Optimizing Health & Longevity Through Functional Medicine with Dr. Darshan Shah

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Health so you can love how you look and feel right now and have the energy to play full out at 100. So you're eating well, you're exercising, you're managing your stress, you're if you're sleeping well. Yay. Check, check, check, check. Or maybe you're looking at improving those a little bit, but you want to know what the next level is and you've heard about some of the different tests out there, like a full body MRI or maybe a liquid biopsy that can help you with early detection. Because one of the things we know, whether it's cardiovascular disease, which is our number one killer, or cancers, that early detection really is single most important thing. I have been so curious about these tests. Which ones make sense to do, which ones don't. There's been so much information flying around the Internet and I'm super excited today to have Dr. Darshan Shah with me because we are going to unpack all of those tests. The things you've been hearing about, like doing a coronary calcium scan, doing a liquid biopsy, doing a clearly test.

What are all these different tests all?

Are they worth it? What should you do? If so, when should you do them or how often, what are they going to tell you? We're going to unpack all of that and we're also going to talk about what are the most important pillars really for longevity. What are the things that really are the 80, 20, that 20% that will make the biggest 80% difference. I have got an incredible new friend here today, I must say, new Franks. It was absolutely one of those people that you first meet them and go, this is someone I've been looking for for a long time. Super smart, super fun. He is a well known health specialist, surgeon, author, entrepreneur and he's the founder of Next Health. This is the clinic that is sweeping the nation. There are now 6 and 44 on the way all over the country and actually all over the world. And this is the world's largest health optimization and longevity clinic. And not only is it doing all of the fundamentals and then the advanced testing, but it also has some of the advanced fun stuff to the biohacking lab. So we're going to be talking about that and also what things you are going to be looking at, wanting to look at to optimize your well being and extend your lifespan. Because literally Dr. Shaw has helped thousands of patients do this. So this is the, this is a, another Doogie Howser here. He completed his medical training and finished all of that at 21. He also has alumni status at Harvard Business School and Singularity University. Quite an overachiever and super smart and has really put all of this together in a way that makes it very understandable so that you can figure out what you do next. Now I put all of this information so you can look at Next Health and also, you know, look at these different tests and what you might want to be thinking about doing. I put them all@jjvirgin.com next health and I will be right back with Dr. Darshan Shah. Stay with me.

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Dr. Darshan Shah, I don't know where you've been all my life, but you're a keeper.

Oh, thank you. That's so sweet of you.

Yes. I mean, just. Even when I met you last night for the first time at our party, it was like, where have you been? Like a long lost friend.

I. I've been following you for a long time and I'm so glad to finally get you.

What are you following me for?

You know, I got into this world of health, wellness, nutrition, quite a long time ago, actually, and back when there weren't many podcasts out there, and you were the first podcast I was listening to for quite a while. Yeah. So I've been following you for a while and, you know, we. We can talk more about kind of like my trials and tribulations in business and things like that. But about that, like, I've. I've had your podcast on the auto download list.

Oh, I'm.

That's.

That.

Yeah.

That makes my heart sing. You never know. You put these things out. There he goes. Anybody listening? Anybody? Anybody out there? So I'd love to go back because you've had quite a journey. In fact, when you were coming in here, I was looking over some stuff. I was kind of stalking you, and I go, you're like Doogie Howser.

Oh, thank you.

You graduated medical school at 21.

Yes, I did.

And then you ended up with like, tell us through your journey. Because usually you were. Big leap.

Yeah.

Which I'm super excited about.

Yeah. So, you know, I came from a family of physicians and for me, being a physician was my goal. And for. For many reasons. One is, you know, I had a lot of familial pressure to become a physician, but also I saw a lot of, like, the respect they got. I saw a lot of good that they were doing, and I wanted to just go into medicine. So I rushed through school. I was very lucky to be able to graduate early. And the nice thing about that for me was it afforded me the opportunity now looking back in retrospect, to really get kind of multiple careers in medicine. So my first career, as soon as I graduated from surgery, from medical school was to learn surgery. And I did trauma surgery, I did general surgery, I did a lot of emergency surgeries. And so doing that, you really gain an appreciation for this, the human body. Right. I mean, when you're operating and you see this incredible machine work, you gain an incredible. About appreciation for that. So I did that for about 10 years, and then I decided I wanted to learn more. And I went to the Mayo Clinic and I trained in reconstructive surgery. And after I got done with that, I started a business opening surgery centers and hiring other surgeons to work at those surgery centers. And I was also operating at.

I was going to say, wait, wait, you jumped ship. So you were. You were both being a reconstructive surgeon and opening surgery centers.

Exactly. So I was an entrepreneur and operating 12, 14 hours a day. Five, six days.

How was your sleep?

This is what led to all of my issues.

I forgot to sleep.

Exactly. Oops. I forgot to sleep. If I got to buy my own food and cook it.

Oh, boy. You were eating hospital food? Hospital food, my God, yeah.

And hot food. Even now you go to the hospital, it's probably some of the worst stuff for you, you know? And so, yeah, I was eating whatever I could find. I was stressed out. I was working in the business and working on the business, and I bec. Very sick. I was 45, 50 pounds heavier than what you see right now. Worse than that, though, I had an autoimmune condition developing, so I couldn't really move well. My joints were all really aching.

And you were.

At the time, I was 40 years old. Well, I mean, all this started in my 30s.

Right, right, right.

For 10 years. Just right.

You don't just wake up with autoimmune disease one day. As we know, we're 45 extra pounds.

Exactly. So.

But.

But wow. I mean, it wasn't like you were like 70 with achy joints.

I felt like a 70 year old. Yeah. I felt like I was on three blood pressure medications.

Oh my gosh.

Yeah. And they couldn't get my blood pressure under control. I could not sleep. And so I did what any, you know, person who wants to get well does. So my wife became pregnant with our first child when I was about 40. And I decided that I need to make a major change because I remember this day like it was yesterday. I came home one day from work, it was like literally 10 o' clock at night, and I opened up a medical journal and there was like this chart in one of the articles about if you have metabolic syndrome combined with. Combined with an autoimmune disease, your, your 20 year survival rate is basically cut in half. And so I was like, doing the math on my own, I was like, that's me. Check that chat. I had like a 50% chance or higher of dying before my son graduated from college. That's what I, you know, the math showed that I was like, I have to make a change here. And so 10 years ago, that's what led to kind of this new journey and this new career I have now.

Wow. Yeah, there's nothing like kids where all of a sudden you stop doing some of the dumb stuff you've been doing. She's like, I need to be around.

Yeah, exactly.

Yes. So. So you had the wake up, the epiphany. How did you learn all of the different things? Because as we know, these are not things taught in medical school.

Right.

So what'd you do?

I did not have the knowledge. So I thought, you know what? I am going to go to Beverly Hills and hire the best concierge medical doctor I can find. He or she must know how to fix me. So I go down to Beverly hills.

This was 10 years ago.

10 years ago, yeah. Yeah, 10 years ago. 25, 000 later, he prescribes me a brand new autoimmune medication.

Oh, no.

To you know, dampen my immune system.

Because concierge back then and even now doesn't mean integrative.

No, not at all.

It just means, you know, Neiman Marcus local service.

Yeah, you just get their cell phone number and call them whenever you want. If you have a cough or call, you call them. But they still like, no advice on nutrition, no advice on exercise, no advice on stress.

Too bad I didn't meet you 10 years ago when I was working with one of these high end knockers in Beverly Hills.

I would have loved to have met. Yeah, I should have wiped out the phone book a few times. So then, you know, he, he also noticed That I was kind of depressed about my situation. So he put me on Prozac. So now instead of 10 pills, I'm on 14 pills. And so I was like, this is not going to work for me. So I decided, you know, I talked to a group of my friends and I decided to take some off and focus on my health. And so that meant to me what it means to like you as well. I know you for listening to your podcast. Like, go get educated about this stuff. Go learn. And so I went to conferences around nutrition. I went to conferences. I got my personal trainer certification. Exercise. Yeah. Where was all of this in medical school? Like, this should have been an entire semester, half a year.

Well, come on. You know, I actually was talking to Dr. Andy Galvin about this. I was like, who? I'm obsessed with? But I was like, why? Is it. Because I had this epiphany. I go, doctors get an hour of nutrition, but they get no hours of exercise. Zero. Like zero. And he goes, come on, let's be real. I was all the way up in a PhD program in exercise science. And I still feel like there's so much to learn. How could a doctor expect to be expected to know nutrition and exercise? And it's too much.

Absolutely.

It's just overload.

Well, and here's the thing. I think people really need to recognize the bucket of Western medicine is meant to diagnose disease and treat that disease. Right. And so, so if you have an emergency, say you have an autoimmune crisis, you end up at the icu. You need a western medicine trained doctor. You don't need, you know, a personal trainer at that point in time, but that entire bucket is completely different than the bucket of lifestyle and health. Right. And so I think once I, in my mind, separated those two, I had that aha moment. Like I'm. I'm using the Western medical system to achieve something that it was never meant to achieve in the first place. Right, right. And so that's why going out and educating myself really started to move the needle for me. And then this is where I discovered I fell into, like 10 years ago, functional medicine wasn't really a big thing. Right. It was just starting with IFM and ihs. And so I fell into an IFM conference. I'm like, oh, my gosh, this is.

And you went to. And you heard Jeff Bland.

Yes, exactly.

I remember the first time I heard Dr. Jeff Bland. I think it was like maybe 15, 20 years ago. And I'm like, he's making up words.

Yeah, like yeah, exactly.

What is he talking about?

What?

Metabolomics? What is he talking about?

That's exactly how I felt. But then I realized that there was something definitely here. And it was incredible. Like, within eight months, I lost, like, 35, 40 pounds. I got off almost all my medications, and I was like, this is. And I was talking to my surgical patients, too, at this point in time. And a lot of them avoided surgery just by doing some of the same things I did. Because they would ask me, like, you're looking so good, Dr. Shaw. Like, what are you doing? I'm like, oh, let me tell you. I, like, learned to sleep better. I started my meals with fiber instead of eating pancakes every morning. And so just these little changes made such a massive difference that I, number one, got myself healthy. But number two, I realized this is the medicine I want to practice. And so, yeah, then I changed my entire career into combining kind of the best of what Western medicine has to offer with this entire field of functional medicine, nutrition, exercise, physiology.

So important, too, because I've always felt like in the years that I've been studying all this, there was this divide. You know, there was like, functional, integrated, natural, holistic, versus. And I. And, you know, I had a son who nearly died, was hit by Carla for dead in the street. Traumatic brain. Like, he had a torn aorta. He had massive brain injury, and he had 13 fractures, which was the least of the issues at the time. You know, crushed, healed, whole bit. And the trauma center, he went to Harbor UCLA. Amazing, amazing doctors there. And this one, Dr. Carlos Donaire, who's like, you know, the angel forever. And they got him. Like, I wouldn't have. Again, I wouldn't have wanted, you know, someone treating with supplements, but he would die on the table.

Right.

I needed the surgery.

Surgery, right.

But once we got him through all of that, they wanted to keep him in the hospital. I go on taking him home. And now we're going to start hyperbaric and red light and exercise and neurofeedback and everything else, and we're going to bring him back through. And so you've got to use, like, why wouldn't you use all the tools available?

All the tools. That's so key. That's a realization, like, there's some great stuff in Western medicine. Like, one of my things I did in Mayo Clinic was I did a lot of research with the hyperbaric oxygen chambers. And, you know, we were treating people with, like, massive injuries that had, like, you know, like, large amounts of tissue loss and the hyperbaric Oxygen would heal these massive injuries from the inside out. I'm like, why can't we use that for people that are not in the hospital?

Yeah.

And so one of the first things I did when I started this new career was get a hyperbaric chamber so people can use it for their wellness and it makes a big difference. So that's just one example of using all the tools that you have available to you.

So you've now put together these centers.

Yes.

And you have, I think you said six of them, but you have like 44 more getting ready to go. So someone's going to come into a center, walk us through the process, like who's a candidate? What can happen for them and what do you see? Well, I'll let you do that. And then I have another key question so that anyone listening, whether they come in or not, will have some key takeaways they can do.

Yes, I'd love to talk about that. So basically, the people that come into our center are people that are either a. They realize that their, their exercise is on point, they're doing good nutrition as best as they can. You know, they've heard about sleep, they've read about it, they're helping their sleep, but they know there's more, you know, and so what's beyond the basics, the basic pillars? How can I access functional medicine? How can I access the best of western medicine and bring that into my life? So that's one group of people. Another group of people are people like in the situation that I was, people that are frustrate the western medical system just getting put on more and more medications and don't really have the tools available to them to turn back their health span, to turn back the clock of their health and get healthier. So that's another group of people. And then a third group of people we have are like the advanced people that are already doing all of this stuff. They've had biomarker panels on and they want real longevity medicine. So we call ourselves a health optimization and longevity center. And what we do is we combine in, because this is what I did in my career and have whole structure around this. Combine the best of sleep, nutrition and exercise education with functional medicine and then western medicine, keeping you alive, making sure you don't die. So the diagnostics of western medicine. And then lastly when we get all that right, we talk about longevity medicine. And I'm making this like real thing because I have this thing called a wellness wheel that we take them through this journey.

Well, what I love the most we were talking offline about this is, is you got to fix the big rocks first. You know, I'm always amazed, like sleep, nutrition, exercise, like these have to be. And when for me, sleep also has stress. Sleep and stress, Right. And I put recovery in there too. That's all, that's really all the recovery pillar, like if you're stressed out, you're not going to be able to recover, you know. And then I think exercise, we actually need to move it more even into movement because you can't exercise 20 minutes a day, sit on your butt for the rest of the time. Right. So I'm like, you know, I became obsessed this year. I'm like, now I'm gonna really be a good step tracker too. So. And then of course, nutrition is just such a huge pillar that creates so much animosity online. And like it's like religious wars. And I said, these are just tools, people. Diets are tools. You have to pick the one that's right for you. And so those, like I said, do those because then you'll see where you're at and what really is going to need to get tweaked and fixed. So someone coming in, like, what are some of the key diagnostic tests and tools you think people should be going through?

Yeah, that's all very well said. And so, you know, I think in those pillars, people get paralysis by over analysis. Just too much information. Right. And so we really try to distill it down. I use what's called the Pareto principle. Do you know what that is?

Oh yes.

20% of information. Give you the 80% of the difference.

The little hinges swinging the big doors.

Exactly, exactly. So that's one thing that we talk about, but the other thing like you mentioned, was diagnostic tools. Okay. So we really encourage people to become the CEO of their own health. We talk about this a lot with our patients. And by that I mean, you know, who runs their business by looking at their KPIs once a year. Right. With a consultant that only has 15 minutes to spend time with them. Right. You're not going to run your business that way. So why would you run your health that way? So we educate people on the KPIs of their health. What are the key biomarkers they need to know so that.

What are those?

Okay, so in the blood testing world, we do, we do about 10 biomarkers. You want people to follow hemoglobin A1C is one of them. HSCRP, it's, which is an inflammatory marker. APOB is another one. Homocysteine levels, uric acid levels. So there's like a little list. We hear people, we actually give them a spreadsheet so they can put these things nice to.

And then do you put optimal ranges?

Because optimal ranges.

Such a mess out there.

Right.

Which, what's nice about that because I, I talk about the fact that 6.8% of us pre pandemic were metabolically healthy, but then when you look at what the metabolic health marker ranges were, those are not metabolically healthy. I'm like, what are we now? Like maybe 3% of the population is really metabolically healthy. Yeah, but already I'm hearing tests in there that you go to the doctor and, and they're not looking at Apoptine and they're not looking at homocysteine and they're not looking at uric acid. I'm sure fasting insulin is in there too. And I look at these and go, why are we missing the ones that have the biggest determinant when you really look at them? Just like, are you doing VO2 max testing by.

Yes, yes, we utilize VO2 max skeletal muscle mass. Dexa scans. We, we, we're utilizing. And the reason we're not looking at those. And I'll tell you, I'll tell you exactly the reason is that none of those have a number that's diagnostic of a disease. So, you know, if you go to a western trained medical doctor, they look at homocysteine level. If they even look at it, most of them won't order it. Like, what are they going to do with the homocysteine level? That's high. The tools are there to fix that in that world. You know what I mean?

So funny. It's one of the easier ones to.

And it is one of the easier ones to fax. Right. But there's not a prescription medication that's, that's attached to homocysteine.

So it's amazing to me, and I'm so thrilled you're doing VO2s. And also when you look at like Dexa, there's not even norms for how much skeletal muscle mass she should have, like how or body fat percentage. And the body fat percentage norms I was taught in doctoral school are totally different than what are listed now. And I'm like, I'm sure that we didn't change in the last 30 years. Why is it all of a sudden okay now to be 30% body fat when back then it was. Why did this become okay, you know?

Right.

How could that possibly be? So for the VO2 max. Like how much are you getting into exercise and specific exercise prescription stuff.

Yeah. So on the exercise pillar, you're absolutely right. You have to have. There's multiple mini pillars within that. Right, right. And so the Pareto principle is exactly what you said. Don't be sedentary. Okay. That's the first thing we gotta fix. Okay.

So the average American, I was just looking up when I was doing my talk here at I NHS, average American right now is getting three to 4,000 steps a day.

Yeah. That is wild. That's wild. Yeah. Gosh. And I would say that I would even think it's even lower than that from what I can see. Yeah. And so, you know, we, we tell people, just because you exercise 20, 30, even an hour a day doesn't mean that counteracts negative effects of you sitting there for four hours plus. So the studies on sedentary behavior show after four hours where it really starts affecting your health. And for every 10% increase you have after four hours of Sedent behavior, you increase your all cause mortality rate by 10%. So it's just like a massive, like exponential curve on the deleterious effects of being sedentary.

So first, just need a shock, a.

Shocker in the seat.

Well, there's, there's something similar to that. I have an app on my laptop that every 45 minutes it shuts the screen off. If you can't do that, just get an egg timer and it goes off every 45 minutes.

I mean we can all do this on our. Because I mean these apps are set up now to just ping you. I had a friend, Manesh Sethi, and he made this, it's called Pavlok and it was to create new habits and it was a little shocker watcher.

Yeah, Remember that? I remember reading some people need that. So. Yeah. And then on the VO2 max.

Yeah.

So we, we put into place. And the other pillars are of course, VO2 max training, zone 2, exercise training and strength trainings. We put all those into place. And then a lot of education around recovery because, you know, if you, if you are. I see so much exercising down one pillar. Not mixing it enough. Especially after the age of 40, 45, you really need to have a balanced exercise regime versus just going down one pillar a lot.

Yeah. Most of the time what I see is people going, because. And I think this is the issue with exercise. Exercise could be qigong.

Yes.

You know, or powerlifting. It's like anything in between. But you do see a lot of people just airing on the Cardio side. And when I was in school, they're like, do not have people lift weights till they've lost the weight. I'm like, like I, I was rogue and I violated that. Because I go, that's the dumbest thing I've ever heard. That's exact opposite. But you know, especially as you age, if you are cardiocentric, you are going to make yourself worse.

You're gonna make yourself worse, you're create more inflammation, you're damage your joints.

You're going to lose those fast twitchers.

Exactly. Lose the fast twitch muscle fibers, all of that. And so we really, we spent a lot of time for women mostly getting them to add strength training and cut back on the cardio. And for men, a lot of men are just gym rats. Right.

Like they just want bison chest.

Exactly. Leg day, chest day, arm day. It's like, where's your walking day? There's none of that. So, yeah, so we do a lot of balancing of exercise routine and then, you know, like everyone asks like, what is the right amount? So I always start slow. And then we look at their VO2 max and if they're improving, if we're improving VO2 max, we know we're adding in enough. If we're not improving it, we know that we need to add more. And the same goes for like, like zone two and measuring lactate thresholds and those.

You do all of that?

Yeah. Wow.

Your patients must love doing those V2 max. Explain what a VO2 max test is for everybody.

Yeah.

So scaring them.

Yeah, yeah. So a VO2 max test is when you get on a treadmill or you can actually join a bike too. And you, you have, you exercise to, to understand what is a maximum uptake of oxygen that your mitochondria are able to do. Basically that's a very basic level. And so we have on and research that show that after you reach the age of 40, your VO2 max will decline if you're not exercising. And so you have different levels of where you should be. That number should be for your age group and your sex. And so you really want to aim for, for, for, for that number. So I always use 50 at 50. You know, if you can be 50 at 50, you're, you're doing okay. And if you can go beyond that, that's even better because then you build up 100 reserve for when you become 70 and 80.

And this is of any of the tests, I think the biggest correlation was all cause mortality.

Exactly. Yeah. There's a massively correlated with all cause mortality. There's a lot of research around this test on the strength front with grip. Grip here.

Yeah. I brought a little prop to my talk yesterday. You would have thought they were like, what is that? I brought a hand grip dynamic.

They were like, what?

People. People are ordering it on Amazon. But, I mean, it's $30. And the other cool thing with hand grip dynamometers, it's a way to test grip strength. I. I told the story. I go, I was always the jar opener. Now, it's interesting because I was showing research showing that your strength declines much faster than your muscle mass. And I actually have the same or more muscle mass than I did even in my 20s and 30s. But my strength was declining because I was having trouble opening jars. And I go, what is this? You know, pull ups to the rescue. This does not mean go squeeze tennis ball. That means I go do a farmer's carrier.

You know, that is such a good point because I have this conversation with people all the time, like, why don't I just buy one of those grip.

You know, those exercises for your overall strength. It's not about your grip strength.

And the same is true of VO2 max. It's a proxy for your overall cardiovascular fitness. And your mitochondrial health is not just, you know, go to head training once a week and you're improving. It's a proxy for all the work you're putting in.

Now, when you're doing a dexa, how are you unpacking that? When you're looking at.

Yeah, so with the DEXA skin, we're looking at bone density, we're looking at visceral fat, we're looking at skeletal muscle mass as well, mostly appendicular, so arm and leg skeletal muscle mass. And comparing that to charts as well as to where we think you should be. But really it's not, you know, I think a lot of people get so hung up on, like, they have a long way to go from where they are to where it should be. It's just, I really try to explain to people that it's not about where you should be so much as are you improving or are you declining. And so I try not to focus so much on where they should be. I just like to focus on, okay, we're here now. Here's how we're going to improve you. Let's check again in six months. Let's see where you're at in six months. Make sure that the actions we put in place are making a difference in the right direction.

What I love about all of that is the in between. And when you're focusing on resistance training, this is why early on it's like, okay, I was one of the first personal trainers. I went, I could run with people, but if I take them to the gym, they're seeing all these changes because all of a sudden they're stronger. Like it is very quantifiable.

Yes.

You know, versus you went for a run, right?

Exactly. Yeah, yeah, yeah. That's very. And like a lot of people, most people like to see numbers. You know, the frequency of those numbers. You know, some people like to see them like every day. Some people like to see them once every six months. Months. But there's very few people I find that don't like the numbers. And those people, I just let me manage numbers for them and tell them they're going in the right direction. So I think it was really important for everyone to realize there's not one way of doing this and works for everybody. And for me, I see hundreds of patients and so I try to divide people up into groups of what is their tolerance to looking at the numbers. And I try to fit the program and my communication style to what the patient is going to react the best to, to create compliance.

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Yeah, so on the sleep front, yes, yes. Any like what is your. This is such. I think this is one of the most complicated topics of all, the whole sleep unpacking. And there's also all this crazy information out there online about sleep. You know, what are some of your fundamentals for sleep Sleep.

In my parental principle, sleep is number one. If you have sleep apnea, you have to have it treated. And so I can't tell you the number of patients that I see come in with sleep apnea and people that don't even look like they should have sleep apnea. I see like runners that have sleep apnea that have a body massiveness of like 20 in it.

Oh, wow. And how are you finding out about sleep?

I. We ask them questions. So there's a stop bank questionnaire that we go put them through. And then, then we measure their sleep at night. So we have the home sleep monitor that measures their pulse oximeter and their heart rate at night. And we find multiple episodes of their oxygen levels dropping at night. And so we have to fix that one way or the other. And a lot of people is as simple as raising the head of their bed. But some people do need cpap. Some people do even need surgery to get it fixed. So I think if you have sleep apnea, the solution is not like wearing blue blocker glasses. You have to be aggressive. That. Exactly. Once we make sure that we have that addressed or we've ruled it out, then we move on to. I always say one of the best ways for us to know how you're sleeping is to track it in some way or form. We need a tracker. We're not going to use it forever. Let's use it for six to eight weeks to see where you're at and what actions we can put into place to improve your sleep. Those actions are divided into two categories. Your sleep routine and your sleep environment. And then we just start making little changes to both of those to get them to the point of improving their sleep quality. And by sleep quality, I don't mean just like the 78 hours of sleep. I also mean making sure they're getting enough deep sleep and REM sleep as well.

Which. Do you have a sleep tracker you prefer?

I don't. And the reason is different things work better for different people.

I know.

I just use two and take the better score.

That's another way of doing it too. Some people are, you know, they can wear a ring on their finger at night. Some people can't. You know, some people like to have a little pad under their mattress at night to wear. Some people do it on their watch. So I try to work with what they have and what they're already used to.

Yeah.

But I will say my favorite for me personally is I've been using the Sleep 8 Sleep bed lately. So I've been.

What is it?

The 8 Sleep bed. Have you seen that?

I haven't seen it. I've heard of it.

Okay. Yeah. So what's great about it is it's a mattress cover, or you could buy a mattress, but it's a cover that actually times the temperature of your sleeping environment. So it changes the temperature of your bed. Yeah. With your sleep cycles, do you need.

To check it out?

Yeah.

What does it do about the dogs.

In the bed and too much about the dogs in the bed. Unfortunately, I think that it might make the dogs uncomfortable enough that they leave because they don't see. Our genetics are wired to look at signals to decide when it's time to sleep and when it's time to wake up. One of those signals is temperature. So as it got cool at night when we were cavemen and we didn't have temperature controlled environments all the time, it was a massive signal to our biology that it's time to sleep. And as it got warm again during the day, it was a signal to wake up. And so I found that just that has improved my personal sleep quality by like 50% just by doing.

Yeah.

We are adamant with the dropping of the temperature at night. And we're trying to. This is more challenging. I say we have the coolest stuff at home. Like we have sunlight and sauna and we have a relaxed sauna, we have a cold plunge, we have juve red lights, but we're not home. So not helping. But when we are home, but I do it on the road, I just take hot baths and then we just drop that temperature down as low as possible.

So makes a good signal. It does. The other thing that's really important about sleep that a lot of people don't realize is your sleep routine starts the moment you wake up. And so the first thing you want to do when you wake up is try to go outside, like physically put your body outside and look at the. And expose your eyeballs to sunlight. And don't look at the sun, just be outside and look at the sunlight. Even if it's a cloudy day, the signal still works for your brain to set your circadian rhythm at that point. The best morning for your brain right.

Now on the nutrition front, before we get to some of the other fun stuff, you know, just because nutrition's a toll of. I know it's been like 10 hours on this, but are there some like clear cut things that you focus on?

Yes. So I always go back to the parental principle. You know that the most important thing you can do with your nutrition that will probably make the most difference is just cut out ultra processed food. Then you can pretty much eat almost anything you want. But cutting out ultra processed food is a massive first step.

Right. I mean, who picks out broccoli, Right?

Exactly, exactly. But it goes beyond that. I think, you know, cutting out ultra processed food is not just like having like packaged food at home. It's also a lot of us eat more than 50% of our meals out. Right. And a lot of the Restaurants we go to, they're using ultra processed foods, you know, vegetables, seed oils, and they're putting together this concoction of ultra processed foods for you to eat and they're serving it to you. And that's where most of us are getting a big dose of ultra processed food. That and of course, fast food.

I know when I went, well, we had sweet greens delivered today. I heard Drew's podcast, the Sweet Greens Guy, and I'm like, okay, because always on my oil hunt. And it's not that, like, I think, you know, we don't have to be like, I'll never have that. That's not the issue. You actually need sixes. They're essential. But you know, your six to three gets so out of whack because of traveling. So that is the one that we really watch. I keep thinking, just, keep thinking I need to just start to travel with my olive oil at some point. Like, I'm like, how many suitcases am I going to take? I mean, it's, you know, come on, you know, now you're at the restaurant with all of your sea salt and sitting there like, you're like, who leave? You know.

Yeah, it gets a little bit. It gets to be a lot.

Sometimes it is, it is wild with the ultra processed foods and the effect on your metabolism. And I heard this one from our buddy Sean Stevens, the cheese sandwich study. Did you hear this? Cheese. So they did a. And this. I mean, I was like, like, well, I wouldn't tell them to eat the cheese sandwich. So this, like this was a cheese sandwich. They did a processed cheese spread. God knows what that is with, you know, a. Yeah, just some bleh.

With.

Basically it was what my mom used to send me to school with was the processed cheese from the white bread, the wonder bread. That used to be lunch. Maybe if I was lucky, I got bologna and then versus a whole grain and real cheddar cheese sandwich. And it. There was a 500 calorie metabolic difference in the thermic effect. Like just this dump in your metabolism. So I mean, it's the multi processed food thing makes you want more and lowers your metabolic rate from it. You know, it's like that's like the one, two big lunch, big bunch.

Horrible. Exactly. And you. I feel like some people think that they're never going to eliminate ultra processed food from their diet. They're never going to stop going to restaurants and they just give up. I try to encourage people that even if you have a 50% reduction, it's going to make A massive difference with exactly that fact that you talked about the thermic effect of fat food versus.

You don't get an A plus and it's like boring. Get a B plus, A minus.

Right.

And I had a great nutrition mentor who said the sicker you are, the farther back in your ancestry you need to go. I think it's like you have very little margin for error if you're in that sit be really clean.

Right?

Right.

But once you get yourself back to it, you know, then you can give a little wiggle room. Plus exercise gives you more wiggle room. Absolutely no. Right. And eating some energy deficit. Like it really becomes problematic if you're eating too much.

Right? Absolutely. And snacking multiple times.

Snacking should not be a thing.

Right.

Just no snacking. Like I still remember when snacking became a thing.

Right.

And it was when Susan Powder scream stopped the insanity sanity. We started taking all the fat out of things. I was working at Pritikin at the time and everything was like, eat as low fat as humanly possible. And we were starving to death. So we had to snack. And so they created a whole snacking thing. And back then I was like, we have not do this. We're keeping our blood sugar up all the time, like and we're dripping food all the time. It's just a terrible idea. All right, so we've got that we, we've talked about over these three pillars.

Right.

Okay. So now that we've gotten Those, the, the 80, 20 there, what would be the next step?

So the next step now is we. I always tell people the next step is now I'm going to make sure you're not going to die. What do most people end up passing away from? If you look at the CDC top 10 causes of death, heart disease is number one. We all know about, you know, heart attacks. 50% of all heart disease is diagnosing your first heart attack and 50% of the those are fatal. Right. So a quarter of the population doesn't know they have heart disease until they're dead from it. So this.

Why is that?

It's because it is massively ignored and underdiagnosed in medicine. Just like metabolic diseases, which is the foundation for heart disease. And Alzheimer's is another major cause of death and cancer is as well. Metabolic disease leads to all of those. Right. And so there's a massive amount of under diagnosis happening in the general population. And you know, the typical western medicine. Doctors are going to kill me for saying this, but it's like we just need to get much more proactive about diagnosing diseases early rather than diagnosing them when people finally get symptomatic. Symptomatic means you've had a heart attack, you might have just pain, you have mild cognitive impairment, you have a tumor that's causing you to throw up. Now it's way too late. All of these things start 20 to 30 years before you get symptoms. And we're so used to diagnosing things as symptoms. So this is where bringing the best of western medicine comes into play. So we have incredible diagnostics in western medicine. We're just not using them early enough. So I have all my patients do tests like full body MRIs. We have the grill liquid biopsy test for cancer as well, in addition to their normal screening. On the cancer front, on the metabolic disease front, we're doing continuous glucose monitors. Insulin levels, homocysteine, uric acid. We talked about those things too. Continuous glucose monitors have been a game changer with the cardiac diagnostics. We are doing a coronary calcium score on everybody. Then it clearly tests if they need it. And that's giving us a lot of information. And also we're doing the full body MRI I think I talked to you about, in addition to a full functional medicine blood panel as well. So these are diagnostics that are getting cheaper and cheaper now as time goes on. They're still expensive for most, but if the patient does do this diagnostic kind of task we call an executive physical, this group of tests, we get incredible information of Pre diagnosed disease 20 or 30 years before it occurs.

And the reality is it is really expensive to treat a disease when it's already entrenched. Right, so let's unpack this a little bit because the first thing you said was full body MRI and a liquid biopsy, but just all like liquid biopsy. Now do you need both? Do you need the liquid biopsy as well or just the MRIs and no.

Okay, so 21st century cancer diagnostics should be your normal screening test. Your colonoscopies, mammograms and GYN exams for women, prostate specific antigen and there's some deeper prostate blood tests we can get for men, skin cancer checks. Okay, so everyone should be checked for skin cancer once a year. And those are like the only recommended diagnostics in the western world right now for cancer. On top of that, the full body MRI is extremely powerful for diagnosing tumors that those tests can't diagnosed.

So then why would you need to do. And especially with mammograms, with Switzerland just outlawing Mammograms. Yeah. And I've got, yeah, I've got some amazing doctors in mindshare who have done gone through all the statistics that show there's no difference between someone getting a mammogram or not getting mammogram and their death from breast cancer. And in fact we have this one doctor, Dr. Jen Simmons, who's actually got a new technology that she, she's pushing out. So it's very, it's a very cool time in the mammoth. But couldn't you just skip all those and just do the full body mri?

No, because MRI is not very good at looking at your colon for colon cancer. Unless you're focused on the breast, it's not going to pick up all breast cancers either.

Could you do that in an ultrasound for your. Yes, that in ultrasound for your breast you could do a virtual colonoscopy and only go in if you have polyps.

Yes, you can do that as well.

Yeah, that's what I did the first time because I was like, I was like, oh no, I don't want to do that. One of my friends had just launched virtual colonoscopy MRI center. I go, that sounds better. Yes, that's a lot better. Granted, insurance didn't cover it, but.

Right, right. This is why like a lot of these things that are like cutting edge insurance is not going to cover it. So how do you get the most from your insurance and then add only what you need to add? You know what I mean? And so look, there's definitely going to be a world where mammograms go away, colonial go away. We're not there yet.

Right.

But it's important to be more complete. I think a lot of people just stop it when insurance covers and they don't go an additional step. And it's time for people to start going that additional.

Especially with early detection being cancer, everything.

So I would say like if Steve Jobs had full body MRI eating.

So weird.

Yeah. In that. Right. I mean, I think that's what caused.

Yeah.

I mean embryonic issue was just, just fructose overload.

Crazy diet. Yeah. You'd be a fruitarian.

Right.

So we could ask Dr. Rick Johnson who would have something to say on that. So. And then the liquid biopsy.

Talk about that. So the liquid biopsy detects cell free DNA of active tumors that are growing inside of you. And what's really powerful about that is I would say cancer's biggest. I would be. Is being diagnosed as stage one. Right. And so if you can diagnose Tumors early, then you have a much better fighting chance of being curative versus like, you know, stage three or four. We're talking five year survival rates now. So liquid biopsy is picking up cell free DNA. That's DNA that's not a genetic risk of cancer. It is actual tumor DNA that's being shed into your bloodstream and you can pull that out of a blood sample now. And so for about 50 different types of tumors, it will find the cell free DNA and then we can go looking for the actual tumors.

So that in itself wouldn't be diagnostic enough.

It wouldn't. No. You have to follow it up with a traditional diagnostic study like an MRI that's looking. So say it picks up a pancreatic tumor on yourself, your DNA. Then we'd have to do a MRI of your pancreas with thin cuts to actually look for the tumor itself because it's likely picking up something if it's not symptomatic. It's not a large enough tumor to become symptomatic, so you have to really go searching for it. But it is very small specific. So it will tell you you have a liver tumor, you have a pancreatic tumor, it'll tell you where to look.

So in the order of how you would do it. Because do you do all of them or do you do this one? And then because of the results of this one, do the next one.

We do everything at the same time. And the reason is most people are not going to pick up anything. Right? Exactly. And the other important thing about the full body MRI to know as well is can also pick up anatomical issues. So things like abdominal aortic aneurysms that.

Would be good to find.

Exactly. Almost all of those are fatal when they're diagnosed. Right. Because they're ruptured.

Yep. That's what my grandmother died of.

Oh, I'm sorry.

Oh, she was like, my mom just passed at 93 and everyone's like, oh, I'm sorry. I go, my mom like won this round of life. She like slid into home, she was fully functional, and then zoop out like a light. Same with grandma, like fully functional. And then poop. It's like, that's, that's what you want in your 90s. Although I want it in my 120s.

Yes.

And then. Right. And then, because here's what, here's what's super cool because we're living to 120. Well, that means that we are. Because I started to go, am I not middle aged anymore? But you are. Middle aged if we're living to 120. So that's it.

I love that.

There you go. Just fix it. Exactly. Okay, what about the clearly test?

Okay, but clearly there's also another revolution in diagnostics for cardiac disease. So the reality is, you know, there's so much controversy around cholesterol. Cholesterol levels are not diagnostic for cardiac disease. It just means you have a high cholesterol. You, you need multiple factors for that high cholesterol to cause damage to your blood vessels. So one of the most un underutilized tests in that we've had available forever is a coronary calcium score. That's a quick CAT scan of your heart that tells you if you have calcium deposited into your blood vessels.

Is that hard or soft plaque?

That is hard plaque. Okay, now that clearly is diagnostic for soft plaque.

So now explain the difference. So everybody knows.

Absolutely. Yeah. So when a blood vessel gets, starts getting clogged, for lack of a better term, there, there's, it goes through kind of a stepwise fashion of that clogging occurring. First thing that happens is cholesterol gets under the arterial wall and that's called soft plaque. And your body tries to heal it with inflammation and it calcifies it. And that's called hard plaque. So first you're going to have soft plaque and then you're going to have heart plaque. Hard plaque is your body's attempt to make sure, you know, this soft plaque doesn't turn into a heart attack. And so it's actually trying to heal this plaque. And so what that clearly does is a CAT scan over your heart and utilizing artificial intelligence, is now able to show us every artery of your heart and how much soft plaque is there, how much hard plaque is there, and it can even go one step further and tell you if that soft plaque is unstable.

Wow. So you wouldn't have to do the coronary calcium score.

Exactly.

Be redundant. Wow, that's amazing. Well, what does if you've got unstable soft plaques. I know, that's the dangerous, super dangerous.

Unstable soft plaque usually means you need to go see a cardiologist and probably get some sort of intervention done. Maybe a second put in. Yeah, exactly. Because you're living with the ticking time bone pretty much.

Wow, what an amazing test. And tell us often, would you get those and at what age would you start?

Yeah, it really depends. So there is more radiation to the clearly test because you now you're really getting a really clear CAT scan of your heart. So we try not to use it unless it's indicated or we feel strongly. So we're looking at really like looking at the overall patient, like what is their family history, what is their cholesterol level, do they have high blood pressure, do they have inflammation? What are their homocysteine levels? And if they have a constellation of risk factors, they won't get the clearly. And then some people are getting the clearly on a yearly basis because they have a lot of risk factors. Other people's once every five years or so. Because we, we have a really good picture, we know what we're going to do and it's not dangerous right now.

And if they have a lot of risk factors and you know, okay, there's a little of the genetics, but it's more just lifestyle risk factors. And they repair all those and their APOB comes down and their homocysteine gets into range. HSCRP is good. Do they still need to do it because there's the long term damage that they've done or have they gotten themselves kind of in the clear because of all the lifestyle steps?

Everyone's different. So there are some people that have completely fixed their lifestyle, but they still have coronary disease that we need to monitor very closely. And so I can think of dozens of patients that we were able to actually reverse first some of their plaque.

I was just going to ask you. So you can revert. How? Well, how do you do that?

Getting all the lifestyle things right? First of all, using some of the more aggressive cholesterol managing medications helps us wild up repatha, which is the injectable medication. But you know, some people are reversing coronary disease just with lifestyle. We've seen that.

Like, where does it go? Like what happens to this, this plaque? How does the hard plaque go away?

Yeah. So the hard plaque is harder to reverse, but the soft plaque, if you.

It'S not risky, it's not breaking free.

And the soft plaque.

Yeah, no, no.

So what happens is your body has a mechanism of fixing this. Your HDLs. Your HDLs go in there, remove cholesterol from your, from the arterial wall. So if you can just give them a chance, your body can reverse this damage. Yeah.

Wow, wow, wow. Another vote for exercise too. I know exercise and fiber are good with that.

Absolutely.

That is super cool.

Yeah.

Which then leads me, when I think of heart disease and especially women, I know there's that one of the things that's irked me for the last decade is all the negativity around hormones and all the concern around breast cancer when women die mostly of heart disease and if they're monitoring it, even if they do get breast cancer, their, their survival rate rate so good if they catch it early and when estrogen goes down, like, and I didn't know this at first, I was working in a cosmetic surgery, a plastic surgery institute, seeing clients in branch of Mirage and I could tell who was on hormones and who wasn't. So they could do all their labs. The doctors would send them in, they'd had their labs done. I'm looking at them and it was like I didn't even have to ask. So was so clear. Yeah, so clear. What would happen with their, their inflammatory markers, their cholesterol, everything was like off the charts bad.

It's. I see that all the time. Yeah. And so, you know, you mentioned this misconception around hormones as creatus. Basically, you know, I think has killed a decade of women. You know, I mean it's, it's just really sad to see what the Women's Health Initiative did and specifically the media that misreported a lot of it.

That was stupid. 25% of all of the breast cancer increased, which was one person.

Oh, there's so many, so many flaws in a lot of the reporting and the study itself, obviously. And so after we talk about, you know, in my kind of paradigm that I take our patients through, once we get through those three things, we didn't talk about Alzheimer's, but everything else feeds into that metabolic disease.

Right.

Alzheimer's is when we. Then we start talking about functional medicine that's hormone owns gut health and detoxifying someone's life and also emotional health, stress, etc. And it's so clear to me, both men and women suffer needlessly from the kind of the backlash of western medicine towards hormone replacement therapy. And there's so much suffering that's happening.

Why is there backlash with Western medicine? Is it because it can't be. Is that the best ones are compounded and what is it?

It's multifactorial. I think that people are stuck in kind of some of these older studies where having optimal testosterone levels can lead to worsening of arterial plaque. We know that's not true. We know that hormones don't lead to breast cancer for women either. And so I think a lot of people in the western medicine world were educated when those. That was the party line of the studies. And now we've turned all that around. But there's not new education and people just entrenched in their opinions. I think that's the biggest problem actually. People are Trenching their opinions. And then the compounding thing is another big problem. You know, like these are, these are compounded, and they're not something that the pharmaceutical companies have available for purchase.

So someone now has cleaned up all of this. How are you evaluating them for hormone replacement therapy? Are there people who are not a candidate?

Yeah, I mean, there's absolutely people that are not candidates. And then we're doing a lot of other types of things, supplements, exercise, nutritional support to get them to where we can help them. But I think that the way we evaluate someone next is we do a full functional medicine panel. Because with functional medicine, as you know, you're really focusing on the root cause of all of these issues. And so a lot of people don't even know what the root causes are. So we do a lot of education around that. Hormone dysregulation is one of them. We're checking for multiple different toxicities. We're checking for heavy metals, molds, indolent infections. We're checking for mitochondrial health as well. Is another root cause gut health?

Checking for mitochondrial health.

Well, that's a really tough one. And I, I knew you could ask me that, but there's a new test out there that I just did it today. You did amazing. So we're so excited about it.

I'm excited about. I've always used organic acids. And I'm like, just like looking at the exhaust in your car, I'm like, this is so cool.

Yeah, I can't wait either. And there's a new NAD level test coming out as well. So we're going to have ways to check for mitochondrial health that I think are extremely exciting. And then we're checking gut health as well. I mean, so much of our inflammation begins in our gut. And so we're looking at all of this together. And the best part about root cause medicine is, number one, you avoid disease. But the second best part is that you end up having people feeling incredible again. Right. They're more vibrant, they have more energy, they're sleeping better.

Maybe not even again. Maybe for the first time ever, you know, I mean, you think about it, there's so much I like, I wish I'd had this information.

Yeah.

And I've always been in the field, but gosh, you know, I mean, well.

This is what changed my life, you know, because I think that even though I did not, you know, I did all the calcium scores and things like that, luckily I was in the clear. But I felt horrible. And really, when I went to the functional medicine courses and fixed my Gut health, fix my hormones with hormone replacement is when I finally felt much, much better. Really reversed the course of my health.

Right. And now you can have quality years and live to 120 plus.

Absolutely.

Right, yes.

Cool.

So now you have these clinics you started with. You have I think six now, six of them. And now you have 44 popping up.

Right.

So this will be fantastic because it's, it is, is one of the challenges is people start to learn about this and they don't know where to go.

Exactly.

So your clinics are called Next Health, Next Health.

Right. And so, yeah, so the other big piece of what we're doing too is we are actually a one stop shop to do all the fun stuff that, you know, you and I use around longevity. So things like sauna therapy, cryotherapy.

Oh, so you have a little biohacking lab too?

Yeah.

So nice.

We call it our longevity circuit. And so we, we have people come in, we've done all the diagnostics and now we also have these things that you can come in once a week and do so.

And what do you have?

Hyperbaric oxygen. We have infrared light. We have heat sauna and cryotherapy. So people do that. We also have IV therapy in all the locations. So we do nutrient IVs, Nad. And we're doing some of the advanced longevity things. Things like therapeutic plasmics, pain, stem cell exosome therapy, ozone. That's kind of like the high level of what we're doing. And we're doing hormone replacement therapy as well. And we're working with some people with weight optimization as well.

Cool. You got it all.

All under one roof.

Fun.

Yes, yes, it is a lot of fun.

I used to have girls night out at the plastic surgery institute where we'd bring all sorts of different people in and do. But now like next level, now we can go to biohacking.

Exactly.

We actually did that in Tampa with one of our doctors, Dr. Lisa Coach. She had a biohacking lab and brought all the mastermind members in and had an evening event. We're all doing cryo and they had the cryotherapy that was like the size of a huge walk in freezer.

Yes.

Which was crazy. And then we had a salt room.

Yes, yes.

And I mean it was, it was so much fun.

So fun.

So fun. Fantastic. Yeah, yeah.

We don't have a salt room, but we do have that big cryogene.

So you have to big one.

Yeah. We get like four people in.

It's so fun. And you three one's in there jumping up and down and trying Dancing. Yeah, a lot of dancing going on.

It's cold.

I do not like being cold but short time. Well thank you so much for that. I'm going to put into the show notes all of the information about the centers, how to get more information how to get on your newsletter. I'll put that@jj virgin.com next health and I just love you. Really revolutionizing things. I love it.

Thank you so much aj. A lot of fun.

Be sure to join me next time for more tools, tips and techniques you can incorporate into everyday life to ensure.

You look and feel great and more.

Importantly that you're built to last. And check me out on Instagram, Facebook, YouTube and my website jjvirgin.com and make sure to follow my podcast so you don't miss a single episode episode@subscribetojay.com See you next time.

Hey JJ here. And just a reminder that the well.

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Hello listeners, this is Anne Bogle, author, blogger and creator of the podcast what Should I Read next? Since 2016, I've been helping readers bring more joy and delight into their reading lives. Every week I tag all things Books and Reading with a guest and guide them in discovering their next read. They share three books they love, one book they don't, and what they've been reading lately. And I recommend three titles they may enjoy reading next. Guests have said our conversations are like therapy, troubleshooting issues that have plagued their reading lives for years and possibly the rest of their lives as well. And of course, recommending books that meet the moment, whether they are looking for deep introspection to spur or encourage a life change or a frothy page turner to help them escape the stresses of work, school, everything. You'll learn something about yourself as a reader and you'll definitely walk away confident to choose your next read with a whole list of new books and authors to try. So join us each Tuesday for what Should I Read Next? Subscribe now wherever you're listening to this podcast and visit our website. What should I read next podcast.com to find out more?