Dr. Tyna Moore: The TRUTH About Metabolic Health Nobody Is Talking About | TUH #109

Obese children come from obese parents. We could say it's all the foods, the lifestyle, but it's both their risk and rates of obesity and metabolic compromise are so high compared to a child who's born of a mom who's metabolically sound.

Metabolic dysfunction is the root cause of essentially every disease that we have.

People don't realize when they hit type 2 diabetes, that's decades of damage. It's really a terrible place to be. And yet we so casually are like, welcome to the club.

You have a chronic condition and your physician isn't at least bringing up to you dietary and lifestyle changes. Then the really not getting to the.

Root cause of, yeah, they're not doing their job. We have to do it all. People want to say, oh, it's this, or there's this magic bullet or there's this magic shot, and it's not. It's the work.

Why is metabolic syndrome creeping down into younger and younger ages?

I think for children especially, it's a double prong problem, because.

Ultimate Human. Hey, guys. Welcome back to the Ultimate Human podcast. I'm your host, human biologist Gary Brecker, where we go down the road of everything. Biohacking, anti aging, longevity, and everything in between. And today's guest is actually somebody I spotted on my own on the. On. On the Internet. I actually really loved her interview on Diary of a CEO with Stephen Bartlett. I've been on that podcast a few times myself. He's amazing interviewer, and I was just like, wow, this doctor has a story to tell. And I forget how we actually came together. But luckily for you guys today, Dr. Tina Moore is on the Ultimate Human. Welcome to the Ultimate Human.

Thank you. I'm so excited to be here. I'm such a fan of yours. So this is.

Oh, really?

That makes me feel better. Yes. Well, I'm a biologist, too, so, you know, in my heart. So I think we'll have a really fun conversation now.

I'm a human biologist. I, you know, I. I fell in love with science. I just found it fascinating, and. And I also found that it made a lot of sense. A lot of things in school didn't make a lot of sense to me. English, you know, philosophy didn't make a lot of sense, but for some reason, you know, biology just made a lot of sense to me, and I've luckily been able to make a career out of it. But you're a naturopathic doctor and a chiropractor. I actually went to chiropractic school.

You did?

Yeah, I went to National College of Chiropractic.

Amazing.

In Lombard. Where'd you go to chiropractic?

I went to two western states in Portland. Okay. So kind of the sister school.

Did you go to naturopathic school here too?

I did.

Okay.

I did them concurrently, which is crazy, but.

Wow, that's tough.

Yeah. I don't know what I was thinking, but here we are.

And, and you know, I, I, I'm, I remember watching your interview with Stephen. I know a lot of people might not fully understand what a naturopathic doctor is. I mean, the name sort of tells you a lot about it. So enlighten us a little bit on what that entails in terms of training.

It is, it's a four year medical program. And in the state of Oregon, we're considered primary care physicians. We have a full license to prescribe, full scope.

Wow.

It's not the case in every state, though. Not every state's licensed. And really the way that I think about it is when people, people tend to understand functional medicine. We are the grandmother of functional medicine. Functional medicine was really appropriated out of naturopathic medicine. And it's truly the root cause medicine. And it is the idea that we utilize nature and the body's innate healing abilities, which jives with chiropractic as well, that the body can naturally innately heal itself. The cool part about my training was I was blessed to have an incredible mentor who taught me really, the art and science of blending allopathic medicine with naturopathic medicine. So I always say, you know, I have a license to prescribe and I'm not afraid to use it because I like that. The goal is, is really the way I describe it is if a patient comes in a litany of pharmaceutical drugs, it's my job to improve lifestyle and function and help them get a leg up so that they can start implementing some of these lifestyle strategies. Because it's not that easy. It's not as simple as saying here, do all of these things that are super overwhelming and good luck, and then we can hopefully get the medications down to a dull roar or out. But, you know, I think that there's a way to utilize both and do so in a really elegant manner.

I love how you say address their lifestyle because I think that that's the, that that's the missing link, in my opinion, in, in all of our approach to modern medicine. And, and I don't, I don't say that to necessarily attack modern medicine. I just think that if you, if your physician's not talking to you, and you have a chronic condition, or you're, you're obese, or you're struggling with some kind of chronic disease, or you're struggling with autoimmune condition and your physician isn't at least bringing up to you dietary and lifestyle changes, then they're really not getting to the root cause.

Yeah. They're not doing their job.

Yeah.

We have magic, whatever it is. And it's not, it's the work. You have to put the work in every day.

Yeah.

And you have to optimize your wellness the best you can.

And we're all journey and emerge from that. Maybe it was drug and alcohol addiction, maybe it was a relationship, Maybe it was they had Lyme disease and they went on a, a journey of their own and they figured out this solution. You know, these are the most passionate, purpose driven people that I find make the biggest impact on, in the world. And, and almost everybody that's sat in that seat on the Ultimate Human podcast has had a journey like that. And I, I heard you talk about your journey with your mother, and it was very compelling to me because I think it's very typical of, you know, like, like the dentist always has the cavity and like the contractor always has the drywall that needs to be repaired.

Yeah. And.

And you talked about how, you know, here you were this functional medicine practitioner, emerging functional medicine practitioner, and your, and your mother was suffering from a chronic autoimmune disease. And I wonder if you might talk a little bit about that because I feel like that is probably a large part of your drive and your, your commitment to your craft.

Well, it. My mom, actually, I was telling you earlier that I specialized in prolotherapy years and years, long before it was cool, decades before it was cool.

And finally becoming non woo woo science, I hope.

I feel like we're losing it. I feel like people are not doing it as often. But I first became interested in that because I began working for my mentor, Dr. Rick Marinelli, who was doing what I thought was magic in his clinic. And he told me that there was a way to regenerate joints. And I was like, what? Because my mom's had. My mom had had a really long history of hip issues, lots of surgeries as a child. And her other hip was of my utmost concern. I'm like, we gotta keep mom's other hip good. So that kind of started me into really taking the path down. That's why I got my naturopathic license was so I can inject people. I mean, it was like I needed to be able to inject and also prescribe, more importantly, so I could take people off their hips. Pharmaceuticals. If you can prescribe them, you can un. Prescribe them. And then I spent 10 years in clinical practice, really busy regenerative medicine practice. And I, like you, had so many gadgets in my clinic and doing IVs and ozone and all of that. And then I actually left clinical practice in 2018 and started shutting it down because I was hitting pretty severe burnout. And then in 2019, my mom just got taken down with Crohn's disease and I was not paying attention. I was.

It was sort of happening before your eyes, but you were not.

I was not paying attention.

Yeah.

And she kept telling me she didn't feel good. And my mom never complains. My mom was a tough little gal. She called her my little mama. She comes up to here on me and, you know, when I hug her, I put my head on her chin on her head, and she was struggling and wasting in front of me. And I have this weird clairvoyance where I can kind of see the reaper after people. And I'm usually spot on. And she was in my apartment and she came out of the bathroom and I looked at her and I was like, oh no. Like she was in black and white. You know, I, I was telling you, we were talking about vitality earlier. I see people in color and like an aura. Yeah. There's like various shades of vitality. And there's some people that just beam sunshine and they're so healthy and they glow and it comes booming out of them. And then there's other people that start to go into grayscale and that's how I can gauge how healthy they are, how hard I can hit them with a therapy.

Yeah.

It really depends on what that vibration of their vitality is, which I know sounds woo, but I know you understand.

Not at all. You know, I. And I don't really don't mean to cut you off, but I, I think some of the oldest medicine in the world, ayurvedic medicine, for example, is based on observation.

Yeah.

And it's so funny how we, we want to, you know, Eastern medicine wants to poo poo Western medicine. And because. But, but it's got centuries of data.

I think it's because they can't see it. People who can't see it want to poo poo it. And anyway, she was in grayscale. And that's not good.

Not good.

My mentor was in grayscale. When I found out he had cancer. Like, I just, I can see the, you know, the looming reaper. And I looked at her and I said, oh, no. And then I had to pull out all the stops, the exosomes, the stem cells. I mean, thank God I had the tools that I had available to me. But we threw them all at her and I pulled her out of this tailspin and then I handed her off to my favorite naturopathic doctor because I don't want to manage my patient, my family's chronic health issues. That's not, you know, that's a bit of an ethical dilemma. So got her in good hands. But she was needing pharmaceuticals from Canada that were really expensive, and we kind of got her. Okay. Okay. And then I stumbled upon the GLP1 data.

Yeah.

And just started fascinating. Playing with everyone who was willing. I was like, here is a clinical indication. Here's the data to support it. Would you be willing to try this and put her on like a minuscule dose and just remarkable. Like her pain reduction. She had somaglutide. Yeah. Full body pain for as long as I can remember her whole life. And just to have her out of pain.

Yeah.

And just to have proper gut function and she can actually go out and eat with us and just little things that we don't realize, you know. And then my dad, my dad's morbidly obese and diabetic. My dad is on a more traditional standard dose, but we went very slow and low, different from the traditional dosing protocol. And I got my dad back. My dad is back. I mean, he's not 100% and there's a lot of damage done that he self inflicted along the way. But I just, I'll die on this hill when people want to vilify it because I'm like, no, no, no, no. It's just not being done right.

Yeah, no, I love that. I was really fascinated by that approach because I, I pride myself on trying not to be too dogmatic about. Because I did find myself going down that opposite road. And then I was like, you know what, are you really just parroting what you're hearing out there?

Good for you.

Or, or you. Are you seeing this? And because I'm, I'm a partner in a, in a, A functional medicine clinic as well, and with real functional medicine practitioners treating thousands of patients. So are you taking data that you're really seeing or are you just listening to sort of the parrots that. And some very well known parrots that are sort of, oh, you had two thirds of the weight that you lose is lean body mass and then immediately you think lean body mass. Well, you're just losing all this muscle. Well, I don't want to waste away and be skinny fat. And of course that's gonna happen if you lose weight and you don't strength train and you don't keep your protein content up and other things anyway. But just to back up for a second for, for the folks that don't know what GLP1 is or what a GLP1 agonist is, can you describe a little bit what, you know, what, what is the glucose like polypeptide? What is the GLP in in the body?

So it is a peptide that our body makes endogenously in our guts and in our brains. That's really what got me excited. I was like, it's made in the brain. There must be impact in the brain. Yeah, important impact beyond just appetite suppression. It does work in the brain to reduce it kind of the food hunger and appetite suppression at high enough doses. But I think there's also just an onus of control that it is impacting. There's some dopamine circuitry, serotonin circuitry that it is impacting and not in a way that is completely turning people into zombies. There's, you know, there's talk going around on some of these podcasts where people say, oh, it takes all of your drive away, it takes all of your pleasure away. I think that's a dosing problem. So that was really interesting to see what it was doing in the brain. Neuroregenerative properties, studies happening on Alzheimer's and Parkinson's. That's what got me excited in the first place. I was like, this is really fascinating. And then in the, in the body, there's receptors all over the body in different organ systems and it's doing different things all over. We know it as it just happened to get utilized for type 2 diabetes because it has an impact on our blood sugar, on our insulin signaling. I think that there's pathways happening that they don't even appreciate that I'm digging up where just the whole insulin pathway, I mean just metabolic pathways in general that are being impacted by GLP1 favorably. So it heals metabolism as much as it wow. Controls appetite. I mean there's impacts on AMPK and CERT 1. Like there's just, I think long enough, when a patient's on it for long enough because it's a peptide, they're healing their regenerative and their anti inflammatory. And I think that there, if it's done properly. And the person is doing all the lifestyle pieces. There's a healing impact on these metabolisms that are completely busted because some people really are. It's too far gone. We can do all the lifestyle intervention, we can do the diet and exercise, but they have gone so far into mitochondrial dysfunction and so far down to metabolic dysfunction. People don't realize when they hit type 2 diabetes, that's decades of damage.

Yeah, that's the end of the road. Right?

It's really, really. Yes. It's really a terrible place to be. And yet we so casually are like, oh, now you have fatty liver and type 2 diabetes. Welcome to the club. Right? Like, welcome to where most Americans are sitting. And people don't realize that just devastating impact of that. And my mentor taught me decades ago to watch people's metabolic health, watch their waist circumference, like, those are the most important variables. Watch their muscle mass as a. As a vital sign. And my colleagues were giving me way back when, like, oh, Dr. Tina thinks everybody has metabolic dysfunction.

Everybody does have metabolic dysfunction.

I saw it happening and I was like, why does every patient have. And this is 20 years ago, you know, why does every patient have metabolic dysfunction? So anyway, GLP1s work in a myriad of ways, but we know them to suppress appetite, slow gastric motility, have pancreatic impact, and that's kind of it. And I even see obesity docs keeping it that kindergarten, and I'm like, no, no, no. They do so many more things in the body.

Hey, guys. I'm really excited to announce this. Perfect aminos has gotten a serious upgrade. They've added nucleotides, the building blocks of our nucleic acids, DNA and rna. And this is important. We know essential amino acids are the building blocks of protein and collagen. Having all the essential amino acids in the correct ratio is necessary for complete protein synthesis without the caloric impact. But if we want perfect protein synthesis, we need to look at the process of protein synthesis itself. Because if the process is faulty, we won't get the correctly made protein, collagen for fibrin or the red blood cells in our bloodstream or our muscles. We can even stop creation of specific proteins which can affect us in so many different ways. Our DNA and our RNA are what direct protein synthesis, building new proteins. If our DNA or RNA get damaged from toxins, harmful bacteria, or just plain aging, we get faulty protein synthesis. So cells, enzymes, and hormones are less functional. And we get premature aging by adding nucleosides and nucleotides. The building Blocks of the nucleic acids, DNA and rna. Our cells get exactly what they need to help repair faulty DNA and RNA and improve the process of protein synthesis itself. This is next level science and you need to try these. Now let's get back to the ultimate human podcast. Yeah, and I think too you get, you pointed out something that I've been screaming from the rooftops. You know, they talk about medullary thyroid cancer. And when, when Ozempic was first, you know, launched, our clinic director, Dr. Sarda, who's a board certified OB GYN, she was the one that was determining whether or not we would use it in our patients. And she was looking through all the research and I was looking through the research and I said, you know, the medullary thyroid cancer was really only in the rat studies. It didn't actually happen in the human trial. And you're the only other person that I've ever heard point that out. And then also it's, it's, you know, there's, there's a difference between causation. Right. And you know, when something is actually directly related. But when you have a toxic biome, you know, somebody who has advanced metabolic syndrome and they've got type 2 diabetes or they have hyperinsulinemia or, you know, they're, they're morbidly obese, that's the high risk category to begin with.

Right.

It wasn't the introduction of the GLP one that boosted them to, you know, having thyroid cancer.

It wasn't causative.

Yeah, it wasn't causative.

It's correlative at best. And even I think recently they've looked at so many meta analysis and long term data and they're like, we just don't see the link of it causing thyroid cancer in humans or causing pancreatic, you know, cancer in humans. Even the select trial that concluded at the end of 2023, the, the placebo group had a higher rate of pancreatic cancer than really or pancreatitis. Then the, the treatment, the control group.

Wow.

It's just, I don't know. I mean, yes, I think if you shove somebody hard though, because you were talking about CO factors and how you have to have systems in place before, you know, metabolic systems and nutrient status has to be in place before you start slamming people with treatment.

Yes.

So I do think when you take a group that's already metabolically compromised, already sitting on the edge of some of these pathologies, the thyroid cancer, the gastroparesis, all of those things are more common in those who are diabetic and obese and, and then you slam them with something that's going to just shove those metabolic pathways.

Right.

And they've got low muscle mass and high inflammatory fat and possibly other pathogens and other things going on. It's just like. Yeah, what's going to happen? You, I think really you can send people over the edge. So my theory is always slow and low and just nudge them along.

I love that because we've learned the slow and low theory by design by, by, by mistake.

Yes.

You know, we've all done, we, you know, in, you know, I've seen our clinical teams in the best interest of the pat say, oh wow, you've got heavy metal toxicity or you've got high viral loads or you have chronic mycotoxin or mold spore, even a low grade viral infection or even parasitic infection and then you hit them too hard to get rid of that pathogen.

Yeah.

And then, you know, parasitic die off or you know, aggressive heavy metal detox, which we were talking about with your husband before we, we came in. You know, those, those things can make the patient sicker than what they had when they started.

Yep.

Right. Like heavy chelation therapy or you know, I actually have a staff member of ours that found out on a test that she had certain parasite in her bowel and then went on a heavy parasitic detox and ended up in the emergency room. Yep. And they can migrate.

Yeah. The thing I think with the GLP1s and the gastric issues, I wonder and I, I, this makes a lot of sense to me. It shifts the microbiome to a more favorable, less pathogenic microbiome. But I'm betting a lot of the initial experience that people are having the side effects is not necessarily due to the mechanism of action of the GLP1, but maybe from the die off when that biome shifts and it's being shifted too aggressively and too fast and furious and maybe they're still pounding the foods that, you know, you eat what your bugs want.

Right.

So they're eating the foods preferential to those pathogenic organisms and then they're having a shift and they're probably having a die off reaction in many cases.

I agree with.

You have to prepare people and you have to prepare people for weight loss. You can't just drop people into extreme weight loss. Like there's so much toxicity in your fat cells. So there's a lot of reasons here why I think that a more personalized slow approach is probably a better approach for most everybody. Because at the end of the day, these can be very effective and therapeutic and like truly therapeutic. Not just a band aid.

Right.

But like anything, you know, they, it's like all the doctors got their hands on it and they're going by the recommended dosages, which I understand, but like you were saying, we can use things off label.

Yes.

And we can do a more personalized, patient centered approach to dosing. I do that with all the medications I prescribe.

So happy to hear that. That's so great.

Like everything, like even antidepressants, statin drugs, all the different drugs that I prescribe, I do a personalized approach. It's never the same for two people. It's not an algorithm. It's like, how much, how old is this person? What gender are they? What age are they? What's their vitality status? How much muscle do they have, how much fat, what's their toxic burden? Like, right. That's going to dictate whether it's prednisone or an antibiotic or, I mean it's all a hormone replacement therapy.

Like it's never once always individualized. And you know, that was even during the pandemic when, when, and, and I'm not saying I'm pro or anti vaccine, but I remember when the vaccine was first being promulgated, I was like, well I, you know, I sit on the board of the NFL Alumni Association Athletica and you know, some of our members are like former nose tackles for, you know, NFL teams. And so, you know, these guys would come and they're 6, 5, 6, 6, 320 pounds. And I have a, I have a, a five year old niece and she's 47 pounds. And I was like, okay, this guy's coming into my unit, he's ducking under the door jambs. And my five year old niece is hanging out too at 47 pounds. And I'm like, you'll never convince me that these two people get the exact same dose of the exact same thing and have the exact same reaction. I mean, this guy looks like he ate a water buffalo for lunch. And she's like, you know, she's five, she's five. And, and like I, I can't, I, I just, I can't get my, and maybe there's scientific evidence to refute that, but that was my initial hesitation is like, that doesn't make sense to me. And, and very often, you know, dosages in, in pharmaceuticals or naturopathic medicines, vitamins, minerals, amino acids, those things also make sense to be done according to, you know, the patient. But I want to back up for a second because you're touching on one of my favorite subjects, and I. And I think it just gets glossed over. And we use a lot of these terms like metabolic health, metabolic dysfunction, and a lot of people don't know what we're referring to. And I've heard people that I hold in very high regard, which I happen to agree with. Dr. Casey means Cali, means her brother. Several others that been on my podcast will say, you know, metabolic dysfunction is the root cause of essentially every disease that we have.

Yeah.

And when you say metabolic dysfunction and metabolic syndrome, I just wonder if you could speak on that for a minute, you know, so that my audience could understand. When you're talking about metabolic dysfunction or metabolic syndrome, what are you referring to?

So a more traditional definition would be, you know, the foods that we ingest and the way that our body breaks them down to be utilized as fuel. That would be your metabolism. And how do we process. How do we cellularly process the carbohydrates, fats, and proteins that we're eating? And do they go to the right places and get utilized the right way? Are the right pathways being turned on? These are pathways that run our mitochondria rev. Our mitochondria, which are the powerhouses of our cells. But the way I explain it to patients is, you know, something has gone wrong in the environment when I tell them they're metabolically busted. And that's really it to me. It's like machinery is going, eek. You know, something is wrong. The engine isn't running correctly in the community. Yeah. And we're spewing out things that we don't want, and we're not processing things the way we do. And this is all contingent on the person's overall health, their age, their muscle mass again, their toxicity burden, how they came into the picture. It's continuing mitochondria, which are the powerhouses of our cells. But the way I explain it to patients is, you know, something has gone wrong in the environment and on their microbiome, their gut health, their hormonal balance and health. There's all of these factors that play in. But at the end of the day, a lot of it, we do have control over. And that would be our muscle mass. That would be the foods we're choosing to put in our mouth. That would be the sleep that we're choosing to optimize or not. You know, people really kind of fuck around and find out with their sleep. Oh, yeah, it's not it's not.

I love that you said that around and find out with your sleep. We can say that on, I think on YouTube. Yeah.

So that, that although all of those things, your stress level is really important when it comes to your metabolic machinery and how your cells are handling and your cells are a little, you know, microcosm in of themselves and your mitochondria are actually bacteria and they're symbiotic. And so we're living with these organisms in our body and that all of that adds up to how ourselves body takes in these foods and process them into fuel and is used as fuel. So there's problems on the intake, there's problems on the outtake. And my job really is just to get people at least doing the non negotiables, the lifestyle factors. These are non negotiables for everyone. So I was telling people to eat steak and deadlift like a long time before it was cool.

We ate steak right before we came on the box.

But you know that back when the health influencers were telling them to go vegan and do yoga, I was like, okay, that's nice, but you need animal protein and you need muscle. And I'm really glad it's catching on. And you know, women weren't into it, nobody wanted to hear it. It was not sexy. But it's the, it's the not sexy stuff.

It's.

I mean, the biohacking stuff is cool and fun too. But at the end of the day, if your health influencers are telling them to go vegan and do yoga, I was like, okay, that's nice, but you need animal protein and you need muscle and I'm really glad it's catching on. And you know, women weren't into it, nobody wanted to hear it. It was not sexy. But it's the, it's the not sexy stuff. It's. I mean, the biohacking stuff is cool and fun too, but at the end of the day, if you're not doing the basics and putting in the work, then you will be metabolically compromised and then that's on a spectrum. Not doing the basics and putting in the work, then you will be metabolically compromised and then that's on a spectrum. And over here we have, you know, pre diabetes or metabolic syndrome, as they call it. They used to call it syndrome X. That's what my mom was diagnosed with when she was right. When I met my mentor and went to work for him, she was in her 40s, she had gained a tremendous amount of weight, menopause was kicking her ass. And I didn't know my mom for a minute. I was like, who is this woman that has taken over this body? And I think a lot of women can relate to that. Or a lot of all of us probably saw. And over here we have, you know, pre diabetes or metabolic syndrome, as they call it. They used to call it Syndrome X. That's what my mom was diagnosed with when she was right. When I met my mentor and went to work for him, she was in her 40s, she had gained a tremendous amount of weight. Menopause was kicking her ass. And I didn't know my mom for a minute. A woman in our lives go through menopause. And we were like, what is happening to this poor woman?

Yeah.

And she gained a bunch of weight. And this is back when they called it Syndrome X. Do you remember those days before? And my mentor Rick diagnosed her with syndrome X and told her to go lift weights and to, you know, stop eating white foods. And yeah, don't worry about cardio. Go build muscle. And this was back in the early 90s.

Oh, good for him.

So, like, who is this woman that has taken over this body? And I think a lot of women can relate to that. Or a lot of all of us probably saw a woman in our lives go through menopause and we were like, what is happening to this poor woman?

Yeah.

And she gained a bunch of weight. And this is back when they called it Syndrome X. Do you remember those days before it was. And my mentor Rick diagnosed her with Syndrome X. We were like, do what? We're not supposed to go elliptical ourselves into oblivion. So I walked and told her to go lift weights and to, you know, stop eating white foods. And yeah, it progress for her, though. And I watched it really derail her health. And that for me was very eye opening. And I did not want that for myself and my whole family. On both sides is a bunch of little apple shaped. Don't worry about cardio. Go build muscle. And this was back in the early 90s.

Oh, good for him.

Diabetics at the end of the day, you know, and it's terrible. I hit 40 and I was like, I, that is not going to be my fate. I'm not right. I'm gonna listen to what Rick told me to do. I wasn't listening. We were like, do what? We're not supposed to go elliptical ourselves into oblivion. So I watched, I didn't listen for a decade. And I was like, okay, I'm gonna do it now. So.

Well, I, I, I, I love what you're saying because you know, I often talk about that too, you know, the, the longevity and it progress for her though.

And I watched it really derail her health and that for me was very eye opening and I did not want that.

Optimal health is not found in the exotics. It's really found in the basics. I mean I have a sincere belief that sleep is our human superpower. Yeah, I mean I really think sleep is our super.

For myself and my whole family on both sides is a bunch of little apple shaped power.

I, I really focus on sleep. I schedule all of my meetings and travel around sleep and exercise. And when I made that shift, it had made a dramatic change in my life and I've learned to bookend my.

Sleep with diabetics at the end of the day, you know, and it's, I hit, I hit 40 and I was like, I, that is not going to be my f, I'm not right, I'm going to listen to what Rick told me to do. I wasn't listening and I didn't listen for a decade and I was like, okay, I'm going to do it now.

So Well, I, I, I, routine to go to sleep and a routine to wake up and I do it religiously. I've done it every day for probably 40.

I want to know what it is.

I'll tell you. I mean it's, it's pretty simple. I mean it's very portable and I, and I post about it all the time. Like I, I, I'll, I, I'll do these intense travel schedules, you know, like nine cities in 11 days. And some of the cities will be on opposite sides of the world. So I change time zones a lot. You know, from Miami, Louisiana to New York, Bahrain, Abu Dhabi back to New York. And, and I'll post sleep scores and I, and I like to do that. And sometimes I'll say the night before, then I'm going to post them the next morning. And then I get nervous. I'm like, shoot, what if I, what if my sleep score really sucks tonight? I love what you're saying because, you know, I often talk about that too. You know, the longevity and optimal health is not found in the exotics. It's really found in the basics. I mean, I have a sincere belief that sleep is our human superpower. Yeah, I mean I really think sleep is our superpower. I, I really focus on sleep. I schedule all of my meetings and travel around sleep and exercise. And when I made that shift, it made a dramatic change in my life and I've learned to bookend my sleep with a routine to go to sleep and a routine to wake up. And I do it religiously. I've done it every day for probably 40.

I want to know what it is.

I'll tell you. I mean, it's pretty. It's pretty simple. I mean, it's very portable. And I. And I post about it all the time. Like, I. I'll. I'll do these intense travel schedules, you know, like nine cities in 11 days. And some of the cities will be on opposite sides of the world. So I change time zones a lot. You know, from Miami, Louisiana. To New York to Dubai, Bahrain, Abu Dhabi back to New York. And. And I'll post sleep scores. And I. And I like to do that. And sometimes I'll say the night before, then I'm going to post them the next morning. And then I get nervous. I'm like, shoot, what if I. What if my sleep score really sucks tonight? But. But I think so few people have a routine for their sleep. And when you ask them, how do you go to sleep? They just go, well, I go to bed, and I'm like, what time you go to bed? Well, whenever I'm done my work day, or whenever I'm finished dinner, or whenever I done watching tv. And I think sleep has a tendency to really get bullied in our schedule. It's like, you know, it's like the stepchild of our schedule. And so I just have a simple routine. It's. I call it contrast therapy. And. And when I'm at the house, I'll do 20 minutes into dry sauna, and then one minute cold plunge. Not trying to cool myself down too much, but when I'm traveling, I'll just do a contrast shower. Like, I'll start with a warm shower, and then I'll turn the water as hot as I can get it on my spine, and I'll stand there for about a minute and a half, and then I'll step out of that water stream, turn it as cold as it'll go, and I step into that stream of water, and then I just deal with it for a minute, and then I turn the water off and it breaks that catecholamine cycle. I find out that whatever I'm thinking about, I stopped thinking about that because I'm mildly miserable for a period of time, right? So if I was like, hey, did I get everything on my grocery list today? Did my belt match my shoes? What time am I speaking tomorrow? You know, it just blows those catecholamines out. I take this, I take a sleep mask with me everywhere I go. Just a six dollar soft sleep mask that goes around my head. Very simple. But it has, there is zero light getting through. Yes. Because Andrew Huberman was the one that turned me on to how little candle wattage it actually takes through the eyes to raise cortisol.

Yep.

And you know, if you, if you shut the lights off in an average, you know, commercial hotel room, even at the Ritz Carlton, you know, there's light coming through the blinds, there's an LED clock on the, on, you know, on the, on the nightstand. And then there's five other lights on around the room. And then the bathroom light never really goes off. And so I use a, a mask and I, I sleep with a, the room kind of obnoxiously cold, which my wife doesn't love, but, but she's learned, she's learned to sleep in it too. So I dropped the temperature another 2 degrees. And then I have a breath work technique that I do in, in, in bed. And if I'm going to be on my phone, I'm on my phone before I get in the bed. And then when I get into bed, I put the eye mask on and I just do this breathing technique. Long, slow in through the nose, about a three second pause and then out through a straw. And I, and I imagine, sounds really corny, but I imagine taking all the thoughts from my head and breathing them into my lungs and then breathing them out.

Oh, I love that.

So I actually focus on that. I'm like, okay, all these things that I'm thinking about, okay, what time am I going to be on stage tomorrow? I'm going to take that thought and I just pull it to my lungs and I just breathe it out. I'm telling you, if I make it through 10 rounds of that, something's wrong. And I, and I've been tracking on my sleep 8 how long it takes me to fall asleep. And it's been less than five minutes for almost 31 days now. And sleep scores usually between like 98 and 100% in the morning. Within 30 minutes of waking, I do breath work and find the sun. And that's.

Yeah, go find the sun. That's, that's. I know you got to get outside the sun.

And yeah, and so those are the little bookends that I use for sleep. And I'm just telling you, like my body knows that if I'm doing breath work, it's within 30 minutes of waking. I'm doing a contrast shower. We're about to go to bed. Right. When things get really, really dark, it's time to go sleep. And, and definitely if I'm doing the breath work and something about giving my body that ro. So it's relied on it. That's, that's my sleep pack. And it cost you zero. Except for the sleep six dollar mask.

Yeah, yeah.

It's the only expense.

So. Nice. And then the earplugs and it's got it.

Oh, you're going next level.

It's got to be like blackout. Like a tomb in the room. I'm. Yeah, that's a big hobby.

Snore over there.

He snores a little.

Oh, he does.

We'll work on that next. A little bit.

A little bit.

But it's cute. Well, it's cute. No joke though. We met in 20, 19, 13 and I was at the point where I was like, I will not date someone that's going to mess up my sleep. So you've got to be a good sleeper. And there were, there were men that I was like, I like you, but you are a terrible sleeper. And I'm not. You're a terrible sleeper. I will not mess with my sleep. I will not have it compromised because it's everything. And your metabolic health, it takes what, like two nights of poor sleep to have your metabolic health shift in the wrong direction and you become transiently insulin resistant. And that's, I think so many problem.

Yeah. Sleep deprivation. I never knew about the link between sleep deprivation and insulin resistance. And so many of nearly all of our sleep deprived patients are insulin resistant and, and pre diabetic.

Yeah.

And, and these are fit looking people.

Yeah.

You know, they, they, it doesn't look like somebody who would have typical metabolic syndrome, which I want to go back to that for a second too, because I think that, you know, we're hearing and seeing now metabolic syndrome in younger and younger ages. And I've heard you talk about the toxic soup that we're bathing our cellular biology in. And I've also heard you talk about the importance of, of muscle. And I think Dr. Gabrielle Lyons doing a great job of getting this message out. I love her. I've amplified her message. You know, she, she wrote a great book, you know, on, on muscle and longevity. But what are your thoughts about that? Why, why is metabolic syndrome creeping down into younger and younger ages and, and what could somebody that's listening to this podcast do about it? And what would they look for to find out if they have it?

I think it's, I think for Children especially, it's a double prong problem, because we are a few generations into this problem, and we're like, do you know who Pottinger was? Do you know about Pottinger's cats?

No.

Pottinger. Weston Price. You know, Western Price was. Okay, so Pottinger was around that same time period. And Pottinger was doing veterinary. I think he was a veterinarian. He was looking at cats, and he found that if he fed them a particular diet, that really all he did was pasteurize the milk and cook the meat. That's all he did to alter the food. This is back in the 30s, I believe that these cats became their. Their livers enlarged, their intestines got boggy, and they became infertile very quickly.

Just from cooking the meat and pasteurizing the milk.

Yeah. Wow. I don't know how old you are, but I'm guessing similar age.

54.

I don't mind. We are.

I'm out there.

I'm 50. We are Pottingers cats. Our generation.

Yeah.

And it took many generations to get them back to fertility and back to health. So we're looking at that. I know we're not cats, we're humans, but we are looking at that right now. And so these kids are coming out of metabolically compromised moms. Like, I was skin and bones and had PCOS way back in 1990. My mentor diagnosed me with it. So we're looking at moms who are metabolically compromised, swimming in insulin. They've got babies in a placenta swimming in insulin. This is for real. And these children are coming out epigenetically marked. So they're epigenetically marked. Their risk and rates of obesity and metabolic compromise are so high compared to a child who's born of a mom who's metabolically sound. So, wow, they're already set. The stage is already set. This is where I know that the.

Deck is already stacked again.

I know that a lot of people are out there saying, like, no Ozempic for children. And I'm like, I also think that maybe there's a time and a place where we can dose it differently and apply it differently as part of a comprehensive treatment plan, because these kids, metabolically are already. They come out the chute compromised.

Right.

And my daughter's 24, and her whole generation is that group. We. I'm seeing those. All those girls have pcos, even the thin ones.

Yeah.

So then on the other side, we've got obese parents. Our age cohort is truly. I'm not Judging anyone. But it's a hot mess. I mean, Gen X is a mess right now.

Trust me, I see it.

I feel like I am obligated to save Gen X because I'm like, I have answers, you guys.

I went to my high school reunion the other day. I mean, it was like. Yeah, I thought it was like, aliens.

Yeah.

I mean, I. I thought I walked in the wrong room.

I didn't go because I. This sounds so bad. I was like, I don't need to see how. How everyone's become diabetic and obese. Like, I just knew it was going to be a mess. So anyway, when we're talking about children who are metabolically compromised, nine times out of 10, truly, those are the stats. Their parents are metabolically compromised and. Or obese. Obese children come from obese parents. And we could say it's all the household, the foods, the lifestyle, but it's both.

Yeah.

We've got these kids who are epigenetically compromised, and we've got a situation that they're living in where they're eating. You know, clearly. I mean, the school lunches are garbage. Education around nutrition is garbage. I am all for the Make America Healthy again, but why are we trading out Froot Loops for Froot Loops? Like, why are we just not eating Fruit Loops?

How about nobody could agree with you.

How about nobody feed the kids Fruit Loops? I'm not gonna argue with Kellogg. I'm just gonna boycott Kellogg.

Right?

Like, I don't care. Like, just don't buy that crap and put it in your mouth. Like, let's talk about education. Let's talk about school lunches. Let's talk about all of these things that we really can have impact on, because we have to. So that is a pickle. And so it's both. I think this is where we're seeing younger and younger generations, because epigenetically and genetically, they're marked. And then on the tail end, lifestyle and environment is dictating what they're putting in their mouths. And we can say all day that, let's blame the parents. I've had a ch. I have a child who had. She had PCOS at six years old.

Yeah.

She was raised in a naturopathic household.

Wow.

The markers on her labs were already showing the glimmers.

She had polycystic variant.

She had the markers showing. They were coming. It was. I was like, this is coming, you guys.

Guys.

And I was trying to tell her dad, and I was trying to tell my mom, and I was trying to tell everybody and nobody wanted to listen to me. And here we are, here she is as an adult, full blown pcos. And it's like. And again, the semaclutide completely turning that ship around.

Yeah.

And it's just miraculous.

So there's so low dose semaglutide. And over what period of time, what kind of markers were you looking at to see whether or not the PCs was PCOS was resolving? Because there is a vast portion of my female audience that has grappled with pcos.

I think just looking, I'm always looking at symptomology first. So how are, how's their skin, how's their hair? How's their hair growth? How's, you know, I mean, often we'll see acne clearing up. When we're, when we're moving in the right direction out of pcos, acne starts to clear, the hertuism and, you know, the dark hair growth starts to recover. You'll see, you'll see other conditions. You'll see fibrocystic breasts. You'll see there's just a variety of like, hormones gone wrong kind of symptomology. Right. Heavy periods, difficult periods, Irregular periods. Yeah, irregular period. So all of that starts to shift in a more favorable way and things start to become more normalized. And I mean, I hate to use that term normal, but in a healthier way, we start to see things shift. The lights come back on, the skin clears and the waste comes back. You know, we go from the tube shape to more of the hourglass shape, more of that. When we start to see in young women, in menopausal women, when women go from that gynoid, you know, curvy hourglass figure over to that Android shape where they turn more, until it's more of a male shape, we, that's where we start to see all the disease processes.

And so especially if the abdominal circumference. Yeah, all of that. Right.

My mentor was always like, keep that waist circumference in check. That's everything really. So he taught me that if your patients aren't strength training, their blood pressure is high or elevated and their waist circumference is elevated, they have metabolic syndrome, period.

And I think classically it also had to have like, you know, elevated insulin, high triglyceride hypertension. But I think, you know, what we noticed in our clinical practice is if you take, you know, all of those as individual processes like elevated hemoglobin A1C hyperinsulinemia, hypertriglyceridemia and waist circumference and hypertension. Right. You know, people think if they only have one or two of those, they don't have metabolic syndrome, but that's the foundation starting to crack.

Those are the early glimmers.

Yeah.

So I'm looking at patients and sometimes they're the hardest to convince because their labs don't add up to anything. That looks horrific.

Right.

But when you put it together in a functional way, it's like, I'm telling you the story that's coming. Yeah. I'm, I'm telling you what chapter 11 is. You're on chapter three. Here's what's coming. You stay on this path, it's going to get worse, it's not going to get better, and you will end up here. And then there's the extreme version of that, but people don't seem to, I mean, longevity is such a trendy word, but people don't really seem to have any future casting. You tell skinny female Caucasian, you know, skinny white girl disease. That's osteoporosis. You tell these very thin, light haired, light eyed, very thin women. I'm seeing them all over Miami. Very thin women. And I'm like, honey, you're going to break a hip in 20 years.

Yeah.

And that's not a fun game. Like, that's the end of the road. And you're lucky if you live through that. And if you do, you know, you, you often will end up with pneumonia in the hospital or you've got a very high increased risk for death over the next two to five years, up to 10 years. And they're not looking at that. They're like, how thin can I stay for how long?

Right.

When you're 40, you don't want to be rail thin.

No.

Like, you need to have muscle on you at the very least. And then there is a protective mechanism, I believe, to a little bit of fat.

Yeah, I, I couldn't, couldn't agree with you more. And you know, when, when, when I was in the mortality space, I mean, that was the, the femoral neck break was the kiss of death. And so many people thought that, you know, well, grandma fell and broke her hip, but the truth is that her.

Hip broke and then broke and then she fell.

Yeah. Because that osteoporotic section, you know, went to the femoral neck. And she would be, you know, standing there doing dishes and crack the hip breaks and she'd fall. And they were like, oh, my gosh, this fall caused this fracture. And we were like, well, no, they actually the fracture caused the fall and this is just indicative of how far progressed that condition is. And I think that's why it's actually not the fact that you have a fracture in an older ages. I think it's the fact that the skeletal system can't support itself. So now, you know, everything's got, you know, gone downhill.

And osteoporosis really, at the end of the day is diabetes of the bones. And osteoarthritis is diabetes of the joints. I mean, it's metabolic dysfunction of those regions. And the bones and the joints and the muscles are all bff. So if you've got no muscle mass, you've got no bone mass.

Yes.

And you've got terrible joints or. They're coming. It's all happening, you know, and malnutrition is a huge Dr. That. And I was full admission. I was anorexic for a long time.

Were you really?

And if you look at my cartilage under ultrasound, it is thin. So I'm always trying to do whatever I can to beef things up because I'm paying the price for, you know, an anorexic. Teenage years. I mean, it was a. I was very malnourished. Purposely. I was very purposely malnourished. And I look back on it, I'm like, oh, my God.

What do you mean by purposely malnourished?

Well, I. I went vegan.

Okay.

You know why? My dad.

Actually, I thought your husband was vegan when he came in. Because he was the only one that didn't eat the meat. Are you vegan?

I don't know. He's fat. He seems to be fasting today.

Oh, you just ate before he came. Okay. So I was like, in my mind, I was like, I wonder if he's vegetarian.

I wouldn't marry.

Okay, good. I'd like to hear.

I wouldn't marry him.

You look like a snake eye to me, so I. I didn't want to offend you.

He raises cattle. Yeah.

Now we're best friends.

He's a farmer.

Okay, good.

Yeah. No, those are my people. We don't. I wouldn't marry him. I wouldn't. They have to sleep and eat meat and like dogs.

That's. Yeah. Sleep hygiene, too. Don't forget. He made it through the sleep. Yeah, yeah.

But no, I. My dad, actually, it's funny. My dad was a food salesman. Like, he did food sales. Food broker. And he was one of the biggest meat distributors of. Or one of the biggest distributors of beef in the Pacific Northwest. And I was a disgruntled teen so my way of rebelling, just to ultimately piss him off.

I'll teach you, dad.

Dad was to go vegan. And then I put like a meat is murder bumper sticker on the truck.

I remember those. In the 80s, they were popular.

We just had a huge blowout and it was always just me trying to, like, piss off my dad. So I destroyed my health in the process during key hormonal growth years and development. But here we are.

Did you piss your dad off, though?

Oh, yeah. Okay.

So that was a success.

You know, all these years later, we've come around. We're on the same team now.

Yeah. He's like, you know, I think we all kind of grow and, and realize our parents were wiser. You're like, damn it, dad, you were right.

You know, I probably almost gave him heart attack. But we're on the same team now. We're at the end of the day, through the. Throughout the pandemic, we all rallied on the same team. So we're good.

Yeah. So I'm want. I'm going to get back to, to, to muscle and the importance of muscle and longevity. And I think there are a lot of prominent speakers in this arena. You know, Dr. Tia and in his book out live, and Dr. Gabrielle Lyon starting to talk about muscle as an. Thinking of it as an organ.

Yeah.

And the organ of longevity. I've even heard, you know, Dr. Lyons use that term. You know, muscles are organ of longevity. We don't even think about our muscles being an organ. And so especially for the women out there, talk a little bit about the importance of muscle mass, because I think women associate with being muscular, with being manly, meaning man, like physique. I don't want to be bulky. And it's hard, I think, for women to put on enough muscle to be bulky.

I can't. I don't even look like I lift. And I work really hard at it. It's hard. It's hard to put it on. Yeah. You know, the first time I met Gabrielle Lyon was at a. At a conference. And she walks into the gym and she's on her cell phone and she's talking to somebody and she just kind of blows into the gym. She grabs the pull up bar, cranks out a bunch of pull ups, and then saunters out of the gym. And I was like, who is this woman? And we must be friends.

This is like, Mr. We must be friends.

Yes, we must be friends. It. So I went into muscle because I wasn't listening to my mentor and actually he was dying of Cancer, sadly. And I know myself and when I am grieving, I waste. I mean, left to my own devices, I will waste away. And I knew it was coming and I, it was like I took over his practice. It was like two years of watching this demise and it was really painful emotionally for me. And so I started training for it. And I went to him and I was like, okay, I know this is it, but like, what do I gotta do? And he's like, you need to put some muscle on. So he's like, not going to waste away on me. So I, I went into the gym and I was so thin at this point, I was so underweight. And I looked at the trainer and I was like, I need to learn how to deadlift and squat. And he goes, well, do you want to do body composition? I'm like, dude, look at me. I was like frail and I was, I was in my 30s and I felt like if I fell down, I was going to shatter. I was so underweight and it was so many decades of undereating. And I said, I have to put on some, some, some. I got to put a, I got to put a, you know, slab of meat on this, this, on this meat suit. And so he helped me just learn to deadlift and squat. And then I could not believe the transition in my mental health, in my well being, in my career, in my just my onus of power. My whole world changed. And I was addicted. And so I was going to every medical conference I could to talk about this and I was getting heckled by MDs, I was getting heckled by naturopathic doctors. Everybody was like, the best exercise is the one the patient wants to do. And I'm like, no, they need to freaking pick up heavy shit.

I agree.

Carry it and put it down. Like, trust me, because I, the more that it was completely changing my life, the more I studied it and the more I found out I learned about Myokines. Myokines, we know about cytokines being these pro inflammatory molecules in our body, but the same molecules are produced by the muscle and they're anti inflammatory. They're myokines. There's. We get hung up on insulin resistance. That's just one way to take glucose into the cell.

Yeah, it's a sponge to get glute.

4 receptors to translocate to the membrane. You can also do that by just squeezing muscles. So exercise and activating the AMPK, insert 1 pathways and also just literally squeezing your muscles will get that glute 4 receptor to the membrane to Bring glucose into the cell to be used as fuel. It also spurs up those same pathways that get your mitochondria revved. So, and then you think about, how can we put more mitochondria in the body? Because some of us, like, like I got dosed with Cipro, like it was going out of style when I was in college. That was the big thing in the 90s, right. It was like, oh, you have a UTI. Here's some Cipro. Let's kill your mitochondria.

Right.

And so this mitochondrial fatigue that so many of us are dealing with and this mitochondrial compromise, you can add muscle. It's the only organ I know. You can literally build.

Yes.

By yourself, without any special anything. You just go to the gym or body weight or whatever, and you can add mitochondria to your meat suit.

Yes. Right, yeah.

So you can make an anti inflammatory mitochondria meat suit that you build.

I like that.

That's how I think of it.

I would wear that.

Your hormones behave better. This whole movement online of like, hormone balance, I'm watching metabolically compromised women, smart women, smart doctors, friends of mine talk about hormonal balance. And I'm like, you can't have hormonal balance without optimal muscles. You just, it's just. Just an illusion.

Yeah.

Putting HRT into a body that's inflamed and metabolically compromised, especially if there's a lot of inflammatory adipose tissue, fat tissue, those hormones go rogue and go in directions we don't necessarily want. And so adding HRT to a metabolically compromised woman, to me is like playing Russian roulette. This is where I think GLP1s are really beautiful because you can clean up that terrain. It literally cleans up the terrain. Right. And then we can get the HRT into these bodies that so desperately need it.

I'm excited to also offer you free access to my premium membership, the rule BRCAs. As a rule BRCA, you'll be able to join me for monthly Q and A sessions, VIP access to all the challenges I host, and advanced access to my most exclusive content. To get your free 30 day trial of Rule BRCAS, head over to joinrulebrecas.com that's joinrulebrecas.com right now. Now let's get back to the ultimate human podcast. So you like the. You like low doses over a certain period of time to sort of clean up the, you know, the metabolic terrain, as you call it, and then maybe relooking at the balance of the hormones, because I I. I think you're. I think you're right. You know what's astounding is, you know, very often we see that you put people on a functional training program and a, In a whole food diet, not raw food. I almost said raw food. I meant whole food diet. And just that alone pull blood work eight or 10 weeks later and then see what's really wrong.

Right.

You get a real accurate picture of. Well, maybe there is some hormonal hypofunction or maybe there is some pituitary hypofunction, but the truth is it's masked when you have this metabolic syndrome and you have all of these other things in the. In. In the way.

Right.

So are you a fan of what, what markers are you kind of looking at in. In. In the blood? What do you think it's. That's important to monitor? You look at C reactive protein as a general marker of information. You look at, I think just some.

Basics, you know, C reactive protein, hemoglobin A1, C, vitamin D. Just because I think it's good to have that optimized. Always huge. You know, we can look at, I like a comp metabolic panel because we can see what the liver's doing and is it being taxed? Right. Is it working too hard? I think running hormones. I just assume, though, I, I really look at hormones from, again, from a symptom standpoint, if a woman's walking into middle age, especially any woman over 40, I think is probably. Or men too, is probably looking at a potential candidate for thyroid support, just for longevity reasons. Again, very tiny doses are sometimes all it takes to totally change.

Right.

Their life. Right. And just completely change the picture.

Are you, are you a big fan of natural dissected thyroid?

Yeah.

Desiccated.

I'm just a big fan of good old armor thyroid, when we can get it, or NP thyroid. And then I'm old school, like, that's how my mentor taught me. And then, you know, obviously supporting the adrenals just so people have a leg up. Anytime I can get someone a leg up. This is also where I think GLP1s are amazing because it does something to the neurochemistry. It decreases inflammation in the brain. And when we can calm the microglial cells down and we can calm the inflammation down and we can get the lights turned on and then we can get those reward pathways actually working in a more favorable way. People feel like they have control of their life back and they want to do the thing. Sometimes it takes a few months, especially if they're really metabolically compromised. It might take three plus months before they say, you know, I want to exercise now. I mean, my dad literally was on, yeah. Ozempic for 9 months and he finally started walking. Yeah, this man was living in a lazy boy night and day.

I mean, it was so for nine months. And we don't need to talk about dosing on the, on, on the show, but when you, when you say he was on it for nine months of a low dose over a prolonged period of time, because the typical zempic dosing is, is, you know that it doubles every four weeks.

Right.

Until you get to pretty substantial doses at cruising altitude. And then essentially you're meant to stay there for life.

I think it's important to mention that really low doses are much better for metabolically healthy people. This is not a strategy for people who are really metabolically compromised.

Right.

But that doesn't mean we need to go fast and heavy. So he definitely is on more standard dosing and he has had no side effects even at doses that would make me fall over and end up in the er. So folks who are really metabolically healthy can handle these tiny, tiny doses because they have good muscle mass. And maybe, like you were saying, like, these people don't look like they have blood sugar dysregulation, but they do. Or maybe they have cardiovascular disease risk, or maybe they have cognitive issues or maybe they've had, you know, and I'm thinking in terms of like traumatic head injuries, life of massive stress, like what's happening to their brains. And so I'm using a neuroprotective cardiovascular protective way. But those who are metabolically compromised have more weight to lose. They definitely are looking probably at more traditional dosing. But I'm still a fan of going slow and low. And I think that the medical establishment is catching on. I'm looking at data that different groups, medical groups are sharing. This one group out of Italy was talking about personalized dosing. And while they were still using higher doses, they went much slower. And really just meeting the patient where they're at. We don't have to dose people.

Frequency, you change the frequency because most of these are dosed in weekly Mom.

It kind of depends on the person and what we're going for. So I know of people who are doing it, you know, much less often. And it's just for smoking cessation because there's data, they're doing studies on alcohol cessation, smoking cessation, opioid cessation.

Like, I, you know, I Don't have any personal experience with opioid or nicotine, but alcohol for sure that. I mean, the vast majority of the patients in our clinic system, I would say I just don't feel like drinks.

I don't want it anymore.

They literally have no impetus for it. And I mean, do they know what that mechanism is? I mean, it's maybe, maybe it's the.

Satiation, it's mechanism pathways. I think it's the reward pathways in the brain. But I think you can go too far. So yes, you can give somebody. It really depends. It's so individualized because a little too much can be a lot too much.

Yes.

In the bright body. And you might send somebody over into a place where they're like, I don't even want to prepare food. I don't want to drink, but I also want to have sex and I also eat. Yeah. The lust for life is kind of leaving the room. So we don't need, we don't need to go there. I think that that's the problem that we're seeing. We're hearing about that. That's what's being sensationalized is like, oh, the suicidal ideology. That is not true, actually. It's a. It's been shown to really have a strong impact on anxiety and low mood. It's. It's a huge mood booster and we have the data on that. And that link has been disproven as well. There's just not. There was one study that came out. They took World Health Organization data. It was just published recently, I think it was in jama. And everybody on the Internet ran with it and said, see, Ozempic causes suicide. And if you look at the study, these, it was, it was an exorbitant. I think it was over 3 million people. They were just looking at chart notes. So it was just correlative again. And they had a signal of like 107 people, I think, or 127 people on semaclutide who had suicidal ideation out of millions.

Right.

And those people, when you broke it down, those people were on benzos and antidepressants. A large portion of them.

Yeah.

So even the, the authors of the study and the limitation section was like this long. And they were like, do not throw the baby out with the bath water. This is simply a signal that we should probably talk to her like any good physician. Talk to your patients about their mood and their overall affect and like their suicidal ideation before they start make. Because maybe they came into it that way. Right. So There's a lot to unpack there. And there's also the idea that I think a lot of people come into obesity not to take it down that pathway, but I do know women, many women who've come into obesity in their, their own lives as a protective mechanism after traumas, after being too visible. I know many women who were sort of hypersexualized and just too incredibly beautiful as young women.

Yeah.

So much attention. The kind of woman that walks in a room and everybody stops and turns and it was very uncomfortable for them and they literally kind of ate themselves into a place where they were a little less visible.

Wow.

So there's so many reasons why people end up in that place and it's not my job to judge how they got there, but I do think that sometimes food is that comfort and it's the way they know how to get their dopamine up and it's their way to stress relieve. And then all of a sudden they're getting hit with a high dose of a GLP1 and their appetite's gone.

Yeah.

So what do they use?

Right.

So I mean, there's a discussion there to be had for sure. But you know what I'm saying, That's.

Why I think the lifestyle, you know, it was the, your first opener when you said, you know, it's, it's, it's my role to bring lifestyle interventions and I love that lifestyle interventions to the table because we, we should be talking about, right. You reaching your goals in a holistic way. Like, you know, when, when, whenever I talk to a client, I say, you know, what are your goals in working with me? And they've already spoken to our clinical team and, and, and, and then you have to be realistic about what you have to repeat back to them. Well, if this is your goal, then these are the lifestyle interventions that you're just gonna have to get comfort. Not comfortable with these. Then we need to readjust the call. You know, if there's, here's some non negotiables that need to happen, and here's some non negotiables in, in your schedule that need to happen. And I go right to work on sleep and right to work on, on morning routine, but the ones that say that they can't do that or can't commit to that, then say, okay, well then we need to readjust your calls.

Yeah, that's a nice way to put it.

Yeah.

I mean, it's just unrealistic otherwise.

Yeah, it's just unrealistic otherwise. And, and I, I, I really love the way that you're, you're, you've really reframed think of, of GLP1s because, you know, I mean, I, I was buying into a little bit of the hype that was going on in the marketplace. It may have been even guilty of repeating some of that hype. But you know, when, when I think back on it, those were in those super physiologic doses that, that were for, you know, the morbidly obese type 2 diabetic, which in their case could be life saving. But you can't apply those same things to somebody who's, you know, mildly metabolic, metabolically off. Maybe it doesn't have full blown metabolic syndrome, but someone like my wife who's lean and muscular but tiny and when she doesn't get good sleep over a prolonged period of time, like she had an L5S1 fusion. And so we noticed that over a prolonged period of time when her sleep was really, really poor because she was tossing and turning it up all night and she, she wasn't supposed to sleep on her stomach and then she would roll on her stomach that her back would flare up.

And so I, I have that dance too. I know that dance.

Oh, you know that dance. O5s one problem would really identify with you. And you know, we, we. Her labs are usually perfect and, and for me it was, it was like the light switch that I couldn't figure out because, you know, and I get really frustrated when, when I can't make sense out of something and I start going deep down the rabbit hole and I call all my colleagues. But she became pre diabetic and I was like, like.

And she's tiny. I've seen pictures.

Yeah, she's very tiny and very lean and, and, and muscular and she's active and she eats super clean.

Yeah.

And, and she is like, I don't even put sugar in my coffee. I don't even put splendor in my coffee. You know, this is very common and.

I know many people who've come out.

Yeah.

Privately to me in the online health space who are like, will you look at my labs? What do you think about me? What do you think about me trying some GLP one? Because like the same thing, like, you know, abs, six pack abs, the whole thing. And, but there's blood sugar markers and, you know, all bets are off when you hit 50. Like, things just start going sideways. And I'm so glad you're bringing this up because everyone keeps saying, well, this is reserved for those who are severely obese. And meta, you know, really metabolically compromised type 2. And I'm like, when a woman comes to you and she's 50ish and she says, you know what, Doc, I didn't do anything different. And I. They're eating cleaner than I am and they are living it to a T. Yeah. And I just put £15 on my midsection. I'm like, that's insulin resistance.

That's insulin resistance for sure.

Journey. And this journey doesn't get better.

Yep.

So what can we do? Because there's nothing else left to dial in.

Right?

Your wife couldn't. She's every tool available.

Yeah. I mean, obviously she's got the red beds and the sauna and the steam and the cold plunge and the whole, the whole bit in the gym. And she's very, you know, like I say, she's very active and, and ultra, ultra clean. I mean, we get all the, our food from an Amish farm. And so there wasn't anything processed in her diet. And we eventually traced it back to her sleep. You know, we were looking at her sleep scores and they were an absolute disaster. And, and she was relying heavily on caffeine, you know, throughout the day. And it was just sort of something we didn't really notice because we, we, we spend a lot of time in our unit. And she would just go back and forth to the coffee maker and I was like, babe, how many cups of coffee have you had today? You know, like, and, and so then we just really started to focus on dialing in the sleep and everything changed. Oh, like really, it was like, was Sunrose for the first time, you know, and the pre diabetes went down and she was like, very thankful of that. But we notice like when, you know, when our travel schedule is heavy or her back starts flaring up or she spends too much time, her stomach, you know, it's, it, it's incredible how connected all these things are. So.

I know, I'm glad, I'm glad she's better.

So I know where you, you've got, you've got a heart out here. But I wanted to. Well, first of all, I wanted to thank you for coming on the Ultimate Human podcast. This is amazing and I'm definitely going to have you back.

Thank you.

But I, I always ask my guests that, you know, the same question if you watch any of my podcasts. I end all my podcasts with the same question. And it is, you know, what does it mean to you to be an ultimate human?

It makes me tear up. My, my mentor taught me how precious our health is and how to take the gift that God gave me and be the best healer that I could be and really optimize it. And I feel. I firmly believe that God put me in his office to become his receptionist all those decades ago so that I could ultimately end up here and have the opportunity to sit on stages like this and have access to huge audiences so I could share the same information he taught. And I wake up every day and I think, how can I be of service and how can I best do that? And I personally have been so plagued with chronic pain and health issues myself. And so I live it. I understand it like this was built. This is sustained every day through a lot of hard work because of that pain and that in that. In that illness. So for me, it's just being healthy enough to be able to continue to pay it forward.

Yeah.

You know, and speak the truth and continue to be brave and resilient and that. And I have to have my health intact. I have to be an ultimate human so that I can do that every day.

Yeah. Well, Dr. Tina Moore, you're amazing. I really feel like your message is very authentic. You know, I. I've had hundreds of guests on the podcast. I've had hundreds of these conversations. I can just tell the authenticity that you have and how much you care and how curious you are, which I think is likely that the most attractive characteristic in a person is when they have that intellectual curiosity to just want to learn and figure out more and then share it with the world. So thank you for coming on the Ultimate Human podcast. I'm definitely going to have you back again.

Thank you. Such a pleasure.

And as always, guys, that's just science.