Aging is Inevitable But Muscle Loss and Sarcopenia Aren’t

Real quick, before we dive into this episode, I have a little sleep secret I want to tell you about. Look, sleep is crucial for your fitness, but it's crucial for just plain old everyday life and function. And I find I sleep great unless I have a migraine. And I've had more than my fair share since perimenopause all the way through postmenopause. My secret weapon was Blue Sky CBD sleep gels. Each gel contains 25 milligrams of CBD and 25 milligrams CBN for deep restorative sleep. Something about it helps to reduce inflammation, which I believe for me was key in helping me get to sleep. But the biggest thing is so many of the over-the-counter solutions, whether for sleep or migraines, can ruin gut health and liver health. Neither one of those did I want to be problematic for me. So this option is recommended by healthcare providers worldwide and backed by thousands of happy customers, many of whom come from our Flipping 50 community. There is zero THC, so it's non-habit-forming. It's made by a trusted family-owned company that we all can feel good about.

Mm-hmm.

Third-party tested for purity and potency. And if you're interested, you too can try a sample for just $6. But even better, you can get 30% off forever with discount code FLIPPING50. That's FLIPPING50. Just go to flipping50.com/blueskycbd. We'll put that link in the show notes and you'll find it everywhere on Flipping 50 at My Favorites. What are you waiting for? Good night. If you're looking for the fountain of youth, spoiler alert, it's muscle. This episode is all about muscle— how to get it, how to keep it, how to get it back if you've lost it. And listen, of all the three, that is probably the hardest. But no matter how old you are, this will lead you to believe, potentially, not the fairy tale, but the actual truth that we don't have to lose muscle as we age. We will fight it. If we let aging take its course, we absolutely will, but we can minimize that to the nth degree. And with the help of something you may hear about today on this episode, maybe there is no need to lose muscle at all. You're in perimenopause, menopause, or postmenopause, and you're not slowing down, you're just getting started. But the old rules don't apply anymore. The workouts that worked before, they're working against you now. The advice you've been given, incomplete at best. I'm Debra Atkinson, and I'm the founder of Flipping 50, the pioneer in fitness for women in midlife. For more than 40 years, I've been in the trenches with women just like you, and for the last 12, right here on this podcast and, and the founder of Flipping 50: The Stronger Way app and membership. Welcome to Flipping 50: The Stronger Way, where science meets strength, where you'll find the tools, research, and real talk to build the body and the life you want in your second half. Each week, you'll get evidence-based exercise and nutrition strategies, conversations with leading experts, and honest answers to the questions your doctor didn't get. Answers to in medical school and doesn't have time to answer in an appointment. This is your show. Let's get stronger. So spoiler alert, this episode hits home just a little bit. So very recently, I have a close relative who was going in for a routine surgery, so to speak, still included anesthesia. And in this episode, you'll hear what to do if you have to undergo anesthesia and why you'd want to do it. I hadn't even thought about that one. But this particular quote-unquote routine surgery turned into anything but. So 2 weeks later, said relative goes home from the hospital and has somewhat of a road in front of him in terms of recovery. So all of this episode really is very selfish if you could look at it this way. It's just the way timing happened. But my guest today is going to come on. We're going to talk about muscle loss with aging. And with inactivity or bed rest when it's forced or planned and what we can do about it. So if you've been in either situation or are approaching and want to be prepared in case it happens to you, this episode will come in handy. Stay tuned. It'll also give those of you who are trying to optimize your body composition, whether that's through use of a weight loss med or on your own, just building muscle, staying lean, or getting there and then staying there. You'll find out how you can optimize that. My guest today is Dr. Chris Malidas. He's an educator, international author, and lecturer. His mission is changing the world's health one person at a time. Dr. Malidas has authored 18 books and over 200 national scientific articles and journals, including Natural Health, Alternative and Complementary Therapies, Townsend Letter for Doctors and Patients, Life Extension, NDNR, and Natural Pharmacy, as well as articles on PubMed. Dr. Molita served as Dean of Naturopathic Medicine and Chief Medical Officer for 7 years at the National College of Naturopathic Medicine, now the National University of Natural Medicine. The American Association of Naturopathic Physicians awarded him the 2003 Physician of the Year. He has a deep passion for helping the underprivileged and spearheaded the creation of 16 free natural medicine healthcare clinics in the Portland metro— metropolitan area of Oregon. Dr. Miletus has been in clinical practice in Oregon for over 33 years, serving as primary care provider with a focus on functional medicine. His practice was focused on the GI microbiome, mitochondrial dysfunction— you will hear us talk about mitochondria— and nutritional biochemistry and botanical medicine. It's a lot. He's an expert, and you're going to hear it as he articulates so very well the answers to my questions. I cannot wait for you to dive into this one with me. Chris, thank you so much for being in the house and making a house call.

Hey, it's a delight. Thanks for inviting me, and I love chatting with people, and you've given me a platform to chat. Ever since COVID I've been largely virtual. So this is my social interaction for the day.

So good. Well, I'm glad we could accommodate. So we're gonna, we're gonna put you to work here, though. I, you know, 33 years, first of all, it makes me stop and think, okay, what was that like? But also, you know, I would guess as a practice, and you earn patients' trust in the same way that so many others do, and I'm sure you've seen people over the course of their lifespan. And we're talking to a group of primary primarily women listeners who were, you know, at a point where muscle becomes an issue. But talk to me, if you will, just for a moment about what have you seen in terms of what is the trend, you know, in terms of aging, and what have you watched people go through and most likely heard repeated over and over?

Sure. Well, I graduated in 1992. Back then I was younger, didn't have kids, had hair, and didn't worry about this whole getting older. And my in-laws used to say, "Wait until you get old-timer's disease." And my father-in-law is from Oklahoma, so he had Oklahoma perspective. And, but we realized we start, if we don't use it, we lose it. Very important. And that seems like a cliché or an overstatement, but no. Research shows that as we get older, we lose grip strength. And grip strength is an independent marker of how well your morbidity and mortality is. So, well, how likely are you to have various health conditions? How likely are you to have a younger or older biological age? We've all, back in the day, were carded. And it's like, oh my goodness, I got carded. I must be getting old enough. Now it's like, oh no, they start calling you ma'am and sir. Like—

That was a big—

It's like, oh my goodness. And then when they start offering you senior discounts on things, like, hey, I don't identify that way. I'm young inside. But you know what I've seen over since '92 till now is people are much more proactive. I think part of that's the advent of the World Wide Web. Back in the time when I first started as a physician, we had dial-up and remember little tones.

Yeah.

And now we have high-speed internet. We have AI. We have all these other things. I've seen lots of just more empowerment, more awareness. I'm here in the Beaverton, Oregon area. So I have Nike and Intel executives. I have the average Joe and Jill as patients, but I have really smart patients, whether they have a degree or not. And now they're applying that intellect to saying, well, Claude, Gemini, Perplexity, whatever their AI, ChatGPT 5.0, you know, what's wrong with me? What could be going on? So now— Yeah. They come in with their differential diagnosis, what should be going on, and they're causing us functional medicine providers to be that much more sharp and be ready for the tough questions. There's no secrets anymore. There's no cracking open of the medical book because back in the day I had a library of books. Now it's all right here on the World Wide Web. So I see more empowered people, smarter people, and very clever in terms of their intellectual acumen and— Mm-hmm. Applying it that nobody's going to help you unless you help yourself. And if, you know, if you have a life partner, they're going to tell you, "Do this," but still we have free will. So, now we're getting people to be motivated and educated. And I find that giving them the reasons why, you know, like for example, our conversation today, why muscle? Well—

Yeah.

It's like, "Wow." I mean, nobody even knew. Now, there's all this medical literature. Not only just grip strength, In fact, MyosMD, Fortetropin, a topic we're gonna talk about today.

Yeah.

They were actually in New York City at a conference, a medical conference called Integrative Health Symposium.

Yep.

And they actually had a grip strength tester at the booth, which was my idea, by the way. So pat myself on the back.

Pat.

And boy, did people get into it. There's competitions amongst ages and genders.

Yeah.

And who had the strongest grip. And it's like, wow. I mean, men and women alike were all in on that one. Mm-hmm. Then also our strength of our legs. You know, we think of our mitochondria, we talk about mitochondria all the time. And mitochondria, of course, are, for those that are not fully aware, is our chemistry factories, our, what a lot of people call our batteries of our cells. But where's our largest amount of mitochondria? Our skeletal muscle.

Mm-hmm.

And so now all of a sudden, if you wanna have a metabolism, what a concept, because as we get older, those things wanna hang around a little bit longer. A little hard to get rid of extra weight and so forth. But, you know, that active metabolic tissue, that strong skeletal muscle, plus who wants to take a tumble in a fall? Earlier today, I was having a conversation with an 80-year-old minister's wife, and she took a tumble, second tumble of the year. First tumble was on a pickleball court, shattered her hip. And I said, you know, I noticed her little right fingers were taped together. She says, yeah, I fell again and I broke it. She says, I'm not gonna fall anymore this year. But balance, strength, good quads, good hamstrings, good glutes, and working on our balance. And it comes back down to muscle and mitochondria.

Mm-hmm. Amen. So many things there. So that hand grip strength and booth. So as an offshoot of that, I was recruited to teach physicians how to do that in 30 seconds or less in an office, along with the sit-to-stand test. And I, So tell me, is that happening now? Are physicians actually using it as a vital sign at a doctor's visit yet? Is it becoming the norm?

It is not becoming the norm enough. And so, you know, of course we all know about the blood pressure, we know about the pulse, we know about the respirations. For years, I've done the pulse oximetry to see how the oxygen levels are. But for us, grip strength is a major, it is a vital sign, and it's a vital sign of your vitality. It's a vital sign of your vitality. And so when I give lectures, I always talk about grip strength and that how these practitioners need to be using it. But once again, it's— they're slow in adopting, adapting. And honestly, I tell my patients, get a grip strength tester. You can get it on Amazon or wherever and see how you're doing and kind of make it a little family competition. And of course, competition is often very motivational, isn't it?

Yes. And actually, it's so funny. So we're We're hosting a retreat next week and that's one of the things that goes into the bag, you know, so that in the assessment and the recovery room that we'll set up, it's— everybody will do that before they leave and understand the value of what it is that they're learning, which I think is a flip side of this does not mean walk around the house with a tennis ball and, you know, get better that way.

Oh no, yes.

What does this measure? And it's the correlation of your total body strength is so clear from it, but we are But also, I think when we, I think about my listener and I'm asking you questions thinking if she were here, what would she wish? Or if she's walking right now, what is she gonna wish I'm asking you? And I think one of the things they face is, you know, we're like, oh, I need to have that bunion fixed, but that means now I'm gonna be laid off and laid up and now will I lose muscle? And, or it's worse and it's a joint replacement or one that needs to happen and they're not doing it. Yep, but they're becoming less active as they're waiting and putting it off. And that, that, boy, that one bothers me, by the way. Um, having a client be told you should wait because it won't last that long. I'm like, no, let's just do it and hope it does and deal with that when we come to it. But talk a little bit about how could someone both proactively bank muscle for those times we know we won't be able to use the obvious in terms of exercise and what other things they could do. And I'll stop there and have you answer that question first.

Great wisdom. Great question. Disuse syndrome is what we call it. And if we've ever been in a sling, or a while ago, I ended up torquing my rotator cuff and I couldn't even raise my arm beyond here. And I had to regain that. And it's very common in menopausal women Yes. You start having rotator cuff issues and other things. And if you're having trouble opening that pickle jar or whatever you're trying to open in the kitchen, that's a sign that maybe we're losing a little bit. Of course, there could be joint issues here as well. But they did an animal study with Fortitrophen. One of the topics of the day is this raw unpasteurized egg product that is actually, it's a protein. And it actually has been shown in an animal model they actually had dogs and they had the dogs that actually took the Fortetrofen or didn't when they had basically equivalent of joint replacement. And those that actually did had the Fortetrofen didn't have the muscle loss like the ones that didn't. But you're correct. And I think the word that you said has to be really captured, bank the muscle.

Mm-hmm.

Because you don't know when something's gonna happen. Just like I tell my patients, don't run so lean that you don't have a little couple pounds around because let's say you get the flu or a cold or whatever, and then you're not eating, and now you're underweight. Never want to be underweight. You don't want to be overweight, but you want to have that lean body mass is working for you when you're sleeping, when you're thinking, when you're whatever. And you brought up a good point, um, if we're the listener, that's walking. Yeah, walking's important. And one of the things that you asked, what's changed in the course of my career? Technology. You know, my phone tracks my steps. I have a little app that says, have you done your 7,200 steps a day? And then it guilts me. Or do you have the watch, or do you have the Oura Ring, or you have whatever? So I think the technology has really became a really great self-motivator, reflecting upon how am I doing it in my own competition.

Mm-hmm.

But yeah, so what you wanna do is you want to load on the muscle before any kind of surgical procedure. And fortetropin is a consideration there. Creatine is. And then now the new big hot thing is Urolithin A. Urolithin A, of course, they've just came out with a 15% increase without exercise, which nothing is ever without exercise, but that's the claim there. And, you know, doing some creatine and then maybe some branched-chain amino acids. But the Fortatrophin, they did a study at Berkeley site by Dr. Evans, and they showed that folks that are in the older age category, that would be me and above, 60 and above, they did not change your exercise, but they took Fortitrofen, which is that raw egg product, which is totally no diseases, no avian disease, nothing like that. But it's raw, so it's never been cooked. So the proteins are alive and vital. And they found an 18% increase in protein synthesis. Well, how do you build muscle? Protein synthesis.

Yeah.

That way you eat your protein, you're doing the branched-chain amino acids, you're doing the creatine, you're doing all these things. But 18% with no change in exercise. And that was a very powerful study. And it's like, okay, wow, cool. But the other big thing that happens is you go in for a surgery and they say, well, you have to lose a certain amount of weight if you're doing a knee or a hip, for example, because you're overweight. And that ties into probably a conversation we're going to have today about GLP-1s and rapid weight loss, which we'll probably talk about in a bit about what happens if you just lose a whole mess of weight.

Yeah.

What weight are you losing? Is it fat? Is it muscle?

Yeah.

And can we afford to lose muscle? And the answer is no, because by the age of 40 to 60, there's actually a tremendous drop in vitality and functionality, some 10 to 40% drop. And by the age of 65, there's one or more daily functions that 35% of people aren't able to do. Maybe it's clipping your toenails, maybe it's walking up the stairs, or maybe it's like opening that pickle jar, whatever it might be. So, it's like we have to be very proactive and safeguard our health. And I will quote the Dalai Lama. I do not follow the Dalai Lama. I follow anybody that has wisdom. Dalai Lama had wisdom on this one. And he said, "What most surprised about humanity?" And it was mankind. And of course, he's used the generic man. And because he'll trade his health to gain wealth, then he'll trade his wealth to regain his health, all the while not living a fulfilled life. Yeah. And we're all trained, "Oh, well, once I'm 62 or 65 or 67 or 70, I can retire. And then, I can get in shape. And then, I can go on my travels." No, you want to have a moment of joy, happiness, and play now, not just when you retire. And that means staying active. Otherwise, you're like, "Okay, I'll just sit in the rocking chair." Like, no. That's an old— like my father-in-law said, "Old-timers problem." It's a play on Alzheimer's that my father-in-law does. And it's like, no, don't accept getting old. Don't accept this. We all see younger— we see younger people around us that are doing worse than us. We see older people that say, I want to be like them. And so what I encourage all listeners to do within their conditioning and health and, you know, reason, become like them. What are they doing that you're not doing to stay vital? Genetics plays a role, That's really epigenetics, diet and lifestyle. Are we sleeping? Do we have sleep apnea? Are we eating enough protein? Is our digestion good? Because as we get older, our digestion drops down, our stomach acid declines, our pancreatic enzymes often decline. We have functional medicine GI issues, irritable bowel syndrome, diarrhea or constipation, two diagnoses in the medical world. It's like, how am I assimilating those nutrients? Am I welcoming those nutrients in? And so if you have got gut issues, then are you really getting all the nutrients you're consuming? If not, it's a waste.

Yeah, yeah, I'm so glad you said that. And I think it, um, our good friend— I don't know if you know her personally, but Cynthia Thurlow just released a book called Menopause Gut. And I would say if we have one topic of the year, I think everybody's talking about gut health. And finally, I think that's a good thing because so many Women won't admit it. You know, they don't talk about it, not with their physicians often, but also not with their spouse or their bestie. It's not necessarily pleasant if you have a gut issue. It's not topic of conversation, but they don't realize how much that interferes with their ability to exercise. In my case, we're diving into that to find— And why aren't you more energetic from what it is we're doing, there's a lot there that could be going on. I want to dive into— we've kind of mentioned this, and we maybe went right over the fact that a listener doesn't know this. Talk about fordetropin and talk about when was this discovered, where did it come from, where is it, and someone can get their hands on it, because we're, we're suggesting this is an option to help them. So let's start at the beginning with this. This episode of the Flipping 50: The Stronger Way podcast with Debra Atkinson is brought to you by Alloy Health. Let's be honest, aging can come with some unwelcome changes. Sleep disruptions, hot flashes, brain fog, weight gain, and decreased libido can hit hard. Menopause is inevitable, but it's also treatable. So this, however, I find shocking, and I hear it every day. Over 50% of women wait 3 or more years to seek relief, and the reason why is almost that many never get offered hormone therapy by their physicians. And over 40% will say, "I'd consider it, but I need education." That's where Alloy comes in. Alloy is a digital health platform that connects you with a menopause-specialized doctor to help you look and feel your best. Your doctor helps you find the best, safe, science-backed treatments for your symptoms— skin, hair, weight, and sexual wellness— delivered to your door. Everything is done online from the comfort of your own home, so there's no waiting for an appointment and no waiting in line at the pharmacy. It's fast and accessible. Here's how it works. Complete your intake form. Because Alloy Solutions are available by prescription, you need to complete that intake form. You receive treatment plan from your doctor. You're matched with a menopause specialized physician who creates a personalized plan tailored to you, and you have unlimited access so you can message them anytime. You get a 3-month supply. Once approved, Alloy will ship that prescription to your door with automatic refills. Look, in our community, I hear that too much. Women are symptomatic and can't comply with fitness they want to do. There's no reason that has to be true for you. As for me, I am 5 years post-menopause. Here's what's been bugging me most lately. I went from tons of compliments on my skin, like, "You have no visible lines and wrinkles," Holy moly, I suddenly have all the signs and wrinkles and enlarged pores. Where did that come from? And what I found is my way to two products through Alloy: Esserol Enhance Cream, use nightly, and tretinoin. I found my way back to it to support with slight discoloration and those pores and get them back on my side. Look, if you're ready, join the 95% of women who've tried Alloy and saw relief in the first 2 weeks. Head to myalloy.com, use the code FLIPPING50, tell them all about your symptoms. You'll get a fully customized treatment plan, unlimited messaging with your doctor, plus you get $20 off your first order today. Head to M-Y-A— My Alloy. L-L-O-Y dot com and use code FLIPPING50 to get $20 off your first order.

So, Fortetrofen has been studied for a long period of time, lots of scientific studies. So if you type in the word Fortetrofen, I'm sure you'll have a link for the listeners.

Yeah.

There's a professional brand called MyosMD, and there's a consumer version called Yoked. It's been in the health industry for a very long time with huge following because people that have great rotator cuff muscles and biceps and triceps and all those things, they've been actually fueling their bodies. And creatine's been around forever. Before it was discovered and the initial research by Bill Evans and Sharp and others, which we can put a link in for everybody that wants to read the literature. I always tell my patients, feel free to read the literature. If you don't feel like you want to spend the time reading the whole journal article, throw it into a GPT or something or a Claude, and it'll read it for you and at least give you the thumbnail sketch of the takeaways. And it's like, but it's nice to see that there's literature. I always like, as a clinician, my responsibility is to ensure that whenever I'm talking to one of my patients, which today I'm just, you know, sharing my general information, not diagnosing or treating, but it's like, I want, I'm the one responsible for vetting products for my patients. Yeah. They're expecting me to apply my science, my clinical experience, and my approach is simple. What would I do for a mirror mine? So my wife's a vegetarian in large part.

Mm.

And she, but she doesn't like eggs. So eggs to me in a baked good, it's good items, but she's not gonna eat an egg. She does not do fish. She does not do meat. So she's a carbo vegetarian is what I call it.

Mm-hmm.

Because it, and it's like, okay, well, where are you getting your protein? So I snuck protein in on some Greek yogurt for her. But I also realized that I saw some aging process, a couple years younger than me, but I saw her seeing that she's losing the muscle mass in her forearm, her grip strength. And so I included Fortetropin for her. So my approach is, would I do it for me or mine? Would I recommend it for my family or would I take it? And so the answer is yes. And therefore that's how I make my recommendation. And the trick that I've used for my wife is mix the Fortetropin powder, which looks like an egg yolk. It's a color of a, egg yolk, because that is what it is, and mix it in with your Greek yogurt and so forth, and then it just kind of disappears. If you try to mix it with water— oil and water doesn't mix— that, good luck there.

So, very cool. And I want to say there's a couple ways. So what is the difference? So one is the clinical version. Are they of the same strength, different strengths? Is there a reason why a consumer might wanna do the medical or clinical version?

I find the medical version very handy because it comes in a canister, it's right there, like when you're making your smoothies and so forth in the morning, which I'm big on smoothies and adding some berries and so forth for those antioxidants. And so I think there's a good convenience, plus it offers a very nice 13.8 grams, a very common dose of Fortetropin, 13.8 grams. And so as a result, you know, it offers that, easy canister there. The egg, the Yoked product comes in little zip packs and you can go ahead and open it up. But I like to have the medical version. That's because I'm a medical provider, but that's just kind of the way I like to go. But in the case of Yoked and MyosMD, unlike other products in the marketplace, there's only one source of it in the world. And that's through MyosMD or YokedMD. And they actually are also very big in the veterinary world. In fact, they have like, I think, 3,000 veterinary hospitals that are using it for animals. And I love my fur babies. Most of us do love our fur babies. And once again, so I said me and mine. Well, that includes my animals. Well, would I give it to my animals? The answer is yes. And the veterinarians are giving it to the animals. And they're doing it for a reason because the animals are just happy-go-lucky. And then they, okay, I have to go to the vet. Trauma, trauma, trauma, right? And then— Yeah. They're like, okay, well, my animal's doing better. You know, they don't know what's going on other than good intention and love. But here's the Phototrophen and it's like, wow, it's helping my animal. But that's the placebo control. Other than, of course, giving our animals lots of love, which we do anyway. It's like they don't know. And it's like, wow, I'm seeing my animal not ambling along with such great difficulty or seeing like the disuse syndrome because animals have to have surgeries too. The larger dogs with the hips and all the— Yeah. Joint dysplasias and so forth, or the knees. And so yeah, I think it's just animals, humans, it's just a great consideration. Now clearly, if you have an egg allergy, a true egg allergy where like if I eat an egg like Jonny eats a peanut and Jonny can't breathe, clearly don't do it if you already are avoiding eggs in your diet.

Bad choice.

Yeah, and kind of, this is the same thing with like when you get a hot cup of coffee, it says contents are hot. Fire is hot. You know, it's like, you know, we have labels for a reason, you know. And so I was like, okay, so, you know, if something looks sharp, it probably is. If something's in a hot container, yeah, it's probably hot. And if you have an egg allergy, it's clearly not for you. From an egg sensitivity perspective, because there's allergies and there's sensitivities, it depends how much a person's being regimented or aware. Are they totally avoiding eggs, or is it in their baked goods? They kind of make that personal choice along with their healthcare provider. But— Obviously, if you have an IgE anaphylactic egg allergy, like I have a latex allergy, found out 7 years ago. I was giving a lecture down in Las Vegas at the A4M conference, very large conference.

Yeah.

Someplace like J.J. Virgin and other people lecture.

Yeah.

And 3 days beforehand, my wife made this wonderful guacamole. She sliced some green and yellow kiwi. I didn't know there was yellow kiwi. And so, I had kiwi, I had avocado guacamole, That was my meal. And all of a sudden I said, I feel tingling in my lips. Then my lips started swelling, then my face started swelling. First time I ever had an anaphylactic reaction to something. So now I avoid latex. So if you offer me a banana or a fig or a potato, yeah, of course I say no thank you because I don't wanna go there again.

Right. Yeah, once is enough for that.

Yeah, once is enough.

Oh goodness. So was this before you spoke or after?

Before. 3 days before I hopped on an airplane from Oregon to Vegas. And then of course, you know, I'm at restaurants in Vegas and it was like, are you using latex gloves back there in the kitchen? I don't wanna do it. And by that time, because I had 3 days to get myself an EpiPen, I got myself an EpiPen. I was walking around with Benadryl, you know? So I was like, it's funny in retrospect, but it was scary at the time.

Yeah, I bet, I bet. Okay, let's talk about this. Post. So we would bank ahead of time, we're thinking about it, premeditating, and we get— we're the lucky ones if that's true, really. But, um, you know, I've alluded to the fact, you know, I have a close sibling who just had what we thought was a routine second shoulder surgery. That's never fun, but, you know, it turned into anything but. So 2 weeks later, he gets out of the hospital and there's several things that have happened. So, he's got a long road and he didn't have the luxury of banking. He thought he was in good shape going in, but he thought he was gonna be walking around the next day. And, I think that happens to a lot of people. All the time. You know, we don't plan all these things. So, what would you do, you know, coming back to your me and mine, what would you do if you're like, I'm gonna, you know, be very limited on my activity for the next 6 to 8 weeks? What do I do?

What I would personally do is of course make sure I'm taking care of my mitochondria. Whenever we go under anesthesia of any sort, like propofol, and we think Michael Jackson or Joan Rivers and the propofol incidents, lots of these anesthetics actually poison our mitochondria. Lots of various medications poison our mitochondria. So that intervention is something to consider. So doing things to augment the mitochondria, not diagnose or treat, but CoQ10, a product called TruNiagen, which is an NR, nicotinamide riboside chloride molecule to help NAD+. Most of us are very familiar with NAD+. And so kind of mitigate some of that. And then I would say for the next 6 months after I have a surgery, whether I banked or not, I'm doing Fortetropin. And I— that's why I do it. That's my protocol for my patients for the next 6 months after a surgery, because you also have to remember you're trying to heal. Yeah. So, they go in, they repair things, they separate the muscle, everything just gets ajar. It's kind of like opening up the back of our computer. It says, "Do not open up, you'll void your warranty." So, the moment we open up the body, sometimes unwillingly, we have to make sure that happens. And, that's what— if I had known about phototropin before I had my hernia surgery, I ended up helping my 2 adult sons move. And, they were on one side of the U-Haul ramp, I was on the other side with a 300-pound dresser. And I'm like, okay, I don't think I— that doesn't feel so good. And they're struggling on their side. I just got the one side by myself. We call it old man strength. And then I went ahead and it was in June of 2020, in the height of COVID My wife drops me off to have my hernia surgery. And then I'm recovering from that. And they say, don't do this and don't do that and be cautious and you have to do— So I had a disuse syndrome and that's when I loaded on quite a bit of weight. Because I was inactive. Everything kind of hurt. It was sore. And then they're saying, don't do your weightlifting. And I loved going to the gym. Now I'm not going to the gym. And so if I had to do it over again, I would have banked, like you said, you know, a good 2 or 3 months ahead of time if I knew a surgery was coming up. And then for 6 months after minimum. But a lot of people are using Fortetrofen as part of their daily supplementation routine, knowing that the muscles, the mitochondria are so critical. So I look at muscle, I look at mitochondria, and then I look at the other M, the microbiome. And those 3 Ms are really the end-all be-all. So you mentioned the gut. So whether it be the gut microbiome, oral microbiome, and then we have the mitochondria, and then we have the muscle. Those 3. So just think of it as the 3 Ms.

Got it. Okay, so you— your answer here may change, may very well change the way I use my Yoked and MyosMD. And I kind of I flip-flop back and forth between them, to tell you the truth. But I also have, you know, I feel like I'm right where I wanna be, and yet I'm very keenly aware of, well, that could be me. Why them, not me? And I just need to, it's a good wake-up call, at least that you get to watch from the outside if it's not you. But it's, hopefully we're all learning from watching someone else. And I every once in a while think, you know, okay, I'm doing all right, but you know, it would be great to have a little more in the bank. And so I will rotate in use and focus on it for 2 to 3 months building, and then say, okay, well, I'm gonna maintain this and see what happens at this point, and then I'll rotate it in again. So talk to me a little bit about that. If you've got somebody listening who would like me feels like I'm kind of at a maintenance level. And yet we're keenly aware that, you know, life is not as predictable as we might think that it is. What would you recommend in that case?

Well, I have patients and included my osteoporosis patients, because even though phototropin has been studied for muscle, some of the same mechanisms also apply for osteoporosis. So they can muscular skeletal. So, we always—

Yeah.

Unfortunately, in today's world of medicine, we have the specialist, the eye specialist, and there's different subspecialists. We have the heart specialist and there's subspecialists. We go to our GYN or our male urologist, but then you're going to go, "No, you're going to go to this specialist for this problem." So, sadly enough, that same mindset of medicine has came to, "Well, I'm treating my muscle. I'm treating my bone. I'm treating my metabolism." Yeah. You're treating it all together. And, Mm-hmm. You know, with all your expertise, weight-bearing exercise, most important thing for osteoporosis. Yeah, you need your vitamin D, you need your calcium, you need to make sure you're not, and you got your protein on board, but, and the collagen. But, and a lot of people forget collagen with osteoporosis. Like, oh my gosh, collagen's critical.

Yeah.

And it's not just for a pretty skin, it's also, it's kind of like what I call internal oil of olé. It's like, you're just like you do essential fatty acids, you have to take care of the inners to take care of the outers. And the skin, even though we're not supposed to judge a book by its cover, it kind of reflects how we're doing. And we all have friends and family, we haven't seen them for a while, we get to a family function or a social and like, I don't think they're feeling very well. They're a little green around the gills, not literally gills, but you get the idea. And it's like, hmm. So what I would do is I would just routinely recommend it on an ongoing basis as the budget allows. And as one's personal healthcare provider recommends it as well. Now, could you rotate it? Can you cycle it as you're doing other things? Because, yeah, of course you want to make sure you're drinking enough water, your kidneys are working well. And when you have good muscle mass, of course, you know, when you tear it up, you tear it up. And of course, the kidneys suffer. And we know people that are very thin, even that do marathons, they'll actually even have some bleeding from the kidneys from just having torn up all that muscle.

Mm-hmm.

And so I think the rotation concept's fine. But I also have patients that take it long-term just from a preventive, proactive perspective. I've just recently had 2 patients which were in motor vehicle accidents. One had a terrible whiplash and they can't barely even walk, sit, or stand. And it's like, wow. I mean, once again, sadly enough, you never know when the next shoe's gonna drop. And that guy named Murphy and Murphy's Law sometimes enters our lives.

Yeah. Darn it. I know.

And who invited him?

Exactly, exactly. Talk to me about this. Is there any evidence or even anecdotally, have you seen this where taking it, again, kind of in the case of somebody who, and it could be anybody, a beginner, it could be somebody who tends to have greater soreness because I find it is just, you know, probably the luck of the draw. And it's very unique to the individual, whether they will or they won't experience soreness after workouts. Is there any benefit to Fortetropin for enhancing recovery?

I've seen it again and again. And I meet my patients wherever they are. They meet me wherever I'm at. And I am a coach. Ultimately, as a good healthcare provider, we're coaching people. We're inspiring them. We're giving them the tools, but they're gonna do the work. We're just the resource for them. And so I just say I'm an overeducated service provider. And that keeps me humble, but that's all I am. You're either going to like me or not. You have good service at a restaurant, you go back to restaurant. You have bad service. So you meet the patient where they're at, you inspire them. And the key here is to go ahead and support them. And do I find people that overtrain? Yes. And the way we define overtraining for me in my practice is if you've exercised and you haven't recovered before your next exercise, you've overtrained unto where you're at. But one of the things that I find often is a little off topic, but not. But if we think about how long can I live without food, in my case, a very long time. How long can I live without water? About 3 days, give or take. And how long can I live without air? Not so long. And I don't want to try holding my breath, but I mean, give me a minute or 2 and then I'm kind of outta. And so, but how many people have undiagnosed sleep apnea? I remember diagnosing 2 women. One was 103 pounds. Wow. One was 105 pounds. You said, oh, there's no way in the world they have apnea. But they have very small everything, small nose, small airways, small this. They both had apnea. One came to me routinely asking for benzodiazepines and drugs because she's always anxious. She couldn't sleep because she was autosuffocating at night. She never startled awake. She never snored. Never— neither one ever snored. And the other one was having gut issues because her mesentery, her intestines were not getting oxygen at night. Hmm. And so those were symptoms. And so imagine you're working out and you end up with that problem, which comes to a personal story. When I was 36 years old, I decided I was going to get back in shape. We all had those little weekend warrior things, and it wasn't a New Year's resolution, which is, hey, I'm going to get in shape. So I decided to grab my 20-pound dumbbells, which were light for me. I used to do 70-pound individual curls. I said, okay, I'm going to just grab— I cranked out 100 reps and went to bed. The next day I could not move my arm. It was literally like this. And this was back in the '90s. I'm dating myself a little bit. You can do the math. And I had a briefcase. That's when briefcases were in, right? And even with the briefcase, my arm was like this, like, okay. And I said, "Boy, it hurts." I said, "Well, now that I'm getting in shape." So, I ordered my own blood work and my liver enzymes were elevated. Everything, I was like, "Oh my goodness, I'm dying," I thought. And I mean, once again, this is called medical school syndrome, by the way. And it's like, okay, you start ending up with the problem of whatever.

Of course.

Yeah, of course, of course, of course. And so, lo and behold, I said, my liver enzymes, normally they should be below 40. They were 400 and something, both the AST and ALT. Back then they were called SGOT and SGPT. Sometimes they're still referenced that way. And I said, what I found was I didn't know I had apnea. I was a buck 85, 6 foot 1. And I went to bed having engorged my muscles. And I had, at that time, still fairly large arms from having all my heavy lifting days. And I went to bed and I basically might as well have put a tourniquet around my arms 'cause I went apneic. And I didn't know how bad my apnea was, but when I was dating my wife, I would always say, "Hey, do you mind if we pull over so I can take a nap?" I had to finish that story with a little dramatic pause. And it's because like, wow, you mean while you were dating, you actually pulled over and asked your wife and she— we're still married— to, um, take a nap. Yes, I took a nap because I was tired. But I— now, at that time, I was 6'1" and 165 pounds. And it's like, because once again, we don't even know you have it. So there's a home sleep study I tell everybody to do because you have to oxygenate the body. And the test— I don't work for them— it's called lofta.com. It's self-directed patient test, lofta.com. And right now, I think the test is $132. You get the little kit at home, use your little smartphone, and then a sleep medicine doctor will tell you thumbs up, yeah, or— So you can imagine working out and this whole story, this whole rabbit trail came from, am I still sore after working out? And it could be something as little as having undiagnosed apnea, 'cause you're not perfusing your tissues.

Mm-hmm.

So I'm sorry for taking all that time, but you got me on a rabbit trail.

Yeah. But you've seen Fortetropin actually help recovery. Yes.

Yes. There's no question.

Yeah. When I think that just needs to sink in with a lot of women. And I think back to the, the issue of, you know, you mentioning your shoulder and how common that is. Thanks to Dr. Vonder Reit, you know, we have the name for the term now, musculoskeletal syndrome of menopause. And for decades, you know, myself and other trainers or physical therapists, chiropractors would get together and say, what is this? Like all of our 40 and 50-something females, they get these chronic injuries and then they keep them and they're recurring. They keep coming back. We know it's got to have something to do with hormones, but we never had a name for it. So thankfully, at least we have a— a name for that cluster. And I won't say the second word that should go with that, but—

I think we can figure that one out.

I think you got it.

Yes. And see, the thing is, you saw it. And see, that's the beauty of empirical healthcare providers, coaches. You're seeing something, but until it's officially in the medical literature, it doesn't exist. But all of us see things. We see these patterns, but then it has to have a name before it can officially exist, or a diagnosis. Is it fibromyalgia? Took forever to get that diagnosis. Now there's long COVID, whole nother thing. It's like, oh, well, now it's officially kind of a working diagnosis through exclusion, largely. You have to rule out all these things, and now you have long COVID, whether it be from the vaccination or from having had the COVID um, virus itself, or some combination thereof. And it's like, wow. But once again, until it hits the literature— but we must not allow ourselves to be limited by labels. You saw it. And so back in the day, before it had that label, I realized there was a hormonal component. So I'd often give my patients some progesterone. And there was a link between lower progesterone and more frozen shoulder syndrome. So yeah, not recommending that without, of course, talking to your doctor, but you get the idea.

Yeah, obviously. Well, I think you, you have done a great job here opening our eyes to the fact that supplementing for muscle is not just about strength, but it's also about number one, protecting ourselves from instances where sarcopenia can sneak up on anybody if you are forced to bed rest, it's spontaneous because you're trying to avoid pain for one reason or another. But also, I think what people don't think about or don't connect, at least in, in the discussion of a supplement like this, is the osteoporosis or the bone density part of the factor. And, you know, obviously we know the relationship is there. If we strengthen the muscle, it's pulling on the ends of a bone, we get bone density that way. But bone is directly made up of protein, and so hence that and the collagen both fulfilling that. And nod to the pet, so we've got some on the shelf for Moses as well.

Yes. And if we think about osteoporosis, and I'm thinking about a patient I talked to a week ago, she's 74 years old, she's 130 pounds. She has 4 markers for osteoporosis, 2 for osteopenia. Osteopenia is a preamble to osteoporosis, full-blown weak bones. And I says, "Well, have you ever thought about a weight vest?" She said, "My trainer told me about that just a day ago." Mm-hmm. 'Cause think about weight-bearing exercise. So she's slight of build, and so, and she's also slighter built on top, if everybody knows what I mean by that. She's not carrying a lot of mid-thoracic weight. And so I said, why don't we consider, you know, starting with a low amount of weight and a weight vest? Of course, talk to your doctor again, talk to your trainer. But, and so she's doing that, but her personal trainer actually recommended that. And I independently said, well, why don't we do that? Because— but think about when you load on muscle, now you're bearing a little bit more weight, but it's good weight.

Exactly.

It's healthy metabolic weight. So now all of a sudden, if I load up weight— and I always like to remember when I'm growing up, I watched WWF and WWE, the professional actor, um, phenomenal physical shape individuals. But it's like, would I ever call any of those gentlemen fat? Like, no, because we all get stuck on a BMI. So I have a gentleman that was a personal trainer. He's now deep in this, and he's still doing personal training, but his calves were the size of my thighs and his biceps were the size of my calves. And I'm not a small fellow, and I— but he just constantly was ripping up his muscles just existing. He was one large metabolically active happy fellow. And, and but we also know that now the muscle produces something I'm sure you've talked about at other shows, myokines and exokines. It's the largest hormonal-producing organ in the body. You say organ? Muscle is an organ? Yes, it is the largest hormone-producing thing in your body. So it helps with your immune system, helps with controlling inflammation, unless you're overdoing it, then you back it off a little bit.

Yeah.

And of course, hydration comes in, and of course, oxygenation while we're sleeping. It's like, wow. It's like, gotta take care of our muscle because our muscle's been taking care of us. Takes care of us.

Yeah, absolutely. And I think definitely we've used that before. And I mean, it is, you know, the greatest organ of longevity, but it acts as an endocrine organ.

Yes.

Yeah. And it helps so much. And we talk so much at Flipping 50 about the, interaction and integration of hormones and, and exercise, and exercise and hormones. And there's no way to separate the two. But I think now collectively we're all coming around to this conversation and we're getting it. And it's so great to see that strength training is no longer just about, you know, my mirror muscles, we used to call it, you know, when I taught in kinesiology, it was— you'd see the guys in the gym you know, pumping up before the date on Friday night. But it's so much more than that. And, you know, no longer— knock on wood— at least less or so are we using exercise as a weight loss strategy. And it's instead, it's, you know, I think you alluded to this earlier, it's about living the bucket life instead of having a bucket list.

Precisely.

Yeah.

And then we throw on some GLP-1s. A lot of people are losing weight with GLP-1s.

Yeah.

And we're generally an overfed, undernourished society. That's why we have often more calories, not because we made terrible choices, but our food quality has dropped dramatically over the decades. Whether you call it pesticides, herbicides, forever plastics, the parabens and the phthalates in your shampoos and shower gels, all these things are hormone disruptors. But when we start doing a GLP-1 and we're already or maintaining our weight on a certain amount of calories, GLP-1 kills the appetite. Now we are eating less of those same foods.

Yeah.

And then all of a sudden, what happens? Our nutritional status goes down, and we start losing more lean body mass, or at least are at the risk for it. And so Fortifrofen is a great tool for also those people that are actually lose doing a GLP-1. And then what's happening? You're losing potentially lean body mass, you're eating less protein, you're eating less carbs, you're not fueling your body. So how are you going to maintain your muscle mass? And that's not picking on GLP-1s. What happens if I just all of a sudden started cutting my calories down to 500 calories a day? Um, and it's like, of course we're going to start losing muscle mass. So this is also a great adjunct for those people that are doing GLP-1s, in my opinion. Of course, individual results will vary. Yeah. Talk to your doctor. But it's like, wow, why wouldn't you conserve it? Because you want to lose your fat, but you don't want to be losing that lean body mass, which as we're getting older, it's hard to get back once we lose it.

Yeah.

It's a, it's a, it's the, the curve that, you know, it's like, this is when we're younger, we regain things like, okay, now this is us climbing up. And it's like, you know, don't, don't want to get start at 5th gear at the bottom of a very steep hill. So you gotta, gotta protect it, protect it, protect it. With Lean Body Mass.

Yeah, I totally agree. And I think, you know, with the number of people— and there are probably more within our Community that are using it who don't volunteer their experience because I think there's still a stigma and they feel like they'll be judged if they let us know. But for those who have come forward and said, "I've been doing this and here's what's happened," You know, a lot of times we, we have not seen in them the loss of muscle so much, but we've seen, and they've recognized, that they're eating so little, they're too tired to exercise.

Yes.

And so that becomes the alarm for them, that I don't even have the desire or the interest and the ability. I don't have the energy because not just protein, but overall micronutrient density is so low because they're— they just have no interest in food.

Correct. And you're 1,000% correct. So then you're not fueling your mitochondria. And I give the example of a Chevy Chase traveling America to go to Wally World, and you only have vapors in your car, your station wagon. You have to have more than vapors to fuel your body. As you and I are sitting here, 20% of our oxygen goes to our brain. 20% of our blood sugar goes to our brain. So if you're underfueled, you're underperforming.

Mm-hmm.

And the other big thing is when we lose weight, and this is a little off topic, but since I have your wonderful audience, thanks for inviting me again, we're losing toxins. So today I'm being exposed to indoor air pollution. I have forever chemicals I've accumulated over my 60-plus years. And it's like, okay, well, I have today's toxins, I have yesterday's toxins now liberated from my fat cells. What am I doing to fuel the detoxification pathways? And one of the big side effects of GLP-1, other than potential lean body mass loss, is constipation.

Mm-hmm.

And there's a lovely little chart for those that are adventuresome. You look up the Bristol stool chart, B-R-I-S-T-O-L stool chart, and you'll see, well, where does your poo fall on the list? And there's a reason as human beings, we pick the stall furthest from the door in the bathroom for privacy. Or when you have to raise kids, what did they do when they start learning to potty train and they're aware of the bowels? They go hide behind something, they go potty in their diaper. And it's like, we haven't outgrown that. But now we're not talking about poo adequately. So we have to make sure we're having good bowel movements while we're losing that weight. And that we have the micro and macronutrients of vitamins and minerals to support phase 1 and 2 liver detox, and phase 3 kidney sweating and stool elimination. So otherwise you can stir the pot, so to speak, in terms of risk losing weight too quickly.

I see what you did there too, by the way. Okay. So very good. And I'm so glad you tapped into that because I think it is first, it's a discussion when somebody's thinking GLP-1s, it feels like almost a moral dilemma, like, "Shouldn't I be able to do this on my own?" And then it becomes something else that you hide and you don't want to do. But that means you're not getting the help, potentially, and the support you need to take care of all the components that are— it's not just weight loss, it's so much more. It's your metabolic health going forward and what that will look like. Of all the things we've talked about, when we're talking about maintaining our musculoskeletal health and our metabolic health to, to have the lifespan that, that includes the healthspan. So our last breath is really a healthy one, and we get, we get as close as we can to that anyway. Is there a question that I should have asked you, knowing that you're talking to women who not only are making decisions for themselves, but they influence potentially 3 generations.

And your wise woman question, women have kept us alive. And I often give the example of back in the caveman days, you know, Velma and, you know, Mary met at the bush and said, "Hey, there's people over there, pretty good." And the husbands are out there with little sticks like, "No, we should be more sociable." And then they start saying, "You know, when I make my soup, I do it this way." And health information's always passed through women. 70 to 80% of my practice is female. And they drag in, if they have a male partner, they drag in their male partner, they drag in their male kids, because often it's not until one thing particularly isn't working that we get a male patient in. And, and there's like, okay, well, then they're heavily motivated. But no, women are the conduit. You folks are taking care of not only this generation, but the next generation. And I think I think you've covered it. I mean, you're very wise in the questions you had. I think hydrate, clean water, clean air, great sleep, and really eating with intention.

Mm-hmm.

And one of the things I've shared with my patients is take the moment to be present with your food. It might be prayer for some people, might be just an affirmation, but I've had patients time and time again that they, eat while working. I know, create a time to say, let these nutrients enter my body. Let this water be clean and pure and flush my body and envision and manifest. It sounds very esoteric, but it's really a mindset. Imagine if you and I, instead of being here in North America, was sitting around the Riviera and there's a little Mediterranean, there's a little breeze, a blue sky, there's a little veranda. Mm-hmm. And we're digesting our food versus right before or right after our podcast and before we get to our next thing. We, you know, this whole concept of allowing our body to be in the parasympathetic versus the sympathetic. Sympathetic being the fight or flight or fright. So, just allow ourselves to be more chill. And that comes back to the bucket list. Enjoy just some peace and harmony now.

Beautifully said. What a great way to close. So, from muscle to mindset. Awesome. Thank you so much for being here and for your time and your expertise and sharing what you know to be true about the benefit of muscle and fortetropin and its role in— and I think it's a really exciting time when we have these things available to us and we're becoming so much more aware of we can change the way we age by doing this.

Thank you for your platform, and thanks for being you.

Thank you. So there you have it. That was a lot, right? But we discussed really how you can bank muscle for those times that are predicted, expected, and in your future, and how you can get muscle back and mitigate if you're faced with something that surprises you, completely blindsides you, or otherwise just wasn't in the cards until it was. And in the show notes, in resources, I will put for you the links to Fortetropin, whether you want to try it in the form of Yoked or MyosMD, the links to Urethelin A through Mitopure, and a very special discount for our Collagen Boost. It's an unflavored collagen with Fortigel, which is a patented version used for muscles, but it's got 4 unique strains of collagen for hair, skin, and nails, for joint health and bone health as well. And as a special podcast listener, there's a code in today's show notes for 10% off. The information shared on Flipping 50 the Stronger Way is for educational and informational purposes only, not intended as a substitute for medical advice, diagnosis, or treatment. Always consult your physician or qualified healthcare provider before beginning any exercise program, making changes to your diet, or adjusting any medications or supplements. Individual results may vary. Debra Atkinson and Flipping 50 are not responsible for any injury or adverse outcomes resulting from information presented on this podcast.