
• 28:06
  let's say, because we know that when
• 28:08
  the liminer and urine curve on a pause,
• 28:09
  one of the earliest signs is a little bump in LDL
• 28:12
  as that estrogen starts to drop, right?
• 28:14
  That I'd seen for so many years in my
• 28:16
  conventional practice, I just didn't know what to do with it.
• 28:18
  So, it's not you need to get the gym more in exercise
• 28:20
  and watch a diet.
• 28:21
  Now, it's, okay, let's get you a dental
• 28:24
  hormone specials or looking at environmental
• 28:27
  toxicity.
• 28:28
  I mean, one of the things that I'm so passionate about now
• 28:30
  is understanding the role of environmental
• 28:32
  toxicities in the cardiovascular disease.
• 28:34
  And I've been talking about this for years,
• 28:36
  nobody really responded, but there is just an article
• 28:39
  in the Journal of American Medical Association,
• 28:41
  JAMA, looking at lead levels and cardiovascular risk.
• 28:44
  And if you, and there's a straight association
• 28:47
  with the higher your lead level is,
• 28:49
  the greater the risk of athletic disease, right?
• 28:52
  So, so taking environmental exposures
• 28:55
  and toxicities as part of the equation,
• 28:57
  looking at stress, you mentioned stressing,
• 28:59
  one of the greatest undoing, like as we look at upstream
• 29:02
  causes, root causes of like cancer,
• 29:04
  metabolic disease, heart disease, you name the auto-immunity
• 29:07
  is stress and trauma.
• 29:10
  And that immune activation that happens as per
• 29:13
  assault, like the biological changes that happen as a result
• 29:16
  of the emotional and mental stresses that we have.
• 29:18
  And as a cardiologist, if I'm not dealing with that,
• 29:23
  I'm not really doing the patient a great service
• 29:25
  by just saying, hey, let's put you on a drug and gear.
• 29:27
  A cholesterol that I'm not really taking care of the fire
• 29:29
  that continues to smolder underneath everything.
• 29:32
  I just had a social media post that went out.
• 29:35
  If it's so many comments on it that it kind of makes me go,
• 29:38
  maybe I should be more there.
• 29:39
  We were actually talking about GLP1s,
• 29:41
  which I know is an area that you're focusing a lot on right now,
• 29:44
  but one of the comments that I made, which it's funny,
• 29:47
  because like I said, it's got a lot of, you know, people keep
• 29:50
  about Gary emotional about GLP1s.
• 29:52
  Well, this comment that I made was one of the things
• 29:55
  that we have to be careful about with any kind of exogenous treatment
• 30:00
  is if I'm taking exogenous GLP1s,
• 30:03
  I understand that my body actually creates GLP1 on its own.
• 30:07
  And what I'm taking is not a GLP1, it's a GLP1 agonist.
• 30:11
  But what ends up happening is that when we're introducing natural substances
• 30:16
  into the body and people don't realize this even with supplementation,
• 30:20
  you can supplement their way into unhealthy.
• 30:23
  Oh, sure, because if my body is supposed to produce something,
• 30:27
  and I'm exogenously introducing it to my body all the time,
• 30:31
  my body sees this as a surplus and quits making more,
• 30:34
  which means now I become dependent on the exogenous form
• 30:39
  because my body's not making it like it used to and perhaps won't again.
• 30:43
  Well, and it's, I call this the Jurassic Park effect, right?
• 30:46
  Is what do you mess with nature?
• 30:47
  Nature will mess back with you.
• 30:49
  And I get so nervous about the GLP1s,
• 30:51
  and I love what you said is that the GLP1 agonist is not the same
• 30:56
  as our exogenous GLP.
• 30:58
  It is chemically altered to last longer.
• 31:01
  And what I think is so funny about this movement,
• 31:05
  and I've got dear friends that say, you know, this is great
• 31:08
  because you've got GLP1 receptors in your brain and in your heart
• 31:12
  and in your blood vessel and in your liver and in your muscles
• 31:15
  and all these different places, you know,
• 31:17
  what an amazing thing that we can turn all of these around
• 31:21
  with just one drug.
• 31:23
  And I always get nervous because nothing in nature happens by accident.
• 31:28
  And so if you had GLP receptors in your brain and in your liver
• 31:32
  and in your heart and in your blood vessels
• 31:35
  and now we are overloading your body with GLP,
• 31:39
  there's not like a normal level of GLP.
• 31:42
  You can't go to lab and get a GLP1 mobile checked, right?
• 31:45
  Like it does, like we don't know what that normal range is.
• 31:48
  But now we're overwhelming it with these doses of medications.
• 31:52
  We don't know what's going to happen.
• 31:54
  And I've lived through so many rounds of therapies,
• 31:57
  but you know, I tell people, like think about epithet friend, right?
• 32:00
  Epi is great. You'd need it.
• 32:02
  If you didn't have it, you wouldn't be able to function.
• 32:04
  You wouldn't be able to wake up.
• 32:05
  You have physiologic amounts in your body all the time.
• 32:08
  But if you shoot an affi-pad into your heart,
• 32:12
  that can be a very bad situation, right?
• 32:14
  It's a natural compound that we're just giving you an unnatural dose of.
• 32:18
  And so similarly with these GLPs,
• 32:20
  you know, I think that they are definitely useful for people and diabetes,
• 32:26
  right? They're definitely helpful for weight loss.
• 32:29
  But this is not something that I think people should be on long term.
• 32:32
  And I think we're about a decade away from seeing some sort of weird health condition
• 32:36
  that only existed in medical literature
• 32:39
  because we are now overwhelming the GLP receptor.
• 32:41
  Well, I started using them just to get it on the client's action.
• 32:44
  I mean, that might be a good,
• 32:46
  that might be a good financial bed.
• 32:48
  Yeah, I probably was just tiring a couple of hairs.
• 32:50
  Let me just shoot up.
• 32:51
  But it's so funny to me that there's, you know,
• 32:56
  and I understand it, it's almost tragic.
• 32:58
  This continued myth about weight and health
• 33:03
  and how it just persisted.
• 33:06
  And I mean, we don't have to go that far back in history
• 33:09
  to bring out fenthen, which is a great drug for weight loss.
• 33:13
  Or, right, but we were told that it was safe
• 33:16
  with all the clinical trials.
• 33:18
  I, this was maybe when I was in med school that that came out
• 33:21
  or whatever, there were pens and the notepads and all the stuff.
• 33:25
  We've got a great option for weight loss for your patients.
• 33:28
  And then as I became a cardiologist then,
• 33:30
  about 10 years later, seven or eight years later,
• 33:32
  all of a sudden we had this rampage,
• 33:34
  this rampant kind of epidemic of people
• 33:36
  with mitral intracuspid valve pathology
• 33:39
  because this drug that was also safe,
• 33:42
  right, was chewing away their heart valves.
• 33:45
  And I had to send probably 10 to 15 people
• 33:47
  to open heart surgery for the valve.
• 33:50
  And if you'd asked them, not that I did,
• 33:52
  but had I asked them as they were going
• 33:54
  to the operating room, was it worth it?
• 33:56
  Like, was that weight loss really worth it?
• 33:58
  I bet about 80% of them would have said,
• 34:00
  yes, still.
• 34:02
  You know what I mean?
• 34:03
  Like it is...
• 34:04
  We had a new adopt, he was based in almost in Maryland or Virginia.
• 34:07
  We did some work for him years ago.
• 34:10
  And it was a weight loss clinic.
• 34:12
  And of course I was intrigued like, what are you doing?
• 34:14
  What's different?
• 34:15
  And I forget where the whole introduction came from.
• 34:17
  But he literally was prescribing fentermine.
• 34:20
  Yeah.
• 34:21
  And this was his recent as a few years ago.
• 34:23
  And I might not terribly familiar with what he was doing.
• 34:27
  But like, okay, sure.
• 34:29
  Like, I want to, before we do anything for you,
• 34:31
  I want to know that this is safe.
• 34:32
  So a couple people in my office were like, oh, yeah, we'll do it.
• 34:35
  What is it?
• 34:36
  And he's like, oh, well, we'll get you all set up.
• 34:38
  So on so forth.
• 34:39
  And I said, but you had to go get an EKG.
• 34:41
  Like before you could even get on his prescriptions
• 34:44
  and all this other kind of stuff.
• 34:46
  And again, not knowing what he was doing.
• 34:48
  We went ahead and went through the,
• 34:49
  into the induction or here and,
• 34:51
  and it was like, okay, well, I got a good schedule at EKG.
• 34:54
  We said, get into your weight loss program.
• 34:57
  Only to later find out they're rinky-cented to us.
• 35:00
  It was fenterny.
• 35:01
  I mean, you know, it's also great for weight loss.
• 35:03
  Probably is meth.
• 35:05
  But it was so funny.
• 35:07
  It's like, I was like, all right, well, I'm going to try it.
• 35:09
  And so what it is.
• 35:10
  I mean, I'm healthy anyways.
• 35:11
  And I was like, I probably dropped 20 pounds, you know, by Tuesday.
• 35:14
  You know, also slept about two hours out.
• 35:17
  I mean, anybody had an unbridled energy.
• 35:20
  Yeah.
• 35:21
  But it was, it's too much.
• 35:22
  Yeah.
• 35:23
  But let me ask you, a GLP's was not where I was planning to go
• 35:26
  and felt conversation, but I like it.
• 35:28
  And my, my, I want to stop there for just one quick moment longer.
• 35:32
  And that is, people are taking his GLP's butt hair.
• 35:35
  I'm asking you because I just read a study the other day.
• 35:40
  And GLPs are weight loss.
• 35:42
  Everybody knows him for weight loss and diabetes and so on.
• 35:44
  Those are the ozepics through what others.
• 35:46
  But GLPs are now being used for addiction recovery.
• 35:50
  Because there, as you mentioned, there's GLP receptors in the brain.
• 35:54
  And they're actually reducing the pleasure centers and the dopamine receptors in the brain,
• 36:00
  which means people that are into alcohol and gambling and even sex addiction
• 36:04
  are being prescribed to GLPs to produce the pleasure sensation from the addiction,
• 36:11
  which is an entirely different problem because now you've got people who are using it for alcohol
• 36:16
  and now they're going to go on food.
• 36:18
  And now you're dealing with dealing the addiction under malnourishment,
• 36:22
  which is also usually an issue with addiction recovery anyways
• 36:25
  because I eat like garbage cans.
• 36:27
  But I, my question to you, I suppose, is like, where does that end?
• 36:33
  But one layer deeper, the study that I just read recently
• 36:36
  was actually about how GLP ones at now been linked to the exact same dopamine receptors in the brain.
• 36:43
  GLP ones are now causing people to become relationally distant.
• 36:47
  Yeah.
• 36:48
  Because that dopamine receptor that makes me want to hang out with my friend
• 36:52
  or get into a romantic relationship.
• 36:54
  And you're right, you want to spend time with your wife,
• 36:57
  whether if it's sitting on the couch or even intimately,
• 37:00
  that's even going away because a lot of people don't need it.
• 37:04
  I mean, in this signal existed years ago,
• 37:07
  where they were...
• 37:09
  So one of the GLPs came out and the reps were coming to the office
• 37:13
  so they'll tell me all these great benefits and how it affects the reward system.
• 37:16
  Anybody who understands biology can see the chest match.
• 37:21
  I can see five moods from now.
• 37:23
  And so that's what frustrates me about this so much
• 37:25
  because we're using it so willy nilly,
• 37:27
  but part of what they said is it affects the reward center in your brain.
• 37:31
  And so it's no surprise if you understand biology
• 37:35
  that we talk about addiction and these things
• 37:38
  and that pleasure that you get from doing something
• 37:41
  and you know that you're not supposed to be at drinking alcohol, sex addition,
• 37:45
  whatever it may be, right?
• 37:47
  It's no surprise, but there are also signs of
• 37:51
  treatment, refractory depression,
• 37:54
  meaning that all these medications,
• 37:56
  no matter how much SSRI or depression medicine you gave them,
• 38:01
  these pleasure centers were so blunted in people
• 38:04
  that they just felt depressed all the time.
• 38:07
  And you know, I've got three daughters now
• 38:10
  who are starting to date and whatnot.
• 38:13
  That's a weird time for me as a dad,
• 38:15
  but you know one of the things I want them to experience is love.
• 38:17
  Like actually tomorrow is my 22nd wedding anniversary.
• 38:20
  And I love my wife. I would never not want to be with her.
• 38:22
  But to think that we're giving people a medication
• 38:25
  that's going to deprive them of that emotion
• 38:27
  and those reactions and that closeness.
• 38:30
  I mean this is a societal level problem.
• 38:33
  It already as it is, I think that the dating apps
• 38:37
  and kind of all this stuff are you know,
• 38:39
  fling me online if you want.
• 38:41
  But it just changed the way that the younger generation approaches,
• 38:44
  you know, relationships.
• 38:45
  But now you're not getting the pleasure of company
• 38:49
  and the hit of dopamine when you're with someone that you love.
• 38:53
  I remember like how happy I was when my wife would call me
• 38:56
  and my spirit PCS phone.
• 38:57
  That's how long ago we dated right the first, the first cell phones.
• 39:00
  But now you're not going to have that.
• 39:02
  I mean, what does that really mean for society, right?
• 39:05
  And the way that we're going about this is just,
• 39:07
  it's so interesting to me because we're just, again,
• 39:11
  for someone who understands biology,
• 39:13
  I can see five or six moves down or 20 moves down.
• 39:16
  I just don't understand why we're okay with this.
• 39:19
  Well, and there's, it's such a disconnected cell phone generation
• 39:23
  as it is.
• 39:24
  It's, you know, I now call out my sister.
• 39:27
  She's not going to watch this.
• 39:29
  There's like, well, she's deep into like gaming, yeah.
• 39:32
  And she's in these gaming rooms and stuff all the time.
• 39:35
  And it's like, and I see her in, you know, in person.
• 39:38
  And when you're having these conversations,
• 39:40
  she's so wired into this network.
• 39:43
  And my friend, this, my friend, this, am I friend that?
• 39:46
  It's like, and I'm of course, you know,
• 39:48
  a big brother through and through regardless of age.
• 39:50
  And I'm always like, who?
• 39:52
  Yeah, what?
• 39:53
  Have you even met these?
• 39:54
  Or have you, do the existence read a medical space fee?
• 39:56
  Yeah, they've never met, but they're so close.
• 39:59
  See how it's like, and that's, as a psychologist,
• 40:03
  that starts to worry me because I'm like,
• 40:05
  you actually believe that that's what human connection feels like,
• 40:10
  which means you don't even search for a,
• 40:12
  I'm not saying it's about her, but people who get to that point
• 40:15
  may not even look for a deeper human connection
• 40:18
  because they feel they found it, right?
• 40:20
  And especially in this GLP one world,
• 40:22
  like you're suppressing that award center,
• 40:24
  which means they physiologically don't even need it.
• 40:29
  Yeah.
• 40:30
  But no, it leads to psychological retardation in that level.
• 40:34
  Yeah, it's, you know, again,
• 40:36
  I am so surprised at the adoption
• 40:40
  because from people who should understand biology,
• 40:43
  to see these things happening,
• 40:45
  and now they're playing out, I mean,
• 40:47
  you know, this is exactly as I predicted it would happen years ago,
• 40:50
  we're seeing it play out,
• 40:52
  but the scarier thing is people still don't care, right?
• 40:55
  Like that's the, my doctors are still prescribing,
• 40:58
  patients are still taking it,
• 41:00
  and you know, there's this interest that human need
• 41:02
  that I guess it's filling, but we need to,
• 41:05
  you know, but we need to go back and say,
• 41:07
  fine, you know, getting back to original point is that,
• 41:10
  what we're giving is not a naturally occurring compound
• 41:12
  in the body, it's an analog of an naturally occurring compound.
• 41:15
  It's going to hijack all these things.
• 41:18
  Look, there's a great benefit to these medications
• 41:22
  with the weight loss in terms of cardiovascular disease,
• 41:25
  sleep apnea.
• 41:26
  I'm sure there's going to be a cancer study
• 41:28
  if there hasn't already been one
• 41:29
  because you're losing visceral fat
• 41:31
  and inflammatory signaling and all these stuff.
• 41:33
  Yeah.
• 41:34
  So, you know, again, understanding how biology works,
• 41:36
  still surprised, but at the same time,
• 41:38
  just like I see with gastric bypass patients,
• 41:41
  that, you know, they go through a whole surgery
• 41:43
  to lose weight.
• 41:44
  They lose weight.
• 41:45
  I'll tell you, nine times out of 10 within a year,
• 41:48
  they're at pro-stop.
• 41:50
  We'll say, let's say within two years,
• 41:51
  they're back at their initial pre-op weight,
• 41:53
  if not higher.
• 41:54
  Why?
• 41:55
  Because they didn't do the diet, they didn't do the lifestyle.
• 41:57
  They didn't make all the other changes that are necessary
• 42:00
  for that to be successful.
• 42:02
  And so, similarly, when it comes to these GLP1 meds,
• 42:04
  yeah, you know what, they're going to work.
• 42:05
  They're going to work great.
• 42:06
  You're going to lose your weight.
• 42:08
  There was trial done that show that after stopping the medication
• 42:12
  about 1.7 years, you'd gain the weight back,
• 42:14
  or even more than you had before,
• 42:17
  so that weight loss signal comes back.
• 42:19
  It's that doing anything treat,
• 42:21
  all it's doing is suppressing.
• 42:23
  And the alarm, you're on these medications
• 42:25
  and suppressing these signals,
• 42:26
  the further and further your body gets out of balance,
• 42:29
  and it's just like a rubber band, you know,
• 42:31
  the tire you stretch it, the faster it snaps back,
• 42:35
  I mean, there's just going to be a wick lash,
• 42:37
  or people come up to you.
• 42:38
  And so much of that is GLP1 meds to pause buttons
• 42:41
  so that I can reset everything else that's going wrong.
• 42:44
  And in that respect, I look at it
• 42:46
  when I tell our people to call me all the time,
• 42:48
  you know, what do you think about this?
• 42:49
  I'm thinking about this, and I'm like,
• 42:50
  look, I'm a fan of GLP1s, yeah.
• 42:52
  When used short term,
• 42:54
  and when used intermittently, yeah.
• 42:56
  I don't want a person to take a GLP1 every week for a year.
• 42:59
  And when I tell people, if you get on a GLP1,
• 43:01
  that's great.
• 43:02
  You use it for two weeks,
• 43:03
  go without for a week, yeah.
• 43:05
  Like, you're sickle.
• 43:06
  Recycle through it.
• 43:08
  And as part of that is also,
• 43:10
  and when you have the hunger relief
• 43:13
  that you're looking for,
• 43:15
  be intentional about what you're doing.
• 43:18
  But it's like, I know too many people
• 43:19
  who go on the GLP1,
• 43:20
  and they're starving themselves to healthy.
• 43:22
  Yeah.
• 43:23
  You know, but when they do actually touch food,
• 43:26
  it's something that's pleasurable,
• 43:28
  not something that's healthy,
• 43:29
  because they're deprived of the pleasure of food,
• 43:33
  because food is great.
• 43:34
  So they're exactly the wrong thing,
• 43:36
  so they eat the wrong thing,
• 43:37
  or drink the alcohol.
• 43:39
  Right.
• 43:40
  We had a coworker here last year,
• 43:41
  the year before or something,
• 43:42
  and she was all a bun set bound,
• 43:46
  and she's on set bound,
• 43:48
  and she'd been on it for like a year straight,
• 43:51
  and melted.
• 43:53
  Yeah.
• 43:54
  I mean, there was nothing of her left.
• 43:55
  The problem is you'd go out to eat
• 43:57
  when she was in town visiting the office,
• 44:00
  and she would order a plate of lasagna
• 44:03
  and have three bites of it,
• 44:05
  and then would order a beer,
• 44:07
  and then order a whiskey,
• 44:08
  and then order a glass of wine.
• 44:09
  Yeah.
• 44:10
  Not joking.
• 44:11
  And I was like, oh my gosh,
• 44:13
  the calories you are getting are horrible,
• 44:16
  and all that goes through my mind is,
• 44:18
  and when you're off of this,
• 44:20
  you're still been ordered lasagna,
• 44:22
  and you're still going to have three drinks with dinner,
• 44:24
  and you're going to get all of that weight back,
• 44:27
  because you don't know how to fix the problem.
• 44:29
  I think the GLP1 is like,
• 44:31
  you're in an auto race,
• 44:33
  and you're able to pull into the,
• 44:35
  and it's down to the pits up for a moment.
• 44:38
  You know, great.
• 44:39
  Take a second to fix what's wrong,
• 44:42
  so that when you get back on the track,
• 44:44
  you're fresh again,
• 44:45
  but when I find there's too many people,
• 44:47
  they're not fixing it.
• 44:48
  It's the, I'm on this,
• 44:49
  and I need to make sure
• 44:51
  that my meal today is protein.
• 44:54
  But, and I'll be honest,
• 44:55
  I'm taking a GLP3.
• 44:56
  I started taking red ochre tide two, three weeks ago,
• 44:59
  partly just to see what it,
• 45:01
  see what it is right now.
• 45:03
  Because I'm all about experimenting like that.
• 45:05
  I'm like, oh, that's cool.
• 45:06
  Suppress is appetite,
• 45:07
  speeds metabolism,
• 45:08
  builds muscle.
• 45:09
  Sure, perfect.
• 45:10
  Perfect.
• 45:11
  But yeah, okay.
• 45:12
  So I'm taking some red ochre tide right now,
• 45:14
  and I'm loving it.
• 45:15
  I'm actually really enjoying the experience of it,
• 45:17
  but what I'm doing differently
• 45:20
  and what I think is correct is
• 45:22
  I don't find myself eating a lot,
• 45:24
  but not hungry.
• 45:26
  But when I do eat,
• 45:27
  I'm so intentional about protein intake,
• 45:30
  and I've gotten, you know,
• 45:32
  I use their quest protein,
• 45:35
  45-virus, a protein, or drinks.
• 45:37
  Okay.
• 45:38
  I just like, they're like the shakes,
• 45:39
  but they taste great.
• 45:40
  And it's like,
• 45:41
  but I'm drinking two of those a day
• 45:42
  for 400 calories,
• 45:44
  but also for 90 grams of protein
• 45:46
  between the two of them,
• 45:48
  and baking sure I'm having high protein,
• 45:50
  meals with vegetables,
• 45:52
  so that when I do eat,
• 45:54
  I'm breaking bad patterns,
• 45:56
  and that when I'm not taking it,
• 45:58
  I eat the same way now.
• 45:59
  Well, and I think you bring up a good point
• 46:01
  is that these medications
• 46:02
  should not be an enabler
• 46:03
  or bad behavior, right?
• 46:04
  And that discussion is not happening
• 46:08
  in the physician's chair
• 46:10
  when these are being prescribed.
• 46:12
  In fact, I run a program
• 46:14
  that really kind of does exactly
• 46:16
  what you're doing,
• 46:17
  is helping people be very intentional
• 46:20
  about their intake,
• 46:21
  because my line is,
• 46:23
  and I say this with utmost respect
• 46:25
  as a dad of someone who's suffered from this,
• 46:26
  there's nothing healthy
• 46:28
  about a medically induced eating disorder, right?
• 46:30
  We're not looking at kids
• 46:32
  with eating disorders,
• 46:34
  and one of my daughters went through it,
• 46:35
  and saying,
• 46:36
  wow, that's a life goal, right?
• 46:38
  And there's malnutrition
• 46:39
  and there's physiological changes
• 46:41
  that happen,
• 46:42
  and all these things,
• 46:43
  and now just because we're doing this
• 46:44
  with an injection,
• 46:45
  does it make it any more healthy than that?
• 46:48
  And so you have to be intentionally,
• 46:50
  you have to get the protein,
• 46:51
  you can be malnourished.
• 46:52
  In fact, the reason I started this program
• 46:54
  is when I was speaking to my surgeons,
• 46:56
  this was about maybe three or four years ago,
• 46:58
  they said, you know, we've had
• 46:59
  so many people recently
• 47:00
  with bleeding complications,
• 47:02
  in surgery,
• 47:04
  we don't understand what's going on,
• 47:06
  and then I looked in,
• 47:07
  the common thread was there on a GLP1 receptor
• 47:09
  and the antagonist
• 47:10
  and what was happening
• 47:11
  is they were malnourished,
• 47:12
  so they weren't taking in
• 47:13
  in our vitamin K,
• 47:14
  they weren't taking in enough protein,
• 47:16
  so the bodies weren't able to heal,
• 47:18
  so it took them longer to heal,
• 47:19
  they had more bleeding complications,
• 47:21
  traumas, and all these things,
• 47:22
  and I said, well, you know,
• 47:24
  as you look at a root cause,
• 47:25
  right, kind of approach,
• 47:26
  I said, well,
• 47:27
  I see what's happening here,
• 47:29
  right, let's get out there
• 47:30
  and fix it,
• 47:31
  and then we created this GLP rescue program
• 47:32
  that I run, but,
• 47:33
  but, you know,
• 47:35
  the fact that you're doing that intentionally
• 47:37
  and you've got this kind of biohacker,
• 47:39
  kind of experimenter,
• 47:40
  experimenting, kind of mindset,
• 47:42
  is great for you,
• 47:44
  but that's you're like,
• 47:46
  you're the, you know,
• 47:47
  the island, right,
• 47:48
  in the ocean of people,
• 47:50
  like 99.99% of people
• 47:52
  that are doing this medication,
• 47:53
  are doing it incorrectly.
• 47:54
  Well, so much,
• 47:55
  one of the major contributors,
• 47:57
  and again, 12% of the US population
• 47:59
  are currently taking GLPs,
• 48:01
  and 60% of them are experiencing
• 48:04
  what they would call severe symptoms from it,
• 48:06
  and that'd be everything for reflows,
• 48:08
  your nausea,
• 48:10
  and the constipation,
• 48:11
  everything else,
• 48:12
  like all of that happens,
• 48:13
  and a lot of that constipation
• 48:14
  is lead to hemorrhoids,
• 48:15
  like, I mean, just,
• 48:16
  you and,
• 48:17
  and, I mean,
• 48:18
  so many of,
• 48:19
  however, right?
• 48:20
  So as you're losing that weight,
• 48:21
  if you're constipation,
• 48:22
  if you've got constipation,
• 48:23
  you're reabsorbing toxins
• 48:24
  that your body,
• 48:25
  I don't suppose so,
• 48:26
  as you're liberalizing fat,
• 48:28
  and getting rid of that fat,
• 48:30
  now you're releasing
• 48:31
  all these fat-soluble toxins
• 48:32
  that all of us carry,
• 48:33
  if you're not poorer,
• 48:34
  detoxing correctly,
• 48:35
  that makes you feel like crap.
• 48:37
  You know, it's,
• 48:38
  it's just, it's unbelievable,
• 48:39
  and again, there's no,
• 48:40
  there's no intention behind this.
• 48:42
  It's just, get healthy,
• 48:43
  lose weight,
• 48:44
  and it's the farthest thing from the truth.
• 48:46
  Well, and that's exciting.
• 48:47
  I mean,
• 48:48
  getting that level of education,
• 48:50
  yeah, when they're getting on GOP-1.
• 48:52
  So that's exactly right,
• 48:53
  but you're, you're actually getting rid of fat,
• 48:54
  but now you're actually all of the toxins
• 48:56
  that exist, in fact,
• 48:58
  because that's the toxins are stored.
• 48:59
  Yeah.
• 49:00
  Like, where's that going?
• 49:01
  Right?
• 49:02
  But you said you're liberalizing
• 49:03
  all of these toxins,
• 49:04
  and now you're not detoxing,
• 49:05
  and first of all,
• 49:06
  now you've got,
• 49:07
  and that your jam packed colon,
• 49:08
  but,
• 49:09
  does you can't poop it out?
• 49:10
  You're not eating,
• 49:11
  you're not getting in,
• 49:12
  like glutathione,
• 49:13
  and vitamin C,
• 49:14
  and the pain vitamins,
• 49:15
  so now you're in the ear,
• 49:16
  and liver is not able
• 49:17
  to conjugate them,
• 49:18
  to get rid of them,
• 49:19
  even if you're getting rid of the sweat,
• 49:20
  or in urine,
• 49:21
  or whatever it may be.
• 49:22
  I mean,
• 49:23
  there's just you have to do this
• 49:24
  in the right order,
• 49:25
  in the right way,
• 49:26
  and that's, you know,
• 49:27
  that's what I'm trying to help people
• 49:28
  out with that program.
• 49:29
  I love that,
• 49:30
  and the two things that I,
• 49:31
  one thing that I want to say
• 49:32
  I have laugh at,
• 49:33
  because it's not a funny matter,
• 49:34
  but there's an irony to it,
• 49:35
  and that is,
• 49:36
  you know,
• 49:37
  they don't body-shing people,
• 49:38
  there's nothing wrong
• 49:39
  with being overweight,
• 49:40
  so on, so forth,
• 49:41
  and yet the minute a drug comes out,
• 49:42
  they're able to get everybody skinny,
• 49:43
  the whole world jumps to it,
• 49:45
  and it's like,
• 49:46
  so wait a minute.
• 49:47
  Did you actually believe
• 49:48
  that being overweight was okay,
• 49:49
  or did you just now,
• 49:50
  have a solution for it,
• 49:51
  build out that there's a,
• 49:52
  did you watch the Oscars?
• 49:53
  There's a year and a half
• 49:54
  to look like that.
• 49:55
  Yeah.
• 49:56
  Yeah, but everybody,
• 49:57
  having their own Botanorexic.
• 49:58
  No, I know, but, you know,
• 49:59
  that's my point,
• 50:00
  and like, you know,
• 50:01
  again, as a data daughter,
• 50:02
  is like, what is this saying to,
• 50:03
  an already vulnerable population
• 50:04
  in teenage girls,
• 50:05
  when you look at someone like,
• 50:06
  you know,
• 50:07
  Ariana Grande,
• 50:08
  or, you know,
• 50:09
  whoever may be,
• 50:10
  anybody who stars a wicked,
• 50:11
  I mean, that,
• 50:12
  yeah, exactly,
• 50:13
  but, you know,
• 50:14
  I don't want to call her out,
• 50:15
  but she's the one that,
• 50:16
  that, that,
• 50:17
  that to me is a dad,
• 50:18
  like, I just want to give her
• 50:19
  a big hug,
• 50:20
  and be like,
• 50:21
  well, her,
• 50:22
  it's going to be okay, right?
• 50:23
  Like, I just,
• 50:24
  I just want to like,
• 50:25
  to, to,
• 50:26
  to just give her some reassurance
• 50:27
  and get her out of this,
• 50:28
  whatever spiral she's in,
• 50:29
  but,
• 50:30
  I'm,
• 50:31
  look, I'm not going to comment
• 50:32
  on her personal,
• 50:33
  maybe she's super happy,
• 50:34
  but like, as a doc,
• 50:35
  and as a dad,
• 50:36
  like, I just want to,
• 50:37
  I just want to kind of,
• 50:38
  kind of give her some love, right?
• 50:39
  But, um,
• 50:40
  but, you know,
• 50:41
  it just sends some extra messages,
• 50:42
  I mean, we,
• 50:43
  you have all these people
• 50:44
  that, like,
• 50:45
  what happened to that,
• 50:46
  body okay movement, right?
• 50:48
  Where,
• 50:49
  where it was okay,
• 50:50
  and, and, you know,
• 50:51
  one of the things I often say,
• 50:52
  and look, I've been a chubby kid in my whole life,
• 50:53
  is that you don't,
• 50:54
  you don't have to be,
• 50:55
  you don't have to be skinny,
• 50:56
  to be healthy, right?
• 50:57
  And again,
• 50:58
  I think it's a myth
• 50:59
  that, that,
• 51:00
  that persists
• 51:01
  for whatever reason,
• 51:02
  but, you know,
• 51:03
  when you look at,
• 51:04
  metabolicly healthy people,
• 51:05
  and I see this all the time,
• 51:06
  is that there are sometimes
• 51:07
  where the outsides
• 51:08
  don't match the insides at all,
• 51:09
  meaning,
• 51:10
  the relatively lean person
• 51:12
  that is an absolute
• 51:13
  metabolic disaster,
• 51:14
  or in the flip side,
• 51:16
  I've got a gentleman,
• 51:17
  who's like maybe 34
• 51:18
  50 pounds overweight,
• 51:19
  who metabolically is actually
• 51:21
  remarkable, right?
• 51:22
  So, so, you know,
• 51:24
  but it's a societal myth,
• 51:25
  you know,
• 51:26
  or a societal norm,
• 51:28
  I guess, that we just can't
• 51:29
  disprove.
• 51:30
  So,
• 51:31
  GOP1 society.
• 51:32
  Yeah.
• 51:33
  Wait, I'm going to,
• 51:34
  quote,
• 51:35
  asperry amongst other people
• 51:36
  who've said it.
• 51:37
  There's,
• 51:38
  you're a cardiologist.
• 51:39
  And they,
• 51:40
  statistically,
• 51:41
  one of four things
• 51:42
  is going to kill you.
• 51:43
  Yeah.
• 51:44
  Right. You're going to,
• 51:45
  you're going to die from
• 51:46
  diabetes,
• 51:47
  you're going to die from
• 51:48
  Alzheimer's,
• 51:49
  you're going to die from cancer,
• 51:50
  or you're going to die
• 51:51
  from heart disease.
• 51:52
  Yeah.
• 51:53
  You're a cardiologist.
• 51:54
  I want you to give some
• 51:55
  practical advice to a listener,
• 51:56
  on how not to die
• 51:57
  of cardiovascular disease.
• 51:59
  You know,
• 52:00
  one of these horses yet,
• 52:01
  and is likely to take you out.
• 52:02
  Yeah.
• 52:03
  As ends,
• 52:04
  by far,
• 52:05
  I mean, cardiology,
• 52:06
  cardiovascular disease
• 52:07
  is number,
• 52:08
  that,
• 52:09
  and again,
• 52:10
  I think it's post-controlable,
• 52:11
  which is the crazy thing here.
• 52:12
  I mean, maybe,
• 52:13
  diabetes in many cases.
• 52:14
  But,
• 52:15
  similar.
• 52:16
  Yeah.
• 52:17
  So, how not to die?
• 52:18
  So, number one,
• 52:19
  look at the underpinning.
• 52:20
  Right.
• 52:21
  So, you talk about coronal astral disease,
• 52:22
  you talk about metabolic disease,
• 52:23
  you talk about cancer,
• 52:24
  and you talk about neurodegeneration,
• 52:25
  metabolic insufficiency,
• 52:26
  or metabolic abnormalities,
• 52:28
  are, I think,
• 52:29
  key in all four of those.
• 52:30
  So,
• 52:31
  if you really want to optimize
• 52:32
  your health,
• 52:33
  then you want to be
• 52:34
  metabolically healthy.
• 52:35
  What does that mean?
• 52:36
  Well,
• 52:37
  understand what your lab said.
• 52:38
  Right.
• 52:39
  You would never
• 52:40
  drive your car
• 52:41
  with a posted note over your
• 52:43
  speedometer. Right.
• 52:44
  You want that feedback,
• 52:45
  you know, how fast you're going.
• 52:46
  So, being
• 52:47
  metabolically healthy,
• 52:48
  I think,
• 52:49
  will take care of a lot of that,
• 52:50
  because as you look at brain,
• 52:51
  health,
• 52:52
  and particular,
• 52:53
  a lot of that is neurovascular,
• 52:54
  is the small arteries
• 52:56
  that supply your blood
• 52:57
  to your brain,
• 52:58
  and oxygen,
• 52:59
  and all that stuff,
• 53:00
  get diseased over time.
• 53:01
  So, you know,
• 53:02
  a couple of the things,
• 53:03
  you know,
• 53:04
  number one,
• 53:05
  get your lab checked. Right.
• 53:06
  Understand the contribution
• 53:08
  that metabolic disease
• 53:09
  has to everything,
• 53:10
  to cancers,
• 53:11
  to heart disease,
• 53:12
  all these things.
• 53:13
  And I think it is a major component
• 53:15
  of the equation
• 53:16
  of cardiovascular disease.
• 53:18
  Number three, certainly,
• 53:19
  looking at LDL,
• 53:20
  but looking
• 53:21
  in a more comprehensive
• 53:23
  lipid profile.
• 53:25
  So, looking at the damaged LDL,
• 53:27
  we call oxidized LDL.
• 53:28
  There's a neurometric
• 53:29
  called oxidized L.P.
• 53:30
  little A.
• 53:31
  So, people know L.P.
• 53:32
  the L.A.
• 53:33
  is this really bad character.
• 53:34
  I think of it as those, like,
• 53:36
  the, when you go hiking,
• 53:37
  you get those burrs
• 53:38
  that stick to you everywhere.
• 53:39
  That's kind of what that does
• 53:40
  to LDL.
• 53:41
  It makes it super sticky
• 53:42
  on the blood-best wall
• 53:43
  that causes it to be very
• 53:44
  afterogenic.
• 53:45
  Well, also, we get
• 53:46
  it LDL on HDL ratios.
• 53:48
  So, LDL,
• 53:49
  HDL ratios, triglyceride
• 53:50
  to HDL,
• 53:51
  those are like metabolic
• 53:52
  markers as well.
• 53:53
  But in terms of absolute
• 53:54
  LDL numbers,
• 53:55
  I think that a lot
• 53:57
  of the functional
• 53:58
  medicine world says LDL
• 53:59
  doesn't matter.
• 54:00
  I kind of don't agree
• 54:01
  with that as a cardiologist.
• 54:02
  It matters.
• 54:03
  It just doesn't matter
• 54:04
  as much as cardiologists
• 54:05
  think, I think.
• 54:06
  And then getting back
• 54:07
  to that.
• 54:08
  So, the number forward
• 54:09
  would be, you know,
• 54:10
  it's the unsexy things
• 54:11
  that get you across
• 54:12
  the finish line, right?
• 54:13
  What's that?
• 54:14
  What do we learn?
• 54:15
  The tortoise and the hair
• 54:16
  are slow and city
• 54:17
  wins the race, right?
• 54:18
  So, it's not about going
• 54:19
  and running 10 miles
• 54:20
  on a Saturday.
• 54:21
  But it's about doing
• 54:22
  the stairs at work every day
• 54:23
  as opposed to taking
• 54:24
  the elevator.
• 54:25
  It's about making
• 54:26
  those healthy lifestyle
• 54:28
  diet choices on a daily basis
• 54:30
  if you can go with, you know,
• 54:32
  the big dessert
• 54:33
  or the plate of fruit
• 54:34
  make that plate of fruit.
• 54:36
  You know, I'm not saying
• 54:37
  never have the big
• 54:38
  fancy cake or whatever
• 54:39
  but eating healthy
• 54:40
  90% of the time
• 54:42
  and giving yourself a cheat
• 54:43
  I think is fine.
• 54:44
  Like a cheat meal
• 54:45
  once a week.
• 54:46
  I think it's important
• 54:47
  because it tells your body
• 54:48
  that you're not in this
• 54:49
  scarcity kind of zone
• 54:50
  that there aren't
• 54:51
  there is food around.
• 54:52
  And like it's
• 54:53
  to safety.
• 54:54
  So, really kind of making
• 54:57
  those unsexy choices.
• 54:59
  That's really what's
• 55:00
  going to drive
• 55:01
  that jumping
• 55:02
  in a ice cold bath
• 55:03
  or wearing
• 55:04
  amber-colored glasses
• 55:05
  or whatever that may help.
• 55:06
  But that's like
• 55:07
  such an iterative
• 55:08
  fix as opposed to
• 55:10
  really taking
• 55:11
  here in that beast
• 55:12
  of the period.
• 55:13
  That's yes.
• 55:14
  And I've said that frequently
• 55:15
  and that is when we talk
• 55:16
  about biohacking,
• 55:17
  we're talking about
• 55:18
  optimization.
• 55:19
  We're not talking
• 55:20
  about health.
• 55:21
  That is there is health
• 55:22
  in biohacking.
• 55:23
  But it's like so
• 55:24
  much of their biohacking
• 55:25
  world is,
• 55:26
  it's the optimization.
• 55:27
  It's the cars already
• 55:28
  running amazing.
• 55:29
  How do I get an extra
• 55:31
  selection out of use
• 55:32
  and then too many people
• 55:33
  are trying to, you know,
• 55:34
  on 50 pounds overweight.
• 55:35
  But I'm wearing my
• 55:36
  blue-blocker glasses
• 55:37
  and saying,
• 55:38
  that's cool.
• 55:39
  I mean, I used to run triathlon
• 55:40
  and I remember this
• 55:42
  race that I did.
• 55:43
  It was, oh, and I did
• 55:44
  a half iron man.
• 55:45
  And I bought myself
• 55:46
  what I thought was a pretty
• 55:47
  fancy bike.
• 55:48
  Triathlon equipment can
• 55:49
  get really expensive.
• 55:50
  But it wasn't
• 55:51
  by any stretch.
• 55:52
  The imagination
• 55:53
  most offensive bike.
• 55:54
  And, but I worked a lot
• 55:55
  on the engine.
• 55:56
  Right?
• 55:57
  You know, when my coach
• 55:58
  said, don't
• 55:59
  worry about getting
• 56:00
  a carbon fiber
• 56:01
  everything until you're
• 56:02
  yourself are healthy.
• 56:03
  And this was up
• 56:04
  in Sonoma where I did
• 56:05
  this.
• 56:06
  And so there's obviously
• 56:07
  some sort of a tech guy.
• 56:08
  His wheels,
• 56:09
  each wheel of his bike
• 56:10
  was probably about
• 56:11
  10 to $20,000.
• 56:12
  And like carbon fiber,
• 56:14
  I mean, his entire kit
• 56:15
  probably weighed
• 56:16
  as much as my watch.
• 56:17
  But I just blew past it
• 56:19
  because this guy was probably
• 56:20
  about 100 pounds overweight
• 56:21
  and didn't fix
• 56:22
  the right thing.
• 56:23
  So he was,
• 56:24
  he was optimizing
• 56:25
  the equipment
• 56:26
  without optimizing
• 56:27
  the engine.
• 56:28
  Right?
• 56:29
  I always think
• 56:30
  of that guy when,
• 56:31
  what I think about health
• 56:32
  is, yeah, you maybe
• 56:33
  will eat out
• 56:34
  in extra 15 minutes
• 56:35
  of sleep by doing this
• 56:36
  or, you know,
• 56:37
  maybe your HR
• 56:38
  will go off
• 56:39
  by a couple of points
• 56:40
  if you jump in a cold
• 56:41
  bath.
• 56:42
  But really, the major
• 56:43
  lift happens
• 56:44
  by those unsexy
• 56:45
  daily habits that,
• 56:46
  no, you're not
• 56:47
  winning a cold
• 56:48
  medal for.
• 56:49
  But that's really what's
• 56:50
  going to keep you going
• 56:51
  for a long period of time.
• 56:52
  Agreed.
• 56:53
  And then that kind of
• 56:54
  becomes where we're going
• 56:55
  with all that.
• 56:56
  I want to throw one
• 56:57
  again.
• 56:58
  I know you personally.
• 56:59
  So I, I know
• 57:00
  this about you.
• 57:01
  But when I think
• 57:02
  of longevity,
• 57:03
  I think of there's no
• 57:04
  reason to have longevity
• 57:05
  if you're not a
• 57:06
  purposeful person.
• 57:08
  Like, why
• 57:09
  live longer?
• 57:10
  If there's no reason
• 57:11
  to live longer.
• 57:12
  Yeah.
• 57:13
  Especially if you're
• 57:14
  not happy in the life
• 57:15
  you're living.
• 57:16
  But I also find
• 57:17
  that that is such a
• 57:18
  down-regulation
• 57:19
  for a nervous system.
• 57:20
  It is such a
• 57:21
  cortisol
• 57:22
  inhibitor.
• 57:23
  When there's
• 57:24
  purpose in your life,
• 57:25
  you know,
• 57:26
  you're not in a stressful
• 57:27
  mood as much.
• 57:28
  Like, you're actually
• 57:29
  like, I, I love what I do
• 57:31
  every day.
• 57:32
  Some days I hate
• 57:33
  coming to work.
• 57:34
  I'm not going to lie.
• 57:35
  But I love what I do.
• 57:36
  Which means even on the days
• 57:38
  that I'm frustrated
• 57:39
  or I'm stressed
• 57:40
  or something along those
• 57:41
  lines, I'm able to keep my
• 57:43
  nervous system
• 57:44
  the check simply because
• 57:46
  even in the hard days,
• 57:47
  I drive what lights you
• 57:51
  up and what
• 57:52
  advice do you give people
• 57:53
  who are optimizing.
• 57:55
  But I think we have to
• 57:56
  optimize with
• 57:57
  purpose and he attend.
• 57:58
  Well, and that gets
• 57:59
  in the mental, emotional
• 58:00
  spiritual aspect
• 58:01
  and health.
• 58:02
  So for me, I left a very
• 58:04
  lucrative career as an
• 58:06
  interventional cardiologist
• 58:08
  to do what I do.
• 58:09
  And people will ask me
• 58:10
  all the time, you know,
• 58:12
  do you ever, would you
• 58:13
  ever go back?
• 58:14
  Do you ever, do you
• 58:15
  regret your decision?
• 58:16
  And I tell people, you know,
• 58:18
  this, this wasn't really
• 58:19
  a choice for me.
• 58:20
  Like, it was just like,
• 58:21
  I feel like I'm on one
• 58:22
  of those people
• 58:23
  movers at the airport.
• 58:24
  Like, it was just an
• 58:25
  undeniable force that's
• 58:26
  pulling me like gravity
• 58:28
  into this world.
• 58:30
  Then so for me, as I
• 58:31
  approach 50, you know, my
• 58:33
  mission is really figuring
• 58:35
  out how to heal its
• 58:37
  scale, right?
• 58:38
  And that really happens
• 58:39
  to forms like this and
• 58:40
  teaching diet, teaching
• 58:41
  lifestyle.
• 58:42
  And so for people who are
• 58:43
  out there, I think that
• 58:44
  feeling as part of a
• 58:46
  community, whatever that
• 58:47
  may be, is so important
• 58:50
  because it gives you that
• 58:52
  human interaction, right?
• 58:53
  You're in the
• 58:54
  energy fields of other
• 58:55
  people, you know, around
• 58:56
  similar people, it gives
• 58:59
  you purpose to show up to a
• 59:00
  group.
• 59:01
  I mean, so one of the
• 59:02
  things that I recently did
• 59:03
  was I started playing
• 59:04
  ukulele, and I joined a
• 59:05
  ukulele group, and I go
• 59:06
  there, and it is the
• 59:07
  funniest thing.
• 59:08
  I mean, I think it's, I
• 59:09
  think it's kind of this,
• 59:10
  kind of low-key, key to
• 59:11
  longevity.
• 59:12
  Because, you know, I go to
• 59:15
  this group, and it's just
• 59:16
  a bunch of, like, it is a
• 59:17
  motley crew of people.
• 59:19
  I mean, you, you, you, you
• 59:21
  if you ask me to select a
• 59:23
  group of people who I would
• 59:24
  probably never interact
• 59:25
  with in my life.
• 59:26
  Otherwise, it's this
• 59:27
  ukulele group, right?
• 59:28
  But you go, you're, you're
• 59:30
  looking at the music on
• 59:31
  the screen, you're worrying
• 59:33
  about the chords over
• 59:34
  here, the strumming pattern
• 59:35
  over here, you're visually
• 59:37
  looking at this, you're
• 59:38
  singing, singing and
• 59:39
  humming actually regulates
• 59:40
  your vagus nerve, right?
• 59:41
  It brings you down, and
• 59:42
  you're all just laughing.
• 59:43
  You can't play the ukulele
• 59:44
  in being a bad mood, right?
• 59:46
  So, so it is just one of
• 59:48
  the most fun things that I
• 59:49
  get to do.
• 59:50
  So, I build in, like, you
• 59:51
  know, 10, 20 minutes a day
• 59:52
  of just yuketime for me
• 59:54
  or ukulele time to just
• 59:55
  sit here and play
• 59:56
  in the strum a stupid
• 59:57
  song, right?
• 59:58
  And it's all like
• 59:59
  Beatles songs.
• 1:00:00
  The great thing is all
• 1:00:01
  the songs that you know
• 1:00:02
  are all by style, are all
• 1:00:04
  made for the ukulele.
• 1:00:06
  And it's just brought so
• 1:00:08
  much fun and joy in my
• 1:00:09
  life and like being part
• 1:00:10
  of the script.
• 1:00:11
  But again, that, that
• 1:00:12
  sensation of community
• 1:00:13
  and not being stressed
• 1:00:14
  and just having fun and
• 1:00:15
  bringing joy is one of
• 1:00:17
  the things that has
• 1:00:19
  changed the most in my
• 1:00:20
  life.
• 1:00:21
  And so, maybe it's not
• 1:00:22
  ukulele for you.
• 1:00:23
  Maybe it's, you know,
• 1:00:24
  CrossFit or maybe it's a
• 1:00:26
  walking club or hiking
• 1:00:27
  club or poetry or
• 1:00:28
  whatever it may be.
• 1:00:30
  But just finding that
• 1:00:31
  becomes so therapeutic.
• 1:00:32
  About that.
• 1:00:33
  First ball.
• 1:00:34
  That's tidbit.
• 1:00:35
  I did not know it.
• 1:00:36
  It might be so happy.
• 1:00:37
  However, again,
• 1:00:38
  next time we hang out, well,
• 1:00:39
  if I had to campfire,
• 1:00:40
  it's seeing some,
• 1:00:41
  well, it's per six.
• 1:00:42
  Some ukuleles.
• 1:00:43
  You're going to laugh
• 1:00:44
  because a couple of
• 1:00:45
  years ago, I lived in Dallas
• 1:00:46
  for a year and a half.
• 1:00:47
  But it's like, I didn't
• 1:00:48
  know a lot of people.
• 1:00:49
  Yeah. So I decided
• 1:00:50
  I need to do something
• 1:00:51
  with my time other than
• 1:00:52
  work, so I ordered a
• 1:00:53
  cello.
• 1:00:54
  A cello is a lot more
• 1:00:55
  difficult to carry around.
• 1:00:56
  Correct.
• 1:00:57
  So I decided I was
• 1:00:58
  going to learn how to play
• 1:00:59
  the cello.
• 1:01:00
  It gave me a
• 1:01:01
  vulnerable amount of joy.
• 1:01:02
  Making these awful
• 1:01:04
  shrieks.
• 1:01:05
  It neighbors probably
• 1:01:06
  love you.
• 1:01:07
  Like, at least I'm like,
• 1:01:08
  it was the worst
• 1:01:09
  hobby I got.
• 1:01:10
  And it made me laugh
• 1:01:11
  every time I picked it up.
• 1:01:12
  But it was
• 1:01:13
  something where you went
• 1:01:14
  in intentionally knowing
• 1:01:15
  that I'm a suck at, right?
• 1:01:16
  And so the pressure was
• 1:01:17
  a hot flow, which
• 1:01:18
  anything, it was all
• 1:01:19
  uphill.
• 1:01:20
  Well, I've got the
• 1:01:21
  ability to make my laugh
• 1:01:22
  myself when laugh at the
• 1:01:23
  dumbest stuff in me.
• 1:01:24
  So I think that's actually
• 1:01:25
  my greatest medicine.
• 1:01:26
  But dude, it's always
• 1:01:27
  great having you.
• 1:01:28
  And by such an
• 1:01:29
  else of that insight, I
• 1:01:30
  want to make sure that
• 1:01:31
  everybody goes and checks
• 1:01:32
  out. If you are a person,
• 1:01:33
  I mean, we kind of talk
• 1:01:34
  about GLP1s a lot in this,
• 1:01:35
  which was not necessarily
• 1:01:36
  our conversation, really
• 1:01:38
  focused around cardiology
• 1:01:39
  and making sure that
• 1:01:40
  we're keeping that real
• 1:01:41
  core tendon of our
• 1:01:42
  healthy.
• 1:01:44
  GLP1s are a big
• 1:01:45
  conversation right now.
• 1:01:46
  Again, 12% of people
• 1:01:47
  are on them.
• 1:01:48
  And that doesn't even
• 1:01:49
  count the people that want
• 1:01:50
  to be or the people that
• 1:01:51
  are off already.
• 1:01:52
  Right.
• 1:01:53
  12% currently.
• 1:01:54
  And I, your new program,
• 1:01:56
  GLP1 Rescue,
• 1:01:57
  will put the notes
• 1:01:58
  and the website links
• 1:01:59
  and everything else to
• 1:02:00
  that for anybody else
• 1:02:01
  who's looking for that
• 1:02:02
  type of assistance.
• 1:02:03
  GLP1s, I'm a fan
• 1:02:05
  overarching, if done
• 1:02:07
  correctly.
• 1:02:08
  And that's what I was
• 1:02:09
  going to say.
• 1:02:10
  I'm a fan if they're
• 1:02:11
  done correctly.
• 1:02:12
  Yeah.
• 1:02:13
  And 99.9 people are
• 1:02:14
  not doing it correctly.
• 1:02:15
  So that's one of the
• 1:02:16
  risks.
• 1:02:17
  And that is, I do believe
• 1:02:18
  that they do need to be
• 1:02:19
  done with some kind of
• 1:02:20
  person he understands
• 1:02:21
  what they're doing.
• 1:02:22
  Even if not a medical
• 1:02:23
  professional, but somebody
• 1:02:24
  who knows what they're
• 1:02:25
  talking about.
• 1:02:26
  I have a lot of people
• 1:02:27
  who will call me because
• 1:02:28
  they're starting it,
• 1:02:29
  and they just want somebody
• 1:02:30
  to help coach them through.
• 1:02:32
  So if you are on a GLP1,
• 1:02:34
  check out GLP1 Rescue,
• 1:02:35
  learn how to do it correctly.
• 1:02:36
  Learn what are the
• 1:02:37
  supplemental things that
• 1:02:38
  you need to be doing
• 1:02:39
  in addition to this.
• 1:02:40
  But more than anything as it
• 1:02:42
  relates to GLP1s,
• 1:02:43
  as it relates to cardiology,
• 1:02:44
  as it relates to anything
• 1:02:45
  in the medical field.
• 1:02:46
  And I always encourage
• 1:02:49
  look for root cause issues.
• 1:02:51
  Always, we had a tendency
• 1:02:53
  to stare at the downstream
• 1:02:54
  symptom when the upstream
• 1:02:56
  problem is continuing.
• 1:02:58
  And we can't figure out
• 1:02:59
  why the water keeps flowing,
• 1:03:00
  but we never fixed the
• 1:03:01
  dam.
• 1:03:02
  We're rearraging the deck
• 1:03:03
  chairs on the Titanic.
• 1:03:04
  Right.
• 1:03:05
  And too often we're
• 1:03:06
  doing that.
• 1:03:07
  So thank you.
• 1:03:09
  Sanjay Bojraj, who's here,
• 1:03:11
  MD, now functional medicine.
• 1:03:13
  I don't know what he's
• 1:03:14
  all over the map right now.
• 1:03:16
  But I love that,
• 1:03:17
  that insight that you provide
• 1:03:19
  because I think there's a lot
• 1:03:21
  of people who see these
• 1:03:23
  as being too polarized worlds.
• 1:03:25
  And I love when I see
• 1:03:26
  someone with wisdom,
• 1:03:27
  as well as knowledge,
• 1:03:28
  who's standing in the middle
• 1:03:29
  of them and giving really
• 1:03:30
  good advice to people.
• 1:03:31
  And as you said,
• 1:03:32
  you can't treat a patient
• 1:03:33
  15 minutes at a time.
• 1:03:35
  And I love that you care
• 1:03:36
  that much.
• 1:03:37
  I encourage you go check
• 1:03:38
  out Sanjay online.
• 1:03:39
  All of the information
• 1:03:40
  will be down in the notes,
• 1:03:41
  as well as checking out
• 1:03:42
  GLP1 rescue.
• 1:03:44
  And any other way that you
• 1:03:45
  would like people to be able
• 1:03:46
  to go all the year,
• 1:03:47
  you can find me online.
• 1:03:48
  Instagram is probably my
• 1:03:49
  biggest channel.
• 1:03:50
  So it's at Dr.
• 1:03:51
  Sanjay MD,
• 1:03:52
  D-O-C-T-R,
• 1:03:53
  S-A-N-J-A-Y-M-D.
• 1:03:55
  Excellent.
• 1:03:56
  And he has the curious
• 1:03:57
  cardiology podcast
• 1:03:58
  where I encourage you to go
• 1:03:59
  listen to that as well.
• 1:04:00
  You've got some really
• 1:04:01
  cool.
• 1:04:02
  Here like my hot
• 1:04:03
  man, I forgot about my
• 1:04:04
  podcast.
• 1:04:05
  And yeah,
• 1:04:06
  you can go check out
• 1:04:07
  this at www.dllr.com
• 1:04:08
  as the website
• 1:04:09
  from a practice.
• 1:04:10
  So I'll see you guys.
• 1:04:11
  So if you're in
• 1:04:12
  California and you want
• 1:04:13
  seeing telehealth patients,
• 1:04:14
  I'm solely expanding that
• 1:04:15
  to other states,
• 1:04:16
  so well,
• 1:04:17
  I'll join the newsletter.
• 1:04:18
  Good having you,
• 1:04:19
  buddy.
• 1:04:20
  And we will see you again
• 1:04:21
  on AgedFightly.
• 1:04:22
  .