Podcasts about A1C

In this evidence-packed episode, Dr. Scott Watier and Tommy Welling dissect a December 2025 systematic review and meta-analysis from Frontiers in Nutrition examining how intermittent fasting improves metabolic syndrome outcomes compared to traditional calorie restriction. They reveal that participants with metabolic syndrome—defined as having three or more risk factors including elevated waist circumference, high triglycerides, low HDL, elevated blood pressure, and high fasting glucose—experienced significant improvements in fasting blood glucose, A1C, insulin resistance, LDL cholesterol, and inflammatory markers with high certainty of evidence when using various IF protocols. The hosts explain why smart, experienced people spend years tracking and counting calories yet feel stuck, emphasizing that intermittent fasting addresses the root drivers of metabolic dysfunction rather than just creating a caloric deficit through willpower and restriction. They demonstrate how modified alternate-day fasting showed 50-100% greater reductions in inflammatory markers over 16 weeks, and why time-restricted eating delivers faster blood sugar improvements, providing practical guidance on matching your fasting pattern to your metabolic profile while focusing on beneath-the-surface changes happening long before the scale or the world can see them. ⁠⁠⁠⁠⁠⁠Take the NEW FASTING PERSONA QUIZ! - The Key to Unlocking Sustainable Weight Loss With Fasting!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Resources and Downloads: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SIGN UP FOR THE DROP OF THE ULTIMATE GUIDE TO BLOOD SUGAR CONTROL⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠GRAB THE OPTIMAL RANGES FOR LAB WORK HERE! - NEW RESOURCE! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠FREE RESOURCE - DOWNLOAD THE NEW BLUEPRINT TO FASTING FOR FAT LOSS!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SLEEP GUIDE DIRECT DOWNLOAD⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠DOWNLOAD THE FASTING TRANSFORMATION JOURNAL HERE!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Partner Links: Get your⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ FREE BOX OF LMNT⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ hydration support for the perfect electrolyte balance for your fasting lifestyle with your first purchase⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ here!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Get ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠25% off a Keto-Mojo⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ blood glucose and ketone monitor (discount shown at checkout)! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Click here!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Our Community: Let's continue the conversation. Click the link below to JOIN the ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Fasting For Life Community⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, a group of like-minded, new, and experienced fasters! The first two rules of fasting need not apply! If you enjoy the podcast, please tap the stars below and consider leaving a short review on Apple Podcasts/iTunes. It takes less than 60 seconds, and it helps bring you the best original content each week. We also enjoy reading them! Article Links: https://pubmed.ncbi.nlm.nih.gov/41459076/

Justin, diagnosed at age 3 in 1987 , explores how DIY looping lowered his A1C from 10.0 to 5.1 , CGM necessity , and how stability improves relationships. Type 1 Diabetes Pro Tips - THE PODCAST Eversense CGM Medtronic Diabetes Tandem Mobi ** Use code JUICEBOX to save 40% at Cozy Earth  CONTOUR NextGen smart meter and CONTOUR DIABETES app Dexcom G7 Go tubeless with Omnipod 5 or Omnipod DASH * Get your supplies from US MED  or call 888-721-1514 Touched By Type 1 Take the T1DExchange survey Apple Podcasts> Subscribe to the podcast today! The podcast is available on Spotify, Google Play, iHeartRadio, Radio Public, Amazon Music and all Android devices The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here or buy me a coffee. Thank you! *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Omnipod 5 Controller is not waterproof.  ** t:slim X2 or Tandem Mobi w/ Control-IQ+ technology (7.9 or newer). RX ONLY. Indicated for patients with type 1 diabetes, 2 years and older. BOXED WARNING:Control-IQ+ technology should not be used by people under age 2, or who use less than 5 units of insulin/day, or who weigh less than 20 lbs. Safety info: tandemdiabetes.com/safetyinfo Disclaimer - Nothing you hear on the Juicebox Podcast or read on Arden's Day is intended as medical advice. You should always consult a physician before making changes to your health plan.  If the podcast has helped you to live better with type 1 please tell someone else how to find it! Diagnosed at 3, Justin shares decades of frustration, lost time, and finally finding CGM, Loop, and better control—plus why he's angry at the system, not just diabetes.

In this biochemistry-made-simple episode, Dr. Scott Watier and Tommy Welling use the powerful "metabolic battery" analogy to explain why some people feel stuck despite doing everything right with their fasting and food choices. They break down how excess glucose creates a traffic jam in your mitochondria by overloading NADH and depleting NAD+, which promotes insulin resistance and blocks fat burning even when you're following your fasting schedule perfectly. The hosts reveal why reaching for NAD+ supplements misses the point—it's like adding more battery packs to a device you never unplug—and instead provide actionable strategies to restore natural battery cycling through consistent fasting windows, protein-based meals, post-meal movement, and protected sleep. They explain how continuous glucose monitors show you the real-time movie of your metabolic battery's charge-discharge cycle, not just the final score like A1C tests, helping you understand why certain food choices create the wired-and-tired, crashing-after-meals pattern that sabotages your fasting efforts and keeps you trapped in a cycle of cravings and inconsistent results. ⁠⁠⁠⁠⁠Take the NEW FASTING PERSONA QUIZ! - The Key to Unlocking Sustainable Weight Loss With Fasting!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Resources and Downloads: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SIGN UP FOR THE DROP OF THE ULTIMATE GUIDE TO BLOOD SUGAR CONTROL⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠GRAB THE OPTIMAL RANGES FOR LAB WORK HERE! - NEW RESOURCE! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠FREE RESOURCE - DOWNLOAD THE NEW BLUEPRINT TO FASTING FOR FAT LOSS!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SLEEP GUIDE DIRECT DOWNLOAD⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠DOWNLOAD THE FASTING TRANSFORMATION JOURNAL HERE!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Partner Links: Get your⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ FREE BOX OF LMNT⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ hydration support for the perfect electrolyte balance for your fasting lifestyle with your first purchase⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ here!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Get ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠25% off a Keto-Mojo⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ blood glucose and ketone monitor (discount shown at checkout)! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Click here!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Our Community: Let's continue the conversation. Click the link below to JOIN the ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Fasting For Life Community⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, a group of like-minded, new, and experienced fasters! The first two rules of fasting need not apply! If you enjoy the podcast, please tap the stars below and consider leaving a short review on Apple Podcasts/iTunes. It takes less than 60 seconds, and it helps bring you the best original content each week. We also enjoy reading them! Article Links: https://www.youtube.com/watch?v=7gN0hEyCO_E

For me, intermittent fasting is a time travel machine. I started my weight loss journey (in the modern era) a few years ago. I've been overweight since I finished college in the mid 90's, and though I used to run marathons, I did not run for about 20 years and gradually got heavier andHeavier through 2019, when I used the advice of a dietician to briefly lose about 20 pounds from 240 to 220, but then went back up when I couldn't maintain my food habits. I got to be my heaviest soon after, when I ballooned all the way up to 257, which is the highest I ever remember being on the scale. I was extremely uncomfortable and not enjoying how my clothes fit– 'cause they didn't. Though the exact timing is foggy to me, I chose to begin running again in early 2023, when I had gotten back down to 242. It was also around this time that I fully transitioned into a newcareer. My last career, though exciting, was not conducive to establishing a daily routine—a daily routine is very important for establishing a fitness routine and reducing friction in healthyhabits. My new career is as a carpenter, which I've been doing since 2020. My old career was as an ice sculptor–yes, I am that guy. Both careers allowed lots of physical activity, butmy new career was not seasonal–thus daily routine became possible. Therefore, a fitness journey became a reality. Running helped my state of mind and helped me lose weight—I steadily lost weight all the way down to 209-213 and then hit a plateau I could not get past. On October 13th of 2025, I had my annual Doctor's appointment, where my Doc usually tells me my cholesterol is high, my A1C is high, and I'm pre-diabetic–only this time he didn't say any of that. My cholesterol was fine, and my A1C wasn't outrageous–maybe 6. This was the first Doctor's appointment I remember where one of those wasn't too high. He said to keep doing whatI was doing, but I said I can't get past 209, so I'm thinking of trying Intermittent Fasting. He was supportive of the idea, saying he had to change the routine whenever he hit aplateau, so I thought to myself, I can try this (for 30 days). I can do anything for 30 days, so I started that day. Four days later, I said to myself–I feel so good, I think I can do this for the restof my life! Also, during that time, I fully immersed myself in all IF podcasts and YouTube videos. I listened to a lot of Gin Stevens' podcasts, and that's where I heard about your podcast and then listened to yours for a while–(which I appreciate as a man). The IF journey is individual for allof us, but I really wanted to hear about the experience of men since I cannot relate to anything related to menopause. I also watched a lot of Jason Fung on YouTube. I stopped eating breakfast–I just drank black coffee and went to work. At lunch time, I ate the lunch my wife had made for me, and at 5 pm, I went home and ate dinner—then I did it all over againthe next day and the next. I started losing weight again right away–I was at 213 on October 13 and lost 2 pounds per weekfor the next month…Around December, I got to around 199, but December is filled with culinary delightsand hazards–I still fasted every day, but I ate richer and sweeter foods, making it throughthe holidays, maintaining my weight instead of gaining (which is what I'd do every other year). In January, when my food became more routine again, I started losing again. I got down to 193 at theend of January, and now I am at 191. I say IF is like a time travel machine because every week I am lighter than the week before, I have to look further back in time to find the last time I was that weight. I am encroaching upon 1996 when I was working my first job out of college. The weight loss is not quick on 16:8, 17:7, or 18:6, but it is fairly steady, with some weeks showing gains and a big loss, and some weeks showing little to no change. More in the episode.

Type 2 diabetes remission is possible. In this episode of the Health Pioneers Podcast, Dr. Salvatore Gorla explains why the standard medical approach keeps patients stuck managing their blood sugar instead of actually fixing the problem.Dr. Gorla ran one of the largest functional medicine practices in America for over 25 years. He has spoken at Harvard on reversing type 2 diabetes and has helped thousands of patients lower their A1C naturally using his evidence-based three-pronged approach.His journey started after watching his grandfather follow every doctor's order and still die from diabetes complications at age 67. That experience led him to develop a method that targets the three root causes most doctors never address: chronic inflammation, fatty infiltration of the liver and pancreas, and hormone imbalance.What we cover in this episode:00:00 Can type 2 diabetes actually be reversed  05:08 The three pronged approach to diabetes remission 06:56 Why disease management is not the same as health care 08:00 Why insulin resistance is a symptom not the cause 13:22 How inflammation causes type 2 diabetes 17:07 What high A1C does to your brain and mood 21:07 Best diet for type 2 diabetes explained simply 25:34 How big pharma profits from long term patients 28:54 Why hope matters for reversing type 2 diabetes 32:26 The danger of diabetes drug side effects and polypharmacy 35:04 Is type 2 diabetes genetic or lifestyle 36:35 How type 2 diabetes causes erectile dysfunction in men 38:25 Can severe type 2 diabetes still be reversed 41:03 Why internet health information confuses diabetic patientsAnswered In This Episode: Can type 2 diabetes be reversed naturally?Yes. Dr. Gorla explains that type 2 diabetes is one of the easiest chronic conditions to put into remission when the root causes are addressed. His approach focuses on reducing inflammation, removing fatty buildup in the liver and pancreas, and restoring hormone balance.Is managing type 2 diabetes with medication enough?Standard diabetes management treats symptoms but often does not address the deeper causes like gut inflammation, nutrient deficiencies, and adrenal hormone imbalances. Many patients on multiple medications still see their A1C go up and down while dealing with serious side effects.What is a dangerous A1C level?An A1C between 5.7 and 6.3 is considered prediabetic and already increases the risk of stroke and heart attack. Dr. Gorla explains why even prediabetes should be taken seriously and treated early.Find Dr. Salvatore Gorla:Website: https://drgorla.com/ Health Pioneers PodcastIf you've ever left a medical appointment feeling rushed, dismissed, or more confused than when you walked in, you're not alone.Health Pioneers is a podcast featuring clinicians and health practitioners who looked at the conventional system and decided to do things differently.Each episode highlights a practitioner who stepped off the beaten path to build a better way of helping patients…one focused on root causes, deeper thinking, and care that actually makes sense.These are thoughtful conversations about how great practitioners think, what they see that others miss, and why they chose a different path.Health Pioneers is a Healthpreneur production hosted by Jim Rohr, our head of marketing at Healthpreneur. Healthpreneur is on a mission to help the best health experts serve the most people, and Jim has spent the past 20 years as a practitioner, author, and advocate for root-cause medicine.#type2diabetes #diabetesremission #functionalm edicine #A1C #insulinresistance #bloodsugar #healthpioneerspodcast

In this episode, Dr. Eric talks with certified nutritionist and menopause specialist Leah Vachani about blood sugar imbalances, insulin resistance, and how these issues often show up long before a diagnosis of prediabetes or type 2 diabetes. Leah shares how her work with women in perimenopause and menopause led her to see blood sugar as a major missing piece in hormone health, energy, sleep, and weight regulation.Together, they explore why stress, poor sleep, processed foods, and hormone shifts can all contribute to unstable blood sugar. Leah also explains how continuous glucose monitors can help people see their individual patterns more clearly, from food triggers to stress spikes, while also discussing the limits of CGMs, fasting insulin, A1C, protein intake, apple cider vinegar, intermittent fasting, and exercise.This conversation gives listeners a practical, realistic look at how to support better metabolic health without chasing perfection. If you want a clearer, more balanced understanding of blood sugar imbalances and insulin resistance, you'll get a lot out of this episode.To take the Save My Thyroid Quiz visit www.savemythyroid.com/quiz Free resources for your thyroid healthGet your FREE Thyroid and Immune Health Restoration Action Points Checklist at SaveMyThyroidChecklist.comHigh-Quality Nutritional Supplements For Hyperthyroidism and Hashimoto' s Have you checked out my new ThyroSave supplement line? These high-quality supplements can benefit those with hyperthyroidism and Hashimoto's, and you can receive special offers, along with 10% off your first order, by signing up for emails and text messages when you visit ThyroSave.com. Do You Want Help Saving Your Thyroid?Get free access to hundreds of articles and blog posts: https://www.naturalendocrinesolutions.com/articles/all-other-articles Watch Dr. Eric's YouTube channel: https://www.youtube.com/c/NaturalThyroidDoctor/videos Join Dr. Eric's Graves' disease and Hashimoto's group: https://www.facebook.com/groups/saveyourthyroid Take the Thyroid Saving Score Quiz: https://quiz.savemythyroidquiz.com/sf/237dc308 Read all of Dr. Eric's published books: http://savemythyroid.com/thyroidbooks Work with Dr. Eric: https://savemythyroid.com/work-with-dr-eric/

Get Dr. Vonda's latest insights on strength, bone health, longevity, and aging with power delivered straight to your inbox. Join her free health & longevity newsletter here: https://www.drvondawright.com/resources/aging-longevity   You only build bone during deep sleep, and only if you get enough of a growth hormone spike to make it happen. As someone who has spent her career fighting osteoporosis, I had never connected those dots that clearly before. Morning light, deep sleep, and bone density are part of the same biological chain. That alone is worth the listen. This week, I am joined by Dr. John La Puma, the originator of culinary medicine. After reviewing over 2,200 studies for his new book, Indoor Epidemic, his conclusion is both sobering and actionable: we are spending 93% of our lives indoors, and our biology is paying for it in ways most of us cannot even perceive. Fatigue. Brain fog. Disrupted sleep. Accelerated aging. And we keep reaching for supplements and prescriptions when the answer is often just outside the door. What we cover: - Why 93% of our time indoors is a biological emergency quietly aging us faster from the inside out. - How 10 to 15 minutes of morning light resets your circadian clock and primes your body for deep, restorative sleep. - Why screen light within 30 minutes of bedtime drops melatonin by 20%, no matter what else you did right. - How deep sleep triggers the growth hormone spike your body needs to build bone, making it a frontline tool against osteoporosis. - Why green exercise feels 20% easier and drops cortisol by 21% when done in a place of your choice. - What digital obesity really means and why too many pixels burn out your brain the same way too much sugar burns out your metabolism. - How one hour of gardening a week can lower hemoglobin A1C by 0.5%, roughly equal to a starting dose of metformin. - What the Louisville Green Heart Study found, including a 22% drop in CRP, when greenery came to a community. - Why two to five intentional hours outdoors each week can give you up to five years of health span back.   About Dr. John La Puma: Dr. John La Puma is an academic clinician, trained chef, and organic farmer recognized as the originator of culinary medicine. He runs a certified organic educational farm in Santa Barbara and led the first CME course in the country teaching physicians to use nature as medicine. Indoor Epidemic is his distillation of 2,200 studies into a practical guide for reclaiming your biology. Connect with Dr. John La Puma: Website: https://www.drjohnlapuma.com/ Instagram: https://www.instagram.com/johnlapuma/   Timestamps 00:00 Intro 01:30 Culinary Medicine, Organic Farming and the Origin of a Field 03:30 The Indoor Epidemic: Why 93% Indoors Is a Biological Emergency 07:00 How 10 to 15 Minutes Resets Your Entire Biology 11:00 Screens, Melatonin and the 30-Minute Rule Before Bed 13:30 How Your Brain Cleans Itself During Deep Sleep 17:00 Why Over 50% of Your Genes Run on a Body Clock 20:00 20% Less Effort and a 19% Reduction in Mortality 24:00 Digital Obesity and What Ultra-Processed Time Is Doing to Your Brain 28:00 Indoor Air, Toxins, Carbon Dioxide and the Invisible Cognitive Drain 32:00 Chronic Inflammation, Telomere Shortening and Premature Aging 34:00 Greenery, CRP and Cardiovascular Health 38:30 Gardening, Hemoglobin A1C and the Metformin Comparison 41:00 Deep Sleep and Bone Building 44:30 The Biggest Barrier to Change and Why Knowledge Comes First 46:30 Two to Five Hours Outdoors a Week Can Add Five Years to Your Health Span  

In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes David Seiter, FNP-C, for a wide-ranging discussion on challenging dermatologic dogma and integrating emerging evidence into clinical decision-making. They begin with Seiter sharing his approach to reviewing new literature, encouraging clinicians to look beyond mainstream dermatology journals to cross-disciplinary publications to help reshape long-held assumptions. Using lichen planus as an example, he revisits the entrenched association between diffuse lichen planus and hepatitis C. While many clinicians routinely test for hepatitis C in these patients, new data suggest the association is uncommon. More compelling, however, is the emerging link between persistent, widespread lichen planus and underlying malignancy. Seiter outlines how he thoughtfully screens for red flags and gaps in preventive care without alarming patients prematurely, reinforcing the importance of looking beyond a single lab test. The conversation then shifts to acanthosis nigricans, where traditional teaching centers on hyperglycemia and diabetes risk. Seiter explains why acanthosis nigricans is more accurately viewed as a marker of hyperinsulinemia rather than elevated A1c. He discusses incorporating HOMA-IR calculations to identify early insulin resistance, particularly in adolescents whose A1C may remain normal for years. Both clinicians stress that a “normal” A1C should not prematurely reassure patients when cutaneous markers signal metabolic risk. Additional topics include reconsidering intralesional triamcinolone as the default therapy for keloids, with discussion of emerging data on intralesional insulin as a potentially lower–adverse event alternative, and a pragmatic conversation about JAK inhibitor safety. Comparing adverse event data across agents, they emphasize individualized risk assessment, careful monitoring, and shared decision-making over reflexive fear of boxed warnings. Tune into the episode to explore how questioning assumptions, broadening your literature review, and contextualizing risk can sharpen your clinical reasoning and elevate patient care in everyday dermatology practice.

After a shocking LADA diagnosis, endurance runner and pharmacist Zach relearns insulin, exercise, and vigilance—finding confidence, a 5.4% A1C, and balance in just nine months. Free Juicebox Community (non Facebook) Type 1 Diabetes Pro Tips - THE PODCAST Eversense CGM Medtronic Diabetes Tandem Mobi ** Use code JUICEBOX to save 40% at Cozy Earth  CONTOUR NextGen smart meter and CONTOUR DIABETES app Dexcom G7 Go tubeless with Omnipod 5 or Omnipod DASH * Get your supplies from US MED  or call 888-721-1514 Touched By Type 1 Take the T1DExchange survey Apple Podcasts> Subscribe to the podcast today! The podcast is available on Spotify, Google Play, iHeartRadio, Radio Public, Amazon Music and all Android devices The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here or buy me a coffee. Thank you! *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Omnipod 5 Controller is not waterproof.  ** t:slim X2 or Tandem Mobi w/ Control-IQ+ technology (7.9 or newer). RX ONLY. Indicated for patients with type 1 diabetes, 2 years and older. BOXED WARNING:Control-IQ+ technology should not be used by people under age 2, or who use less than 5 units of insulin/day, or who weigh less than 20 lbs. Safety info: tandemdiabetes.com/safetyinfo Disclaimer - Nothing you hear on the Juicebox Podcast or read on Arden's Day is intended as medical advice. You should always consult a physician before making changes to your health plan.  If the podcast has helped you to live better with type 1 please tell someone else how to find it!  

Your hemoglobin A1C might look “normal,” but that doesn't mean your hormones are. In this episode, we explore how early insulin resistance can quietly delay ovulation, shorten the luteal phase, and disrupt fertility long before blood sugar levels raise red flags. You'll learn which metabolic tests actually reveal early dysfunction—and practical cycle-timed steps to restore steady energy and predictable ovulation.If you've been told everything is fine but your cycles disagree, schedule a free discovery call at radiantclinic.com to uncover a personalized restorative plan.Send a text

***JOIN THE NEXT MASTER YOUR FASTING CHALLENGE THAT STARTS MARCH 4th, 2026!*** We'll GUIDE you on how to FAST to LOSE FAT for good, and use ‘fast cycling' to achieve uncommon results! ⁠REGISTER HERE!⁠ Click the link for DATES, DETAILS, and FAQs! In this evidence-based episode, Dr. Scott Watier and Tommy Welling examine a groundbreaking 2026 study showing how a simple 12-hour overnight fast (8 PM to 8 AM) produced remarkable results for type 2 diabetics, including 50% better fat loss, significant A1C reductions, and medication decreases—all without extreme fasting protocols. They reveal that 80 million Americans have undiagnosed prediabetes and challenge the belief that severe metabolic issues require drastic interventions, demonstrating how modest timing changes aligned with circadian rhythm create meaningful improvements in just 12 weeks. The hosts explain why protecting sleep quality through earlier eating cutoffs enhances next-day insulin sensitivity and reduces cravings, breaking the cycle of metabolic dysfunction without requiring aggressive fasting windows. They offer practical guidance on using 12-hour fasting as either a starting point for beginners, a recovery strategy for those who've lost fasting momentum, or a foundational baseline that can be built upon, emphasizing that consistency and structure matter more than extreme measures when creating sustainable lifestyle change. ⁠⁠⁠⁠Take the NEW FASTING PERSONA QUIZ! - The Key to Unlocking Sustainable Weight Loss With Fasting!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Resources and Downloads: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SIGN UP FOR THE DROP OF THE ULTIMATE GUIDE TO BLOOD SUGAR CONTROL⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠GRAB THE OPTIMAL RANGES FOR LAB WORK HERE! - NEW RESOURCE! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠FREE RESOURCE - DOWNLOAD THE NEW BLUEPRINT TO FASTING FOR FAT LOSS!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SLEEP GUIDE DIRECT DOWNLOAD⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠DOWNLOAD THE FASTING TRANSFORMATION JOURNAL HERE!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Partner Links: Get your⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ FREE BOX OF LMNT⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ hydration support for the perfect electrolyte balance for your fasting lifestyle with your first purchase⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ here!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Get ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠25% off a Keto-Mojo⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ blood glucose and ketone monitor (discount shown at checkout)! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Click here!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Our Community: Let's continue the conversation. Click the link below to JOIN the ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Fasting For Life Community⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, a group of like-minded, new, and experienced fasters! The first two rules of fasting need not apply! If you enjoy the podcast, please tap the stars below and consider leaving a short review on Apple Podcasts/iTunes. It takes less than 60 seconds, and it helps bring you the best original content each week. We also enjoy reading them! Article Links: https://www.nature.com/articles/s41430-025-01693-z

Loren was diagnosed with type 1 diabetes at 18, right as she was starting college. What followed were 15 years of highs and lows, not just in her blood sugars, but in her relationship with herself. From struggling with diabulimia in her early 20s to feeling anxious, burnt out, and alone, Loren shares what it was like to look “fine” on the outside while silently fighting her diabetes behind the scenes.In this episode, she opens up about the moment she realized she couldn't keep living that way, when travel, friendships, and even future motherhood felt overshadowed by diabetes. Through coaching, she stopped dieting, shifted her focus from calories to patterns, lowered her A1C from 7.4 to 6.8 in three months, lost 10 pounds as a byproduct (not the goal), and rebuilt her relationship with food and insulin. Most importantly, she stopped seeing diabetes as the enemy and started seeing it as something she could navigate with confidence.This conversation is about more than numbers. It's about healing your relationship with diabetes so you can stop fighting yourself and start reclaiming your rise.WHAT WE COVER:Loren's 15-year journey with T1D, including diabulimia and hidden burnoutThe emotional toll of masking diabetes while feeling anxious and aloneWhy traditional therapy didn't fully address the root issueHow shifting from calorie counting to carb awareness changed everythingThe specific tools that helped her lower her A1C from 7.4 to 6.8 in 3 monthsLetting go of diet culture and rebuilding a peaceful relationship with foodTraveling with confidence (and no blood sugar chaos)Preparing for pregnancy from a place of empowerment, not fearWHAT'S NEXT:‼️Finally eat pizza and ice cream without the blood sugar roller coaster: Join our free live workshop.

Dr. Deb Muth 0:00 Welcome back to Let’s Talk Wellness Now. I’m your host, Dr. Zab, and we are continuing our discussion this week on 0:08 peptides. And so, if you haven’t heard our first conversation about peptides, 0:13 please go back and look at that episode. We talk all about the manufacturing, the safety, the quality of peptides, and we 0:20 dove into GLP1s. And today we’re going to dive into peptides for sexual 0:26 wellness, immune function, growth hormone, and all the amazing fun things 0:32 we can do with peptides. So, as usual, grab your cup of coffee or tea, settle 0:37 in, and let’s talk wellness now. And we’re going to take a short pause from our sponsor. I know we’ve got to do 0:44 that, you guys. They’re who keep us on the air. So, I’m going to pause for just a minute and be right back after this 0:50 message from our sponsor. Ladies, it’s time to reignite your vitality. Primal 0:56 Queen supplements are clean, powerful formulas made for women like you who want balance, strength, and energy that 1:03 lasts. Get 25% off at primal queen.com. Serenity Health. That’s primalqueen.com. 1:10 Serenity Health. Because every queen deserves to feel in her prime. All 1:15 right, everybody. We are back. And are you ready? We are talking all things peptide and I am opening the show today 1:23 with sexual wellness. Yes, I’m going there, you guys. I am going there. You 1:29 know, this has really become a big issue for people um of all ages. It’s not just 1:3 4us older people. It’s younger people, too. And there’s a whole variety of reasons why we have sexual dysfunction. 1:42 And when we’re talking about sexual dysfunction, we’re not just talking about it doesn’t work, right? Or I can’t 1:48 reach orgasm. A lot of it is around desire and um the thought of it and 1:54 wanting to connect, wanting to be kinder to one another, wanting to be touching 2:00 one another. A lot of it resolves or revolves around that. And so there are some peptides that can help us and I’m 2:08 really excited to be able to talk about those today. So the first one is called PT-141. 2:14 This targets the brain not the periphery. Right? So for many women I 2:20 will always tell you sex starts between here. It is a brain thing for us. It is 2:26 not necessarily a physical thing. For guys that’s a little different. It’s very physical. For women it’s all in our 2:32 brain. So tip for you men that are listening. You have to prime your woman’s brain first if you want her to 2:38 have sex with you that night. You have to be nice to her. You have to bring her flowers. Do the dishes for her. Do 2:45 something kind. Bring her a cup of coffee or tea or a glass of wine. Take her to dinner. You have to woo her. And 2:51 I don’t care how long you’ve been married. That has to happen. And tip number two, don’t say anything stupid 2:57 that day. I’m just being honest. When you guys say things that make us upset, 3:03 that lingers with us for the rest of the day. And it’s it’s a turnoff for us. And 3:08 for a lot of women, we can’t get past that when it comes time to snuggle at night. And sex doesn’t always have to be 3:14 at night either. So, you can tell I really love talking about this conversation, but we’re going to get into the peptide part of it because this 3:21 is going to help people. So, um, PT-141 is marketed as I’m going to slaughter 3:28 this name, Vali, and it represents a fundamentally different approach to 3:34 sexual dysfunction than the PDE5s inhibitors like Slenden, Viagra, 3:40 Tedataphil, which is Seialis. And while the PDE5 inhibitors work specifically by 3:47 enhancing blood flow to the genital tissues, PT-141 works centrally in the brain by 3:54 modulating neural s neural circuits involved in the sexual desire and 4:00 arousal. Now PT-41 is a cyclic hpatipeptide. It’s seven amino acid 4:07 peptide arranged in a cyclic structure that acts as a melanoortin receptor 4:13 agonist and with particularly the infinity for MC3R and MC4R subtypes. 4:20 It’s actually a metabolite of the melanotan 2, a peptide originally 4:26 developed for tanning that was also found to enhance sexual desire in early 4:31 studies. Now the melanoortin system in the brain is involved in multiple functions including energy homeostasis 4:39 but it also is involved in sexual motivation and arousal behaviors. The FDA approved PT-141 in 2019 specifically 4:48 for the treatment of acquired generalized hypoactive sexual desire 4:54 HSDD in permenopausal women. So for the first time we have a medication that was 5:01 approved by the FDA to use for women for sexual dysfunction. We have had all of 5:07 these seialis tedataphil viagros for men but we had nothing for women. And so 5:12 this is amazing that this is available for women and approved by the FDA. It’s a big deal. This represents the first 5:19 and only FDA approved medication specifically targeting these circuits of sexual desire rather than the peripheral 5:27 arousal mechanisms. And this indication is quite specific, meaning it was developed at some point, not lifelong. 5:35 So I if you’ve had sexual dysfunction your entire life, this medication was 5:40 not approved for you. But if it’s something that you developed over time, like when you went through pmenopause or 5:46 menopause or some women have this experience happen after childirth, that’s what we’re talking about here. 5:53 Now, it’s also not just um supposed to be used if you dislike your partner, 5:59 right? If your relationship is bad and you dislike your partner, this probably isn’t going to fix a ton. It might help 6:05 a little bit, but that’s not what it’s meant for. So, you really have to know what you’re using it for and why. And 6:11 the other thing that I would say is this is something that we don’t go to if your hormones are not balanced properly. You 6:17 have to balance your hormones properly before using something like this because it still may not work. Now, the only 6:24 caveat to that is if you’re a woman that has a risk of breast cancer and can’t use hormones, then that’s a different 6:31 story and we would have that conversation about whether or not this medication would be appropriate for you. Now, the FDA label specifies PTA1 uh 6:39 PT-141 as it not being indicated for HSDD in causes where low sexual desire 6:46 is due to coexisting medical or psychiatric conditions, problems with relationships, like we had talked about, 6:53 side effects to medications or other substance use. This specifically reflects the importance of differential 6:59 diagnosis. Low sexual desire can have many root causes and PT-41 is only 7:05 appropriate when those causes have been ruled out. Now, I have I used PT41 in 7:10 people who have sexual dysfunction issues as a result of using 7:16 anti-depressants. Yes, I have. I’ve used Flynn in that effect as well. And it 7:21 does work sometimes, but it doesn’t work completely. But you need to know that that is not what the approval is for the 7:27 FDA. So that is done in something that we call off label use. So very important 7:33 to know. Now in these clinical trials leading to FDA approval, this was published by Kinsburg and colleagues in 7:40 obstetrics and gyne gynecology in 2019. PT-141 demonstrated statistically 7:46 significant improvements in sexual desire and decreases in distress related 7:51 to low desire compared to placebo. The effects manifest over 45 minutes to 7:56 several hours after the injection and the mechanisms involved modulation of dopamine and melanoorton pathways in the 8:04 hypothalamus and the brain regions that involved sexual motivation. Now cardiovascular effects of PT 141 require 8:12 careful attention. This drug causes transient increases in blood pressure about 3 to four points and transient 8:20 decreases in heart rate. And because of this, it is contraindicated in patients 8:25 with uncontrolled hypertension or known cardiovascular disease. And it has been studied in patients who’ve had recent 8:32 cardiovascular events or sorry hasn’t been studied hasn’t been studied in patients who’ve had recent 8:39 cardiovascular events. So patients need to have their blood pressures checked before starting therapy. Nausea is 8:45 extremely common. It is one of the biggest things I often will tell people to take an anti-nausea medicine if 8:52 they’re going to do this because the last thing you want to do is inject this medication and think it’s going to give 8:57 you this great time with your partner and you’re so nauseated that you can’t even perform, don’t want to kiss, don’t 9:05 want to do anything. It it can be pretty profound for some people. um it does affect about 40% of the patients in 9:12 clinical trials which is why many clinicians require or recommend an 9:17 anti-nausea medication like I had just said other common adverse effects include flushing injection site 9:24 reactions headache in about 13% of the population which I have seen worse if 9:30 people are prone to headaches and the headaches are pretty intense so I will also have them premedicate if they have 9:36 that um sensitivity ity with a Tylenol or Advil, Alie, whatever it is they 9:42 typically use for their headaches to help prevent that from occurring. Now, some patients also experience a 9:50 generalized hyperpigmentation of their skin, particularly in areas with chronic friction, and this may not be reversible 9:57 after discontinuation. So from an integrative perspective, PT-41 10:03 represents one tool in addressing female sexual dysfunction, but it should never be the first or only intervention. And 10:11 low sexual desire in women is complex. Multiffactorial involving hormonal imbalances, low testosterone, estrogen 10:18 deficiency, progesterone imbalances, thyroid dysfunction, adrenal dysfunction, and with elevated or 10:24 disregulated cortisol levels, sleep deprivation, relationship issues, unresolved trauma, including sexual 10:31 trauma, chronic pain, body image concerns, and medication side effects such as SSRIs are notorious for this. So 10:39 a comprehensive hormone panel including total and free testosterones, estradile, 10:45 progesterone, DHEA, thyroid function in cortisol assessment, ideally four-point 10:51 cortisol, salivary should precede any pharmacological intervention. And additionally, addressing the 10:57 psychological component and relationship dimensions through appropriate therapy is necessary. I have a lot of patients 11:03 that say, “This is just too much work for sex. I don’t want the side effects. I don’t want to deal with this.” and that’s totally fine. But for some 11:09 people, their sexual dysfunction is actually causing more problems on their 11:14 relationship and they want to do something to fix that. And just know that if you’re using a peptide like this 11:20 that comes with some of these side effects and you have to premedicate for it, it is not the end of the world. Um, 11:27 but it may be a possibility that you may need that. So, let’s dive into body composition and growth hormone access. 11:34 So Tesmarellin is the only FDA approved GH 11:40 analog. Tesarelin is marketed as Agrifta and Agria SV. It is a synthetic analog 11:48 of human growth hormone releasing hormone. So GH RH human growth hormone 11:53 releasing hormone. These things are such long names it’s confusing and it’s difficult to spit out, right? It 11:59 consists of 44 amino acids. The structure is identical to our own 12:05 body’s growth hormone GHR um with the addition of trans3 hexonol group which 12:14 stabilizes the molecule that extends its half-life compared to the native GHR. 12:19 The mechanism of tesmarellin is elegant in its preservation of physiological 12:24 growth hormone GH secretion patterns and rather than administering an exogenous 12:30 growth hormone directly, tesmarillin binds to the GH receptor in the anterior 12:36 pituitary gland stimulating the indogenous pulsatile release of GH. So 12:42 you know it it’s slower in that stimulation and it pulsates instead of a direct rise and fall. This pusile 12:49 pattern more closely mimics natural GH secretion which occurs in bursts 12:54 primarily during sleep. The GH then stimulates the liver to produce insulin-like growth factor IGF-1 which 13:01 exerts many of the downstream metabolic effects including lipolytic effects on 13:07 the atapost tissue. So fat atapose and how we break that down. The FDA approved 13:13 tesmarellin in 2010 for a very specific narrow indication, the reduction of 13:19 excess abdominal fat in HIV infected patients with lipodistrophe. This 13:25 condition characterized by abnormal fat redistribution with accumulation of visceral body fat and the loss of 13:32 subcutaneous fat in face and limbs developed as a complication of an 13:37 antiviral therapy particularly with older protease inhibitor reg uh 13:42 regimens. The visceral fat accumulation in patients is not just cosmetic. It’s associated with increased cardiovascular 13:49 risk, insulin resistance, and inflammatory markers. The pivotal trial that led to the FDA approval included 13:56 work by Stanley and colleagues published in the annuals of internal medicine in 2014. It demonstrated that tesmarillan 14:03 significantly reduced the visceral atapose measured by CT scan by approximately 15 to 20% which is a 14:10 significant difference to placebo over a short period of time only 26 weeks. Now, 14:16 interestingly, the total body uh weight typically remained stable or even 14:21 increased slightly as the reduction of visceral fat was sometimes offset by increases in lean body mass or 14:28 subcutaneous fat. This highlights an important point. Tesmearellin is not a weight loss drug in its conventional 14:34 sense. Its effects are specifically on body composition and fat redistribution. 14:40 Now the glucose metabolism effects of tesmarellin do require careful monitoring because GH and IGF1 can 14:47 induce insulin resistance. Tesmearellin can increase glucose levels and hemoglobin A1C and in these clinical 14:54 trials glucose tolerance and new onset diabetes occurred in some patients. So 14:59 this creates a therapeutic paradox while res reducing visceral fat we should theoretically improve metabolic health. 15:07 The GH mediated insulin resistance can worsen the glycemic control and patients 15:12 with diabetes require particularly close monitoring. The potential need for adjustment in diabetic medications can 15:19 occur. So I already know what you guys are thinking. Can I use Tesmarellin and 15:24 GLP1 at the same time? And the answer is yes. Especially in those people that we 15:30 know have an insulin resistance already or are prone to that, we can use lowd 15:36 dose micro doing GLP-1 along with tesmarellin to help prevent this from 15:42 occurring um or reduce the risk of it occurring. Now there are some other adverse related problems to growth 15:49 hormone access which include fluid retention which can uh manifest as uh 15:55 ankle swelling, joint pain, muscle pain, paristhesas, carpal tunnel syndrome is 16:01 common to see. Of course you can always see injection site reactions reported about 26 to 30% of the time in the trial 16:08 participants. And this also theoretically has a concern about IGF-1 elevation potentially promoting 16:14 malignancy through long-term data is limited. So we have to be cautious about 16:20 this but it is a growth hormone and anything that is a growth hormone can cause cells to grow and it cannot 16:26 necessarily differentiate between healthy cells and bad cells. So the drug is contraindicated is contraindicated in 16:33 patients with active cancer and in patients with the disruption of the HPA access from conditions like pituitary 16:40 tumors, pituitary surgery, head of radiation um and traumatic brain injury. 16:46 Now off label use of tesmarellin for general anti-aging or body composition 16:51 optimization in non-HIV population, it doesn’t have FDA approval. There is no 16:58 FDA studies. um that promote this, but practitioners do prescribe it for these 17:04 purposes under an experimental and not supported by FDA approved indications. 17:10 And um from an integrative medical standpoint, optimizing natural growth 17:15 hormone secretion through lifestyle interventions, high quality sleep is important. GH primarily is excreted 17:22 during sleep and deep sleep waves. So improving your deep sleep is important. Intermittent fasting can also increase 17:28 growth hormone by five-fold as demonstrated in a Hartman and colleagues uh study from the journal of clinical 17:35 endocrinology and metabolism in 1992. And highintensity interval training, adequate dietary protein, blood sugar 17:42 control, these all can help naturally increase your growth hormone. So, let’s 17:47 dive in now and talk about bone health. peptide hormones um such as oh I’m gonna 17:54 I’m gonna really slaughter this name. Terraparatide is a true bonebuilding 18:01 peptide. It’s marketed as forio. It’s a recumbent form of the first 34 amino 18:08 acids out of 85 of the human parathyroid hormone PTH. It represents a unique 18:13 approach to osteoporosis treatment because it’s one of the few truly anabolic anabolic bone therapies meaning 18:21 it actively binds new bone rather than simply preventing bone loss. The biology 18:26 of parathyroid is fascinating and seemly contraindicated or uh contradictory. 18:32 Continuously sustained elevations of PTH as occurs in hyperarathyroidism 18:37 is catabolic to bone. So people who have hyperarothyroidism typically have significant bone loss 18:44 especially before it’s diagnosed and it causes causes increased bone 18:49 reabsorption loss of bone density increased fracture risk and however 18:55 intermittent exposure to PTH as achieved with once daily uh injections of forio 19:01 has the opposite effect. This intermittent exposure preferentially stimulates osteoblasts bone building 19:08 cells over osteoclasts bone reabsorbing cells and it leads to 19:13 the net bone formation. So terraparatide binds to the PTH receptors on 19:20 osteoblasts and renal tubular cells in bone. It increases the number of 19:25 activity of osteoblasts stimulating the differentiation of osteoblast precursor cells and may 19:32 reduce osteoblast apoptosis basically programmed cell death allowing this bone 19:37 building cell to work longer. The result is increased bone formation, improved bone architecture and tbacular 19:45 connectivity and ultimately increased bone mineral density um particularly in the hip and the spine which is so 19:51 difficult to regain. The FDA approved this medication in 2002 based on pivotal 19:57 studies by Near and colleagues published in the New England Journal of Medicine in 2001 which demonstrated significant 20:05 reductions in vertebral and non-vebral fractures in post-menopausal women with 20:11 osteoporosis. specifically uh reduced new vertebral fractures by 20:17 65% and nonvettebral fragility fractures by 53% 20:23 compared to placebo over a median followup of 21 months. This is really 20:29 incredible because we have not seen this kind of um change uh in other 20:35 medications that we’ve used for osteoporosis. So current FDA approval 20:40 indicates uh this for post-menopausal women with osteoporosis at high risk for 20:46 fracture, men with primary or hypoconatal osteoporosis at high risk for fracture 20:53 and men and women with glucocord cord glucocordide 21:00 induced osteoporosis at high risk for fracture. The high risk qualifier is 21:05 important. uh terrapeptide is reserved for patients with severe osteoporosis, 21:11 multiple fractures, very low low bone density and those who have failed or are 21:16 intolerant of other therapies. The most significant concern for this medication 21:21 is highlighted in a boxed warning with rat toxicology studies where it caused 21:27 osteioaroma which is a bone cancer in a dose dependent and treatment duration dependent manner. The revolence of this 21:34 finding to humans is debated. Rats have fundamentally different bone biology than humans with continuous bone growth 21:41 throughout life and different PTH receptors. Now post marketing 21:46 surveillance in humans hasn’t shown a clear increase in osteocaroma risk but 21:51 theoretically concerns persist and because of this terapeptide is 21:57 contraindicated in patients at risk baseline risk for osteioaroma 22:02 including those with pageantss disease of the bone unexplained elevations of alkaline phosphate prior skeletal 22:10 radiations bone metastases or skeletal malignancies and pediatric patients or young adults 22:16 with open hyes. There’s also a lifetime treatment duration of only 2 years and 22:22 terrapeptide can cause transient hypercalcemia. So an elevated blood calcium and as PTH normally increases 22:31 calcium levels by enhancing bone reabsorption, increasing renal calcium 22:36 reabsorption and promoting activation of vitamin D which increases intestinal calcium absorption. Some patients 22:43 experience orthostatic hypotension within 4 hours of injecting requiring 22:48 caution in at risk populations for blood pressure. Common side effects include 22:53 muscle pain, joint pain, pain in the limbs, nausea, headache, and dizziness. So from an integrative bone health 23:00 perspective, terrapeptides should be part of a comprehensive strategy. Adequate calcium intake, 500 to a,000 23:08 milligrams of calcium a day from food and supplements combined. and vitamin D. 23:13 Getting vitamin D levels of at least 50 to 80 are essential for the drug to work 23:20 optimally. But beyond this, bone health requires vitamin K2, which directs calcium into the bones rather than soft 23:27 tissues, magnesium as a co-actor in bone metabolism, trace minerals like boron, 23:33 copper, silica, and of course, adequate protein intake, which many of us, especially as women, don’t do 0.8 8 to 1 23:42 gram of protein per kilogram of body weight, weightbearing exercise. Of 23:47 course, these all provide mechanical signals that complement the biochemical 23:52 symbol uh signals of terrapeptide. Sequential therapy is also critical. The 23:58 bone mass gains from terraparatide can be lost if patients don’t transition to 24:05 an anti-resorbbitive agent a bisphosphinate after completing this therapy and the anabolic effects to 24:12 build bone but maintaining the new bone requires preventing excess reabsorption. 24:18 So positive things about this but there are definitely some concerns as well. So 24:23 the next one we’re going to talk about is Lu Prolrooide. It is marketed under 24:29 the multiple brand names of Lupron, Depo, Eligard, and it’s a synthetic 24:34 nonapeptide analog of naturally occurring ginonadotropen releasing 24:39 hormone G&R, also called luteinizing hormone releasing hormone, LHR. 24:46 It’s a fascinating example of how manipulating natural hormonal feedback systems can create therapeutic effects. 24:53 So, G&RH is normally secreted in a pulsatile fashion by the hypothalamus 24:59 and travels to the anterior pituitary where it binds to G&R receptors and 25:05 stimulates the release of luteinizing hormone LH and follical stimulating hormone FSH. These ginatotropins signal 25:13 the ovaries or the testes to produce sex hormones, estrogen, progesterone in 25:18 women, testosterone in men. Uh, luoprololi lupron as a GNR agonist 25:26 initially mimics the action of natural G&R causing an acute flare response with 25:33 uh increased LHFSH secretion which temporarily increases sex hormone 25:38 production. However, the continuous administration which is in the depo 25:44 formulations, the GNR receptors in the pituitary become desensitized and 25:50 downregulated. And after about 2 to four weeks of continuous exposure, LH and FSH 25:56 secretion is profoundly suppressed, leading to what’s termed as chemical 26:01 castration. Testosterone levels in men drop to castrated levels less than 50 26:08 and estrogen production is marketkedly suppressed in women. This bifphasic 26:13 response creates both therapeutic applications and management challenges in prostate cancer where tumor growth is 26:20 typically androgen dependent and the ultimate goal is testosterone suppression. However, the initial 26:27 testosterone surge during the flare phase can temporarily worsen symptoms potentially causing increased bone pain, 26:34 urinary obstruction, or even spinal cord compression in patients with metastatic 26:40 disease. This is why uh luoprolide is often started with an anti-ad androgen 26:47 like bicladamide for the first two to four weeks to block the effects of the 26:52 testosterone surge. The FDA has approved lupalide for multiple indications across 26:59 formulations. In oncology, it’s used for palletive treatment of advanced prostate cancers. In gynecology, various 27:06 formulations are approved for endometriosis, for pain management and lesion reduction and for fibroids. 27:13 Typically for pre-operative uh hematological improvement in anemic patients. In pediatrics, it’s used for 27:20 central precocious p puberty basically to halt the premature sexual development of these young people. Now, there are 27:28 adex uh adverse effect profile that reflects profound hormonal suppression. 27:34 In men treated for prostate cancer, hot flashes affect about 59% of the patients. Other common effects include 27:41 general pain, swelling, bone pain. Um long-term use of these medications leads 27:47 to metabolic changes. It increases fat mass. It decreases lean mass. It worsens 27:53 insulin sensitivity, disrupts the cholesterol uh lipid panels, increases 27:59 diabetic risk, has some concerns over cardiovascular disease. And the metaanalysis have shown increased risks 28:06 of heart infarction, myocardial inffection, sudden cardiac death, and stroke in populations receiving 28:13 long-term androgen deprivation therapy. The bone effects are particularly dramatic. Without sex hormones, bone 28:20 density decreases significantly, typically 3 to 4% per year during the 28:26 first two to three years of therapy. And this bone loss may not fully be reversible after the the therapy 28:32 discontinues. The American Society of Clinical Oncology recommends bone density monitoring and consideration of 28:39 bisphosphinates uh in men receiving long-term androgen deprivation. In women treated for 28:46 endometriosis or fibroids, the estrogen suppression creates a hypoestrogenetic state similar 28:54 to menopause. Hot flashes affect 90% of patients with other common effects 29:00 including headaches, emotional irritability, decreased sex drive, vaginal dryness, bone density loss. And 29:08 because of these bone concerns and treatment duration with endometriosis, typically limited to six months, though 29:14 some formulations allow for longer use with adback hormonal therapy to 29:20 partially mitigate these side effects. The mood and cognitive effects can be s 29:25 significant. I’ve seen it over the years. the depression, the memory impairment, difficulty focusing and 29:31 concentrating. It can be very very traumatic and the quality of life that 29:37 happens for these uh women and men can be unbearing for many of them. Um, from 29:44 an integrative perspective, patients receiving this medication need comprehensive support care. Bone health 29:51 interventions using calcium, vitamin D, vitamin K2, weightbearing exercise, 29:58 cardiovascular risk management becomes critical, including blood pressure monitoring, lipid management, diabetes 30:05 screening. For hot flashes management, some patients respond to black coohos, 30:10 sage, or vitamin E. Though evidence is mixed and individual response varies, 30:16 omega-3s may help with the mood and the inflammation, resistance training becomes specifically important to 30:22 preserve lean muscle mass in the face of hormonal suppression. 30:27 Now there’s something called calcetonin salamon which is marketed as miaelin. 30:34 It is a nasal spray. It is now discontinued. And foral is the new 30:39 synthetic polyeptide hormone of 32 amino acids identical to calcetonin of salamon 30:47 origin. It represents an interesting case study in how initial promise gives 30:52 way to safety concerns that regulate a therapy to historical footnote status. 30:58 Calcetonin is naturally occurring hormone in humans. It’s secreted by the paraphalicular sea cells in the thyroid 31:04 gland. Its primary physiological role is to lower blood calcium levels by 31:10 directly inhibiting osteoclast activity, reducing bone reabsorption, increasing 31:16 renal calcium secretion or excretion, and possibly reducing the intestinal 31:21 calcium absorption. So, salamon calcetonin is used therapeutically because it’s more potent and longer 31:27 acting than human calcetonin. The FDA initially approved calceton and salmon 31:34 for several indications post-menopausal osteoporosis in women more than five 31:39 years post-menopausal when alternative treatments are not sustainable. Padet’s 31:44 disease for bone and hypercalcemium as emergency treatments. The nasal spray formulation is particularly popular for 31:53 osteoporosis because it offered a non-injectable alternative to bisphosphinates. 31:58 However, in 2012, the European Medicine’s Agency, EMA, conducted a 32:05 comprehensive safety safety review after a poolled analysis of 21 clinical trials 32:10 involving over 10,000 patients showed a statistically significant increase in 32:15 malignancy risk in patients treated with calceton salamon compared to compared to 32:21 placebo. The overall malignancy rate was 4.1% in calcetonin treated patients 32:28 versus 2.9% in placebo patients. The types of cancer 32:34 varied with no single cancer type predominating, making it difficult to establish a clear mechanistic link. 32:41 However, the signal was concerning enough that the EMA restricted the use of calcetonin containing medicines. In 32:48 the United States, the FDA issued communications about malignancy signal and conducted its own review. While they 32:56 didn’t fully withdraw the drug, the cons consensus shifted dramatically. The nasal spray formulations miaelson was 33:03 voluntarily discontinued by the manufacturer and current clinical practice guidelines now consider 33:10 calcetonin salamon as a second line or lower option for osteoporosis. While 33:15 behind bisphosphinates, dennism mob, uh, terrapeptide, the analesic effect of 33:21 calcetonin in bone pain, particularly in acute vitibbral, uh, compression 33:26 fractions from osteoporosis or pageantss disease may still provide a role for short-term use in these selected 33:32 patients. The mechanism of this pain relief is unclear, but may involve 33:38 effects of endorphin systems and/or direct actions on pathways. The history serves as an important reminder in 33:45 peptide medicine. Initial approval and early clinical use does not guarantee 33:50 long-term safety effects. Post marketing surveillance and poolled analysis of the clinical trial data can reveal adverse 33:58 effects that weren’t apparent in initial studies. It also underscores why newer 34:04 agents with better safety profiles um have largely replaced calcetonin in 34:10 clinical practice. So this is really an important thing. Not one thing stays the same forever. We have to change as we 34:18 identify new and better products as we identify problems and concerns. I will 34:24 always tell my patients if you are uncertain of taking a new drug which we 34:30 all should be wait five years. Within five years we are going to find the 34:36 problems that they didn’t find in the clinical studies. Remember, a lot of these clinical studies are small, small 34:43 groups, short periods of time. It’s expensive to do these trials. So, if you 34:49 wait for five years, in the first two to three years, you will see the problem start to emerge. And what are you going 34:55 to look for? You’re going to look for the the news um commercials from lawyers 35:02 suing a drug. And they will tell you what the problem is. and then you can decide, is this something that I want to 35:09 use or not. Don’t jump on bandwagon and be the first one to do this, especially 35:14 if you’re sensitive. You know, give it time so you can see exactly what’s going on. So, I’m going to end our show on 35:22 this and we are going to pick up on part three of peptide therapy in our next 35:28 segment where we’re going to talk about the investigational peptides and some 35:34 exciting things that are happening with that. So, I want to thank you for joining me today on Let’s Talk Wellness 35:39 Now. It’s always a pleasure having a conversation with you guys and I hope this brings value to you with what we’re 35:45 talking about. If you have ideas for topics that you want me to discuss, 35:51 please message us, you can share your comments on Facebook, you can email us, 35:58 um you can get a hold of us however you would like to share that. I do look at the comments below in the episodes as 36:04 well. So you can place your comments there. And once again, one of the best things you can do for me is like, 36:11 subscribe, and share so that we can spread the messages of what we’re doing. 36:16 I do this at no cost. I don’t make any money out of this. I do this as an 36:21 educational purpose for everybody else. I love doing it, but it really helps us 36:28 on the algorithms if you would be just willing to like, subscribe, and share. 36:33 So, thank you for spending your time with me. I know time is important.The post Episode 257 – Peptides for Sexual Wellness & Hormonal Health: PT-141, Growth Hormones, Bone Health & More! first appeared on Let's Talk Wellness Now.

A high calcium score, a stack of prescriptions, and the nagging sense that “healthy eating” wasn't working—David Etheridge's story captures what millions feel but rarely decode. When he shifted from chasing calories to controlling insulin, everything changed: he moved from a 12:12 rhythm to a 16:8 fasting window, led meals with protein and natural fats, saved carbs for later on the plate, and watched both cravings and brain fog fade. The scale moved, but the labs told the real story—A1C from 5.8 to 5.1, triglycerides from 285 to 72, and a dramatically improved lipid ratio.We dig into why this works. Intermittent fasting gives insulin time to fall, reigniting fat mobilization and cellular repair. Sequential eating blunts glucose spikes and steadies appetite. And building plates around eggs, meat, dairy, and vegetables respects how satiety actually functions. Along the way we confront the legacy of “low fat” guidance that pushed sugar and seed oils into everyday foods, trained us to graze, and stretched ingredient lists while shrinking satiety. David argues for flipping the pyramid: prioritize protein and real fats, add non-starchy vegetables for fiber and micronutrients, treat sugar as an occasional indulgence, and skip the ultra-processed traps.This isn't anti-medicine; it's pro-data. With medical oversight, David watched his markers improve and discussed next steps with a supportive clinician focused on outcomes, not dogma. Even with a high coronary calcium score, the goal becomes halting progression by lowering inflammation and improving insulin sensitivity. We also touch on how AI can translate cryptic test reports into plain English so patients ask better questions and make calmer choices. If you've tried to white-knuckle your way through snack culture, this conversation offers a clear, humane alternative: fewer eating windows, protein-first plates, simpler ingredients, and measurable wins. If this resonated, follow the show, share it with a friend who needs hope, and leave a review to help more people find the path back to metabolic health.Continue this conversation on SubStack: https://robertlufkinmd.substack.com Get 120 Biomarkers for $99 and CT Calcium scans anywhere in the US. https://www.vitalsvault.com/ Lies I Taught In Medical School : Free sample chapter- https://www.robertlufkinmd.com/lies/ Web: https://robertlufkinmd.com/X: https://x.com/robertlufkinmdYoutube: https://www.youtube.com/robertLufkinmd Instagram: https://www.instagram.com/robertlufkinmd/LinkedIn: https://www.linkedin.com/in/robertlufkinmd/TikTok: https://www.tiktok.com/@robertlufkinThreads: https://www.threads.net/@robertlufkinmdFacebook: https://www.facebook.com/robertlufkinmd Bluesky: ...

What if the reason fat loss feels impossible is not willpower, not discipline, and not “eat less, move more” but your hormones, your hunger, and your body's fat thermostat? In this episode of The Ben Azadi Show, Ben welcomes back Dr. Jason Fung to break down why most weight loss advice fails long term and why obesity and type 2 diabetes are not calorie problems, they are hormonal problems. Dr. Fung explains how insulin acts as a fat storage signal, why fasting insulin and C-peptide can reveal metabolic dysfunction years before A1c rises, and how hunger is the real problem behind overeating. He also introduces key ideas from his new book, The Hunger Code, including the fat thermostat, the “three whys,” and the three types of hunger: physical, emotional, and conditioned. You will walk away with a clearer framework for sustainable fat loss that works with human physiology instead of fighting it. Key Topics Covered Why “eat less, move more” has an extremely high long-term failure rate Calories vs hormones: why the body can store or burn the same calories differently Insulin's role in fat storage and fat burning shutdown Insulin resistance as “overflow,” not “under-fuel” Why fasting insulin and C-peptide matter earlier than A1c The fat thermostat concept and why metabolism adapts fast Hunger hormones and satiety signals (including GLP-1 related discussion) The “three whys” framework for getting to the root cause of weight gain The 3 types of hunger: homeostatic, hedonic, and conditioned hunger Why ultra-processed foods reshape hunger and behavior Why low insulin matters more than “low carb” for many people How environment and community influence obesity risk and habits Resources & Special Offer Dr. Jason FungWebsite: https://www.doctorjasonfung.com/ Book: The Hunger Code (Release Date: March 3) Pre-order the book through Dr. Jason Fung's website to receive exclusive bonuses, including a free masterclass and additional resources. Follow Ben Azadi

What does over 18 months of precision medicine actually look like in practice? In this episode of the Optispan Success Story Series, Dr. Matt Kaeberlein sits down with Carlos Pinto, a tech executive and early Optispan client, to trace his longitudinal health journey from metabolic warning signs to measurable, sustained transformation. Carlos shares how a decade of overlooked biomarkers, a post-pandemic health decline, and a single panic attack became the catalyst for a data-driven approach to his own biology. Together, he and Dr. Kaeberlein review real DEXA, lipid, metabolic, and environmental biomarker data, unpacking what moved the needle, what didn't, and why the answer was rarely simple. This conversation is a candid look at what it means to become your own best health advocate, not through quick fixes, but through personalized, longitudinal learning.Timestamps:0:00 – Cold open & highlights0:50 – Welcome & Carlos's background in tech leadership2:15 – How career ambition displaced health in his 20s and 30s3:39 – A panic attack as the turning point: connecting mental and physical health4:24 – A previous medical wellness program: what worked and what was missing6:34 – Arriving at OptiSpan: intention, mindset, and expectations7:15 – Gateway Day: comprehensive baseline testing and initial surprises8:51 – Early metabolic lessons: CGM data, glucose spikes, and dawn effect11:32 – Confronting white coat hypertension with 78 data points13:28 – How stress, sleep, and nutrition interact to drive metabolic dysfunction15:44 – Personal experimentation as methodology: berberine, time-restricted eating, and fish17:09 – Mercury toxicity from fish consumption: a case study in biomarker surveillance18:33 – Stress management protocols: walking, meditation, and measurable outcomes19:49 – Statin introduction: the role of medication as a tool, not a failure20:27 – DEXA results: visceral fat reduction, body fat loss, and lean mass gain24:17 – Lipid profile transformation: ApoB from ~115 to 70, LDL from 160 to 7425:57 – A1C trajectory and the complexity of glucose optimization30:01 – Reframing medication: proactive use vs. reactive disease management31:29 – Mercury biomarker deep dive: from 2.4 to 16 and back to 232:21 – Goals for the future: sustainability, muscle retention, and mental clarity36:30 – Lineage biological age algorithm: from mortality risk of 54 to 5239:27 – Closing reflections: health as a lifelong trajectory, not a program

Could chronic parasitic infections be an overlooked driver of insulin resistance and rising A1C? In this episode of The Ask Dr. Ernst Show, we examine how intestinal parasites can disrupt gut integrity, trigger systemic inflammation, impair nutrient absorption, and alter liver metabolism—creating the perfect internal environment for blood sugar dysfunction. You’ll learn how exposure happens, the symptom patterns most clinicians miss, advanced testing options, and a structured strategy to eliminate parasites and restore metabolic stability at the root.See omnystudio.com/listener for privacy information.

Our hormones are essential to our mental and physical health, yet we often don't understand (or we minimize) the key role hormones play in fostering our wellbeing. And to make matters worse, many--or dare I say most – medical practitioners are not given adequate training when it comes to understanding the role hormones play in the health of our bones, heart, muscles, and brain. And when our bodily systems are not functioning well – whether we're experiencing issues such as a lack of focus, sleep disruption, weight gain, or low libido – our mental health can be deeply affected. Today, I'm joined by a top medical expert, Carrie Levine, who will help us discover key components of HRT (hormone replacement therapy) and so much more. Topics discussed include mental heath, depression, psychotherapy, support, physical health, hormones, HRT, hormone replacement therapy, estrogen, progesterone, progestin, DHEA, HPA Axis, cortisol, stress, stress management, exercise, resistance training, weight training, carbohydrates, protein, testosterone, Women's Health Initiative, menopause, perimenopause, post-menopause, relationships, A1C, blood glucose, sex, and libido. Please note that this episode contains sensitive material; listener discretion is advised. Note: If you or someone you know needs immediate support, please call your emergency services. In the US, 24/7 help is available by calling "911," "988" (Suicide and Crisis Hotline), or SAMSA (Substance Abuse and Mental Health Services Administration) at 1-800-662-HELP (4357). As applicable, additional resources may be provided in the show notes. Non-Emergency Online Mental Health Information:https://www.nami.org/support-education/nami-helpline/https://odphp.health.gov/myhealthfinder/healthy-living/mental-health-and-relationships IMPORTANT DISCLAIMER: No expert is offering medical or psychological direction or advice; the content is purely informational in nature. Please consult your physician or healthcare provider before undertaking any new regimen or procedure.https://www.nami.org/support-education/nami-helpline/Connect with Dr. Carla Manly:Website: https://www.drcarlamanly.comInstagram: https://www.instagram.com/drcarlamanly/Twitter: https://www.twitter.com/drcarlamanly/Facebook: https://www.facebook.com/drcarlamanlyLinkedIn: https://www.linkedin.com/in/carla-marie-manly-8682362b/YouTube: https://www.youtube.com/@dr_carlamanly_imperfect_loveTikTok: https://www.tiktok.com/@dr_carla_manlyBooks by Dr. Carla Manly:Joy From Fear: Create the Life of Your Dreams by Making Fear Your Friend Date Smart: Transform Your Relationships and Love FearlesslyAging Joyfully: A Woman's Guide to Optimal Health, Relationships, and Fulfillment for Her 50s and BeyondThe Joy of Imperfect Love: The Art of Creating Healthy, Securely Attached RelationshipsImperfect Love Relationship & Oracle Card Deck by Dr. Carla Manly:EtsyAmazonConnect with Carrie:Website: https://carrielevine.com/Instagram: https://www.instagram.com/carrielevine.cnm/Facebook: https://www.facebook.com/CarrieLevine.cnm/LinkedIn: https://www.linkedin.com/in/carrie-levine-cnm/Love the show? Subscribe, rate, review, and share! https://drcarlamanly.com/

In this episode of the Gladden Longevity Podcast, Dr. Jeffrey Gladden sits down in person with fitness and nutrition expert Autumn Calabrese to unpack the full truth about GLP-1 agonists. With millions of people jumping on semaglutide, tirzepatide, and soon retatrutide, the conversation most doctors aren't having is about what's actually happening inside the body while the scale goes down. Dr. Gladden breaks down how GLP-1s suppress hunger, slow metabolism, and trigger muscle wasting when used without proper diagnostics or a supporting protocol. He explains the critical differences between GLP-1s, GLP-2s, and GLP-3s, reveals why the ghrelin rebound causes most people to regain everything they lost, and shares the strategies he uses in his practice to help patients lose fat while protecting lean tissue. From the 5-day fasting mimicking diet to natural GLP-1 boosters like metabolic probiotics and calocurb, this episode lays out a smarter, more sustainable path to optimizing body composition. Whether you're considering a GLP-1, already on one, or looking for alternatives, this is the conversation that could change your entire approach. For Audience • Use code 'Podcast10' to get 10% OFF on any of our supplements at https://gladdenlongevityshop.com/!  • Subscribe to the Gladden Longevity Newsletter for the latest on longevity medicine, peptide protocols, and hormone optimization → https://start.gladdenlongevity.com/subscribe • Ready to find out what's really going on inside your body? Book a call with the Gladden Longevity team → https://start.gladdenlongevity.com/apply-now Takeaways • Peptides are signaling partners, not substitutes for the work your body needs to do.  • GLP-1s were designed for diabetics and metabolic syndrome, not casual weight loss. • GLP-1s decrease energy expenditure while GLP-3s (retatrutide) increase it. • Many GLP-1 users are losing muscle mass instead of fat without realizing it. • The ghrelin rebound after stopping a GLP-1 drives appetite higher than before while metabolism stays slower. • A fasting blood sugar and hemoglobin A1C alone are not enough to understand your metabolic health. • A two-hour glucose tolerance test with an insulin curve reveals insulin resistance most doctors completely miss. • The 5-day fasting mimicking diet resets ghrelin, taste buds, gut biome, and leptin sensitivity without destroying muscle. • You can boost your body's own natural GLP-1 production through the right probiotics and bitter receptor activation. • Weight gain is not always an appetite problem. Thyroid dysfunction, declining sex hormones, and missing micronutrients can all be the real driver. • Sex hormone optimization during perimenopause and andropause is critical for maintaining body composition. • Willpower never wins long term. Systems and environment design are what create durable results.    Chapters 00:00 Introduction and Welcome with Autumn 00:44 What Is a Peptide and How Peptides Work in the Body 03:07 BPC-157 and the Pharma Model vs. Peptide Signaling 05:00 You Can't Out-Peptide Bad Habits 06:31 What Is a GLP-1 and How It Affects Your Brain and Gut 08:57 GLP-1s Were Designed for Diabetics Not Weight Loss 09:40 GLP-2 Tirzepatide and GLP-3 Retatrutide Explained 11:00 Why Retatrutide Increases Energy Expenditure While GLP-1s Decrease It 12:00 The Muscle Mass Crisis on GLP-1s 14:06 The Patient Who Lost 20 Pounds of Pure Muscle 15:00 Protecting Muscle with Perfect Aminos and Creatine 17:00 Autumn's Personal Supplement Stack for Training 19:00 Food Noise Ghrelin and the Appetite Rebound 21:18 The 5-Day Fasting Mimicking Diet as a Metabolic Reset 23:00 Building Your Own Natural GLP-1 Production 25:00 The Glucose Tolerance Test Most Doctors Never Run 28:30 Risks of GLP-1s Pancreatitis Thyroid Tumors and Unsupervised Use 29:50 Microdosing GLP-1s in Perimenopause 30:30 Calocurb the Natural Appetite Suppressant from Hops 32:00 Sex Hormone Optimization for Body Composition 35:00 Resting Metabolic Rate Testing and Hidden Thyroid Dysfunction 38:00 Autumn's Hormone Health Program and Real Results 39:30 Willpower vs Systems and Architecting Your Environment 41:30 Bio-Individuality and Why Someone Else's Plan Won't Work for You 43:00 The Power of Diagnostics and Understanding Your Genetics  To learn more about Autumn: Instagram: @autumncalabrese Reach out to us at: Facebook: https://www.facebook.com/Gladdenlongevity/ Instagram: https://www.instagram.com/gladdenlongevity/?hl=en LinkedIn: https://www.linkedin.com/company/gladdenlongevity YouTube: https://www.youtube.com/channel/UC5_q8nexY4K5ilgFnKm7naw   Gladden Longevity Podcast Disclosures Production & Independence The Gladden Longevity Podcast and Age Hackers are produced by Gladden Longevity Podcast, which operates independently from Dr. Jeffrey Gladden's clinical practice and research at Gladden Longevity in Irving, Texas. Dr. Gladden may serve as a founder, advisor, or investor in select health, wellness, or longevity-related ventures. These may occasionally be referenced in podcast discussions when relevant to educational topics. Any such mentions are for informational purposes only and do not constitute endorsements. Medical Disclaimer The Gladden Longevity Podcast is intended for educational and informational purposes only. It does not constitute the practice of medicine, nursing, or other professional healthcare services — including the giving of medical advice — and no doctor–patient relationship is formed through this podcast or its associated content. The information shared on this podcast, including opinions, research discussions, and referenced materials, is not intended to replace or serve as a substitute for professional medical advice, diagnosis, or treatment. Listeners should not disregard or delay seeking medical advice for any condition they may have. Always seek the guidance of a qualified healthcare professional regarding any questions or concerns about your health, medical conditions, or treatment options. Use of information from this podcast and any linked materials is at the listener's own risk. Podcast Guest Disclosures Guests on the Gladden Longevity Podcast may hold financial interests, advisory roles, or ownership stakes in companies, products, or services discussed during their appearance. The views expressed by guests are their own and do not necessarily reflect the opinions or positions of Gladden Longevity, Dr. Jeffrey Gladden, or the production team. Sponsorships & Affiliate Disclosures To support the creation of high-quality educational content, the Gladden Longevity Podcast may include paid sponsorships or affiliate partnerships. Any such partnerships will be clearly identified during episodes or noted in the accompanying show notes. We may receive compensation through affiliate links or sponsorship agreements when products or services are mentioned on the show. However, these partnerships do not influence the opinions, recommendations, or clinical integrity of the information presented. Additional Note on Content Integrity All content is carefully curated to align with our mission of promoting science-based, ethical, and responsible approaches to health, wellness, and longevity. We strive to maintain the highest standards of transparency and educational value in all our communications.

Today's Case A 53-year-old woman presents with difficulty falling asleep and excessive daytime sleepiness for the past 6 months. She had a well-woman examination approximately 8 months ago, which was significant for diet-controlled diabetes mellitus type II (DMII) and Graves' disease status post radioiodine ablative therapy. The remainder of her examination and all laboratory tests, including hemoglobin A1c and thyroid stimulating hormone, were normal. She denied any other health changes since her recent physical. However, she reports that on most nights of the week, she struggles to initiate sleep, usually laying in bed for up to an hour and a half “tossing and turning.” Today's Reader Ryan O'Connell is a junior biology major at Loyola Marymount University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠⁠⁠⁠⁠⁠⁠The Dr. Raj Podcast⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠Dr. Raj on Twitter⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠Dr. Raj on Instagram⁠⁠⁠⁠⁠⁠⁠⁠ Want more board review content? ⁠⁠⁠⁠⁠⁠⁠⁠USMLE Step 1 Ad-Free Bundle⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠Crush Step 1⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠Step 2 Secrets⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠Beyond the Pearls⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠The Dr. Raj Podcast⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠Beyond the Pearls Premium⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠USMLE Step 3 Review⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠MedPrepTGo Step 1 Questions⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠MedPrepTGo Step 2 Questions⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Ashley shares her decade-long journey with HA from losing her cycle during an eating disorder in college, to being reassured by doctors that it was “normal” and nothing to worry about.She was praised for her low weight. Told to eat 1,800 calories. Advised to go on birth control if that didn't work.At one point, she was even misdiagnosed with type 2 diabetes due to an elevated A1c, which pushed her into more restriction, only to later discover she was severely anemic from malnourishment, falsely elevating her labs.After joining our FREE Recovery Bootcamp, she finally had the tools to fully commit and recover on her own.In this episode, we cover:The subtle behaviors that kept her stuck (even when she thought she was "all in")The comfort zone disguised as “healthy habits”How validation from her GP reinforced the problemUsing FAM to objectively track progressThe discomfort of real recoveryHer biggest regret: waiting so longIf you're hovering in half-in recovery, told you're “fine”, know deep down you're not doing everything…This one is for you.Jool Wellnesshttps://joolwellness.comHHAP Period Recovery Mastermindhttps://www.holistichapractitioner.com/mastermindJoin The HA Societyhttp://thehasociety.com/joinWork 1:1 with us to get your period backhttp://thehasociety.com/coachingVisit us on YouTubehttps://youtube.com/c/danisheriffFollow us on IGhttp://instagram.com/thehasocietyhttp://instagram.com/danisheriffhttps://instagram.com/ashley_marie_smith_https://www.instagram.com/itsmishigarcia/https://www.instagram.com/abbylowekey/The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician.Support this podcast at — https://redcircle.com/the-hypothalamic-amenorrhea-podcast/donations

What if the real lever for lasting weight loss isn't calories, but hunger itself? We sit down with Dr. Jason Fung to unpack why willpower-based diets fail and how hormones like insulin, cortisol, GLP-1, and sympathetic tone quietly set your “fat thermostat.” Instead of fighting biology, we explore how to work with it—lowering insulin, raising satiety, and removing the triggers that keep appetite stuck in overdrive.We dig into the three types of hunger that shape daily choices: homeostatic (physiological signals like ghrelin and leptin), hedonic (reward and emotion), and conditioned (learned cues from cars, screens, and social settings). Jason explains how ultra-processed foods exploit these systems by maximizing pleasure and minimizing fullness, why sleep and stress can spike cravings through cortisol, and how fasting strategically restores access to stored energy. We also discuss the difference between visceral and subcutaneous fat, why some people appear “skinny fat,” and how testing insulin, A1C, and C‑peptide gives a truer metabolic picture than BMI alone.From the failures of low-fat, calorie-counting eras to the surprising benefits seen with GLP-1 agonists, the throughline is clear: control hunger, and calories take care of themselves. You'll leave with three golden rules to start today—ditch ultra-processed foods, use fasting windows to lower insulin, and build a supportive circle that normalizes real food. It's a humane, science-driven framework that helps you stop battling your body and start resetting your internal settings.If this conversation helped reframe your approach to weight and health, follow the show, share it with a friend, and leave a quick review to help others find it.https://www.doctorjasonfung.com/Continue this conversation on SubStack: https://robertlufkinmd.substack.com Get 120 Biomarkers for $99 and CT Calcium scans anywhere in the US. https://www.vitalsvault.com/ Lies I Taught In Medical School : Free sample chapter- https://www.robertlufkinmd.com/lies/ Web: https://robertlufkinmd.com/X: https://x.com/robertlufkinmdYoutube: https://www.youtube.com/robertLufkinmd Instagram: https://www.instagram.com/robertlufkinmd/LinkedIn: https://www.linkedin.com/in/robertlufkinmd/TikTok: https://www.tiktok.com/@robertlufkinThreads: https://www.threads.net/@robertlufkinmdFacebook: https://www.facebook.com/robertlufkinmd Bluesky: ...

Ever feel like you're doing everything right with your diabetes - carb counting, pre-bolusing, measuring your food, working out, AND your blood sugars still won't cooperate?! It's one of the most frustrating parts of living with Type 1 diabetes. You're putting in the effort. You're checking all the boxes. And yet the numbers just aren't reflecting it. In this episode of the Your Diabetes Insider Podcast, I break down why your blood sugar control might feel stuck even when you're "doing everything right." I've lived with Type 1 diabetes for over 20 years, and I've seen this pattern over and over - both in my own life and with the people I work with. There are often hidden factors at play that you don't even realize are affecting your numbers. Most importantly, I share how to build in a little cushion with your A1C and time in range so when life gets chaotic (because it will), your numbers don't completely spiral. There's no prize for perfect blood sugars - you're managing diabetes alongside real life. The goal is sustainability, not perfection. Want the best blood sugars you've ever had while enjoying great food? Peep this: https://www.yourdiabetesinsider.com/coaching   RESOURCES: Download these FREE guides that will help you on your diabetes, nutrition, and exercise journey! https://www.yourdiabetesinsider.com/free-stuff LET'S TALK! Instagram: @yourdiabetesinsider Tiktok: @yourdiabetesinsider  

Does nutrition matter when you are facing prostate cancer? In this episode, Dr. Stephen Petteruti lays out a practical, data-driven framework for prostate cancer nutrition, cancer progression, metabolic health, PSA management, and longevity medicine. Portion control, feeding timing, insulin sensitivity, hemoglobin A1C, triglycerides, and visceral fat all matter. He explains why structured eating patterns, net carbohydrate awareness, and metabolic control often outweigh trendy diet labels.Dr. Stephen also addresses high-risk dietary exposures that many overlook: processed meats and nitrites, sodium benzoate, artificial sweeteners and weight gain signals, petroleum-based food dyes, and chronic high-sugar intake in insulin-resistant individuals.Instead of extreme restriction, he advocates strategic elimination of the biggest carcinogenic inputs while preserving quality of life.If you care about longevity, cancer prevention, and metabolic optimization, spend time with this episode of Best Diet for Prostate Cancer | What Actually Matters for Cancer Progression.Enjoy the podcast? Subscribe and leave a 5-star review.Dr. Stephen Petteruti is a board-certified physician specializing in longevity-focused, integrative medicine. He works with men navigating prostate cancer, testosterone and hormone health, aging, and performance using proactive, evidence-informed strategies grounded in real clinical practice. His approach prioritizes preserving function, strength, and quality of life while helping patients make clear, informed decisions beyond reactive, fear-driven care.Learn more: https://www.drstephenpetteruti.com/Learn more: https://www.intellectualmedicine.com/Connect with Dr. Petteruti on:⁠Instagram: ⁠https://www.instagram.com/dr.stephenpetteruti/⁠Facebook: ⁠https://www.facebook.com/dr.stephenpetteruti⁠Subscribe to Intellectual Medicine on:Apple Podcast: https://tinyurl.com/DrPetterutiApplePodcastSpotify: https://tinyurl.com/DrPetterutiSpotifyPodcastDisclaimer:The content presented in this video reflects the opinions and clinical experience of Dr. Stephen Petteruti and is intended for informational and educational purposes only. It is not medical advice and should not be used as a substitute for professional diagnosis, treatment, or guidance from your personal healthcare provider. Always consult your physician or qualified healthcare professional before making any changes to your health regimen or treatment plan.Produced by https://www.BroadcastYourAuthority.com 

Most health insurance brokers rely on reactive cost-containment strategies. They wait for a catastrophic claim to hit and then scramble to manage it through cheaper drug sourcing or traditional case management. But looking in the rearview mirror won't solve the reality of 20% stop-loss increases. To win in a brutal renewal market, brokers must shift from managing claims after the fact to avoiding them entirely.My guest, Ryan Chapman, VP of Sales at HealthCare Strategies, joins me to share the predictive care playbook. We discuss how AI algorithms can identify emerging health risks, like missed screenings and trending A1C levels, years before a member ever reaches the hospital. We break down how to position predictive intervention to self-funded employers, the strategy behind running low-risk pilot programs, and why stop-loss carriers are actively rewarding this proactive approach. This is the blueprint for delivering long-term savings and proving your value before you ever win the Agent of Record.▶▶ Sign Up For Your Free Discovery Callcompletegameu.com/agaCONNECT WITH ANDY NEARY

View This Week's Show NotesStart Your 7-Day Trial to Mobility CoachJoin Our Free Weekly Newsletter: The AmbushIn a world obsessed with “optimal” routines, Dr. Rachel Pojednic cuts through the noise with a grounded, evidence-based approach to longevity and performance. This conversation is a reset for anyone overwhelmed by conflicting health advice, anxious about wearable scores, or stuck chasing perfect protocols that collapse under real life stress.You'll learn what the science actually supports, what's still uncertain, and how to build a simple, sustainable health strategy using the biggest levers first—movement, nutrition, sleep, stress, and relationships—before you bother with the “fun stuff.” Dr. Pojednic also shares what she's learned studying wellness therapies in industry and academia, why most people misunderstand Zone 2, and what to track if you want a clearer picture of your health over time.What You'll Learn in This EpisodeWhy “protocol life” is making people more confused (and often less healthy)The difference between big levers (high impact) and little levers (fine-tuning) for longevityWhat to track that's actually useful: A1C trends, fasting glucose, lipids, resting heart rateWhy wearable metrics can conflict—and how that can create anxiety and false certaintyA clearer, non-hype explanation of HRV and why “low” isn't always “bad”What Zone 2 is really for (and why it isn't a magical mitochondrial hack)How to think about supplement safety, including third-party testing and the “lead in protein powder” scareA simple 7–30 day “one change” experiment to build habits that survive real lifeIf you've ever felt like you're “failing” health because you can't follow a perfect routine—or you've been pulled in six directions by influencers, devices, and contradictory advice—this episode gives you something rare: a sane framework. You'll walk away with fewer rules, better priorities, and a practical way to measure progress that doesn't depend on hype, fear, or the latest trend.Chapters(00:00) - Intro(01:39) - The Problem with Protocols(05:29) - Rachele's Backstory and Research Journey(13:06) - Rachele's Research Focus(18:45) - Sponsor: Vitality Blueprint(20:40) - Science Communication and Social Media(23:24) - Getting Started in Science Communication(25:10) - Bridging Research and Real-World Applications(29:35) - New Lane for Performance Therapy(31:05) - Key Metrics to Track(32:07) - Importance of Observable, Measurable Data(34:34) - Need for Common Diagnostic Suite(40:19) - Current State of Healthcare and EHRs(42:32) - Momentous: Protein Powder Insights(44:44) - Subscribe to This Podcast(46:30) - Basics We Can All Agree On(47:10) - Regular Tracking Essentials(53:10) - Heart Rate Variability (HRV)(54:42) - Wearables and Big Games(57:06) - Desire to Train(59:28) - Big Opportunity and Challenges(1:00:30) - Rapid Fire: Zone 2(1:03:02) - LMNT: Try a Personal Experiment(1:06:58) - Your Micro-Experiment(1:10:34) - Rachele's “Infinite Shelf” Recommendation(1:14:55) - Join The Starrett SystemWebsite | Instagram | Facebook | YouTubeCheck our Dr. Rachele's courses at Strong ProcessHuge thanks to our sponsors, Vitality, Momentous, and LMNT.

Barbecue is about community, tradition, and bringing people together — but what happens when your health forces you to rethink how you eat? In this powerful and personal episode, Jay and Brian are joined by Dr. Cory Jenks, co-host of the Diabetes Remission Roadmap Podcast, to talk about BBQ and diabetes. 

The Silent Threat Women Face Heart disease remains the number one killer of women in America, yet nearly half of all women fail to recognize it as their greatest health threat. During a recent Community Health episode of The Valley Today, host Janet Michael talks with Dr. April Shewmake, a board-certified interventional cardiologist at Winchester Cardiology and Vascular Medicine I Valley Health, to uncover the truth about cardiovascular health. What emerged was a compelling conversation that challenges common misconceptions and empowers listeners to take control of their heart health. Understanding the Specialist's Perspective Dr. Shewmake brings a unique dual expertise to her practice. As an interventional cardiologist, she treats heart attack emergencies in the catheterization lab using minimally invasive procedures to open blocked arteries. However, she emphasizes that general cardiology—the preventive side of her work—plays an equally vital role. "Before things become an emergency or a heart attack," she explains, "that's the general cardiology piece." This preventive approach focuses on long-term care, diagnostic imaging, and medication management to stop heart disease before it starts. The Prevention Paradox Perhaps the most striking revelation from the conversation centers on prevention. According to Dr. Shewmake, between 70 and 90 percent of heart disease is entirely preventable. This statistic transforms heart health from a matter of fate into one of choice. The key lies in daily habits that many people overlook: maintaining a healthy diet, exercising regularly, controlling blood pressure, managing stress, getting adequate sleep, and remaining tobacco-free. Nevertheless, Dr. Shewmake acknowledges that genetics do play a role. Some patients develop heart disease despite doing everything right. This reality underscores why awareness and early detection remain crucial, even for those who maintain healthy lifestyles. Recognizing the Warning Signs When it comes to identifying potential heart problems, Dr. Shewmake urges people to pay attention to specific symptoms. The major warning signs include chest pressure, shortness of breath, fatigue, dizziness, nausea, and pain radiating to the jaw, arms, or back. Critically, symptoms that appear during physical exertion and improve with rest signal early-stage heart disease. Furthermore, Dr. Shewmake dispels the Hollywood myth that distinguishes heart attacks from indigestion. In reality, many people—particularly young adults and women—delay seeking treatment because they assume their symptoms indicate simple indigestion. Women especially tend to experience atypical presentations, manifesting nausea and shortness of breath rather than classic chest pain. "Don't delay," she insists. "If you think something's wrong, come to the hospital." The 911 Rule Dr. Shewmake reinforces a critical safety message: never drive yourself to the hospital if you suspect a heart attack. Instead, call 911 immediately. Emergency medical services can begin life-saving treatment en route, significantly improving outcomes. This advice echoes the guidance of other cardiologists and represents a consensus among heart specialists. Women's Unique Risk Profile The conversation takes a deeper dive into the specific challenges women face regarding heart disease. Dr. Shewmake reveals that nearly 45 percent of women over age 20 have cardiovascular disease, yet less than half recognize this reality. Heart disease kills more women than all cancers—including breast cancer—combined, claiming one in three female lives. Moreover, women face distinct risk factors that men do not encounter. Hormonal changes during menopause, pregnancy-related complications, and autoimmune conditions all contribute to cardiovascular risk. Additionally, women often present with symptoms later in life but develop more complex disease. The medical community sometimes dismisses women's symptoms, compounding the problem. The Caregiver's Dilemma Janet raises an important point about women's tendency to prioritize others' health over their own. Women rush their husbands and children to the doctor at the first sign of trouble, yet they dismiss their own symptoms as minor inconveniences. Dr. Shewmake validates this observation and emphasizes the need to close the gap in how heart disease gets recognized and treated in women. She advocates for reframing primary care visits as self-care—an hour dedicated to one's own wellbeing. Using the airplane oxygen mask analogy, she reminds women that they must take care of themselves first to remain available for their families.  The Rising Threat to Young Adults Alarmingly, cardiovascular disease increasingly affects younger populations. Dr. Shewmake shares that her youngest female heart attack patient was 38, while her youngest male patient was just 30. Janet recounts the tragic story of her son's two high school friends—both in their early thirties—who died from heart attacks within three months. This trend stems from rising cardiovascular risk factors among young people, including diabetes, high blood pressure, and high cholesterol appearing at earlier ages. Additionally, genetics likely play a stronger role in these younger cases. Young adults often assume they're invincible, delaying treatment when symptoms appear. This dangerous mindset can prove fatal. Know Your Numbers Throughout the conversation, Dr. Shewmake repeatedly emphasizes the importance of knowing four critical numbers: cholesterol, blood pressure, BMI, and blood sugar. These metrics serve as early warning indicators for heart disease risk. She encourages everyone to discuss these numbers with their primary care physician and take action when they fall outside healthy ranges. Importantly, all these risk factors respond to treatment. Modern medicine offers excellent options for managing weight, cholesterol, and blood sugar. Some newer weight-loss medications not only help patients shed pounds and lower A1C levels but also provide cardiovascular benefits. These treatments represent powerful tools in the fight against heart disease. The Technology Trap When Janet mentions the false sense of security that fitness trackers provide, Dr. Shewmake agrees wholeheartedly. While devices like the Apple Watch offer some benefits, they cannot replace a comprehensive medical evaluation. No wearable technology can measure cholesterol levels, assess blood glucose, or provide the nuanced analysis that comes from a conversation with a healthcare provider. The Path Forward Dr. Shewmake welcomes referrals from primary care physicians when patients need specialized cardiovascular assessment. She sees many patients who request consultations even when their primary care doctors deem it unnecessary, and she views these visits as valuable opportunities for in-depth risk evaluation. Cardiologists can order specialized tests and provide individualized guidance that goes beyond population-level statistics. Breaking the Biggest Myth As the conversation concludes, Dr. Shewmake tackles the most dangerous misconception about heart disease: that it primarily affects men. While society recognizes heart attacks as the leading killer of men, this awareness doesn't extend to women. This gap in understanding costs lives. Her final message centers on empowerment. She urges everyone—especially women—to listen to their bodies, take symptoms seriously, and advocate for themselves when they know something feels wrong. Heart disease may be common, but it remains both preventable and treatable. Early action saves lives, and awareness changes everything. The Simple Truth Ultimately, Dr. Shewmake's message boils down to simple, actionable steps: eat well, move more, manage stress, get enough sleep, know your numbers, and remain tobacco-free. These everyday habits make a profound difference in cardiovascular health. Combined with regular medical care and self-advocacy, they form a powerful defense against America's leading cause of death. The conversation serves as both a wake-up call and a roadmap. Heart disease doesn't discriminate, but knowledge and action provide protection. By recognizing symptoms early, understanding personal risk factors, and prioritizing preventive care, individuals can take control of their heart health and potentially add years to their lives.

This episode explores tadalafil (Cialis) as a potential longevity drug, though no randomized human trials prove it extends lifespan. Cialis works by blocking PDE5, enhancing nitric oxide signaling, and improving blood flow through vasodilation. Originally approved for pulmonary hypertension, it's also used for erectile dysfunction and BPH. Its 36-hour half-life makes it superior to Viagra for continuous longevity effects.   The host frames vascular aging and endothelial dysfunction as key drivers of age-related diseases (heart disease, stroke, dementia, kidney disease). Observational data shows Cialis users have 44% lower mortality, fewer cardiovascular events, reduced dementia risk, and lower mortality in diabetics. Additional benefits include improved cardiac function, reduced infarct size, arrhythmia suppression, and regression of left ventricular hypertrophy. A 2024 meta-analysis found it lowers hemoglobin A1C, possibly via improved microvascular perfusion, insulin sensitivity, and mitochondrial function.   Cialis crosses the blood-brain barrier and may improve neurovascular coupling and hippocampal plasticity, potentially benefiting those with or at risk of dementia. Safety is generally good with long-term daily use (2.5–5 mg), though cautions include avoiding use with nitrates, low blood pressure, or certain retinal disorders. Common side effects are headache, nasal congestion, and acid reflux. The host recommends consulting a doctor and references potential synergy with telmisartan.   Tadalafil (Cialis) — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a604008.html](https://medlineplus.gov/druginfo/meds/a604008.html) Sildenafil (Viagra) — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a699015.html](https://medlineplus.gov/druginfo/meds/a699015.html)   Key mechanisms mentioned Nitric Oxide (NO) — NCBI Bookshelf: [https://www.ncbi.nlm.nih.gov/books/NBK554485/](https://www.ncbi.nlm.nih.gov/books/NBK554485/) Cyclic GMP (cGMP) — NCBI Bookshelf: [https://www.ncbi.nlm.nih.gov/books/NBK542234/](https://www.ncbi.nlm.nih.gov/books/NBK542234/)   Conditions mentioned in the episode Benign Prostatic Hyperplasia (BPH) — MedlinePlus: [https://medlineplus.gov/benignprostatichyperplasia.html](https://medlineplus.gov/benignprostatichyperplasia.html) Pulmonary Arterial Hypertension (PAH) — MedlinePlus: [https://medlineplus.gov/pulmonaryhypertension.html](https://medlineplus.gov/pulmonaryhypertension.html)   Blood pressure drug mentioned Telmisartan — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a601249.html](https://medlineplus.gov/druginfo/meds/a601249.html)   Other longevity / comparison drugs mentioned Metformin — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a696005.html](https://medlineplus.gov/druginfo/meds/a696005.html) Sirolimus (Rapamycin) — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a602026.html](https://medlineplus.gov/druginfo/meds/a602026.html)   Side-effect helper mentioned Ibuprofen (Advil) — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a682159.html](https://medlineplus.gov/druginfo/meds/a682159.html)   Dementia meds mentioned Donepezil (Aricept) — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a697032.html](https://medlineplus.gov/druginfo/meds/a697032.html) Amantadine — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a682064.html](https://medlineplus.gov/druginfo/meds/a682064.html)   Lab markers mentioned Hemoglobin A1C (HbA1c) test — MedlinePlus lab test: [https://medlineplus.gov/lab-tests/hemoglobin-a1c-hba1c-test/](https://medlineplus.gov/lab-tests/hemoglobin-a1c-hba1c-test/) Insulin in blood test — MedlinePlus lab test: [https://medlineplus.gov/lab-tests/insulin-in-blood/](https://medlineplus.gov/lab-tests/insulin-in-blood/)   People referenced (where the claims were mentioned) Huberman Lab (Dr. Andrew Huberman) — site: [https://www.hubermanlab.com/](https://www.hubermanlab.com/) Clip about low-dose tadalafil (2.5–5mg) — X post: [https://x.com/tbpn/status/2022350426394534334](https://x.com/tbpn/status/2022350426394534334) Bryan Johnson (Blueprint) — site: [https://blueprint.bryanjohnson.com/](https://blueprint.bryanjohnson.com/) Dr. David Sinclair (Harvard profile) — site: [https://sinclair.hms.harvard.edu/people/david-sinclair](https://sinclair.hms.harvard.edu/people/david-sinclair)   Show Notes   00:00 Welcome to the Hart2Heart Podcast. 01:56 What Cialis Is: PDE5 Inhibition, cGMP & Nitric Oxide Explained 03:43 Approved Uses & Origin Story: Pulmonary Hypertension, ED, and BPH 05:33 Why Cialis Over Viagra: 36-Hour Half-Life & 24/7 Vascular Benefits 06:52 Vascular Aging 101: Endothelium, Perfusion, and Why It Drives Disease 11:14 What the Human Data Shows: Observational Evidence for Mortality, CVD & Dementia 13:04 Mechanisms Deep Dive: Heart Protection, Heart Failure, and Anti-Atherosclerosis 15:02 Cialis for Diabetics: Lowering A1C and Improving Insulin Sensitivity 16:21 Brain Effects: Blood–Brain Barrier, Neurovascular Coupling & Dementia Potential 18:21 Safety, Who Should Avoid It, and Daily Longevity Dosing (2.5–5 mg) + Wrap-Up   The Hart2Heart podcast is hosted by family physician Dr. Michael Hart, who is dedicated to cutting through the noise and uncovering the most effective strategies for optimizing health, longevity, and peak performance. This podcast dives deep into evidence-based approaches to hormone balance, peptides, sleep optimization, nutrition, psychedelics, supplements, exercise protocols, leveraging sunlight, and de-prescribing pharmaceuticals — using medications only when absolutely necessary. Beyond health science, we explore the intersection of public health and politics, exposing how policy decisions shape our health landscape and what actionable steps people can take to reclaim control over their well-being. Guests range from out-of-the-box thinking physicians such as Dr. Casey Means (author of "Good Energy") and Dr. Roger Sehult (Medcram lectures) to public health experts such as Dr. Jay Bhattacharya (Director of the National Institutes of Health (NIH) and Dr. Marty Mckary  (Commissioner of the Food and Drug Administration (FDA) and high-profile names such as  Zuby and Mark Sisson (Primal Blueprint and Primal Kitchen). If you're ready to take control of your health and performance, this podcast is for you.We cut through the jargon and deliver practical, no-BS advice that you can implement in your daily life, empowering you to make positive changes for your well-being.   Connect with Dr. Mike Hart Instagram: @drmikehart Twitter: @drmikehart Facebook: @drmikehart

Send a textStrap in—this one's a mess. The crew breaks down how the Air Force's first female SERE Chief thought it was a good idea to dox an A1C because his dad called her a “garrison bunny.” Yeah, you read that right. Instead of clapping back with humor, she weaponized her platform of 195k followers to drag a kid who had zero involvement. We torch the hypocrisy, roast the power abuse, and ask the question no one else will: how the hell is this acceptable in uniform? Sprinkle in some Pete Buttigieg jokes, Atlas Shrugged doomsday signals, and a little self-owning about Ones Ready's own social media run-ins, and you've got an episode that pulls no punches. Chiefs, take notes—this is how not to lead.⏱️ Timestamps: 00:00 – Worms ready, chaos begins 00:07 – Special Warfare selection: raw materials, not perfect products 01:02 – Peaches vs Pete Buttigieg: airline meltdown edition 02:00 – Atlas Shrugged and America's blinking red warning lights 05:00 – Chiefs are the worst people in public life 06:20 – The cringe reel that started it all 08:40 – From clapback to doxxing: the Chief's power trip 10:45 – Big Tit Energy podcast receipts resurface 12:14 – Social media rules the Chief just torched 14:30 – Why nothing will happen (and why that's the problem) 18:59 – Dragging an A1C who might've idolized her 20:30 – Hypocrisy: building followers off thirst traps, deleting receipts later 23:42 – Owning mistakes vs burning careers 26:20 – How she should've responded (and won the internet) 28:16 – Walking the dog: consequences for the A1C 30:39 – Ones Ready on negativity, scaling outrage, and why this matters

Are medications solving the root of metabolic disease — or just masking it? In this powerful episode that started as a Instagram LIVE, I break down what you're not being told about the most commonly prescribed drugs for blood sugar, cholesterol, and weight loss: GLP-1s (Ozempic, Wegovy), statins, and Metformin. I help you unpack: What these medications actually do (mechanisms of action) The real data behind their risk reduction claims How statins may suppress natural GLP-1 production Why GLP-1s cause significant muscle loss, not just fat loss Why Metformin doesn't reverse insulin resistance More importantly, I walk you through what does restore metabolic health — including a system that's helping real people normalize labs, lose weight, and feel better without long-term prescriptions. What You'll Learn: The surprising truth about how statins impact your gut hormones Why insulin resistance — not cholesterol — is the real root cause How GLP-1 drugs work and what happens when you stop them The 3-step system to support blood sugar and cholesterol naturally How to evaluate your labs beyond A1C and LDL Resources Mentioned: Join my 90-Day Insulin Reset: Comment RESET on Instagram or Facebook and I'll DM you the link- https://shanahussinwellness.com/programs-courses/reset/ Feel Great Nutraceuticals: The first step to restoring insulin and liver function- https://shanahussinwellness.com/programs-courses/feelgreat/ Connect with Shana: Instagram: @shana.hussin.rdn Website: shanahussinwellness.com Facebook: Shana Hussin Wellness

On this episode of Vitality Radio, Jared takes a closer look at the cholesterol conversation and the widespread use of statin medications through a functional health lens. Rather than relying on fear or headlines, he explores how cholesterol numbers are interpreted, the difference between risk markers and root causes, and why metabolic health, inflammation, and lifestyle factors may play a larger role in long-term heart wellness. Jared also explains concepts like absolute risk, number needed to treat (NNT), and why informed decision-making matters when evaluating any health strategy. This episode encourages listeners to ask better questions, seek clarity, and consider a comprehensive approach to cardiovascular health that includes nutrition, movement, and targeted supplementation. As always, this discussion is educational and designed to empower you with information so you can make the best decisions for your personal health journey.Products:N.O. Cardio BoostVital 5 Omega-3 + AntioxidantsNatural Factors Rx Omega-3Natural Factors BerberineSolaray BerberineVital 5 Magnesium BisglycinateAdditional Information:#563: Bad Medicine: Why Your Gallbladder Isn't Disposable & How to Thrive With or Without It #332: Cholesterol Controversy - Jared's Interview on Inside The Aisle with Niki WolfeDr. Aseem MalhotraDr. Uffe RavnskovDr. Zoë HarcombeDr. Malcolm KendrickDr. David DiamondVisit the podcast website here: VitalityRadio.comYou can follow @vitalitynutritionbountiful and @vitalityradio on Instagram, or Vitality Radio and Vitality Nutrition on Facebook. Join us also in the Vitality Radio Podcast Listener Community on Facebook. Shop the products that Jared mentions at vitalitynutrition.com. Let us know your thoughts about this episode using the hashtag #vitalityradio and please rate and review us on Apple Podcasts. Thank you!Just a reminder that this podcast is for educational purposes only. The FDA has not evaluated the podcast. The information is not intended to diagnose, treat, cure, or prevent any disease. The advice given is not intended to replace the advice of your medical professional.

Hey Diabuddy thank you for listening to show, send me some positive vibes with your favorite part of this episode.In Episode 331 of The Healthy Diabetic Podcast, Coach Ken is joined by Graham Hubbard for Episode 003 of the live show, where they dive into how people with diabetes actually make decisions—and why some of the most common metrics may be missing the bigger picture.The conversation covers Time in Range vs A1C, redefining what a personal blood sugar “target” really means, and why stability and variability matter more than chasing perfect numbers. Ken also shares real-world insights on Afrezza, insurance challenges, CGM access, early screening for Type 1 diabetes, and the pros and cons of modern intervention strategies.This episode is raw, honest, and full of practical perspective—exactly what this new live format is designed to deliver.

As BMIs and weights increase across the US population, there have been increased calls for universal screening for existing DM at entrance to prenatal care, if under 20 weeks. Others, including the ACOG, prefer to screen early those with additional risk factors (like prior GDM HX, prior macrosomia, BMI >30, PCOS, first degree relative with diabetes, or age >40). In July 2024, the ACOG released its publication, “Screening for Gestational and Pregestational Diabetes in Pregnancy and Postpartum”. In this guidance, it states, “At this time, there are insufficient data to support the best screening modality for pregestational diabetes in pregnancy, but consideration can be made to use the same diagnostic criteria as for the nonpregnant population (A1c value 6.5 or higher, or fasting plasma glucose value 126 mg/dL or higher, or 2-hour plasma glucose value 200 mg/dL or higher during a 75-g OGTT, or random plasma glucose value 200 mg/dL or higher in patients with classic hyperglycemia symptoms)”. However, a new proposed protocol has been published in AJOG for early screening for DM in pregnancy. This also describes the differences in diagnosis and care for Standard GDM diagnosed at 24-28 weeks, vs a diagnosis of pregestational DM diagnosis made prior to 20-weeks vs “early” GDM also diagnosed under 20 weeks of gestation. Listen in for details. 1. McLaren, Rodney et al.nA Proposed Classification of Diabetes Mellitus in PregnancyAmerican Journal of Obstetrics & Gynecology, Volume 0, Issue 0. Epub Feb 2, 2026; https://www.ajog.org/article/S0002-9378(26)00061-X/fulltext2. ACOG Clinical Practice Update: Screening for Gestational and Pregestational Diabetes in Pregnancy and Postpartum; July 2024; https://journals.lww.com/greenjournal/abstract/2024/07000/acog_clinical_practice_update__screening_for.34.aspx3. Simmons, David et al. “Treatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy.” The New England journal of medicine vol. 388,23 (2023): 2132-2144. doi:10.1056/NEJMoa2214956

Superpowers for Good should not be considered investment advice. Seek counsel before making investment decisions. When you purchase an item, launch a campaign or create an investment account after clicking a link here, we may earn a fee. Engage to support our work.Watch the show on television by downloading the e360tv channel app to your Roku, LG or AmazonFireTV. You can also see it on YouTube.Devin: What is your superpower?Dr. Sahasranam: Emotional intelligence.Diabetes education saves lives, yet only 5 to 7 percent of people with diabetes ever receive it. This startling gap in care is the driving force behind My Diabetes Tutor, a telehealth platform founded by Dr. Prem Sahasranam. His mission? To make diabetes education accessible to everyone, regardless of geography or socioeconomic barriers.Dr. Sahasranam, a board-certified endocrinologist with nearly two decades of experience, explained how critical education is in diabetes management: “Studies have shown that just going through diabetes education reduces A1C by 0.73 points. At our program, our outcomes are two times better than the national average.” With over 9,000 patients served, My Diabetes Tutor consistently delivers remarkable results, achieving an average A1C reduction of 1.6 points—enough to significantly lower complications and mortality rates.The idea for My Diabetes Tutor was born out of necessity. Dr. Sahasranam shared a story about how two full-time diabetes educators in his rural California practice helped patients achieve exceptional outcomes. When they retired in 2018, he struggled to recruit replacements, a problem endemic to underserved areas. “I decided to build a telehealth program,” he said. “My goal was to solve an access issue and deliver diabetes education to people, irrespective of their zip code or language.”My Diabetes Tutor provides nationally accredited virtual diabetes education, covering medical nutrition therapy, continuous glucose monitoring, insulin pump training, and more. The platform recently launched the first-ever pediatric diabetes education program, a groundbreaking step toward addressing the needs of young patients.Dr. Sahasranam's vision extends beyond patient outcomes to include investor participation. My Diabetes Tutor is currently raising capital through a regulated crowdfunding campaign on StartEngine. “I want investors to own a piece of our growth and be part of our journey,” he said. The company generated over $2 million in revenue last year with a 61 percent gross margin, demonstrating both impact and financial viability.Dr. Sahasranam's work is not just about business; it's a mission to transform lives. By breaking down barriers to education, he's giving people the tools to manage their diabetes effectively, live healthier lives, and reduce complications.For those looking to make a difference—or simply to invest in a business delivering measurable impact—My Diabetes Tutor offers a unique opportunity.tl;dr:Dr. Prem Sahasranam founded My Diabetes Tutor to provide virtual education for diabetes management.The program addresses barriers to care in underserved communities by delivering telehealth services nationwide.My Diabetes Tutor achieves outcomes twice as effective as national averages in reducing A1C levels.The company generated over $2 million in 2025 and is raising capital via StartEngine crowdfunding.Prem credits emotional intelligence as his superpower, driving his mission to revolutionize diabetes care.How to Develop Emotional Intelligence As a SuperpowerDr. Prem describes his superpower as emotional intelligence, honed through years of experience as a board-certified endocrinologist. He explained, “Most health systems focus on the biology of the disease and fail to address the human part.” By understanding the emotional and practical needs of patients, Prem has created innovative solutions to improve access to diabetes education. He added, “I learned from my experience and built the right team, content, and technology to bring in diabetes education, easily accessible for patients.”Prem shared a pivotal story of a patient who had been struggling to control their diabetes despite receiving appropriate medications. The patient hesitated to make a two-hour drive to see Prem but eventually visited his practice and met with a diabetes educator. Without altering the patient's medications, the educator provided tailored guidance that helped the patient manage their condition. This experience inspired Prem to create My Diabetes Tutor, ensuring patients could access life-changing education from their own homes.Tips for Developing Emotional Intelligence:Reflect on past experiences to identify unmet needs and learn from them.Stay aware of the human challenges behind systemic issues.Focus on creating solutions that address both emotional and practical barriers.Build strong, empathetic teams that align with your mission.By following Dr. Prem's example and advice, you can make emotional intelligence a skill. With practice and effort, you could make it a superpower that enables you to do more good in the world.Remember, however, that research into success suggests that building on your own superpowers is more important than creating new ones or overcoming weaknesses. You do you!Get Your Copy!Guest ProfileDr. Prem Sahasranam (he/him):Founder, CEO, and Chief Medical Officer, My Diabetes Tutor (MDT)About My Diabetes Tutor (MDT): My Diabetes Tutor (MDT) is an ADCES-accredited telehealth service that provides comprehensive Diabetes Self-Management Education and Support (DSMES) via virtual, 1-on-1 sessions with Certified Diabetes Care and Education Specialists (CDCES). We bridge the gap for the 93% of eligible patients who currently do not utilize DSMES due to access barriers. We accept Medicare, Medicaid, and most private insurance (often with $0 out-of-pocket for patients). Participants achieve an average 1.6 pt reduction in A1C, 2x the national average for diabetes education.Website: mydiabetestutor.comCompany Facebook Page: facebook.com/mydiabetestutorInstagram Handle: @mydiabetestutor_Other URL: startengine.com/offering/my-diabetes-healthBiographical Information: Prem Sahasranam, MD (Dr. Sahas) is a Board-Certified Endocrinologist with over 20 years of clinical experience. He founded My Diabetes Tutor in 2019 to address the critical shortage of specialists in rural “care deserts”. A graduate of Madras Medical College with post-graduate training at Cornell University's Weill Medical College, he is currently an Assistant Clinical Professor at Loma Linda University and a dedicated advocate for health equity.LinkedIn Profile: linkedin.com/in/prem-sahasranam-ba10077Personal Facebook Profile: facebook.com/PremsahasranamThe Super Crowd, Inc., a public benefit corporation, is proud to have been named a finalist in the media category of the impact-focused, global Bold Awards.Support Our SponsorsOur generous sponsors make our work possible, serving impact investors, social entrepreneurs, community builders and diverse founders. Today's advertisers include rHealth, and Make Money with Impact Crowdfunding. Learn more about advertising with us here.Max-Impact Members(We're grateful for every one of these community champions who make this work possible.)Brian Christie, Brainsy | Cameron Neil, Lend For Good | Carol Fineagan, Independent Consultant | Hiten Sonpal, RISE Robotics | John Berlet, CORE Tax Deeds, LLC. | Justin Starbird, The Aebli Group | Lory Moore, Lory Moore Law | Mark Grimes, Networked Enterprise Development | Matthew Mead, Hempitecture | Michael Pratt, Qnetic | Mike Green, Envirosult | Nick Degnan, Unlimit Ventures | Dr. Nicole Paulk, Siren Biotechnology | Paul Lovejoy, Stakeholder Enterprise | Pearl Wright, Global Changemaker | Scott Thorpe, Philanthropist | Sharon Samjitsingh, Health Care Originals | Add Your Name HereUpcoming SuperCrowd Event CalendarIf a location is not noted, the events below are virtual.SuperCrowd Impact Member Networking Session: Impact (and, of course, Max-Impact) Members of the SuperCrowd are invited to a private networking session on February 17th at 1:30 PM ET/10:30 AM PT. Mark your calendar. We'll send private emails to Impact Members with registration details. Upgrade to Impact Membership today!SuperCrowdHour February: This month, Devin Thorpe will be digging deep into my core finance expertise to share guidance on projections and financial statements. We're calling it “Show Me the Numbers: Building Trust with Financial Clarity.” Register free to get all the details. February 18th at Noon ET/9:00 PT.Superpowers for Good Live Pitch: The top-raising Reg CF campaign of 2025 won the June 2025 Superpowers for Good Live Pitch. We're taking applications for the March 17, 2026, Live Pitch now. There is no fee to apply and no fee to pitch if selected! Apply here now!Community Event CalendarSuccessful Funding with Karl Dakin, Tuesdays at 10:00 AM ET - Click on Events.If you would like to submit an event for us to share with the 10,000+ changemakers, investors and entrepreneurs who are members of the SuperCrowd, click here.Manage the volume of emails you receive from us by clicking here.We use AI to help us write compelling recaps of each episode. Get full access to Superpowers for Good at www.superpowers4good.com/subscribe

Watch the FULL podcast here: https://youtu.be/qHFymGgsYyECan you do everything right and still face Alzheimer's risk? It can happen, and we discuss how environmental toxins, metabolic health, and shifting hormones may play a role. This clip explores two grandmothers with opposite lifestyles, highlighting possible factors like hemoglobin A1c, menopause-related drops in estrogen, and other hormones including IGF-1 and thyroid. We also consider genetic resilience and detox capacity, and why relying on luck isn't wise. Women are addressed directly, with advice to see a good hormone doctor during perimenopause and menopause. ***This episode is sponsored by:NOWATCH: The compassionate health trackerConnecting body and mind with unique stress recovery insights so you can live fully today15% off with code LWBW15 at https://nowatch.com/Mojo: the app for expert-led courses in better sex.Learn from world-class sex therapists and relationship experts with courses tailored to your needs.15% off with code LiveWell15 at mymojo.com/livewellbewell***The Great British Veg OutHow to support your gut, energy, and hormones by eating more — not less.

Diabetes isn’t a blood sugar disease—it’s a metabolic communication problem. In this episode of The Ask Dr Ernst Show, Dr. Ernst exposes why conventional treatment fails and walks you through the six functional root causes driving high blood sugar, A1C, and insulin resistance. Learn how restoring insulin signaling, liver and gut health, nervous system balance, and cellular energy can help the body heal itself—naturally.See omnystudio.com/listener for privacy information.

Watch the FULL podcast here: https://youtu.be/yZDzsfNjG_MCurious what Akkermansia actually does for your health? It's discussed here as a keystone gut microbe linked to improved insulin sensitivity, lower A1C in clinical studies, GLP-1 release and healthier blood vessels, with associations to cancer immunotherapy response. This clip explores the gut brain circulation connection, how metabolism and energy relate to this microbe, and why people considering immunotherapy might also focus on gut health. We also touch on the importance of discussing immunotherapy with an oncologist and staying within medical advice boundaries. ***This episode is sponsored by:NOWATCH: The compassionate health trackerConnecting body and mind with unique stress recovery insights so you can live fully today15% off with code LWBW15 at https://nowatch.com/Mojo: the app for expert-led courses in better sex.Learn from world-class sex therapists and relationship experts with courses tailored to your needs.15% off with code LiveWell15 at mymojo.com/livewellbewell***The Great British Veg OutHow to support your gut, energy, and hormones by eating more — not less.

Dr. Aaron Zelikovich discusses recent survey findings highlighting the wide variability in how clinicians evaluate and diagnose small fiber neuropathy. Fill out the Neurology® Clinical Practice Current survey.  Show citation:  Thawani S, Chan M, Ostendorf T, et al. How Well do We Evaluate Small Fiber Neuropathy?: A Survey of American Academy of Neurology Members. J Clin Neuromuscul Dis. 2025;26(4):184-195. Published 2025 Jun 2. doi:10.1097/CND.0000000000000502  Show transcript:  Dr. Aaron Zelikovich: Welcome to today's Neurology Minute. My name is Aaron Zelikovich, a neuromuscular specialist at Lenox Hill Hospital in New York City. Today, we will discuss a recent article, How Well Do We Evaluate Small Fiber Neuropathy? A survey of The American Academy of Neurology members, which evaluates small fiber neuropathy in clinical practice. The current landscape of evaluating and testing for small fiber neuropathy remains highly variable in regards to serum testing, skin biopsy, and nerve conduction studies. In this survey study, 800 members of The American Academy of Neurology were randomly selected and emailed a survey. 400 neuromuscular physicians and 400 non-neuromuscular physicians were selected. The overall response rate was 30% with half of the completed surveys coming from neuromuscular physicians. The most common overall initial blood work for this patient population was a CBC, vitamin B12, basic metabolic profile, TSH, and hemoglobin A1C. Other high yield blood tests included ESR, SPEP, immunofixation, and ANA. 70% of responders would also order a nerve conduction study as part of the initial workup. Second line evaluation had less consensus and included skin biopsies for intraepidermal nerve fiber density, hepatitis panel, HIV, and paraneoplastic testing. Responders noted that if the patient had acute onset of symptoms, had symptoms that were asymmetric, or being under 30 years old, they would order a more extensive workup. The authors discussed the importance of both clinical exam, history, and diagnostic workup in patients with symptoms compatible with small fiber neuropathy. They highlight that there is no current objective gold standard for a diagnosis of small fiber neuropathy. The current diagnostic recommendation by the AAN for distal symmetric polyneuropathy includes serum blood sampling for glucose, vitamin B12, SPEP, and immunofixation. Clinical practice in the diagnosis of small fiber neuropathy remains highly variable based on the provider and clinical context of the patient. Neurology Practice Current is currently accepting surveys on clinical practice patterns for patients with small fiber neuropathy. Please check out the link in today's Neurology Minute to complete the survey. Thank you and have a wonderful day. 

In this episode, Lyell K. Jones Jr, MD, FAAN, speaks with Aaron L. Berkowitz, MD, PhD, FAAN, who served as the guest editor of the February 2026 Neurology of Systemic Disease issue. They provide a preview of the issue, which publishes on February 2, 2026. Dr. Jones is the editor-in-chief of Continuum: Lifelong Learning in Neurology® and is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Dr. Berkowitz is a Continuum® Audio interviewer and a professor of neurology in the Department of Neurology at the University of California, San Francisco, in San Francisco, California. Additional Resources Read the issue: continuum.aan.com Subscribe to Continuum®: shop.lww.com/Continuum Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @LyellJ Guest: @AaronLBerkowitz Full episode transcript available here Dr Jones: The human nervous system is so complex. You can spend your whole career studying it and still have plenty to learn. But the human brain does not exist in isolation. It's intricately connected with and reliant on other bodily systems. When those systems go awry, sometimes the first sign is in the nervous system. Today we will speak with Dr Aaron Berkowitz, an expert on the neurology of systemic disease, and learn a little about how these disorders can present and what we can do about it. Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about subscribing to the journal, listening to verbatim recordings of the articles, and exclusive access to interviews not featured on the podcast. Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum: Lifelong Learning in Neurology. Today, I'm interviewing Dr Aaron Berkowitz, who is Continuum's guest editor for our latest issue of Continuum on the neurology of systemic disease. Dr Berkowitz is a professor of clinical neurology at the University of California, San Francisco, and he has an active practice as a neurohospitalist and in outpatient general neurology---and, importantly, as a clinician educator. In addition to numerous teaching awards, Dr Berkowitz has published several books and also serves on our editorial board for Continuum. Dr Berkowitz, welcome. Thank you for joining us. Why don't you introduce yourself to our listeners?  Dr Berkowitz: Thanks, Lyell. As you mentioned, I'm a general neurologist and neurohospitalist here in San Francisco, California at UCSF and very involved in resident education as well. And I was honored, flattered and a little bit frightened when I received the invitation to guest edit this massive issue on the neurology of systemic disease. But I've learned a ton, and it's been great to work with you and the incredible authors we recruited to write for us. And I'm excited to have the issue out in the world.  Dr Jones: Yeah, me too. And you and I have talked about it before: you're one of a very small group of people who have guest edited multiple issues on different topics, right?  Dr Berkowitz: That's right. I did the neuroinfectious disease issue in… was it 2020? 2021? Something like that.  Dr Jones: Yeah. So, congratulations, more people have walked on the moon than done what you've done. And I'm looking forward to chatting, Aaron, and really grateful for your work putting together a fantastic issue. I think our listeners will appreciate that the nervous system does not function in isolation. It's important to understand the neurologic manifestations of diseases that originate within the brain, spinal cord, nerves, muscles, etc., but also the manifestations of diseases that begin in other systems and, you know, may masquerade as a primary neurologic disorder. So, it's obviously an important topic for neurologists, since many of these patients are receiving care in another setting, perhaps from another specialist. I almost think of this issue of Continuum as a handbook for the consultant neurologist, inpatient or outpatient. I don't know. Do you think that's a fair characterization of the topic? Dr Berkowitz: Absolutely. I completely agree with you. I think, yeah, many of us go into neurology interested in our primary diseases, whether it's stroke or Parkinson's or neuropathy or particular interest in neurologic symptoms, whether they're cognitive, motor, sensory, visual. And we quickly learn in residency, right? As you said, a lot of what we see is neurologic manifestations of primary diseases. So, I don't know how similar this is to other training programs. But it seemed like, if I'm remembering correctly, my first year of residency was mostly on primary neurology services, general stroke, ICU. And we moved into the consultant role more in the PGY-3 year the next year. And I remember explaining to students rotating with us on the consult services, this is actually much more complex in a way, because the patient has some type of symptom in a much broader and much more complicated context of multiple things going on. And I call it "neurology in the wild." There's, like, neurology of, this patient's had a stroke and we know they have a stroke and we're trying to figure out why and treat it. That's all interesting. But our question here, is there a stroke needle buried in this haystack of all of these medical or surgical complications? And learning what I call neurology of X, which is really what this issue is; as you said, that there's a neurology of everything. There's a neurology of cardiac disease. There's a neurology of the peripartum. There's a neurology of rheumatologic disease. There's every new treatment that comes out in oncology has a neurology we learn, right? There's a neurology of everything.  Dr Jones: There's a lot of axes, right? There's the heart-brain axis and the kidney-brain axis. And… I think we cover everything except the spleen-brain axis, which maybe that's a thing, maybe not. I'll probably hear from all the spleen fans out there. So, I want to do a little bit of an experiment. We're going to do something new today on the podcast. Before we get into the questions, we're going to start with a Continuum Audio trivia question. So, this will be a first time ever. Dr Berkowitz, we all know that chronic hyperglycemia, or diabetes, can lead to many neurologic and systemic complications and that optimal glucose control is our goal. For our listeners, here's the question: what neurologic complication can occur from correcting hyperglycemia too quickly? What neurologic complication can occur from correcting hyperglycemia too quickly? Stick around to the end of our interview for the answer. So, Aaron, let's get right to it. You had a chance to review all the articles in this issue on the neurology of systemic disease. What do you think in all of those is the most exciting recent development for patients who fit into this category? Dr Berkowitz: Yeah, that's a great question. I think we talked about when we were putting this issue together, right, a lot of the Continuum subspecialty topics; there should have been updates on particular disease diagnostics, treatments, new phenotypes. Whereas here probably a lot less has changed in primary heart disease, primary cancer. As I'd like to say to our students trying to excite them about neurology, most specialties have new treatments, but I can name a large number of new diseases, right, that have been discovered since we've been out of training. So, a lot of the primary medicine stays the same, and the neurologic complications stay the same. But probably the thing that many readers will want to keep handy and will probably be much in need of update again in three years are the neurologic complications of all the new cancer treatments. So, if we think back to I finished training just over ten years ago when a lot of the fill-in-the-blank-umabs were coming out, CAR T therapy, and we were starting to see a lot of neurology, I remember, related to these and telling the oncologists and they said, oh, you just wait. We are seeing at the conferences that there's a lot of neurology to these. And I feel like that is always a moving target. And I think we are seeing a lot of those and it's hard to keep up with which treatments can cause which complications, which syndromes and which severities require holding the treatment when you can rechallenge longer-term complications of CAR T cell therapies now that we've learned more about the acute complications. So, Amy Pruitt from Penn has written us a fantastic article for this issue that covers a lot of the updates there. And I learned a lot from that. I feel like that's the one that just like every time the carnioplastic diseases are reviewed in Continuum, it seems like the table is another page longer from your colleagues there in Rochester teaching us about new antibodies. And I feel like, for this issue, that's one of the areas that felt like there was a lot of very new content to keep up with since last time.  Dr Jones: That's good news, right? It's good that we have new immunotherapies for cancer, but it does lead to neurologic catastrophes sometimes, and it is a moving target, really rapid. So, you mentioned that just over ten years ago you finished your training and now we see a lot more of these complex immunotherapy-related neurologic complications. What about in the other direction? Are there any things that you see less commonly now in your practice than you might have seen ten years ago right when you were finishing training?  Dr Berkowitz: I would say no, I think. I think we're seeing a lot of new stuff, and we're still seeing a high volume of the classic consults we tend to get, whether that's altered mental status in a patient who's systemically ill; weakness or difficulty reading from the ventilator in a patient who's critically ill; patient has endocarditis and has a stroke hemorrhage or mycotic aneurysm, what do we do? Yeah, one of the parts that was really fun and educational editing this issue is, I really wanted to ask the experts the questions I find that are really troubling and challenging and make sure we could understand their perspective on things like the endocarditis consult, which I always feel like each time there's some twist that even though the question is what do we do about this stroke and/or hemorrhage and/or aneurysm and is surgery safe? It seems like each time I always feel like I'm reinventing the wheel, trying to really sort out how to think about this. And we have a great article from Alvin Doss at Beth Israel and Steve Feskey from Boston Medical Center. It covers a lot of cardiology, as you know, in that article about a great section on endocarditis where every time it came back for review, I would say, but what about this? This comes up. What about this? Can you explain how you think about this for our readers? I don't know. I'd be curious to hear your perspective. It sounds like we agree on what has become more common. I don't think anything in neurology seems to become less… Dr Jones: Well, no, I guess we haven't really solved anything, I guess we haven't cured any problem. But that's okay, right? I mean, it's building on an established foundation of experience and history in our field. And you know, we mentioned earlier that in many ways this issue is kind of like a neurology consultant's handbook. We did something a little different with it in that sense. In addition to you serving as the guest editor, you have authored an article in the issue. It touches on something that we've talked about a couple of times, and I'd be interested to hear you talk through it with our listeners a little bit on how to approach the neurologic consultation. Tell us a little more about that and your article and how you approached it.  Dr Berkowitz: Oh, yeah, thanks. Well, thanks first of all for inviting me to think about a sort of introductory article to this issue. And I was trying to think about what to write about because, as you've said and we've been talking about, no one could know every neurologic complication of every medical disease, treatment, surgery, hospital context. Probably many of us don't even know all the muscle diseases, right, within neurology. So how could we know all this stuff? And we need some type of manual from our colleagues that can explain, okay, I know this patient has inflammatory bowel disease and they've had a stroke. Is that- are these related? Are these unrelated? And I thought the articles kind of answer all of these questions. What would I say beyond this patient has disease X and is on drug Y? Well, look up in this issue disease X and see what the neurology can be, common and rare and how often it's associated, how often it's the presenting feature, how often it means the treatment is failing, etc. I thought, I'm not sure there's much to say there. That's about a paragraph. And I thought, well, let's think even more broadly about neurologic consultation. And as you know, I like to think about diagnostic reasoning and clinical reasoning. And we talk a lot about framing bias right? And I think that is very common in consultative neurology because we'll be told in the consult or in the page or E-consult or whatever it is, this is a blank-year-old blank with a history of blank on treatment blank. And right away your mind is starting to say, oh, well, the patient just had heart disease, or, the patient is nine months pregnant, or, the patient is on an immune checkpoint inhibitor. And whether you want to do it or not, your mind is associating the patient's neurology with that. And it's- even if we know we're framing or anchoring, it's hard to kind of pull away from that. And most of the time, common things being common, a patient with cancer develops new neurology, It's probably the cancer, the treatment, or sometimes a paraneoplastic syndrome. But I've definitely found if you do a lot of inpatient neurology and a lot of consults that you're seeing so much and you have no choice but to apply these heuristics, because you're seeing a lot of volume quickly and the patients are in the hospital or they're being closely followed and outpatient setting by another specialist. You presume if you didn't get it quite right the first time, it's going to come back to you. And there's a little bit of difficulty figuring out, this is a case, actually, of all the altered mental status in acutely ill patients I got today, this is the one I should dig deeper in that I think this could turn out to be a stroke or encephalitis as opposed to delirium. I felt like that I really haven't approached that except knowing that it's easy to fall into traps. And so, I started to think about framing bias. You know, we talked about if we become aware of our biases, right, we're better at not falling prey to them. But it's subconscious. So, we might be applying it without even realizing, or even saying, I might be framing this case the wrong way, you can go right on framing it the wrong way. So, I want to kind of get a little more granular on what types of framing biases actually are relevant, specifically, to the console setting. And so, I tried to come up with a few more specific examples and try to think about ways that we could at least have a quick, if our knee-jerk is to associate primary disease X that the patient has or primary treatment X with neurologic symptom Y, what's at least a quick counter-knee jerk to say, what if it could be something else? So, for example, one of them I call "low signal-to-noise ratio bias." Altered mental status in the acutely ill hospitalized patient. What would you say, Lyell? 99 out of 100- 99.9 out of 100, it's not a primary neurologic disease. Is that fair to say? Dr Jones: Very high, yep. I agree. Dr Berkowitz: Yeah. But could it be a stroke? Could it be non-convulsive status epilepticus, meningitis encephalitis? So, how do we sort of counteract low signal-to-noise ratio bias, acknowledging it exists, acknowledging most of the time there is a low signal-to-noise, that it's not going to be neurology---to just for example, use the time course. This is pretty acute. Have I convinced myself this is not a stroke or a seizure or an acute neurologic infection? And if I'm not sure at the bedside, should I err on the side of more testing? Or the "curbside bias," as I call when your colleague just sends you a text message on your phone, No need to even open the chart, Dr Jones. Patient had a cerebellar stroke. Incidental. They're here for something else. Aspirin, right? Just like a super tentorial stroke. And you might reply thumbs up. And then imagine you open the CT scan and it's a huge cerebellar stroke with fourth ventricular compression- and patient can hide a lot of stroke back there, might just have a little ataxia. You were curbsided and that framed you to think, oh, they asked me, is aspirin okay for a cerebellar stroke and I said yes, without realizing actually the question should have been posed is, how do you manage a huge stroke with mass effect in the posterior fossa? So, these types of biases, I come up with five of them, I won't go through all of them. I'm in the article to sort of acknowledge for the reader, most of the time it's going to be what you look up in this issue, but how to think about the times where it might not be and how to be more precise about what framing is and different types of framing that occur specifically in the consultant arena. Dr Jones: And I think the longer we practice, the more of those low-frequency exceptions that you see. And, you know, and then it sticks in our mind and sometimes the bias swings the other way; people, you know, think primarily about the low frequency. And so, it's tricky. And what I really enjoyed about that article, we started talking about this probably more than a year ago, and more than a year ago, I would say relatively few clinicians were using a now widely popular large language model for clinical decision-making; we won't name the model. And now I think most clinicians are using it almost every day, right? And I think it puts a premium on how to think and how to engage with the patient, and less about the facts and the lists that a lot of conventional medical education really is derived from. So, I really appreciate that article. We can pat ourselves in the back. We had some foresight to put it in the issue, and I think it's a great addition to it. Dr Berkowitz: Thank you. Dr Jones: So, the list of potential topics when we think about the neurologic manifestations of systemic disease, we tend to break it down by organ systems, right? But the amount of things that could end up in the issue is almost infinite. Is there anything that, when you were putting this issue together---either in terms of the topics or editing the articles---is there anything that you wanted to include, but we just didn't have room? Dr Berkowitz: I certainly won't say we covered everything, but I will say we were able to recruit a fantastic team of authors. And as you and I also talked about at the beginning, although you could say, we're doing the movement disorders issue, let's find all the top movement disorders folks who are expert specialists in this field, there's not really a neurohematologist or a neurogastroenterologist out here. So, you and I put our heads together to think of phenomenal general neurologists in most cases, some subspecialists who know a lot about this but were also excited to read a lot more about it and assemble the existing knowledge by the practicing neurologist for the practicing neurologist. And I think with that approach and letting folks have kind of, you know, I asked some specific questions. These are topics I hope you'll cover. These are vexing questions in this area. I hope you'll find some answers to how often can this neurology be the primary feature of this rheumatologic disease with no systemic manifestations and when should we look or as we mentioned, the complicated endocarditis consult. I won't say we covered everything. This could be, and is, textbook-sized, and there are textbooks on this topic. But I think on the contrary, authors came back and had sections on things that I might not have thought to ask- to cover. Dr Sarah LaHue, my colleague here at UCSF, I asked for an article, as traditionally in this issue, on the neurology of pregnancy in the postpartum state and included, I think probably for the first time in Continuum, a fantastic review of neurologic considerations in patients in menopause, which I'm not sure has been covered before. So, things that I wouldn't have even thought to ask for. Our authors came back with some fantastic stuff. And the ICU article by Dr Shivani Ghoshal, instead of focusing just on altered mental status in the ICU, weakness in the ICU---those are all in there---I also asked her to discuss complications of procedures in the ICU. How often do procedures in the ICU cause local neuropathies or vascular injury, these types of things. Dr Jones: Yeah, me too. And I guess that's a great advertisement, that there probably are things that we didn't cover, but if there are, we can't think of them. We've done as best as we can. So now let's come back to our Continuum Audio trivia question for our listeners. And I'll repeat the question: what neurologic complication can occur from correcting hyperglycemia too quickly? And I actually think there might be two correct answers to this one. Dr Berkowitz, what do you think? Dr Berkowitz: Yeah, I was thinking of two things. I hope these are the things you're thinking of as well. One is what I think used to be referred to as insulin neuritis, sort of an acute painful small fiber neuropathy from after the initiation of insulin, I think also called treatment-induced diabetic neuropathy or something of that nature. And then the other one described, defined and classified by your colleagues there in Rochester, the diabetic lumbosacral radiculoplexis neuropathy or Bruns-Garland syndrome or a diabetic amyotropy, I think, can also---if I'm not mistaken---also occur in this context; you should have weight loss in association with diet treatment of diabetes. But how did I do? Dr Jones: Yeah, you win the prize, the first-ever prize. There's no monetary value to the prize, but pride, I think, is a good one. Yeah, those were the two I was thinking of. The treatment-induced neuropathy of diabetes is really nicely covered in Dr Rafid Mustafa's article on the neurologic complications of endocrine disorders. It's a rare condition characterized by the acute/subacute onset of diffuse neuropathic pain and some usually some autonomic dysfunction. And it occurs when you have rapid and substantial reductions in blood glucose levels. And you can almost map it out. There was a study from 2015 which is referenced in the article, which found that a drop in hemoglobin A1c of 2 to 3% over three months confers about a 20% absolute risk of developing this treatment-induced neuropathy of diabetes, and a drop of more than 4%, more than 80% risk. So, very substantial. And then in the other---we see this commonly in patients with diabetic lumbosacral radiculoplexis neuropathy---they have the subacute onset of usually asymmetric pain and weakness in the lower limbs that tends to occur more frequently in patients who have had recent better control of their sugar. We can also see it in the upper limbs too. So, you get a perfect score. Dr Berkowitz, well done. Again, I want to thank you. I want to thank you for such a great issue, a great article to kick off the issue, and a great discussion of the neurology of systemic disease. Today I learned a lot talking today, I learned a lot reading the issue. Really grateful for your leadership of putting it together, pulling together a really great author panel, and I think it will come in handy not just for our junior readers and listeners, but also our more experienced subscribers as well. Dr Berkowitz: Thank you so much. Like I said, it was a big honor to be invited to guest edit this issue. I've read it every three years since I started residency. It's always one of my favorite issues. As you said, a manual for consultative neurology, and I learned a ton from our authors and really appreciate the opportunity to work with you and the amazing Continuum team to bring this from an idea, as you said, probably over a year ago to a printed issue. So, thanks again, Lyell. Dr Jones: Thank you. And again, we've been speaking with Dr Aaron Berkowitz, guest editor of Continuum's most recent issue on the neurology of systemic disease. Please check it out, and thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. Thank you for listening to Continuum Audio.

We're answering real diabetes questions straight from social media in this episode of the Your Diabetes Insider Podcast - and yeah… some of them are insightful, some are wildly confusing, and a few left me absolutely speechless! We're talking net carbs vs total carbs, whether caffeine actually spikes blood sugar, what happens if your phone controls your insulin pump (and you lose it

Welcome back to our weekend Cabral HouseCall shows!   This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track!   Check out today's questions:    Will: Hi Dr Cabral, Thank you for giving us the opportunity to ask you questions. I've learned so much from other people's questions! I have two of my own. 1. Regarding your past podcast on the importance of broccoli and garlic. I travel a lot for work. When I travel and can't get broccoli or garlic, would it be ok to take a broccoli and garlic supplement. ? 2. I recently purchased the equililife mushroom supplement. Do you recommend taking it all year round or just in the winter. Thanks so much! Will   Carol: Dr Cabral, I would like to start by thanking you for all the information you freely give. I've been listening to your podcast almost since it started and I have been able to make positive changes in my life and my family's. I am a healthy, active 62 year old woman. I walk 5 to 10 miles most days. I do strength training 3 to 5 times a week plus cardio a couple days a week. Through diet and exercise I have been able to maintain my weight most of my adult life. If my weight started to go up I would make adjustments in my diet (which was usually from getting sloppy with my diet). Since 2017 I've done your detox at least 3 times a year (I just haven't been able to swing 4), and they usually help me lose the few pounds I gained and put me back on track with my eating. For the last few years, however, my weight has been creeping up higher and nothing (not even the detoxes) have helped me lose the added weight. I've tried everything I could think of, but my weight continues to go up instead of down. I went through menopause 10 years ago. I'm at a loss at what to do, but I definitely don't want to continue to gain weight. Do you have any thoughts or suggestions? Thank you, Carol                                                                                                                                                                                  Mohamed: Good morning to you Doctor Cabral and all the listeners. Grateful for all that you do. My question is regarding a sort of pinch like feeling on my left side (near heart). On and off randomly.. did blood work and EKG (normal findings). Ran minerals and Metals.. on the higher side for K & N.. Mg green and Calcium (leaning towards high). Other minerals were low, except phosphorus (slightly high) Noticing bloating after meals.. could leaky gut be related to the occasional pinch feeling I get… it's either that or cortisol.. Which lab should I run (can only do 1).. Taking Omega3 support, DNS, Magnesium and exercising twice a week.. I'm a 27 year old man. Noticing new onset fatigue, bloating.. A bit worried about my heart.. thanks.. What can help, proteolytic enzymes, Apple cider Vinegar before meals. Or B vitamins. Thoughts?    Cheryl: Morning, My 73 year old dad has type 2 diabetes. He is otherwise in good health, an active golfer, is about 165lbs and walks daily. My parents are old school and believe everything the dr says. Recently, his dr just uped his metformin to 2x a day from 1x and put him on a pill for his A1C. I am annoyed that the meds are just increased instead of looking at the root cause. They recently saw a dietician who said it is not reversable which I know is not at all true. My mom cooks healthy meals but my dad does have a sweet tooth. When he wants something sweet it is often sugar/free which is terrible and full of chemicals. I do not agree with all of the sugar free stuff/sweetners and try go get them to choose different things-monkfruit/coconut sugar but the dietician recommended the splenda type stuff. would love to help my dad reverse this. Any suggestions where to start would be appreciated. Thank you:)    Elizabeth: Hi Dr Cabral! Thank you for the amazing work that you do! My 80 year old mother has been experiencing consistent burning mouth syndrome for the past 12 years. She had tried all the conventional methods, gabapentin, CT scan etc and nothing has helped. I recently read that the drop in estrogen during menopause could be the cause. What do you think and any recommendations? Thanks again!    Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!    - - - Show Notes and Resources: StephenCabral.com/3648 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

Support your health journey with our private practice! Explore comprehensive lab testing, functional assessments, and expert guidance for your wellness journey. Find exclusive offers for podcast listeners at nutritionwithjudy.com/podcast. _____Stephen and I examine why standard lab markers like A1C, thyroid hormones, glucose averages, and antibodies can misrepresent health in carnivore and low-carb contexts. We break down physiological shifts in red blood cell lifespan, glycation, thyroid signaling, hydration, and electrolytes, and why symptom-based assessment often matters more than reference ranges.Stephen is a UK-based coach, specialist in obesity and diabetes, and former private lab director with an honors degree in physiology and health sciences. After worsening health under conventional nutrition advice, he transitioned to low-carb and carnivore and has spent over a decade translating blood markers through a physiology-first lens. He writes daily science explainers and authored The Guide to Blood Tests in the Context of Keto, Carnivore, and Low Carb.We discuss the following:All about Stephen ThomasWhy A1C can rise on carnivoreRed blood cell lifespan and A1CPhysiology over reference range focusAdaptation vs. under-eating and thyroid dysfunctionWomen's early carnivore challengesStephen's role in lab interpretationHarm of fear-based healing messagesWhere to find Stephen ThomasEPISODE RESOURCESCarnivore group WebsiteSubstackGuide To Blood Tests bookEFH Complete Wellness PanelNutritionist's Guide to the Carnivore Diet_____WEEKLY NEWSLETTER 

Hemoglobin A1c is one of the most high-yield lab values you'll see on NP boards and in real life. In this minisode, I review its alternate names, the key A1c cutoff and goal values, and how boards expect you to use trends to decide when treatment needs to be adjusted.    Follow us on Instagram: instagram.com/smnpreviewsofficial

In this solo episode, Lauren breaks down one of the most important skills for navigating Type 1 Diabetes with more confidence: spotting blood sugar patterns without getting trapped in constant data analysis. She speaks to two common experiences, the person who's already deep in the charts but still feels stuck, and the person who feels overwhelmed and convinced they “don't have patterns.”Lauren shares a simple, human approach to pattern recognition that prioritizes curiosity over judgment. You'll learn how to slow down, identify what's actually driving your out-of-range numbers, and build awareness in a way that supports your life (instead of taking it over). If you've ever felt like diabetes is running the show, this episode will help you shift from reacting in the moment to making decisions with more clarity and calm.WHAT WE COVER:How to identify which “group” you fall into: over-analyzing vs. overwhelmed and unsure where to startWhy changing ratios isn't always the answer and what the graphs don't showHow to start with awareness first, before trying to “fix” everythingFour practical ways to find patterns without living inside your CGM dataHow to build a weekly review habit using curiosity over judgmentKEY TAKEAWAYS:1️⃣ The goal isn't perfect numbers. It's clarity and confidence that you can repeat consistently.2️⃣ Patterns aren't always in the graphs. Often, the real drivers are beneath the surface: fear of lows, stress, sleep, routines, and habits.3️⃣ You don't need to find every pattern. Pick one frustrating context, slow down, and build awareness one bite-sized step at a time.WHAT'S NEXT:

Diagnosed at three, Shane discusses growing up with T1D, navigating the college party scene, and his transition to adulthood. He covers alcohol, mental health, dating, and improving his A1C. Free Juicebox Community (non Facebook) Type 1 Diabetes Pro Tips - THE PODCAST Eversense CGM Medtronic Diabetes Tandem Mobi ** Use code JUICEBOX to save 40% at Cozy Earth  CONTOUR NextGen smart meter and CONTOUR DIABETES app Dexcom G7 Go tubeless with Omnipod 5 or Omnipod DASH * Get your supplies from US MED  or call 888-721-1514 Touched By Type 1 Take the T1DExchange survey Apple Podcasts> Subscribe to the podcast today! The podcast is available on Spotify, Google Play, iHeartRadio, Radio Public, Amazon Music and all Android devices The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here or buy me a coffee. Thank you! *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Omnipod 5 Controller is not waterproof.  ** t:slim X2 or Tandem Mobi w/ Control-IQ+ technology (7.9 or newer). RX ONLY. Indicated for patients with type 1 diabetes, 2 years and older. BOXED WARNING:Control-IQ+ technology should not be used by people under age 2, or who use less than 5 units of insulin/day, or who weigh less than 20 lbs. Safety info: tandemdiabetes.com/safetyinfo Disclaimer - Nothing you hear on the Juicebox Podcast or read on Arden's Day is intended as medical advice. You should always consult a physician before making changes to your health plan.  If the podcast has helped you to live better with type 1 please tell someone else how to find it!  

Blood work is trending — but most people are reading it wrong.“Normal” labs don't mean optimal, and context is what everyone is missing.In this episode, we break down why blood work has become a trend instead of a tool, how people are misinterpreting their labs, and why “normal” results often create false confidence instead of real clarity. Everyone wants answers from a single panel, but very few understand how to read blood markers in context.Joined by Lindsay Perry, the conversation dives into what blood work can and cannot tell you, why markers like insulin, glucose, and A1C must be viewed together, and why relying on isolated numbers leads to poor decisions. We also discuss the limitations of cortisol testing, why blood work alone doesn't capture nervous system stress, and where additional tools like genetics and functional testing actually fit.This episode isn't anti–blood work — it's anti-misuse.You'll hear a grounded, coaching-driven perspective on:Why blood work became popular — and how it's being misunderstoodThe danger of reading labs without lifestyle, behavior, and symptom contextInsulin as a missing piece in most standard blood panelsWhy cortisol is difficult to assess accurately through blood work aloneHow genetics, gut health, and deeper testing inform smarter decisionsWhy data without interpretation creates confusion, not solutionsLindsay Perry brings real-world coaching insight into how health data should guide action, not anxiety, and why context matters more than any single number on a report.If you've ever been told your labs are “normal” but still don't feel right — this conversation explains why.00:00 – Why Blood Work Is Trending Right NowBlood work has become the latest health trend and why everyone wants answers from labs.01:18 – Everyone Wants to Be a Blood Work ExpertHow access to data without education creates confusion and false authority.03:05 – Why “Normal” Blood Work Can Be MisleadingUnderstanding reference ranges vs optimal health and why people feel stuck.05:12 – The Missing Marker: InsulinWhy insulin is often ignored, how it connects to glucose and A1C, and why it matters.08:04 – Looking at Markers Together, Not in IsolationWhy single lab values don't tell the full story.10:36 – Cortisol and the Limits of Blood TestingWhy cortisol is difficult to assess through blood work alone.13:02 – Stress, the Nervous System, and What Labs MissWhy lifestyle and nervous system regulation don't show up clearly on labs.15:48 – Genetics as a Coaching ToolHow genetic testing is used to guide smarter decisions, not labels.18:22 – Detox, Methylation, and Mitochondrial Pathways ExplainedBreaking down common genetic categories and what they influence.21:10 – Gut Health, Sensitivities, and Deeper TestingWhen blood work isn't enough and additional testing becomes relevant.24:05 – Why Context Matters More Than Any NumberHow symptoms, behavior, and lifestyle complete the picture.26:42 – Coaching vs Data ObsessionWhy data should guide action, not anxiety.29:30 – Using Blood Work the Right WayHow to treat labs as a tool, not a diagnosis.32:10 – Final Thoughts: Blood Work Isn't the EnemyWhy blood work is valuable when used correctly and responsibly.⚠️ DisclaimerThis content is for educational purposes only and is not intended to diagnose, treat, or replace medical advice. Always consult a qualified healthcare professional regarding your health and lab results.

In this episode, Rip sits down with Jet, a 66-year-old husband, father, hiker, and former keto devotee whose health collapsed despite doing “everything right” according to low-carb gurus. After a terrifying calcium score, debilitating angina, and near-widowmaker blockage, Jet found himself out of breath, unable to hike his favorite mountains, and feeling an impending sense of doom.A reunion — and one shocking scar from a friend's open-heart surgery — jolted him into action. Jet pivoted from years of high-fat keto eating to a whole-food, plant-based, SOS-free lifestyle inspired by Dr. Caldwell Esselstyn. Within weeks, his symptoms vanished. Within months, he was summiting mountains he hadn't touched in over a decade. Today, his cholesterol is stellar, his A1C is normal, and he's hiking peaks he hasn't done in years.Jet's story is an inspiring reminder that the body can heal when given the right fuel — and that it's never too late to turn your life around.Key Topics Covered:Growing up in the Philippines on a fat and sugar-heavy dietThe moment Jet realized keto was harming — not helping — his heartHow a reunion wake-up call shifted his perspectiveThe emotional and physical toll of worsening symptomsWhy he finally chose a whole-food, plant-based lifestyleThe shocking improvements in angina, energy, cholesterol, sleep, and moodHis new life of hiking, strength, and vitality at 66Advice for anyone curious but hesitant to go plant-basedEpisode WebpageWatch the Episode on YouTubeLearn More About our 2026 Live PLANTSTRONG Events: https://plantstrong.com/pages/events Let Us Help Your PLANTSTRONG JourneyLearn More About Our Corporate Wellness Program: https://liveplantstrong.com/corporate-wellness/ COMPLEMENT: Use code PLANTSTRONG for 30% off at https://lovecomplement.com/pages/plantstrong-special-offer Follow PLANTSTRONG and Rip Esselstynhttps://plantstrong.com/ https://www.facebook.com/GoPlantstrong https://www.instagram.com/goplantstrong/https://www.instagram.com/ripesselstyn/ Follow the PLANTSTRONG Podcast and Give the Show a 5-star RatingApple PodcastsSpotify

In this episode of the Metabolic Freedom Podcast, Ben Azadi reveals how insulin resistance can exist long before it appears on standard blood work and how the body shows clear warning signs that most people overlook. Ben explains that insulin resistance is not caused by laziness or lack of discipline. It is a biological response to years of metabolic stress, often hiding in plain sight even in people who eat clean, exercise, and appear healthy. You'll learn the five silent physical signs of insulin resistance, including dark skin patches, skin tags, stubborn belly fat, water retention, and cold or numb extremities. These visible signals often show up years before glucose or A1c levels become abnormal. The episode breaks down what insulin really does in the body, why chronically elevated insulin blocks fat burning, increases inflammation, and damages blood vessels, and why doctors frequently miss insulin resistance by relying only on glucose-based labs. Ben shares real client examples and walks through two simple, science-backed steps to start reversing insulin resistance immediately: eating protein and fat before carbohydrates and using apple cider vinegar correctly to blunt glucose and insulin spikes. This episode also explains why fasting insulin is the most important lab marker to request, how skinny individuals can still have dangerous visceral fat, and why insulin resistance is reversible when the right signals are restored. If you are dealing with stubborn belly fat, fatigue, inflammation, or unexplained health issues, this episode provides clarity, empowerment, and practical tools to take control of your metabolic health naturally.

In this episode of Intermittent Fasting Stories, Gin talks to Corinne Loe from North St. Paul, MN.Join Gin in the new Fast Feast Repeat app for The Grown-Up Year: 52 Weeks to Listen, Play, and Nourish, as well as a growing collection of intermittent fasting resources. Go to app.fastfeastrepeat.com to join us or go to the App Store and download the Fast Feast Repeat app, available for both iPhone and Android.Are you ready to take your intermittent fasting lifestyle to the next level? There's nothing better than community to help with that. In the Delay, Don't Deny community we all embrace the clean fast, and there's just the right support for you as you live your intermittent fasting lifestyle. You can connect directly with Gin in the Ask Gin group, and she will answer all of your questions personally. If you're new to intermittent fasting or recommitting to the IF lifestyle, join the 28-Day FAST Start group. After your fast start, join us for support in The 1st Year group. Need tips for long term maintenance? We have a place for that! There are many more useful spaces beyond these, and you can interact in as many as you like. Visit ginstephens.com/community to join us. An annual membership costs just over a dollar a week when you do the math. If you aren't ready to fully commit for a year, join for a month and you can cancel at any time. If you know you'll want to stay forever, we also have a lifetime membership option available. IF is free. You don't need to join our community to fast. But if you're looking for support from a community of like-minded IFers, we are here for you at ginstephens.com/community. Corinne shares her transformative journey with intermittent fasting, detailing her struggles with childhood trauma, anorexia, and the impact of family dynamics on her eating habits. She discusses her path to healing through therapy, the significant weight loss she achieved, and the non-scale victories that have improved her health. Corrine emphasizes the importance of emotional healing and self-acceptance, encouraging others to embrace flexibility in their fasting journey.Takeaways:• Corrine started intermittent fasting on July 18th, 2024.• She was borderline type two diabetic before starting her journey but now has a normal A1C.• Childhood chaos and control issues led to her early struggles with anorexia.• Family influence played a significant role in her eating habits.• Stepping away from legalism in food choices has been crucial for her.• Dealing with loss and grief has shaped her journey.• Therapy has been a vital part of her healing process.• Intermittent fasting has provided her with freedom and mental clarity.• She lost 60 pounds and improved her health significantly.At the end of the episode, Corinne encourages listeners to start with the clean fast, and also to not overlook the issues that brought you to overeating in the first place.Join Gin in the new Fast Feast Repeat app for The Grown-Up Year: 52 Weeks to Listen, Play, and Nourish, as well as a growing collection of intermittent fasting resources. Go to app.fastfeastrepeat.com to join us or go to the App Store and download the Fast Feast Repeat app, available for both iPhone and Android.Get Gin's books at: https://www.ginstephens.com/get-the-books.html. Good news! The second edition of Delay, Don't Deny is now available in ebook, paperback, hardback, and audiobook. This is the book that you'll want to start with or share with others, as it is a simple introduction to IF. It's been updated to include the clean fast, an easier to understand and more thorough description of ADF and all of your ADF options, and an all new success stories section. When shopping, make sure to get the second edition, which has a 2024 publication date. The audiobook for the second edition is available now! Join Gin's community! Go to: ginstephens.com/communityDo you enjoy Intermittent Fasting Stories? You'll probably also like Gin's other podcast with cohost Sheri Bullock: Fast. Feast. Repeat. Intermittent Fasting for Life. Find it wherever you listen to podcasts. Share your intermittent fasting stories with Gin: gin@intermittentfastingstories.comVisit Gin's website at: ginstephens.com Check out Gin's Favorite Things at http://www.ginstephens.com/gins-favorite-things.htmlSubscribe to Gin's YouTube Channel! https://www.youtube.com/channel/UC_frGNiTEoJ88rZOwvuG2CASee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.