The Jordan Syatt Podcast
Understanding Your Blood Work (For Women and Men) with Derek from More Plates More Dates
Try Marek Health for 10% Off ► https://marekhealth.com/syatt In this episode I speak with Derek from More Plates More Dates all about blood work. He provides a simple (yet comprehensive) guide to help you understand your blood work for both men and women of all ages. He emphasizes the importance of blood work in assessing health and discusses key health markers that individuals should monitor. Our conversation covers various aspects of blood work, including the significance of blood pressure, comprehensive blood counts, fasting insulin, and the role of ApoB in assessing cardiovascular risk. Derek also highlights the importance of iron levels, particularly for women, and the need for proactive health management. In this conversation, the discussion revolves around the critical aspects of hormonal health, particularly focusing on hormone replacement therapy (HRT) for women and testosterone management for men. The importance of regular blood work to monitor health markers is emphasized, alongside practical lifestyle changes that can significantly improve overall health. The conversation highlights the necessity of understanding hormonal balance, the implications of lifestyle choices, and the role of professional guidance in managing health effectively. In this conversation, Derek and J discuss the importance of movement in daily life, the complexities and misconceptions surrounding GLP-1 medications, and the innovative approach of Marek Health in providing accessible health management.
00:00 Introduction to Derek and His Journey
02:55 The Importance of Blood Work
05:55 Key Health Markers in Blood Work
08:53 Understanding Blood Pressure and Its Significance
12:05 Comprehensive Blood Count Explained
14:51 Metabolic Health and Fasting Insulin
18:08 ApoB and Atherosclerosis Risk
21:00 Iron Levels and Their Importance for Women
28:15 Understanding Hormonal Health in Women
31:04 The Importance of Hormone Replacement Therapy (HRT)
37:01 Navigating Testosterone Levels in Men
42:59 The Role of Blood Work in Health Monitoring
46:05 Lifestyle Changes for Optimal Health
54:29 The Power of Movement in Daily Life
55:44 Understanding GLP-1 Medications
01:06:28 Navigating the Controversy Around GLP-1s
01:10:27 Marek Health: A New Approach to Health Management
I hope you enjoy this episode and, if you do, please leave a review on iTunes or Spotify (huge thank you to everyone who has written one so far).
Finally, if you've been thinking about joining The Inner Circle but haven't yet... we have hundreds of home and bodyweight workouts for you and you can get them all HERE: https://www.sfinnercircle.com/
- Duration:
- 1h 24m
- Broadcast on:
- 10 Nov 2024
- Audio Format:
- other
how do you manage it? - Derek, welcome to the podcast, man. - Thanks for having me, man, I appreciate it. - And like I just said, off recording, it is a huge honor to have you on the podcast. I sincerely appreciate it. I've looked up to you for many years. I think you've done so many amazing things for the industry. Before we dive in, can you just tell people who you are? Like who are you? What do you do? Like give people the intro to Derek. - Yeah, my name is Derek and I have been a content creator since March 2016, my YouTube channel that primarily focuses around fitness, longevity, quality of life, but also stemmed from roots and bodybuilding was named more plates, more dates, and started when I was a lot younger. And it's kind of just a funny name I came up with when I was younger that I thought was catchy and kind of stuck and I've stuck with it since. And my interests have evolved over time from the bodybuilding realm to kind of extending into the wellness, anti-aging space, hormone therapy, and preventative medicine as a whole. So how do you go about preventing disease before the onset rather than waiting until you're in a state of poor health to then take control of your situation? So it's become something I've been very passionate about over the years, especially with what I deem to be a relative lack of access to high quality medical oversight and diagnostics, especially in Canada, it's quite difficult even not being allowed to pay for certain things even when you want to. And that motivated me to kind of get even deeper in the trenches with this stuff, learn from experts in their fields. And here I am now on podcasts. I'm trying to bring awareness to the masses. - Can I ask, how did you learn, like what's your educational background? I mean, are you self-taught? 'Cause you're wildly intelligent. You're, and where does this come from? - I would say the capacity to retain information, I suppose, is just somewhat innate, but I have a business background. I have an undergrad in marketing, actually. All but quite not useful, actually, for marketing in modern day. I have not really used my education for much, but in terms of health and longevity and wellness and body composition, all that, it's been self-taught through obsessions since I was a teenager. When I find a topic that I am highly interested in, I will just bury myself in it until I feel I understand it to the capacity that my interest has kind of peaked at. And fortunately for me, it has extended into many different facets that helps support the health of me, my family, and also hopefully brings education to people at scale now through YouTube and whatnot. - Amazing, amazing. All right, so I have a bunch of questions that I wanted to speak to you about, and I believe that they were sent to you before we got on. But like I was saying before we got on the call, our reports are recording, my audience is mainly people who want to improve their health. They want to be healthy for themselves, for their families, for their kids. They want to live longer, healthier lives. Yes, they want to get stronger, they want to improve their performance, but it's not generally the group of people that's like, I need to get shredded to bits, I need to have a six pack, I need to look a certain way. It's just, they're not that group, which quite frankly I'm really happy about 'cause I can't stand that group. The people are like, well I need to track the calories of my broccoli. I'm like, I hate myself talking about this, it's really annoying. So I want to talk to you about something that I've spoken about a lot, and I've had some doctors on, I've had Dr. Spencer Nadalski on who's been wonderful. I've had Dr. Danielle Bellardo on who's been wonderful. I want to dive in with you something that I think you're very, very good at, which is analyzing blood work. And first and foremost, could you just talk about why blood work is so important? Like give an introduction into blood work, like what is it, why is it important, and just give some information on that? - Yeah, I don't think there is a better way currently to get in more informed assessment of systemic health and also subcategorizing to different organs and systems in the body. So it gives us a snapshot of time of your current health status. And I feel like it is very informative for catching underlying issues, also rooting out deficiencies, inflammation, hormonal imbalances. And oftentimes if you get it early enough and establish a baseline, you can note aberrations or changes that might otherwise give significant clues to identify the onset of disease before it actually happens, or to identify why you may feel a certain way that is, you know, a general poor state of health can often be rectified via identification of certain biomarkers of, you know, typical ones that are often problematic and identify why you might be in a poor state of health. So I find it very informative for getting very rigorous insights into your current status of health ultimately and how to improve it moving forward. - And I feel like that's probably the least controversial thing anyone could say regardless of what community they're in. Any area of the medical world, if you want to take a deeper look at someone's health, you get blood worked on, right? That's now one of the major issues, and we can probably talk about this later on, is sometimes people really struggle to get blood work done, and even if they get blood work done, they struggle to get it analyzed by their doctor. And, you know, I'm speaking from personal experience where I've spent literally thousands of dollars to get comprehensive blood panels taken, and doctors wouldn't analyze it, and doctors wouldn't order metabolic panels for me. I would have to go off and do it by myself, which a blessing that I have the ability to do that, but most people don't have the ability to spend that much money, and then all the time to try and dive into it. So, before we go down that rabbit hole, which will light me up, can you just talk about, and I know in the questions that I sent you, I said three to five, but it doesn't have to be three to five, it could be more, what are some of the most important health markers that you would encourage people to be aware of in their blood work? So, if you were getting blood work done for a parent, or a sibling, or someone that you really cared about for yourself, what blood markers would you pay the most attention to? - Well, one thing I want to make sure I mention as a, kind of like a biomarker that is worth mentioning, is blood pressure, 'cause I know once I go down the rabbit hole of blood work. - Thank God, thank God. Yes. - Yes. - I'll forget blood pressure entirely. - So, just first and foremost, I would say that is, one of the easiest things to get in check too, 'cause it's very manageable through lifestyle. - On my desk, I have my blood pressure monitor, right? I'm so glad you said that, 'cause not enough people talk about it at all. - And it's like, I would say probably the lowest hanging fruit, 'cause you can actually assess it at home easily, every day, and note when your changes are actually impacting the result in real time, and it gives you that feedback too, that's positive reinforcement to continue doing things to continue to move your health forward and whatnot. So, with blood pressure, it's like, you could have a perfect blood panel, and you might, there could be the argument that you wouldn't have a terrible blood pressure in a perfect blood panel simultaneously, 'cause metabolic health, blah, blah, blah. But in general, I've seen guys who have had pretty major issues from unaddressed high blood pressure, despite the fact that their blood work looked pretty solid. So, for me, having-- - That's very doable. That's definitely doable, where you could have bad blood pressure, but have a good metabolic rate, especially like presenting at this moment in time. - Yeah, exactly, 'cause it is ultimately a snapshot in time. So, having a blood pressure cuff, it's not a crazy barrier to entry these days. You can get a cuff pretty budget-friendly, and it's pretty accurate nowadays too. They track pretty closely with actual physician-administered manual readings, depending, you don't have a really large or really small arm, at which point, you might have to take some more custom measures, but ultimately having your blood pressure assessed on a regular basis is like, one of the easiest, lowest hanging fruit things you can do. So, that aside, which is like, one of the major contributors to atherosclerosis, which is the leading cause of death in the US, I would say as far as kind of like the top markers, and I certainly wouldn't want anyone to take this as, just get these and then, you know-- - Right, right. - Yeah. - This is just like the lowest hanging fruit, like some of the most important. We're not saying this is all you need. - Yeah, I would probably say a complete blood count. The CBC with differential, I think would be totally worthwhile as one of the main, and it's not one, but it's kind of like, seen as one biomarker, 'cause it encompasses red blood cells, white blood cells, platelets, and it gives you status into anemia, especially for the women watching, knowing if you are anemic or not, or how close you are to adequate oxygenation of your body, I feel is pretty important for guys not as typical, but for women, very common, I would say, especially those who have regular site, like regular periods still. Comprehensive metabolic panel is seen as one marker as well, so I'll put that as the second one. It's kind of a constellation of multiple markers that identifies liver function, kidney health, and overall doesn't give it complete insight into metabolic status, but it's pretty comprehensive as per the name. Fastening insulin, I would say, is pretty strong marker as well, because it can actually get ahead of insulin resistance at the manifestation of it, rather than waiting for failure of the pancreas to actually manage things. So as you get closer to type two diabetes, there are later stages whereby you could have caught earlier if you actually saw your fasting insulin creeping up. Apo lipoprotein B, Apo B, I think is kind of the foundational marker for assessing atherosclerosis risk when it comes to what is traditionally seen as, like bad cholesterol. And then I suppose seeing as it's mostly women probably watching, maybe if you wanna say an iron panel, 'cause it's typically consolidated into like a small panel for 10 to 15 bucks or something, I could say iron, but I mean within that there is. Other markers that are of note, but iron ultimately. - Okay. - Yeah, I think that would be a solid five. - Do you think, would it be possible to go through each of these briefly and explain what is happening with each of them, like what it might look like if they're low or if they're high or in a healthy range, what maybe the risks are, if they're not in a good range. Can you talk about those? - Yeah, yeah, for sure. So when it comes to CBC, essentially, if you were gonna differentiate between red blood cells and white blood cells, it's kind of like your ability to carry oxygen to the rest of your body to actually support tissues. And then white blood cells is kind of like fighting disease and immune system and platelets would be your capacity to clot and stop bleeding and having an adequate or a balance of all these is pretty critical for not having an overactive or underactive immune system being able to fight disease, also support adequate daily functions. So not feeling lightheaded constantly or fatigued to being able to walk up a flight of stairs without getting winded, having adequate oxygenation that tissues is critical and then ensuring that you're not gonna have a stroke or a heart attack or something of nature that might be caused by excessive, it kind of depends on if you're a male female, this is more or less prevalence and also baseline state of health. But in general, this gives a pretty decent insight into where you stand for ability to support tissue oxygenation and immune status. And then CMP, I would say in general is your ability to through the kidneys, kind of like filter, waste product and whatnot and deliver to detoxify. So when you see those markers, typically you're looking at AST, ALT, which are like liver enzymes that indicate, could indicate damage or a proxy for damage via your body is detoxifying more things essentially or having a higher demand for detoxifying. And on the kidney side, there are more granular markers too, but ultimately you're gonna be looking at your GFR in particular, typically, and it's always estimated 'cause you're not gonna do a gold standard Inulin clearance, which is like a more rigorous metric, but they have a proxy for that, you can get via blood work that is very closely correlated, if not near identical, that is SDMA or cis statin C and it's a way to calculate EGFR with far greater accuracy and essentially it's your capacity to filtrate. So ensuring that you have adequate detox capacity in the liver and then also your kidneys are functioning correctly. If you have low EGFR, it's worth looking into. If you have really high liver enzymes, it's worth looking into, but there are multiple markers in this panel that kind of, in general, there are reference ranges that indicate dysfunction or higher burdens of stress or lower capacity operating kidneys, I suppose. So that is kind of the, and also fluid balance and electrolyte balance, I forgot to mention as well, which is critical for the CMP, which can affect a myriad of things in the body. So like sodium, potassium, et cetera. Fast the insulin, I would say, that is kind of like your marker you would defer to, to see how hard your body is working to maintain glucose levels. So high levels of blood glucose chronically can damage blood vessels, increase inflammation, cause neuropathy at the extremes, weaken the immune system, and ultimately to ensure you're getting enough glucose into cells to support bodily functions. You have insulin, which drives it into these cells. But if you start to develop insulin resistance, you may need more insulin in order to actually rid your blood of the glucose that could be causing these issues from chronic elevations. And over time, if you see this fasting insulin number creeping up and up, you note that you can kind of take from that and extrapolate, oh, my body is working harder than it should to keep things at homeostasis. So, and over time, this can burden your organs and all the things I mentioned from chronically high blood pressure blood sugar as well. And I think that's kind of like the earliest way to track, is your metabolic health going in a wrong direction as well. When it comes to- - Interesting, fasting insulin is like, you think they're earliest detection marker? - I would say probably, 'cause you could note, there's a large range and the blood test reference range that LabCorp has, I would say is far too lenient when you were looking at it from a fasting context. So, it could go up as high as like 20 plus and it's not gonna say you are traditionally high. But if you're looking at this as a fasting number, if you have a chronically 15 plus fasting insulin, you're working pretty damn hard to keep your blood glucose in check to where you can discern with reasonable certainty, I need to improve something when it comes to my capacity to clear glucose, whether it is reducing my carbon intake, improving my, doing more exercise, building more muscle, like whatever it may be. - Boosing more body fat, whatever it is, yeah. - Sleeping better, like your insulin sensitivity is dramatically reduced just by having a couple hours less of quality sleep per night. So, fasting insulin, I would say is of the kind of glucose management or identification markers, pretty critical and obviously you could have, go ahead, sorry. - That's super helpful information and also, and I know you're not done explaining it, but I wanna interject really quick in terms of, it brings up the question of you said the reference range is a little bit bigger than you would like to see. You think that it, and from what I've seen in many instances, not always, but in many instances people will look at a reference range like some medical providers whatever will often look at a reference range. And as long as you're within the range, they're just like, yeah, you're good, but that doesn't, like if you're tracking your blood, which I think many people don't do frequently enough, but if you're even just getting it annually, and you're seeing this trend upwards, even if you're still within the reference range, I feel like, and I have a feeling many, both doctors, as well as just everyday people, patients, people who wanna improve their health, would get frustrated at the idea of, well, if we're seeing this trend go the wrong direction, even if we're still currently in the healthy range, shouldn't we be addressing it before it gets to the unhealthy range? And I feel like it's a major problem we have at least, from what I see here in the US, and speak to my clients about. - Yeah, yeah, it's, this is kind of where you have to have some proactive, and some proactive approach to managing things on your own before someone calls it out for you, 'cause oftentimes, no one will. If you go to a doctor's office and, you know, they see a, if they're even checking your insulin, you know, they often will not say something until your hemoglobin A1C, which is like your average blood glucose over multiple months is, you know, like pretty diabetic, or literally diabetic. And at that point, you've been in a state of insulin resistance for a while. So it's kind of like, well, if I took note of this on my own earlier, I could have gotten front of it before I had, you know, some level of cardiovascular stress or organ deterioration or what have you, beta cell burnout. So yeah, I think getting a bit more rigorous on the values of importance and also having a medical professional overseeing you who understands the nuance, 'cause it can't be difficult and overwhelming to evaluate some of this stuff. Fortunately, I think that once you kind of get the hang of these subcategories of blood work, then you see the trends and you see the constellation of factors that leads to the improvements that are actually a lot easier than the otherwise overwhelming weird complicated metrics. You kind of realize that there's only so many low hanging, meat and potato things that really move the needle that actually improve all this complicated stuff. - Mm, that's a good way to look at it. - Yeah, so yeah, like if it helps anybody watching you might feel overwhelmed, like, oh my God, how am I gonna remember all these things? 'Cause I even have trouble remembering it oftentimes. And this is like, you know, one of my areas of passion. And doctors, you know, they do too. They oftentimes, even in Maric Health, we have clinical webinars where we'll have one doctor host and then talk about all the cutting edge insights into, you know, a subcategory of, you know, lab panels. And then we kind of assess all of the new innovations in the works when it comes to being more accurate and proactive, but also get a, you know, refresher on certain things as well to make sure we're all up to date, but. - I feel like any logical person would not wanna hear a doctor say, yeah, I haven't done any research since I graduated in school. I don't keep up to date with it. I don't do any research. Like it's, I think any logical individual knows that you have to stay up to date with it. You have to refresh yourself. And anyone knows that science is always improving and we're always learning more. So we have to keep up to date with it. So hopefully, like, I, I think at least with my parents' generation, like the boomers, they almost just like blank it. Like if someone is a doctor, I trust them immediately. And I think with our generation, it's become, there are some really amazing doctors and there's some not so amazing doctors. There's some really amazing police officers. There's some really not so amazing police officers. There's some amazing lawyers and there's not amazing lawyers. Like regardless of your profession, there are good ones and bad ones. And you always have to do your best to stay up to date with what's new and coming out to give your clients, your patients, whatever the best service they can get. - Yeah, no, absolutely. Yeah, and I guess that brings us to APOB, I suppose, which is kind of, I feel like, a not commonly enough assessed marker. And it's, fortunately, it's not that it's more complicated to understand. It actually simplifies things a lot because on a lipid panel, typically you will see L-D-L-C, H-D-L-C, V-L-D-L, like you'll see a bunch of different D-L numbers, essentially, or D-L-C numbers. And they are each different lipoproteins and the cholesterol within them. And APOB kind of encompasses all of the low density, atherogenic, meaning have a propensity to cause atherosclerosis. - Can you explain what is atherosclerosis? For anyone who does, can you just explain that briefly? - Yeah, so it's kind of like, I'm sure a lot of people are probably familiar with plaque in the arteries and they've heard of, if you have too much plaque and cause a stroke or what have you. The manifestation of that happens over years and it is the deposition of these lipids in the arterial wall over time. And that happens via these like, atherogenic lipoproteins. So when you hear of L-D-L-C, that's the bad one. It is one of the bad ones, but it is only called the bad one because it can lead to this deposition that can turn into plaque and subsequent to that cause blockages and whatnot. - Understood, okay. - Yeah, so APOB is kind of a simplified metric that not only actually takes all of the particles that can cause this to manifest and accumulate and it adds them all together essentially into one metric that reflects total atherogenic burden potential. So like you're the amount of atherogenic particles in your blood and that level represents like the L-D-L-C, V-L-D-L, LP, little A, and kind of gives you a comprehensive one metric that defines this is your level that to whatever extent your genetically disposition, lifestyle, et cetera, causes that APOB, how problematic will it become is depending on a bunch of different things. But ultimately, this is the number that dictates, this is your potential for plaque in the arteries over time, so the higher level typically will track with a higher risk of cardiovascular disease over time because there's more potential for plaque to accumulate from that number. So that number, I think, is pretty critical to oversee and kind of be aware of 'cause it is ultimately the leading cause of death in the States is atherosclerosis and it is also probably the most avoidable as well through management of blood pressure as well as the management of lipids, if warranted, sometimes through just diet and lifestyle, but sometimes through pharmacology as well. And by that, I mean actual medications. So managing that, or at least having a baseline to see where you stand and kind of what your risk profile is. And then with that, with your medical provider assessing, okay, my family history of cardiovascular disease is fill in the blank, how aggressive should I be or lack thereof to managing this? Should I implement more fiber in my diet? Should I do more steps? Should I actually take a medication? That's where you work with a provider for a more nuanced interpretation, but that number gives you the snapshot of in your blood right now, this is your potential for plaque accumulation over time. Should it sustain this level? So I think that's a pretty critical one. And then I suppose for the women, typically I wouldn't say for men, iron is like a critical fifth marker, but I think for women, it's probably worth noting 'cause it's vital for red blood cells to carry oxygen through the body and deficiency leads to anemia, in pairs physical cognitive performance and symptoms are pretty apparent. Like when it comes to APOB, you can't feel when you have high APOB. Like one day you might have cardiovascular disease and then you'll feel it, but I mean for decades, you're not gonna know really, whereas for low iron, like you know, for sure, something is off, you feel very fatigued, you think it's beyond obvious that something is wrong. At least it's pretty, I think there's a more difference between being in an adequate state and that also anemic, like you could tell pretty clearly, but those are the things you would look to you is, fatigue, shortness of breath, dizziness, stuff like that. So I think that's pretty critical to look at because if you are bleeding regularly and then also having a, you know, like a B vitamin deficient, iron deficient diet as well, like that could lead to a constellation of things that you're just chronically iron deficient and in a perpetual state of like fatigue more or less. So, yeah, I think those, hopefully that's sufficient. - Dude, that's super comprehensive. I have one more question. If we had to look at women who are peri or postmenopausal, would you have a different fifth marker outside of iron that you might recommend a hormonal, like something to look at for them, that might be relevant to improving their energy, improving their mood, improving their performances or something or improving their health overall somewhat, a woman who's peri or postmenopausal that you would look at? - Um, yeah, I suppose it would depend on if they are or aren't on HRT. And in general, let's say somebody is peri or postmenopausal and on HRT, 'cause in general, that's what we would recommend, rather than operating in a state of hormone deficiency for the rest of your life, which is a terrible state to be in, typically. I suppose thyroid value could be of great utility, so maybe a baseline TSH, just the seabury stank, 'cause at least with women, especially estrogen seems to have a pretty significant role in spiking autoimmune issues. So the prevalence of autoimmune-related thyroid abnormalities is way higher in women than in men. So I would say, in general, having an assessment of that would be worthwhile to see where your thyroid status is, 'cause that could be just as problematic as being anemic almost for your quality of life on a daily basis if you're in a state of a sluggish thyroid where you're not partitioning nutrients properly, you have low resting heart rate, you're cold all the time, like the symptoms from low thyroid are pretty apparent and suck, and oftentimes it can go totally overlooked 'cause it's a more insidious thing that sometimes might not be parsed out without looking at thyroid values. So I would love to say one marker for thyroid is great, but TSH, I know, you can only learn so much from that, but I would say if I had to pick one marker for the thyroid, I suppose free T3 maybe, which is like the active thyroid hormone that imparts biologic activity in the body. And yeah, that number is typically not gonna be where it needs to be if you have the upstream issues that I talked about. So I'm sure if I gave it more thought I could think of a better fifth marker, but that is-- - No, that's super helpful. It's a good one just to give thought to, and also it opens the door to a discussion around HRT. Can you talk about that? We could talk about it for both men and for women, but like starting off with women, it's a topic that from my perspective is very incendiary within the industry, and also there's a lot of misinformation around it. Can you just give a primer on like what it is, who it's for, who might benefit from it and go from there? - Yeah, so HRT stands for hormone replacement therapy, and oftentimes it is thought to be something that men do to replace testosterone as they get older, which it is, but for women, it's becoming more and more commonly understood that it's arguably of even greater importance for them to evaluate if they're a candidate and probably almost inevitably get on it if they want optimal quality of life in, once they hit menopause, 'cause unlike men, which we have a steady decline, it can be precipitous, but it also is not something that bottoms out to essentially nothingness. Like you could be in your 70s with a reasonable testosterone level still. With women, once you hit menopause, your estrogen and progesterone levels like plummet. Like they go to near nothingness, which is thought to be the underlying reason or a big cause of why heart disease rates skyrocket in menopause. And it is critical for bone health, cardiovascular health, offsetting neurodegeneration, estrogen, progesterone, I would say are also the risks around them are becoming more understood as overblown when it comes to the evaluation of cancer causing potential. A lot of those studies were based on relative risk and not absolute risk. - Got it. - And also not using bioidentical hormones, which you almost can't even then speak to the data as legitimate at that point because you're talking about synthetic drugs that mimic these hormones that you would make. So when I say synthetic, I mean, an estrogen that is not the same as the estrogen you make in your body, it is one that does similar things in the body, but it is not the identical one to what your body would naturally produce. So having that in check or at least maintained at a physiologic natural level after that otherwise plummeting of them can sustain that cardiovascular support, neurological health and bone integrity, especially, it's very difficult to maintain that in old age if you don't have the hormonal support. You can do everything right from a lifestyle perspective, diet perspective, sleep hygiene, and if your hormones are in the gutter, which unfortunately post menopause, like you really don't have a choice about essentially, you are at extreme risk for these things, skyrocketing. So yeah, I would say with estrogen, it's critical for a lot of these, for supporting those three things in particular, but also a myriad of other things in the body. And for that, working with a professional, especially is of critical importance, I would say, because it's not something to cowboy on your own, you can't really naturally fix it either, unfortunately. So if you are experiencing symptoms, hot flashes, I would say especially time to go get a panel and kind of see if you're a candidate, and kind of where your LH and FSH levels are at, which is the signaling from your brain to actually produce these hormones, 'cause these will actually indicate how far along you are in perimenopause to actually progressing to full-blown. With men and HRT, it's a little bit more simple. In that, you are symptomatic or not, and some of it might be psychological, so it might not, this is to be parsed out, but in general, we assess testosterone levels, also downstream estrogen that comes from the testosterone, which is critical for all the same things in men as it is in women, as weird as that might sound to many people. Estrogen is critical in both men and women for many of the same reasons, and low testosterone levels increase all cause mortality. They are basically maintaining them in an adequate, at an adequate level is pretty critical for muscle, body comp, brain health, but also quality of life, libido, a myriad of things, and if you were a candidate or not, kind of depends on your actual capacity to produce it to begin with, but also even within that, if the number on paper looks good, it doesn't necessarily mean that you can't be symptomatic. You could still have symptoms, even if the number on paper looks good, and treatment might still be warranted, and that's kind of where the more nuanced interpretation of what's going on could be worthwhile, and the key marker for that, I think, is free testosterone, not total, 'cause for total, you can see the total production, which is important, but the free testosterone is what is actually available to be used in the body for imparting its activity, so you could have total testosterone that looks good, but be symptomatic and have low T for years, solely because you have it all bound up by proteins in the body and rendered unusable, essentially. So having that free testosterone assessed, I think is worthwhile for men, and then also your capacity to produce via the brain, the LH and FSH, similar to women. So I would say as far as HRT, that's kind of a primer on the main underpinnings of why it's important to have adequate hormone levels. That was a complete failure to get granular on what it does, but at a high level, that's kind of like the meat and potatoes, I would say. - Dude, that was unbelievably helpful. One question I have in regard to testosterone, and free testosterone versus total testosterone, is there a way to increase your free testosterone, or are there ways, I should say, to increase your free testosterone to sort of like, unbind it without necessarily HRT, without necessarily testosterone supplementation? Like is there a way to do that outside of simply injecting testosterone? - Yeah, in general, the elevations and binding proteins, we see, and this is equally important in women, like women might be tuning out now and thinking, "Oh, this is just for the men now, "we'll skip ahead," like, "No, free testosterone "is critical for you." - Thank you for saying this, thank you, thank you. - And often, a lot of women who are on combined oral contraceptives at a young age, they have a plummeting of their testosterone, but more proportionally, their free testosterone goes in the gutter 'cause when they take the pill, the liver spikes the production of these proteins, and it binds up the suppressed hormones that they even residual had. So their testosterone, that was already suppressed from the oral contraceptive they're on, is even less impactful at that reduced level because it more of it's being bound up proportionally by the SHBG is what it's called, the primary one, that basically holds it in cargo, and you are manually spiking the holding of this testosterone via oral contraceptives. So with women, oftentimes they have hindered sex drive or even body composition can deteriorate when on to some capacity while on birth control, depending on the person, these are thought to be a consequence of just, you know, either aging or the medication they're on, but they often don't realize like the underlying root of it, and that's a big thing. I think of note is the combineral contraceptive is all rec, essentially guaranteed rec, your free testosterone levels for women. - I had not heard that, that's really interesting. - Yeah, like upwards of 70, 80% reductions in free tea, which is like, ruthless for a girl who's developing and otherwise, you know, yeah. So, and then for men with free tea as well, I would say the most impactful things are going to be diet and lifestyle when it comes to what could be actually manipulating the number. So the more, the most common cause of high SHPG that lowers free test in men is probably calorie deprivation under recovery and excessive exercise is probably less common, but it can cause it as well. But when you are calorie deprived to try and lose mass amounts of fat, you are kind of manually putting yourself in the state of excess expenditure, manually to lose the fat. If you go too aggressive, you can spike this protein and even though your test levels are going down via the deprivation of nutrients in itself, similar to the women on the contraceptives, you are then also binding up more of that reduced testosterone via this kind of like a liver elevation of binding proteins. 'Cause oftentimes the body's trying to compensate to hold onto the test because you are reducing the nutrients needed to actually sustain adequate hormone levels. So it's like, okay, I need to increase the binding proteins to hold onto it now 'cause this guy is starving himself to death. So that's where the binding proteins can elevate. And in men, I think the most impactful thing is eating enough calories of nutritious high quality foods, ideally, as well as ensuring there's a good balance of macro nutrients. So if you are in a keto diet, for example, and you are not eating carbohydrates whatsoever, huge spike in SHBG, which will bind up a lot of your testosterone. - Wow. - So like guys doing the carnivore diet, for example, I'm not to say that that diet doesn't have utility, but if there's not a cyclical implementation of carbs at least intermittently, you can fully expect that despite having high total test levels, like your free test is probably much lower than it should be proportionally. - Dude, that's pretty crazy. Are you gonna get the carnivore people coming after you for saying that now? - I don't like so 'cause I've talked about it before and sometimes they're not thrilled about it, but I mean like it's kind of hard to dispute when like just shows your blood work, you know, like I don't know. - Do you think a lot of those people are taking exogenous testosterone, which so they might not actually believe it? 'Cause I would imagine the carnivore crowd tends to be the people who are often more on that and maybe even in super physiological doses today. (laughing) - Yeah, yeah, it depends for sure. But I have seen even some of the most notable proponents of a carnivore diet kinda change their approach to it and starts to implement carbs once they start to actually have enough regular blood work showing, you know, even my free thyroid levels 'cause these binding proteins don't just apply for testosterone, like they're, they bind sex hormones as well as other hormones. Like they work to hold stuff in cargo and this will elevate your actual binding of your thyroid hormones as well, lower your free T3. Like there are things to be noted that are not just testosterone related in this nature too. And yeah, oftentimes you'll see kind of a pivot to where it's more like from carnivore purists to kind of more animal-based with fruit, honey, you know, whatever it is to kind of have a more, and ultimately a lot of them just, if they don't have significant autoimmune issues, kind of almost congregate ending up at a balanced diet. (laughing) - Shocking, I know they start off at this very sensationalistic, like very extremist point of view and then they're like, oh, you know what, maybe more of a balanced approach is probably the best option. - Yeah, yeah. - So let me ask you this, in terms of, 'cause what you've really done here is highlight how important it is to get blood work done and to understand the blood work. How often would you recommend getting blood work taken? - I think it depends on what the blood work shows 'cause if you have some glaring health issues, it would be worthwhile to get more frequent blood work until it's kind of rectified and then you were kind of just keeping tabs on it more or less. I think to start though, like, annually, once a year, I would say it's kind of bare minimum and then if you have more specific needs or you have glaring issues like you're literally type two diabetic and you're trying to correct it, for example, or to get your APOB under control 'cause you have familial hypercholesterolemia, which is like an extreme genetic predisposition to high atherogenic particles, APOB. You might need to check it sooner just to see that the changes you're making are impactful and bringing it down 'cause these things can actually change pretty quickly contrary to popular belief. Some people think you need to be doing this stuff for years before it fixes itself but you can make pretty dramatic changes in your blood work just via small diet manipulations and lifestyle changes very quickly. So I would say in general, annual once a year is minimum and then biannually, I think pretty much covers the majority of people, but maybe unnecessary, especially for younger people or people who had a good result and have an otherwise consistent lifestyle and diet like annually is more than enough, I would say. But yeah, if you're getting overseen by a professional too and being medicated, I would say biannually is, I think the legal requirement to actually maintain your medications too. - Oh, interesting, okay. - Depending, like if you're on hormone replacement therapy, you need to be seen biannually and get your bloods assessed. - And biannually, just for everyone listening, that means twice a year that that's not every other 'cause I know some people, they'll say biweekly and they think that means every other ain't like nuts. It's two times a year, so once every six months. - Yeah, exactly. - Okay, okay, now in terms of, let's talk about, and I know this changes based on the individual and it changes on what's going on with their individual blood work, but let's just say general population data, general population major issues, what are some of the most important lifestyle changes that you would recommend for the average individual to improve their overall health, especially looking at blood markers? Like what are some of the simplest, lowest hanging fruit, most impactful things someone can do to improve their health and blood markers? - I would say getting adequate amount, but also quality of sleep is kind of the underpinnings for setting you up for the next day to actually have a successful day with maximum willpower to actually do the exercise and stuff to even stick to your diet, as well as the maximize insulin sensitivity that you can via your recovery at night at least, and all the hormones you produce while you're sleeping. - So you're basically telling new parents that they're just screwed. - Well, it is, yeah, one thing that is tough is often in podcasts you'll hear people say how important sleep is, you need to dial it in, if you're screwing it up, like you're hurting yourself so badly, but it's like everyone deals with their own, just varying degrees, levels of ability to get this, and it is one of the major underpinnings, but it's not a make or break to where, if you have a kid waking up in the middle of the night, constantly, you might have to be a little bit more dialed in your other areas to kind of offset that otherwise, inevitable but notable detriment to the other things, but in balance, if you can be pretty eight out of 10 on pretty much everything, the meat and potatoes is gonna cover you for the most part. It would be great if you get higher quality sleep and adequate duration, but if you can't, the other stuff will still move the needle significantly, it just might be a little bit more than the next guy who's single and has the rare ability to just sleep as much as he wants, whenever he wants kind of stuff. - Just don't be like scrolling Instagram and TikTok at two in the morning and complaining that you're not like, you need TRT, you need all this stuff, it's like no, how about you try going to bed at a reasonable hour and put your fucking phone down first? - Yeah, yeah, I think that's kind of, there's a lot of people that I think will look to the kind of exotic solution and spend a bunch of time learning about things that are 1% factors when at the end of the day, the sleep, the exercise in the diet is the meat and potatoes of your health. So if you can be like, you know, as close to optimizing those areas, but even if you fall short of that in one of three of them or something, you will still achieve the majority, a significant chunk of the outcome that you are seeking and oftentimes avoid the need to even use some of the stuff you might deem as necessary. Like testosterone replacement therapy and young age, for example, there's a lot of men that think they need it. Oh, I hear all the time, endocrine disruptors, my plastic water bottle is killing me. You know, it's impossible to have a normal test level. So I must need the hormones right now because I had a 350 total testosterone, one time, it's like, no, this is a, maybe not. You have a snapshot, I get snapshot in time of your blood work right now, but like how many readings have you had? Do you have actual symptoms? Have you actually tried to optimize these areas of your life? Even losing weight in itself can be a huge positive influence on hormones because even if you have perfect sleep and like perfect quality diet, if you're overeating, which might be hard to do if it's a perfect quality diet, all it's to say you're overweight, the fat itself will actually disproportionately increase your estrogen production, which will tell your brain to make less of the signaling hormones that make the testosterone. So losing weight in itself has like a dramatic improvement on blood pressure reductions, testosterone levels, up to a certain point, but I don't think anyone is gonna diet themselves to 7% shredded here. - Accidentally. - Yeah, yeah, yeah, yeah, no, definitely not on this podcast. - Yeah, so in general, yeah, like more sleep and better sleep to the capacity that you can. And I think fortunately it's pretty simple to do the things that at least can produce high quality sleep. It is cold enough room, try and black it out if you can, and not have a bunch of lights or sounds blaring, if possible, if you need to have like a sleep mask on 'cause you can't get blackout blends, that's a hack that I find quite useful, especially when I'm traveling. And for some people not eating right before they go to bed, for some people it could be helpful to have a carb containing meal close to bed 'cause it helps with serotonin and whatnot and melatonin production, but ultimately most people eating within an hour, a heavy meal will impede their sleep and raise their body temperature. So trying to cut off your eating window a couple hours before bed, I would say is pretty solid. And yeah, like if you can get the high quality sleep that has a huge impact on all the other stuff and then the exercise, not that intensive as people might think, getting enough steps per day, I think it's kind of the underpinnings of energy expenditure to actually maintain body comp and then the strength training to build muscle and actually ensure when you're losing weight or gaining muscle that it's like proportionally you're going in the right direction when it's like a muscle to fat ratio. So like when you're losing weight you want to, especially if you're on GLP1 medication or something of that nature, having the strength training in there is pretty critical to ensure that it's mostly muscle that you are keeping or building if you're in a surplus. So I think strength training too to offset kind of in old age issues that could crop up having that bank up of muscle built and bone strength that is much more difficult to build up the base of in old age having that as young as possible as kind of your reservoir or bank to kind of lead you into a successful elderly phase of your life essentially. And go ahead. - This is controversially what you're saying is sleep well, eat well and lift, right? Sleep, eat, lift and move is really like the major things people have to do over years and years and years. That's like the most important things. - Yeah, I would say so, yeah. And to me, I feel like the step count too is pretty important to note in that a lot of people they think of cardio as this thing that needs to be a dedicated block of time on certain days that they dread and is on a treadmill or something. But there's a way to integrate it into your lifestyle that makes the cardio like your actual life. Like there are ways to get the steps without having to go stand on a step mill or a treadmill for 45 minutes every second day or something trying to hit your weekly steps and counting them up. Rather, you just kind of want to build a lifestyle that is conducive to achieving the step count target, I would say, without having to like go way out of your way to do blocks of cardio that you dread. So ultimately integrating it into a sustainable lifestyle where you're doing, you know, like in total, you know, a couple hours per week at least of strength training in total. I'm not sure what the minimum effect of number is there. I can't recall it. I thought my other might be a better question for you to address, but you know, 7,500 to 10,000 steps per day. I think it's pretty solid and the sleep. Yeah, some of the things I mentioned there. And then also just avoiding smoking, limiting alcohol, I think a pretty self-explanatory. And yeah, I think those are kind of the heavy hitters. - I appreciate it. I think it always helps just to have someone, especially as intelligent as yourself, like reiterate these things. And I've said for years, man, the my greatest investment, one of my greatest, I can't say it's the greatest, one of my greatest investments in my health in the past five years has just been a walking pad. Just to have like, and especially for people who work in an office or even people who are stay at home parents and like they're at home. Just having something is, it's not as big and bulky as a treadmill. You can relatively easily move it around. It's not nearly as expensive. And like you could just, whether you're watching TV, on a phone call, they're quiet, having a walking pad is so damn easy to get steps in. And what we got for my wife's grandfather, we got like a little, he has neuropathy actually. And he can't do standing very well. So we got him a little pedal, a seated pedal that he can do like sitting at the couch or just putting under the dining room table. So he can just pedal. Just like finding ways to get movement in. It doesn't even have to be super stressful. I think is one of the ultimate ways to improve health. So I love that. I have a question. Do you have a hard stop at an hour? 'Cause I do have a question that's gonna open up at canoworms. Oh no, I'm good man. Okay, so one thing I wanted to talk about, 'cause you brought up very briefly GLP ones. I wanna talk about those. They're obviously a major topic of discussion right now. I think they are massively misunderstood. Now, I'll give you my initial thoughts. And then I want you to take over and tell me if I'm wrong, not wrong, whatever. I think that they're obviously, obviously, not for everybody, clearly. I also think that they are a legitimate miracle and that they are for the people who need them, they are doing things that for years and years and years, like we've always like, we wish something like this could exist. Now, I also know they're not brand new. It's not like they just came out a couple years ago. They've been around for a little bit now, but I think that it's overwhelmingly clear that they are extraordinary for those who need them. And the way that I think about them at this point is I don't even necessarily think about them solely as weight loss drugs. I think about them as like food noise drugs. Like they help you stop thinking about it as much. It helps you have, I think an unhealthy relationship with food is one in which you're constantly thinking about it. And a lot of these people who really struggle with food are constantly thinking about it. And so GLP1's one of the things of them, many things they can do is just help you stop thinking about it all the time, which will then have so many positive health effects. So I'm gonna shut up now. I want your thoughts on GLP1's primer education, who should, who shouldn't just like go off and riff? - Yeah, it's tough because obviously there is, when they were initially designed, they were for diabetics to manage their condition. And then over time, it extended into obesity management. And then over time, it has evolved into this almost cosmetic kind of, even if you wanna lose five to 10 pounds for the beach, you know, let's get on this. And it's tough to say where the line should be drawn as to if the ROI is positive or not, because oftentimes the people who would even do it for vanity purposes would have otherwise used something worse mechanistically, like heavy stimulant abuse in the fitness industry. Like I've even seen people take up smoking to suppress their appetite, crazy, some of the stuff people do. And over time, that's evolved to like heavy vape use, as opposed to actual cigarettes, but like-- - Which is still terrible for you. - So, you know, and that's not to say you couldn't achieve your goals without it. I'm not to say, oh, you're gonna be on a drug no matter what, such as use it. That's absolutely not what I'm saying. 'Cause there's certainly strategies that are natural that I think go overlooked now that can put you in a conducive state to having an ideal diet and not having to expose yourself to the willpower compromising situations. Like just not having that stuff in your house to begin with is like the number one strategy I found personally. But, you know, for people who have diabetes and have a clinical warranted need for it, like, you know, it's unquestionably make sense for them to continue their medication if prescribed by a doctor. And for obesity management in general, I would say the data suggests pretty strongly that the weight loss that you get from it outweighs whatever potential risks there might be. But that's not to say there's no risks and it's still kind of unknown. Fortunately, there's more long-term, long-term within the short scope that they've been invented but like longer than people might otherwise think 'cause it's been used for a while in diabetics. It's not rigorously studied for dozens of decades necessarily, but it's, we're reasonably certain that it's not going to cause significant issues for somebody with obesity trying to manage it. That would even come close to compare to the havoc that being obese has on human health. So it's almost like with those individuals, you know, I don't even know if there's a point in me getting granular in trying to identify if you've tried, like, there are certainly strategies that are worth implementing that I'm sure you discuss that length on your channel. I don't wanna dive, you know, deviate the discussion into all the strategies I would look to before implementing a GLP one, but they're plentiful. - Yeah, yeah, yeah, I talk about that all the time, my channel, I think, yeah. - Yeah, so I would say, let's just say you've tried and exhausted all those and you are on a GLP one as an obese person, totally worthwhile, I think, based on the data. So we're kind of looking at, like, you know, average person, is it worthwhile for kind of, like, to optimize 'cause some people could still improve their insulin sensitivity, even if they're not seen as like traditionally obese or improve just like their visual appearance and whatnot. For those people, there's technically not a warranted clinical utility for it 'cause it's not prescribed for that, so that in itself could exclude people, but also the risk profile. That is a tougher one for me to say with any certainty that it is or isn't, 'cause some of the unknown stuff is a little bit iffy, like one of the things not often talked about is the increase in heart rate. This is outlined in the drug pamphlet info, but it is discussed in the context of somebody who is losing a lot of weight, they will typically still see, on average, like increases in resting heart rate, even in individuals who are losing lots of weight, which is kinda, that's a pretty significant, in my opinion, 'cause, like, in general, if you're losing lots of weight, it has a pretty strong impact on your blood pressure reductions in resting heart rate. So the fact that it can still net out an increase, despite the fact that you might be losing significant amounts of weight, is, I think, not to be ignored, and even in personal experience, like, I have experimented with them, for similar reasons that I just said might not make sense, for sure. And I-- - You wanna know, if you're discussing them, it's helpful to experiment just so you can have that experience. - And one thing I can say with certainty is, any time I've been on semaglutide or zepitide, there is a blatant jump in five to 10 beats per minute of my resting heart rate. Like-- - So interesting. - I can't get around it, no matter what, I see it just like, I track my sleep metrics and my metrics on a daily basis, and my resting heart rate will go from like 50 to 60 every time, no matter what. - Really? - Yeah. - Do you see a difference? Is there a negative impact on your blood pressure or just your heart rate? - Blood pressure seems to be similar, but the resting heart rate is unavoidable, like, no matter what I do. And it typically, this is not uncommon to see in people who are using it too, like common note anecdotes of, you know, five plus beats per minute increase in resting heart rate. That's not to say that that increases bad though, 'cause if you have a significant amount of caffeine on a daily basis, you can argue it does the same thing. - And it also increases blood pressure, but the data would suggest that caffeine is often neutral or even a positive in the grand scheme of things when it comes to body composition and health, so-- - Even health up to like 400 milligrams a day, like, should be totally fine. - Yeah, and that's like literally a CNS stimulant designed to impede sleep. So with this thing, like, it's not impeding the sleep process, it doesn't bleed into something that would otherwise need to be clear to actually get the restful quality recovery. So it's like, you know, is that a net negative? And then there's the thyroid cancer discussion, which, you know, in rats has shown to be concerning, at least in humans, it hasn't played out to any meaningful degree that seems to be in itself criteria that you should not use it if you could net benefit from the weight loss at all. But I think it's a consideration if you have a thyroid cancer in your family history, for sure, if that's something that you want to be potentially enhancing the risk profile for it when you're already at risk as is, 'cause there's certainly a case to be made that it's certainly not gonna help in that area. - We haven't seen it in humans yet, or have we? - Not to a meaningful enough degree that anyone could say with certainty, it's going to enhance your risk. At least that's what I've seen. And this is like as recent as 2024. So yeah, man, like, I think in general, it's kind of the goal you have, what the outcome benefit-wise from a health perspective could be, but also like how much of this is for vanity versus actual metrics of health that will improve quality of life too. And, you know, working with a professional to oversee it too, 'cause trying to interpret this stuff and the impact it's having in other areas of your life and your health status can be difficult to nuance to especially with this ever-developing class of drugs that becomes more and more refined over time as well. And having a professional, like, you know, that's why typically I would recommend with working with somebody at Merrick Health if you're going to be using a medication like this, 'cause they understand and stay on top of the nuanced, new cutting edge research that's coming out around, you know, is this an increase in sympathetic drive? And over time, it's actually gonna increase your risk for cardiovascular disease if you're somebody who didn't really need that much weight to lose to begin with or who knows. Or even assessing if you're a baseline, state is worthwhile of the risk profile from a thyroid cancer perspective, 'cause you might have no idea. You might even have to modulate your drug intake of if you're on thyroid meds, like that might have to change based on if you're gonna take a GLP one now as well. So yeah, there's a lot of considerations to be had and not just blindly get on it because you're here to the next greatest thing ever that's gonna improve the health of everyone. But to that point too, it is a class of drugs that's remarkable, as you said, and for the right candidate can be exceptionally net positive, I would say. - I love that. It's important for me to bring that up and to have a nuanced discussion around it because so much of what I'm seeing on social media is rage bait, anger, gilting, shaming, often either people who use it are cheating, which I always laugh, it's like cheating at what? Like this isn't a competition number one. But dude, I even get messages, I got a message from a woman within the last 48 hours. And this has happened with many, many, especially women, but numerous times within the last, I don't know, six to eight months, but literally within the last 48 hours a woman told me that she's been on them secretively, and she has a fair amount of weight to lose, but her husband literally said, and I could literally said like he's one of the kind of guys she said that like any type of cosmic, whether it's Botox or whether it's like anything that you do to your body, like he'd like, I would divorce, I would divorce Michael. That's wild, that's like insane in himself, but she literally has to keep it secret because he thinks it's cheating, he thinks you shouldn't do it. And for me, it's like, man, these are such extremist views, and I don't know anyone who actually is knowledgeable on the topic, who has an extremist view. It's only people who have a very one-sided propaganda based, it's done in Kruger, like personified, where it's like you know essentially nothing about it, but you think you know everything, and you're willing to make these outrageously crazy decisions based on what you think you know. And so I think having these nuanced discussions around it, it's great for some people, they really are a scientific miracle, it's definitely not for everyone, and there are risks to be worth about, to be worth, to be aware of. I think it's really important so that we can have more conversations around it and be educated, so I appreciate that point of view. - One thing I did forget to mention, which is probably the most important caveat of GLP1 use as well is potential for muscle loss, so this is often talked about, as if it will induce literal melting of your muscle, which is not the case, the drug doesn't do this. However, what it will do, because it significantly reduces appetite, it could reinforce bad eating behaviors at a proportionally lower scale, where you're now not only lowering the intake of calories to a point where you're losing weight, but if you don't actually improve the quality of the diet to something that is more reflective of supporting of body composition, you could just end up stripping a disproportionate amount of muscle off your frame while also losing fat. So for obese people, oftentimes there's so much fat to lose that it's kind of like a moot point, but for the better the body composition baseline is, the more notable this fact is, is that if you take it and don't make any changes to your diet, or at least if it wasn't a baseline diet that was reflective of adequate protein intake, and you didn't have the strength training bench, like underpinnings as well, you could lose a significant amount of muscle mass while losing the weight and end up in a, you know, if you're especially in older age, like perhaps like a different, but still compromised state. - Mm-hmm, mm-hmm, that makes total sense. Now, at this point, briefly I wanna talk about Merrick and how, so I am very excited to be working with Merrick as an opportunity to give people another opportunity to have access to get blood work done and get care that maybe they're not seeing from their own healthcare provider. Now, I posted about it on my Instagram recently, 'cause I don't do partnerships, like, I don't do them. Like, I've been in this industry, posting online since 2011. I work with a supplement company that I've used for years long before I started working with them, and now I work with Merrick, and that's it. And I think that's why people took it seriously, and dude, their response was amazing. - Dude, hugely positive response. - Massively positive, thousands and thousands of people, and I think it's because they know, number one, I don't do partnerships, but number two is, I talk about getting your blood work done and being aware of your health markers all the time. Like, this is something that could not be more in line with what I believe in, and before I partnered with Merrick, I went through the process of work, and I'm still working with them. Bro, what you guys are doing is amazing. Like, I've been so blown away with the level of care, with the, with not only the accuracy, but just the level of care that I feel as a patient. I've had, and there are some people, there are very, there may be, I think I got like four negative people, like four, actually, out of literally thousands, which is amazing, an amazing data point, 'cause I could say that, I could say on a post, like, hey, I hope everyone has a wonderful day, and I'll get 100 people who are pissed. But like, so just for like four people are upset, was a very good data point. Now, some people are very lucky to have wonderful opportunities with their healthcare provider, with their doctors, and their doctors have no issues getting their blood work taken and analyzing it with them. But man, the number of people who reached out and told me their doctors don't listen to them, their doctors don't get blood work done, I even had, this was actually really interesting. One of the four people who were initially upset with me, she messaged me, and she's a provider, she's a medical provider, and she was like, well, the issue is, she, I had, and she sent me voice memos, by the way, so I saved all of them, 'cause I couldn't believe that this actually came out. She was like, they should only be working with their doctor, they shouldn't be going to a service like this, and I was like, well, in my opinion, I think every single person should have the right and the ability to know what's going on with their health, and they should be able to choose what they do with their body, and find out about the blood, like what's going on with their body, and they shouldn't have to fight for it, like it should be readily available. And she said this, I couldn't believe it, I have the voice memos recorded, she said, well, I understand what you're saying, but a lot of times doctors are opened up to lawsuits by doing that, and so one of my doctors, for example, he won't order blood work because he doesn't want to open up Pandora's box, and I said like, you just made my point for me. Like this doctor won't order blood work for his patients because he doesn't want to open up Pandora's box, you're literally, you're potentially harming people, and I'm not saying this is the norm, there are so many amazing doctors, I'm not saying this is the norm, but what I am saying is, Merrick for me opened up an opportunity to keep track of my health and my blood work that is significantly easier and more convenient and more affordable than I've ever found anywhere else, and that's why I've been so excited to partner with them. Do you want to explain what Merrick is from your, like how, and how you work with them, like what's your role with Merrick and all of that? - Yeah, and first and foremost, like so stoked to hear that that's your experience, and yeah, couldn't have put it better, man. Like that is amazing to hear and makes me very grateful and also proud of the team we have and what we're doing 'cause that's been the mission from day one is providing high quality oversight for preventative medicine and getting access to that. Ultimately, my motivation stemmed from issues that you just described, you know, having to argue, beg almost to get certain things checked and the relative lack of proactive approach to health management and optimization is, you know, it's very difficult sometimes and often completely discouraging to get shunned away or even shamed when you were trying to take control of your situation and be proactive about things. So my own issues with that for my family and myself motivated me to find the avenue to try and bring this to the masses, not just so I and my family can have access to it too, but so I could bring it to people who follow my stuff and hopefully educate at scale about the importance of tackling the stuff early and getting non-judgmental oversight and how impactful it can be on quality of life and hopefully longevity at the end of the day too. So Merrick ultimately stemmed from my desire to bring that preventative medicine to as many people as possible and just give the opportunity to, if you want to, take care of this stuff in a proactive manner. We are one of the go-to places for that, that offers high quality hands-on preventative medicine with medical professionals that are on the cutting edge. And you can tell when you speak to them too, highly passionate about the subject matter. They didn't just go to school to get the, you know, to get the certified to practice, rather they actually even follow this stuff themselves as a fan too, like they will follow the content creators and the medical professionals in their specific fields that are literally doing the research to advance, you know, lipid management metrics and how to most optimally manage patients from a insulin sensitivity perspective. Like all of these things are of not just, are not just emphasized for the sake of providing care to the capacity that they deem high quality when they became a doctor, but also to further educate themselves over time to stay on the cutting edge, to know that they're providing the highest quality of care to their patients at that time. So that makes me incredibly proud of what we're doing and is also a big component of our screening process to determine who gets in to actually represent us and sees the patients. So with us, you know, when you were working with us, you're getting not only the most advanced diagnostics, with the most cutting edge metrics that reflect the most comprehensive insights into your health status, but also the hyper nuanced interpretation of those diagnostics to get the most accurate picture of what's going on and how to optimize moving forward. And I believe very strongly in what we're doing and it's my goal to bring awareness to it, to as many people as possible. - Do you ever get any pushback on it? Like, is there any like negative stuff that you get from like people who haven't actually gone through the service? - Yeah, I would say sometimes it's, oh, like, you're not a doctor, why are you talking about this stuff? And it's ultimately, I'm not providing any-- - You're not the provider, yeah. - So I am a face of the company. I bring the message to the masses in as scalable of a fashion as I can, which I feel like I'm reasonably capable of doing fortunately and have been relatively successful to date at doing. But ultimately, you are going to be seen by a professional who is at, you know, is qualified, certified and at the cutting edge of the stuff and reflects the values and principles that the company stands for at the end of the day. And, you know, ultimately, no one is gonna force somebody through this service that's something you have to want yourself and if you feel it's worth the money, then that we're here for you. If you want to utilize our services and we have free discovery calls where you can see if we're a right fit for you before you go down the rabbit hole of investing a significant amount of time or money into this process. But ultimately, our clientele are those who want to take control and get those comprehensive insights to get the rigorous oversight and know that they are doing what they need to do to be preventative and to feel good that they are making the strides towards either optimizing quality of life or rectifying an inadequate state of health. And if we're not qualified to handle a certain area, we're humble enough to defer people to where to get that oversight as well. So that is notable too. We don't pretend to be experts in areas that we're not and we will absolutely send people to cardiologists when warranted and whatnot and have a very strong referral network in place to ensure that everyone is get seen by the proper professionals for their particular situation, but it's also just the nuance in identifying what that person needs that we're so great at too. - Let me tell you really quick the tipping point that really made me decide I wanted to partner with Merrick. So I was already having a great service and a really wonderful experience. The tipping point was many people in myself included thought, like, okay, you go into one of these services, you're just gonna push testosterone on me 'cause I'm a dude. I was fully expecting to be like, 'cause one of the many, many, many panels that was taken was testosterone. And it wasn't bad by any means. It was like high fives, low sixes in that range like for total and I forget where free was, but like it was fine. And I'm 33 and I wanna have more kids. And so personally, I just don't really wanna go on testosterone right now. Now I didn't say anything because I knew this was like a potential to work together. I wanna just only hear what the professional was talking about and hear their opinion. They said from the beginning, they're like, I don't really think you need to go on testosterone. They're like, I think there's a lot that we can do if we wanna do it naturally. There are some lifestyle interventions that we can change if you wanna talk about like supplements, like natural supplements you can take if you'd like to, but I don't really think there's a need for you to go on testosterone. Bro, I was, had the biggest sense of relief when they said that because I've heard of so many experiences with other companies where they just push and push and push testosterone on people and any drugs that people don't actually need. And so to have that level of honesty and integrity right off the bat, especially, I think it would have made sense for them to think like, okay, male, young 30s, fitness industry, he's probably gonna want testosterone. So I think it would make sense from a money perspective to say, hey, let's get him on test, the exact opposite. That was like, that pushed me over the edge or I was like, that's high level integrity. And really, 'cause, and I was very clear, I was like, listen, I've had genetically high blood pressure. Like, and I, for them to say right off the bat, you don't need it, we don't want you to go on it, it let me know that y'all are doing the right thing. And your goal is right in your goal to try and help people and bring light to this world and help people take their own health into their own hands. Man, I've been super impressed and I don't say that lightly. - Thank you, yeah, I appreciate that, man. And yeah, it's one of the stereotypes of hormone replacement therapy companies or TRT clinics, as many will call them to, is that ultimately you're going to come in, get given a cookie cutter prescription and then get sent out the door. That is often actually what happens, but we do not push medications unnecessarily on anybody and we will always, we pride ourselves on our service and working with each individual to do what we can within the capacity of natural means, whether it be diet, lifestyle, supplementation, sleep hygiene, manipulations, et cetera, to dial things as much as possible before ever exposing somebody to what could otherwise be a lifelong reliance on a medication. 'Cause that's a significant commitment to make to yourself, to be on something that shuts down your hormones for life. We wanna make sure you have all the full picture before you go into something like that and have taken all steps and at least inform too with reasonable insights and depth why you might be in the state you're in and ways you can otherwise attenuate it or rectify it entirely before you go the artificial synthetic hormone route. When I say synthetic, I mean exogenous, like outside source, not that the drug is synthetic to be clear. So yeah, like I'm glad to hear that your experience and should be what people expect when they come work with us as well as, we're not gonna push things unnecessarily on you, we're not gonna put you on TRT because you had one 400 total T, one time. There's more granular insight to get into and ultimately when medication is warranted, it's absolutely consideration and you can be rest assured that we have the highest level professionals in our team to oversee that implementation of that medication and make sure you don't mess yourself up using it. But ultimately, all the measures possible to try and dial things in to get you in the best optimal state for natural function is a priority and we pride ourselves onto, so. - Man, Derek, thank you so much. I'm gonna put a link to Merrick in the show notes and also in the description of this video. Thank you so much for coming on. Do you wanna tell people where they can find you? - Yeah, so you can check out Merrick Health, link in description, Merrickhealth.com. You can check out me, anywhere, more plates, more dates. You'll find me and my content on Instagram, YouTube, et cetera. And I appreciate you having me on, man. It is a cool to connect. Man, it was a pleasure. I'm gonna hit stop recording. Don't hang up just yet. Thank you everyone listening. Have a wonderful, wonderful week. I'll talk to you soon.
Try Marek Health for 10% Off ► https://marekhealth.com/syatt In this episode I speak with Derek from More Plates More Dates all about blood work. He provides a simple (yet comprehensive) guide to help you understand your blood work for both men and women of all ages. He emphasizes the importance of blood work in assessing health and discusses key health markers that individuals should monitor. Our conversation covers various aspects of blood work, including the significance of blood pressure, comprehensive blood counts, fasting insulin, and the role of ApoB in assessing cardiovascular risk. Derek also highlights the importance of iron levels, particularly for women, and the need for proactive health management. In this conversation, the discussion revolves around the critical aspects of hormonal health, particularly focusing on hormone replacement therapy (HRT) for women and testosterone management for men. The importance of regular blood work to monitor health markers is emphasized, alongside practical lifestyle changes that can significantly improve overall health. The conversation highlights the necessity of understanding hormonal balance, the implications of lifestyle choices, and the role of professional guidance in managing health effectively. In this conversation, Derek and J discuss the importance of movement in daily life, the complexities and misconceptions surrounding GLP-1 medications, and the innovative approach of Marek Health in providing accessible health management.
00:00 Introduction to Derek and His Journey
02:55 The Importance of Blood Work
05:55 Key Health Markers in Blood Work
08:53 Understanding Blood Pressure and Its Significance
12:05 Comprehensive Blood Count Explained
14:51 Metabolic Health and Fasting Insulin
18:08 ApoB and Atherosclerosis Risk
21:00 Iron Levels and Their Importance for Women
28:15 Understanding Hormonal Health in Women
31:04 The Importance of Hormone Replacement Therapy (HRT)
37:01 Navigating Testosterone Levels in Men
42:59 The Role of Blood Work in Health Monitoring
46:05 Lifestyle Changes for Optimal Health
54:29 The Power of Movement in Daily Life
55:44 Understanding GLP-1 Medications
01:06:28 Navigating the Controversy Around GLP-1s
01:10:27 Marek Health: A New Approach to Health Management
I hope you enjoy this episode and, if you do, please leave a review on iTunes or Spotify (huge thank you to everyone who has written one so far).
Finally, if you've been thinking about joining The Inner Circle but haven't yet... we have hundreds of home and bodyweight workouts for you and you can get them all HERE: https://www.sfinnercircle.com/