Dr. Frank Lipman: Cutting-Edge Strategies to Boost Longevity

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Hello and welcome to Barons The Way Forward. I'm Greg Bartalus, and my special guest is Dr. Frank Lipman, who is joining us today to discuss cutting-edge strategies to optimize health and increase longevity. Welcome to the podcast.

Thanks for having me on.

My pleasure. So tell us a little bit about your background and, uh, how you got to where you are, and then let's discuss the topic at hand.

Sure. So I grew up in South Africa during apartheid, went to medical school and became a physician there in 1979. So that's 40, 45 years ago, a long time ago. And my wife and I never wanted to live under apartheid. So we immigrated to the United States and I got sponsored for a green card by a hospital in the South Bronx, at Lincoln Hospital because in those days in the early '80s, American doctors didn't wanna work there. So they were able to take the physicians they wanted and sponsor them for green cards. And that was a great introduction to America for me 'cause it was, you know, the South Bronx in those days was a burnt-out area full of heroin and crack addicts. So I started my residency and after a few weeks, and I had to do a residency 'cause I had to do 3 years in a residency to get a license in New York, although I was a physician in South Africa. After a few weeks, I realized that the medicine's very different here and I was disillusioned. So I thought I need to explore other options. And there happened to be an acupuncture clinic attached to the hospital doing detox for the heroin addicts and crack addicts with acupuncture. So I went to explore the acupuncture clinic and long story short, I fell in love with acupuncture. During my residency, I started learning acupuncture and Chinese medicine while I was doing my internal medicine training. And I realized early on the shortcomings of Western medicine. Western medicine was fantastic for acute care. If you had acute pneumonia, if you broke a bone, if you had acute appendicitis, it was wonderful, but it wasn't very good at treating chronic problems. Whereas going to the acupuncture clinic, I saw that they were helping the same problems that we weren't helping in the hospital. And I realized early on there in the mid-'80s that the future of medicine would be some combination of Western medicine for acute care for someone who's very sick and Chinese medicine for these other chronic problems when people couldn't poop and they had headaches and they were tired. We didn't have any tools in Western medicine, whereas I was learning other ways to treat them. And that began my journey on to explore other ways to help patients. And I got into nutrition and herbs and, um, acupuncture, Chinese medicine, meditation, yoga, you name it. I just started reeducating myself or educating myself in a training in addition to my internal medicine. And this evolved over the years and we developed functional medicine and 40 years later, I'm practicing what I call good medicine, which is we use Western medicine, If you come to me with an infection, I'm going to give you an antibiotic. But if you're coming with a chronic problem, I'm probably going to use some other ways of treating you before I resort to drugs. So that just evolved over a long, long period. And now it's quite sophisticated. And especially in the last 10 years with all this new research on longevity, I've melded a lot of this new research with my training in Western medicine and my training in nutrition and all these other modalities.

And just to briefly go back to the '80s, what were some of those shortcomings in traditional medicine that you saw aside from acute severe cases where you say that of course they could be helpful? What were some of the things that you were picking up on way back then or perceiving?

Yeah, so when people would come to the hospital and we'd treat them for their, they'd come in for a heart attack or acute pneumonia, And then they would come to the outpatient clinic a few weeks later and they had problems. They were tired and they were constipated or they had irritable bowel and they had headaches. They had these symptoms or problems that, you know, I could give them a drug, but that would just suppress the symptom. It wasn't really treating what the underlying issue was. And, you know, at the same time in Chinese medicine, it was more about, you know, what's the underlying cause. So, It was just an interesting way for me to revamp the way I got trained to sort of use my Western training, but use that philosophy of Chinese medicine of, you know, looking for the underlying cause, how do you increase, how do you improve function and melding the two together.

And do you think the fact that you were in South Africa gave you a more independent or detached perspective, if you will, on the system here, as opposed to maybe doctors who were educated here that you could maybe have a more global perspective? I don't know.

I'm just curious. No, no, absolutely. Definitely the way I got trained in South Africa first was different, even the Western medicine, because we couldn't afford to do all the expensive tests. You know, over here you did the blood, you did the EKG, and you didn't really have to speak to the people, the patients. There was no relationship. In South Africa, we couldn't afford to do all these tests. It was all about taking a really good history, doing a good exam, and developing some type of relationship with the patient. So our training was actually very different. And secondly, I happened to be exposed to traditional healers out at, you know, I was just very lucky in the hospital and afterwards I got exposed, you know, I worked in the bush for a while. So I was exposed to traditional healers and I saw sometimes they were helping people. So I realized early on that my training was fantastic for certain things, but was lacking in in other ways of treating patients. So yes, I do think my training in South Africa and my exposure to non-traditional healers made a difference to why I was more open to exploring other modalities.

On the topic, on health, longevity, et cetera, tell me what the foundation is. And I think I know what you might say, but I don't want to be presumptive. Tell me what are the core elements?

To me, this is just good medicine. This is not Western or alternative. You always have to look at what I call my 5 foundational elements. That is diet, exercise, stress, sleep, and then what I call the intangibles, either connection or the emotional state of someone. But it's really diet, exercise, sleep, stress, And this connection or relationships, or it's also a relationship to yourself, you know, being kind, having gratitude, having passion, you know, doing what you're passionate about. So all those factors affect your health. And if you don't work on those 5 basics, and it's not gonna be perfect, but if you don't work on those 5 basics, it's very difficult to be healthy, especially as you age.

Right. And I've read you basically said there are no shortcuts. Either you do it or you don't. That's really the foundation upon which all the other things we're going to discuss about their success depends upon. You need that, right?

Absolutely. I mean, I see longevity medicine has become very popular. It's out in the culture. People are doing saunas and cold plunges and biohacking. We can talk about biohacking. But if you don't get your foundations, if you don't work on your foundations, if you eat crap, you're not exercising, If you're sleeping poorly, if you're not dealing with your stress, you can do a cold plunge every day. You can do whatever you want to do. You're just not going to get healthy in the long term.

Okay, so that is a great foundation for this conversation. So that's not per se revelatory to listeners, right? In broad strokes, they're kind of aware of all this, even if they're not actually acting upon it. But that's kind of the baseline now. Let's talk about this whole brave new world of other things that— and much of this, I think, will be news to listeners. I'll let you take the floor and then I'll follow up with questions.

Well, I think we've reached a place in medicine where we can really fine-tune and tailor treatments to every individual. So the generic There's some generic suggestions like everyone should exercise and they should combine aerobic exercise with strength training, whatever, and everyone should learn to sleep well and deal with stress. But we've reached a place in medicine combining blood testing and genetic testing where we can really tailor someone's not only diet, but even exercise, what supplements would be helpful for them, the hormones that we can tell from the bloods, but we can basically personalize someone's program, which is quite a game changer. So in traditional medicine, everyone, if you have high cholesterol, here's a statin. If you have some reflux, here's a PPI. We can really personalized medicine to an extent, which is still— I've been doing this a long time. I've been a physician for, as I said, for 45 years. But we've got to a place in the last 5 years where the ability to personalize treatments is actually quite amazing.

In terms of the arc of ability, I mean, what does that look like? Has it been a slow and steady progress or has it been more like a —a sharp increase in recent years correlating with technological development, et cetera? Exactly.

It was a slow and steady progress. As I said, because I've been doing it for so long, we were slowly evolving functional medicine. We're evolving different treatments. But I'd say in the last 5 years, maybe a little bit longer, but definitely in the last 5 years, yeah, it's mushroomed into what the technological advances, what we can do with wearables, what we can do with this new testing, what we can do with new supplements, understanding of hormones, the new research. And part of it is there's so much money going into longevity because it's obviously lucrative for so many people that the research coming out is— it's pretty amazing and it's very exciting. Yeah.

So there are a lot of subtopics here, and I don't know in what order you want to talk about some, but I'll throw out a few points and then discuss what you deem most worthy. There's hormone replacement therapy. We could talk about the role of Ozempic, protein markers for heart disease. Sure.

Well, okay, let's talk about some of the essentials that I think people should be doing. I do, for instance, a genetic test, which is a once-off test, and it's all what we call low penetrance genes. All genes that can be modified by how you eat, what supplements you take, how you exercise. With that genetic picture, you can really tailor someone's diet and supplements because you can tell if someone— how well they're detoxing, how well they're methylating, how well they're dealing with inflammation. Are they metabolizing saturated fats well? For instance, There's a whole world that says all saturated fats are bad, and for a lot of people they are. But once you start doing genetic testing, you can tell if someone's metabolizing saturated fats well or not. There's certain markers that can tell you if you're predisposed to Alzheimer's, for instance. So the genetic testing I think is very important as a baseline. And so once often it gives us a good idea where people's metabolic weaknesses are. And then there are blood tests that unfortunately are not traditionally done, which I think are essential. The traditional lipid or cholesterol panel is just LDL, HDL, triglycerides. Now everyone should be getting an apolipoprotein B level, a lipoprotein A level. So the apolipoprotein B is a much more significant marker or accurate marker for cholesterol levels in an LDL, but these aren't standardly or routinely done. The inflammatory markers that should be done, the nutrient levels that should be done, hormone levels that should be done. So there's so many markers where one can determine where to focus someone's treatment. Once we find that someone's, let's say, Apolipoprotein B is high, Cardiac tests that I think everyone should have. There's a basic calcium score which just picks up calcification in the vessels, but there's also this new test called the Cleerly, which is an angiogram with AI behind it. Yes, it's more expensive, but it can tell not only if you have calcification, but if you have non-calcified plaque, if you have soft plaque or low-density plaque, which is a dangerous plaque. So we can really dig deep into someone's health. And, you know, I believe we don't have to have heart attacks anymore. We can prevent, if we catch it early, we can prevent heart disease and heart attacks. The same thing with brain health. We can now do EEGs, QEEGs, which can tell us if certain areas of your brain are overactive or underactive. And then from that result, you can program a red light helmet to give you red light therapy to your brain. I mean, there's wild stuff going on. This is all new, the red light therapy to the brain. But I am now of the belief that we probably can prevent Alzheimer's to a large extent as well. So we have got to a place where we can prevent all these diseases that we are all petrified of. Now, cancers are more complicated. I'm not gonna go there because Ultimately, I think we probably could prevent most cancers, but heart disease and Alzheimer's, two diseases that are epidemic and everyone's scared of, are basically preventable. Very interesting.

You mentioned earlier biohacking, and I think some listeners may have heard it, but maybe they're not entirely sure what that exactly means.

So from my perspective, biohacking is just finding ways to optimize function in your body. But, you know, what has evolved with the world of the Joe Rogans and so many other people is they are, you know, using cold plungers, saunas, any way that people can, what they call, hack into the functioning of their body. Certain nutrients can do it, hormones can do it. I think the way to understand biohacking is just how do I improve functioning of my body, and that can be done with supplements. Once, you know, to me, your most important biohack is how well you sleep. So it's all the same things, but biohacking has just added another level. You know, people hack their blood sugar, so they wear a continuous blood glucose monitor, see what foods, you know, peak their blood sugar and adjust accordingly. A lot of people, like, you know, wear an Oura ring to check how— on my sleep. So there are many of these wearables that you can check how you're functioning and then hack or adjust accordingly. Right.

Right. And so it's very holistic, inclusive, meaning nutrition, lifestyle, technology, just kind of anything and everything pulling it in to serve that goal.

That's my take on biohacking. Yes.

Right. Right. And Definitely interesting, just the amount of drugs as well. I mean, talk about the—

Yeah, I think this is important for people to realize. This is not anti-medication. This is about using medications intelligently. If someone's lipid numbers are really off, then they may need to bring their apolipoprotein B down. There are different ways of doing it. Usually diet and exercise is probably not the best way to do it. Statins are the standard drugs used, but statins have problems for a lot of people. You know, the latest drugs seem to be much more effective and have less side effects, the PCSK9 inhibitors, which could be better. So, you know, using drugs accordingly there. I'm a huge fan of the GLP-1 agonists, that's the Zempic, Manjara type, but at much lower doses than are generally used. These drugs, these GLP agonists, first of all, are game changers for people's health, for obesity, diabetes, and that. But I use them in low doses as a longevity drug because as peptides, they have multiple downstream effects. Help with your lipid numbers, they're cardioprotective, they're neuroprotective, they're immunoprotective. They're wonderful, wonderful drugs, call them what you like. So I use them, call them peptides, call them drugs. I use them a lot. I take it myself. I don't wanna lose weight, but I use it as an anti-aging medicine, but at a low dose. So we don't go to the doses, I very, very rarely go to even as high as the starting dose, but And it's after those doses where you start getting side effects. But at the lower dose, side effects are very rare and beneficial effects are— there's so many. It's a good example of a drug, a low-dose drug that can be extremely effective for a lot of people. Right.

So in addition to the weight loss, there might be less of a chance of having other disease, less stress on your knees, your joints, your bones, right? Absolutely.

And another drug which I find fascinating that we use a lot in the longevity world are the drugs like Cialis and Viagra, which vasodilate. Everyone knows them for erectile dysfunction, but why they help with erectile dysfunction is they improve the blood flow to the area, but they also improve blood flow to the brain, to the heart. So they're actually really interesting drugs. And once again, I use them in low doses for all the other beneficial effects. So I think what more and more research is showing is if you use some of these drugs that we've been using for years at higher doses, sometimes using them at lower doses, using them responsibly and in a targeted way can be incredibly helpful for longevity. Yeah.

One more question, just going back to drugs like Ozempic. In the short term, for now, we've heard a lot of positive ancillary benefits to, you know, mention less chance of diabetes, weight gain, joint pain, a whole raft of benefits. To the extent that you know or have an opinion, how do you characterize this long-term safety profile of drugs like that? Yeah, look. At the regular dose too, not at a minor one.

I think these drugs have some, I mean, they're not benign, especially as you start going up with the drugs. You know, the commonest side effect are gastrointestinal. So these aren't harmless drugs. You know, whenever you use a drug or whatever you do, supplements too, you've gotta be smart about it. But I do feel low dose, using these drugs at a low dose and responsibly for the right people can be incredibly helpful. I very rarely see side effects at a low dose. I don't usually use higher doses. Do I see side effects at higher doses? Absolutely. So I do not think— I think they're overused and used irresponsibly too often, but that doesn't mean they're bad drugs when they're used appropriately. Okay.

I've read somewhere that you're positive on nootropics. Tell me about that. And frankly, they weren't on my radar. And then the very day I read about it, I tried a hop water. It's like a— yeah, just what it sounds like, hop-flavored water. And they have it in it. And it was like interesting.

So nootropics are— are substances that are going to help brain function. Caffeine is your classic nootropic, which is a wonderful nootropic. But everyone, especially in the world you live in, wants better brain function. So messing around or exploring different— I use the herbal ones or more natural ones. I mean, there are some drugs. Once you start getting into the drugs, I think once again, that comes with side effects. So I tend to use, whether it's caffeine, I use ketone drinks, I use choline. There are many different nootropics. Fish oils can be considered a nootropic. But once again, I think it needs to be done responsibly with someone who knows what they're doing. The red light helmet is basically a nootropic. So I'm all about improving function and improving function of the brain becomes more important as you get older. I'm all for them. Yeah.

Tell me about wearable health tech. I mean, the Apple Watch is kind of the low-hanging fruit, obvious example. What's your take on those? And are there areas or ways that these can be used that people aren't really thinking about that might be beneficial? Yeah.

So I think wearables are, once again, depends on the personality. It can make people neurotic. So you've got to be careful about that. I personally don't like to wear an Apple Watch. I don't want all that tech. But I do think, you know, there can be help. I mean, they've gotten sophisticated enough where they can track how you exercise. There are rings, or an Apple Watch does it as well, that can track sleeping, which I find helpful. I mean, I don't use them as the only marker. I think you gotta see patterns, but they can be very helpful. I'm a big fan of continuous blood glucose monitors because, Everyone is different. What we find with blood sugar is certain foods spike certain people's blood sugars and the same foods won't spike the next person. So I think it's just, these are just ways of getting more information to really fine-tune what you're doing. I mean, another bio, it's not really a biohack. I mean, we can measure body composition now, which is, really important, especially as you age, because as you age you start losing muscle mass. We can measure body compositions, and especially if someone's on a GLP-1 agonist, because one of the side effects is not only do you lose weight, but you lose muscle mass. You can monitor this. I mean, there's certain scales, the InBody, for instance, I have in my office. You can measure skeletal muscle mass. You can see if someone's losing muscle mass. You can see if someone needs to do more strength training. So there are different ways of measuring how you exercise, the effect of exercise, how you sleep, the effect of sleep. We are entering fascinating times. I mean, in all my time in medicine, this is like the most exciting from my perspective anyway.

These are stories, things in our environment that we read about all the time, and I want to ask your opinion on them. And just, I'm curious to see what you make of this. Anyone listening has surely come across stories talking about microplastics. People also are reading about falling fertility rates, and people are reading about rising colon cancer among young people, which would have been unthinkable years ago, and then a much higher prevalence of autism as well. So these are just a few examples, and I don't know if there's any thread or what have you, so I just put it out there. I'm curious, you know, for your take on any or all of those things.

So yes, there's One of the common threads is the amount of toxins and chemicals in the environment. A lot of them happen to be endocrine disruptors. That means they affect your hormone system in a way that they'll either increase production of a hormone or decrease production of the hormone. They can block productions of hormones. So they work on your hormonal system, endocrine being your hormones. And I, as many others, believe that the common, you know, a lot of young guys have low testosterone, which is probably related to the fact that they've been exposed to so many plastics and other endocrine disruptors in the environment, which are disrupting their hormonal systems and causing low testosterone. So yes, that's a common thread. Microplastics are everywhere. They're finding it in the brain, they're finding it in the eye, they're finding it in the heart. We have a problem that we are just starting, you know, people have been, you know, talking about this for ages, but I think there's more and more research showing that these, whether it's microplastics or other little chemicals, are getting into our system and causing all sorts of problems. You know, colon cancer may be one of them. Colon cancer is probably more likely related to what we have in our food. Even the food, what we put our food in is full of these chemicals that leaches into our food. So we've got a problem. We are inundated with all these chemicals and toxins and it's overloading our body's natural detox systems. And actually why I think For instance, why that genetic test I do is so important. It can actually help us, and there's certain genetic variants where people don't metabolize these toxins well. There's, for instance, the GSTM1 deletion, we call it, where a lot of people do not have enough of an enzyme to actually break down these chemicals. When we see people with a gene variant like that, They are gonna be more prone to cancers. They are gonna not be able to break down hormones as well. When you give them hormone replacement, you've gotta be careful. So you need to upregulate these detox systems. The beauty of the genetic test is if you find a genetic variant like that, you can give them a supplement. It's called sulforaphane, which is basically concentrated broccoli sprouts, which upregulates your detox system. So the beauty of what we can do now is you can measure these things and then you can work with what you see and support someone's weak areas. But yes, to answer your question, I do think these are big problems and we're going to have to address them.

Yeah, I mean, not to— not that we're here to finger point, but I mean, in terms of culprits for this, I mean, you mentioned food companies. I mean, I'm sure A number of companies will use these plastics. So it's a combination of things, right? It's not— Yeah. Yeah.

Yeah, yeah. It's the amount of chemicals that we're exposed to. It's not just one or two. It's just we're exposed to it in the air, in the water, in the food, in air fresheners. So we're exposed to it so frequently, and that's the problem. It's not just one or two things. And our capacity to metabolize as many chemicals is overloaded, so it becomes a problem. Right.

And I know you can do tests for allergies as well about what you're allergic to, but a lot of times people have allergic symptoms and they can't figure out what the heck they're allergic to, but they clearly are having a reaction to something. Yes.

So that's a little bit more complicated because that may be a secondary effect of a microbiome, which is a— You know, the bacteria in your gut, which can be a problem when that microbiome is off. You're going to be more prone to allergies. So that's a whole other discussion, the microbiome. But yes, you are going to be more prone to allergies. Yeah.

Before we conclude, I just wanted to ask if there's anything else that you'd like to add?

Yeah, I think, you know, people need to take their health into their own hands. I think unfortunately I'm a, board-certified internist. I think this information is out there, whether it's from Joe Rogan, Peter Attia, wherever people are getting the information, people are much more educated and aware now. And it's a bit of a problem because they go into their doctors and their doctors are either poo-pooing it or not doing what a lot of people are asking for. And I think you need to know There's certain things that can be done and should be done. And if your doctor's not doing it, you need to find other ways. You know, it's easy to get this stuff done now, but ultimately you've got to educate yourself, take charge of your health, and do what you know is right for you. Now, you should work with your doctor, but if your doctor is not aware of these things, you either start educating him or find somewhere else to get these things done. But I do think We're at a place in medicine where you can measure and test enough or get enough information about your health to make huge changes, and it's never too late.

Well, thank you for all that information and for joining us. Greatly appreciate it. You're welcome. My guest has been Dr. Frank Lippmann. For more podcasts and the latest wealth management news, visit barons.com/advisor. For The Way Forward, I'm Greg Bartalus.

This podcast was brought to you by Wells Fargo Advisors. Looking for a firm your clients can't outgrow? Wells Fargo Advisors offers financial advisors full balance sheet solutions with wealth planning, investment products, banking, and lending that meet the needs of affluent to ultra-high net worth clients. Build your practice your way and on your schedule with independent and employee model options designed to meet your needs today and tomorrow. Learn more at joinwfadvisors.com.