Ep.195 “Normal Isn’t Optimal”: Hormones, Heart Disease, Thyroid & Midlife Lab Blind Spots

Episode Transcript
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Michele Folan (00:00):
The information shared on this podcast is for
educational purposes only andshould not be considered medical
advice.
Please consult a qualifiedhealthcare professional
regarding your individual healthneeds.
You already know I don'tbelieve in shortcuts.
If you're not lifting, walking,eating enough protein, managing

(00:20):
stress, and prioritizing sleep,peptides are not the answer.
Lifestyle is the foundation,always.

But here's the truth (00:28):
midlife biology can be stubborn.
Hormones shift, recovery slows,body composition changes, and
energy dips even when you'redoing the work.
That's where medicallysupported peptide therapy can be
layered in, not as areplacement for discipline, but
as strategic support.

(00:49):
Physician prescribed,clinically guided, compounded
through an FDA-regulatedpharmacy.
This is about optimization, notescape.
If you've built the foundationand feel like you've hit a wall,
this might be the nextintelligence step.
Lifestyle first, strengthmandatory, support biology when

(01:09):
it needs backup.
If this resonates, send me amessage and let's have a real
discussion.
Or check out the link in theshow notes.
I'm your host, Michelle Folan,and this is Asking for a Friend.

(01:36):
Have you ever walked out of adoctor's office with labs
labeled normal, but you know youdon't feel normal?
You're exhausted, your weighthas shifted, your digestion is
off, maybe your heart races, butthe answer you get is
everything looks fine.
For too long, women in midlifehave been told they're okay when

(01:58):
they don't feel okay.
Symptoms get brushed off asstress, aging, or anxiety, and
we start questioning ourselves.
Today we're talking about thespace between normal and
optimal.
What do lab reference rangesactually mean?
What cardiovascular markersshould we be paying attention to
beyond a basic lipid panel?
When is hormone therapyappropriate?

(02:19):
And what about startingestrogen later in life?
And how do we advocate forourselves so our symptoms aren't
dismissed?
Joining me is Dr.
Aaron Hartman, an integrativeand functional medicine
physician and the author ofUncurable From Hopeless
Diagnosis to Defying All Odds.
His work focuses on identifyingroot causes, optimizing

(02:41):
physiology, and helping patientsmove beyond your fine to truly
thriving.
Dr.
Aaron Hartman, welcome toAsking for a Friend.

Aaron Hartman, MD (02:50):
It's great to be here.
I haven't heard about you for along time, so I'm excited to
have a conversation with youtoday.

So I won't divulge who it is, but a family
member of mine, actually twofamily members of mine, are
patients of Dr.
Hartman.
And I feel like I know Dr.
Hartman.
And uh so this is this is funbecause um I've heard so many
wonderful things about you overthe years.
And this conversation, I feellike, is way overdue.

(03:17):
You are traditionally trainedand board certified.
I want to start at thebeginning because what happened
to your daughter Anna's healthjourney that led you to explore
functional and integrativemedicine?

So to kind of fill out what you said, yeah,
I'm triple board certified.
You know, I've had a clinicalresearch company for years, part
of 70 clinical trials.
I've published in Lancet.
I've been an assistant clinicalprofessor of medicine at the
Medical College of Virginiasince like 2010.
So very academic, very typical,very nothing outside the range
of normal there, right?

(03:53):
But my daughter changedeverything.
And um, that part of the storyhas to do, goes back to 2006,
2007.
My wife, who is an occupationaltherapist, who works with kids
with special needs, one of herpatients' homes was closing
down, and she said, Hey, wouldyou consider bringing Anna into
our home to foster her?
I'm like, sure.
And after a while, I fell inlove with her, and we considered

(04:14):
kind of adopting her.
And one of the issues was herweight.
She's failure to thrive, whichmeans she's less than fifth
percentile.
So she's was born itty bitty,still itty bitty, even to this
day, and um petite, we saypetite now.
But um, and the treatment forthat, typically for kids, is you
put a feeding tube into themand put formula into that to put

(04:34):
meat on their bones.
And so um, when we spent monthsand months feeding her, went
back to the GI doctor and theysaid, Yep, failure, wrong.
Standard of care for all thesekids.
This is what we do foreverybody, and we're gonna treat
you like everybody else,nothing special about you.
You get what everybody elsegets.
You get a surgery, you get afeeding tube, and we get to pour
sugar water with seed oils andhigh fructose corn syrup.

(04:54):
And there's actually a bigdebate now on a government level
about changing formula becauseit's so bad for babies.
And um, we said no, like itthat affects speech development,
that affects brain development.
If you know, it's kind of hardto learn how to walk and crawl
when you have a tube out of yourbelly.
The system had set the standthe bar so low.
She was never supposed to walk,she was never supposed to talk,
she was never supposed tocrawl.

(05:16):
So they didn't really worryabout like what she looked like
five years from now.
They just wanted her to lookbetter on the the growth chart.
We said no to that and gotreported to child protective
services for for child neglect,so medical neglect, yeah, for
refusing to basically we justwanted to give her real food, so
we got reported to the theauthorities.
And so that was like my firstinflection point where like the

(05:37):
system, this whole system thatI've been a part of, you know,
graduate summa cum lata fromwith a biology major from you
know university, all that kindof stuff.
They don't like it.

Apparently.

When you push back, right?
And so um, six months later, mywife, being my wife researching
things, found a growth chartwith kids with my daughter's
diagnosis.
Her official diagnosis iscerebral palsy, and she was 50th
percentile, she was in themiddle.
So all of a sudden, it's likethe experts don't know.
They had no idea that she wasfine, that what we were doing
was okay.

(06:08):
She has this diagnosis,cerebral palsy, she's just gonna
be small for whatever.
And in her in her world, onesurgery begets another surgery.
So to put things inperspective, I'm gonna fast
forward 20 years right now,she's 20 years old and actually
getting ready to move out of ourhouse two months from now,
which is starting to worry me alittle bit.
So I'm getting a little anxiousabout her.

Congrats, Dad.

Yeah, but um, but um, she's had zero
surgeries in her life.
To put things in perspective, atypical kid with her diagnosis
has had 13 surgeries by the timethey're her age.
So literally, we've got thesecrazy outcomes from her by
literally not doing what theexperts say.
I still went to the specialist,still got their advice, but all
us were like, you know, cuttingyour eyes to help with the eye

(06:50):
muscles, cutting your spinalcord to help with tone, cutting
your heel cords.
These are surgeries that havebeen recommended to her.
None of them sounded good.
And we've actually figured outways around that to the point
that she has beaten every odd.
And that's what the book isabout.
And that's kind of what got medown this pathway of looking at
things differently because I wasnot because I wanted to, I had
no choice.
I had to figure out a differentway for my daughter.

Yeah.
And then that inspiration, nowyou are doing the same for
patients.
You you have to just be on topof everything because things are
changing so quickly right now.

Things have always changed quickly.
Um, but yeah, you do.
I'm always learning somethingnew.
I mean, I literally I was at aconference over Christmas on
time, the biggest in the worldfor in the grain of medicine,
9,000 people, 9,000practitioners from around the
world in Vegas, right?
And I learned about a therapycalled neurotherapy that blew my
mind.
We started using it in myclinic a couple months ago after
learning about it.
The coin was termed in 1925.

(07:48):
So, this cutting edge therapythat 5,000 practitioners do in
Germany that I've never heard ofhere in the United States until
you know this past Christmastime, um, is 100 years old.
And there's so much stuffthat's like that.
Lipid therapy that I do, that'salmost 50 years old.
There's so many things thatactually really smart people,
mass cell activation.
You know, Lyme is now all thethree age, right?

(08:08):
Lyme disease, you know, it'sbeen around for decades.
It's not new, right?
It's just now coming to publicconsciousness.
And there's so there's morethat's like that.
You people want the new flashything.
I don't want the new flashything that's going to be like no
good in a year.
I want the thing that'ssurvived the test of time,
that's around for decades, thatno one's talking about.
And there's so much of that outthere that I'm still learning

(08:30):
every couple months.
I find something new I've neverheard of before.
And I've been doing this for 25years, and I'm still hearing of
things I've never heard ofbefore.

So yeah, that's it's exciting.
Was this that longevityconference that was out in
Vegas?

Yeah, it's A4M longevity, it's the biggest
of the of its kind in the world.
Um, the top people from aroundthe country come and talk at it,
and they have like all thesebreakout sessions.
And usually what I do is I Iactually bought all the
recordings, and it's about 200sessions, and so over the next
couple of months, I'll justlisten to the talks because you
can't listen to all of themthere.
You know, it's just three days.

So yeah.
Yeah, you're not superhuman.
So, in practical terms, how doyou describe what functional
medicine is to my listeners?

Functional medicine is it's the ultimate
personalized precision care.
It's learning about you,Michelle, your issues, your
history, where you grew up, yourfamily, what you ate when you
were a kid, were you breastfed,what makes you you now?
And then based on your labtesting, your symptoms, putting
an individualized plan togetherfor you that's unique and works

(09:33):
only for you.
It's not saying you've gotdiabetes and we'll treat you the
exact same way I treat the lasthundred people.
You're depressed.
You know, is your depressionfrom a concussion 20 years ago?
Is your depression from a folicacid deficiency?
Is it from your gut where 75%of your neurotransmitters are
made?
Like, why do you have thisthing we, the syndrome we call
depression?
Actually figuring that out andtreating the person as if

(09:55):
they're a real person, anindividual that has unique needs
and requirements.
Like that's basically all I do.

All right.
And for my audience, which isroughly 50, 55 plus women, why
do so many of the women I speakto on a daily basis constantly
hear your labs are normal whenclearly they don't feel well?

When you look at labs, you're looking at data
points.
You know, it's like looking atit's like those games, everybody
play those games, like you puta little thing here or a thing
here, and it's the mountains, oryou try to guess what you're
looking at, you know.
So literally you're taking theentirety of you, taking, you
know, 10, 20, 30, 40 datapoints, maybe 50 if you're
lucky, the person's, you know,advanced, right?
And you're trying to guesswithout your history, without

(10:44):
and taking those data points bythemselves and not actually
applying them to your fiber,your chronic fatigue, your hot
sweats, your brain fog, yourhormone issues or whatever it
is, to connect them.
They're treating just the labs.
And, you know, and if you'redoing that, of course, you know,
most labs are gonna come, nomatter what you do, most lab
results come back normal.
So if I do less of them, theodds are more than what the

(11:06):
proportion wise that they'll benormal.
And to put things inperspective, when I see an
intake, my intake patient umgets about 500 labs done, um,
like data point labs done.
And over the period of year,it's about 900 to a thousand.
I just did a rerund on mydaughter because she's gonna
move out of the house and haveto tune her up before she goes
out.
And I got um 900, I haven'tlooked at yet.
I got yesterday I got in themail from the lab company 900

(11:30):
biomarkers that I have to reviewand put put a plan together for
her when she's leaving in twomonths.
Like she's got a lot of stuffgoing on, and that made me a
little anxious because oh mygosh, and everybody we always
have stuff going on, right?
But if you're not looking atthat much stuff, it's not
surprising that you don't seeanything, right?

Yeah, and so there's there's normal and then
there's optimal.

And I think that well, there's that as well.
I'm I'm talking about just ingeneral, then there's normal and
optimal, and that's a that's atotally different world.

Yeah.
And so when a woman presentswith I'm I'm just gonna throw
this out there, like fatigue,brain fog, gut issues, poor
sleep, but standard labs looknormal.
What would be the most commonblind spots for that patient?

Well, well, one, you can have um leaky gut
or increased gastrointestinalpermeability, which is a thing
where your gut breaks down alittle bit, and you actually
react with the food you eat, andyou can develop these things
called IgG food responses.
So you actually start reactingwith the food you eat, and you
can get that just from eatingthe same thing over and over
again.
You can also get this thingcalled dysbiosis, which is

(12:38):
overgrowth of bad bacteria inyour gut, 75% of all your
neurotransmitters, 90% ofserotonin, which is your happy
neurotransmitter, 50% ofdopamine, which is your go get
them neurotransmitter, are madein your gut.
So all of a sudden, if you'renot making those optimally
because of abnormal proportionsof bacteria in your GI tract,
you're not gonna feel optimal.
Also, 90% of your immune systemis in your GI tract.

(13:01):
If you have a brain issue,brain follic fatigue, here's an
interesting data point for you.
If you get concussion,everybody who gets a concussion
will actually develop leaky gut.
That's how closely connectedyour gut and your brain is.
When people, when um, whenrunners get runners' diarrhea,
you know, you run really long,that's actually a stress-induced
leaky gut that causes thisdiarrhea.
Now, the healthy person goesaway.

(13:21):
So all of a sudden, for afemale, you gotta look at the
gut.
And then your hormones is theother thing.
You know, how many doctors arechecking FSH, LH, estrogen, um
estradiol, estrone,progesterone, DHEA,
pregnantolone, which is yourprimary hormone of memory.
No one checks that, right?
And then your hormones aredetoxified to your liver and to
your gut.
So all of a sudden there's aconnection between your hormones

(13:42):
and your gut, right?
And then as far as like thebrain fog stuff, you know, the
average female puts 200chemicals on her body every day.
And a lot of these chemicalsare neuroendocrine disruptors,
which is a fancy way of sayingthe chemicals act like estrogen,
you know, phthalates, forexample, or an estrogen
modulator.
That's the soft, that's thestuff that makes all your skin
cream silky smooth.
That's the stuff that makesthat's that's the stuff that

(14:04):
makes plastic like reallymalleable.
Women put that on their bodiesevery day.
And so you do that for decades.
And there's just a few of thethings I see routinely that
aren't being looked at by ourhealthcare system that can make
a middle-aged 50 or 60-year-oldfemale feel like she's not, you
can age quicker.
And then there's all thenutritional stuff.
Oh my gosh, I didn't all thenutritional stuff.
Women need more protein, theyneed more trace minerals, they

(14:25):
need more collagen.
You know, have you had a fattyacid analysis, um, a um an amino
acid analysis, all these thingsto see are you actually
absorbing what you eat?
So all of a sudden,nutritionally wise, you might
just be malnourished.
Everybody see has a deficiencyin something nutritionally wise.
You know, if you haven't had afull nutritional panel,
sometimes just fixing your aminoacids, proteins, your vitamin D

(14:45):
levels, your B vitamin levels,sometimes that's all I need to
do with patients to make themfeel better.
So all of a sudden, with thefive things you said, I've
already mentioned, you know, abunch of things that I look at
on everybody because it's it'sthe foundation everything else
is built on, you know?

Yeah.
And so I'm smiling only becausethis goes way beyond just
making sure that you get 25 to35 grams of uh fiber in your
diet every day.
I mean, that's great and thathelps, right?
But but what you're telling meis that there is just this whole
theater of things going on inin your gut that you know we're

(15:23):
we're only getting to one littlepiece of it by just adding more
fiber.

Yeah, and one of the one of the things I do
with all my patients is there'sthe thing called predictive
autoimmunity.
And the idea is that it's verycommon as we get older to get
more inflamed.
It's called inflammaging.
As you get older, you get moreinflamed.
And part of that isautoimmunity.
And that doesn't mean you havelike, you know, lupus or
whatever, but many women willdevelop thyroid antibodies, will

(15:47):
develop a rheumatoid factor,elevates sed rate, elevated
cardiac CRP.
And just finding theseinflammatory markers elevated
lets me know which part of yourimmune system is off out of
kilter.
That's a standard evaluation,and it's it's interesting how
many women will come in and havethyroid antibodies, and all of
a sudden, like this is part ofyour brain follic fatigue,
hormone, you know, osteoporosis,osteopenia.

(16:09):
Is this your body's actuallyattacking itself?
And then there are some basicthings, interventions you can
do, but that's like a screen forme.
Like that's like everybody getsthat.
That's not optional.
Autoimmune diseases bythemselves are the most common
disease.
If I'm all together, are themost common disease like in our
country.
And it's like, you know,something like um something like
between 10 and 20% ofAmericans, depending on which
population you're in, will havea positive autoantibody.

(16:31):
So why isn't screening for thatstandard in regular medicine?
And it's because until you geta disease like you know,
rheumatoid arthritis, the uhtraditional world doesn't have a
treatment for it.
But in my world, it's likegreat, let's dress those toxins,
leaky gut, let's uh um directyour address your immune status.
And you can actually get theseautoantibodies to actually
normalize over time.
And I've had that happen tohundreds of patients.

(16:53):
Wow.

Okay, this is so exciting.
And I wanna I wanna pick upafter the break here about
cardiovascular disease, becauseI think we're gonna we're gonna
we could go down a rabbit holeon this one.
So um, we'll be right back.
Before we jump back intotoday's conversation, I want to
ask you something.
If you've been listening for awhile, you know this podcast

(17:16):
isn't fluff.
We talk about muscle,metabolism, hormones, brain
health, longevity, the stuffthat actually determines how we
live in our 70s, 80s, andbeyond.
And the show keeps growingbecause you share it.
So if an episode has helped yourethink your health, send it to
a friend, text it to yoursister, share it with your

(17:37):
walking buddy.
That's how this communityexpands.
Smart, curious women bringingother smart, curious women with
them.
Also, I'd love to hear fromyou.
What topics do you want me toexplore?
Who do you want me tochallenge?
What questions are you afraidto ask but secretly want
answered?
You can use the link in theshow notes to join the community

(17:58):
or send me an email with yourideas directly.
This podcast exists becauseyou're asking better questions.
All right, let's get back tothe episode.
Okay, we are back.
Before the break, we weretalking about autoimmune
disease.
I'm gonna back up real quickhere.
How do we get our primary caredoctors to do some some of these

(18:25):
tests if we suspect we've gotan issue?

So I actually one of the resources in my
book, actually, on curable, is ahow to talk to your doctor
section.
So kind of like this littlevideo thing I did and some
check, like how do you, if youhave 15 minutes, like how do you
and so part of that is you haveto realize you know, there's
only so much you can do in a15-minute time slot.
I think the current data pointis like the average person
spends eight minutes in a theira doctor's office.

(18:52):
So it's like, so you have to goin there like prepared, ask
two, maybe three things tops.
You have to, you know, holdyour excitement down and say,
hey, you know, I'm feeling kindof crate.
Would you mind checking mythyroid antibodies?
Because I, you know, my thyroidpanel and checking my D level
and you know, maybe doing afatty, you know, what just a few
things.
And for me, when patients cameand asked me those questions, I

(19:13):
was always curious.
I'm like, huh, what's athyroid?
I mean, man, I know thatendocrinologists do that, but
who am I to do that?
Sure, why not?
And then it comes back and youcomes like positive, and I have
to figure out what to do withit.
And that's kind of actually oneof the things I started doing
early on is just ordering stuffand learning from the stuff I
was ordering.
If you're not working withsomeone who's even open to the
idea of doing anything outsidethe box, which is a lot of
people, you know, 80-20 rule,80% of people are going to do

(19:36):
like what everybody else does,right?
So you have to find someonewho's like thinks a little
different, who's open to workingwith you, you know.
And then if they order it, youhave to be willing to do a
little legwork on your own,right?
Because, you know, if you're ina busy practice, you know, the
way I learned how to do this, Iwas getting up my with my
daughter, part of the story, isI was getting, I used when we
got her, I realized I had tofigure things out.
I was getting up at fouro'clock in the morning reading

(19:56):
research articles, readingdoctors' opinions, reaching out
to people for two hours in themorning and then an hour at
night.
So I was spending three hours aday of my own time figuring
this stuff out.
So I learned a lot reallyquick.
But you know, most physiciansdon't have that time.
I've invested hundreds ofthousands of my own dollars into
learning about this.
So it just you have to realizethat most people don't have the
margin for that.
And so you have to be willingto do some legwork yourself.

(20:17):
Show them some grace, bepatient.
But ultimately, if the persondoesn't have the temperament to
like work with you, and they'relike, they're like, that's not
standard of care.
You don't need to do vitamin Dlevels on people, they're all
low.
Just take vitamin D.
We don't check A1C's on youbecause you're not diabetic, you
know.
I'm like, well, A1C can you canpredict my risk for diabetes
over the next 10 years.

(20:37):
Like, that's not a big deal, oryou know, and so if you don't
have a person who's at leastopen to it, which is a lot of
people aren't open to it, thenyou might need to find someone
else.
But I did a whole thing on thisabout how you actually work
through this.
It's a big deal because thereality is if every doctor in
our country went to functionalmedicine, we would need 10 times
more practitioners than we havenow to meet the current need,

(20:58):
and we still don't have enough,right?
So the reality is there's notenough people out there like me
to meet the need for everybody.

So yeah, and it's I as you're sitting here
talking, I'm I'm going, yeah, II have to ask my doctors for
certain labs, and they'll say,Well, why do you want that?
And I'll say, Well, because Iwant, I want to check this,
this, and this.
So I've I've done my homework,but what you're saying is we
it's some of the onus is on usto make sure that we are doing

(21:27):
that.

The one thing you can like Lab CornQuest
actually have discount labs thatyou can directly you can get
your own labs, you just pay cashprice.
And they actually have specialprices that are about 10 to 20
percent the sticker volume, youknow.
So you can get an A1C for like$12, right?
You can get a vitamin D levelfor 20 bucks.
So you can actually, if yourphysician isn't gonna order it

(21:48):
for you, you can just pay cashand go online and order it to
these places at Lab Core Questand order a lot of these things.
That's an option as well.
But then again, the onus is onyou.
So then you get the resultsback to figure things out.
But I was tell people.
start with basic you know Bvitamin levels you know B12
folic acid homocysteine levelsyou know uh uh omega omega check
which is a fatty acid bloodfatty acid analysis antibody

(22:10):
tests there's a lot of basicthings you can do vitamin D
levels you know there's a lot ofbasic things you can do on your
own but then it's then it's onyou to figure out what to do
with them.

Are those in your book any of those like
suggested tests?

Those um I do oh yeah I do have a whole
section that talks about thingsthat do with my daughter and
tests and I don't think Iactually mentioned if I recall
sometimes I say so much stuff Iforget what I say where but um I
don't know if I mentioned theactual um lab companies like
one's like one lab but um butthey're not hard to find because
they've got all so many ads upso all right great all right I
want to talk aboutcardiovascular disease and in

(22:44):
particular because right now I'mworking through the American
Heart Association for the Go Redevent to raise more money and
awareness around women andcardiovascular disease.

So I have a kind of a soft spot because I've
worked in the cardiovascularmetabolic world for most of my
previous career.
And I was wondering you knowbeyond the fact that
cardiovascular disease is theleading cause of death in women,
are we missing early warningsigns in midlife that this is

(23:19):
impending?

100%.
You know, one of the things Ido talk about in the book and I
talk about on social media a lotis this idea of medical
gaslighting or medical blindspots.
And so unfortunately women hitthe brunt of that great example
you know it's funny most of thestudies on men, middle aged men,
Caucasian men until recentlyand women tend to present with
heart attacks more stomach pain.

(23:40):
So literally women would comein I got reflux my stomach's off
you know um it's just youranxiety and they would be having
angina but women presentdifferently and that took us I
mean I remember that was cuttingedge when I was oh my gosh
cutting edge women lookdifferent than men with heart
disease and you're like wellthey kind of sort of are
different.
And so yeah the 100% earlythings but the thing about that

(24:03):
is people start developing heartdisease in their teens and
early 20s.
We know from autopsy reportsthat teenage kids will already
have soft plaques.
So the question isn't don'twait till symptoms that the
heart disease the heart diseaseyou have when you're 60 is a
plaque in your 40s which wasvascular inflammation in your
20s so the question the betterquestion is can I actually do

(24:23):
lab test and the answer is yesby the way can you do lab
testing that picks updysfunction in the lining of
your arteries inflammationimmune dysregulation which are
the three causes of all heartdisease it's can I pick those up
you know in my 20s and 30s andactually prevent the whole thing
from going forward and theanswer to that question is is
yes and a data thing for youthis was actually published by
the NIH they're legit I thinkthey're still legit right

(24:45):
November of 20 of 2024.
And you can predict the females30 year risk for heart disease
with three numbers it's yourHSCRP which is a marker for
inflammation in your arteriesyour LDL particle number okay
which tells you big small stuffand then an ellipoprotein A or
LP little a knowing those threenumbers and if they're high

(25:06):
you're like if they're low it'slike wow you are now in a low
risk and that can help predictyour risk for the next 30 years.
So my thing is like shouldn'tevery female get those three
labs done?
Yeah you know and the other theother data point for you in
general in our in our country30% of all heart disease is
directly related to leadexposure.

What?

Okay is directly related this is this is
EPA data this is not Dr.
Hartman this is governmentdata.
Okay and and most and of courseand that's older people you
know people in our range I'm5253 if you were born before
1991 you had you were exposed tolead whether the paint the gas
whatever so all of a sudden nowif you're a female or a male
worry about heart disease youknow what's your blood lead

(25:46):
level you know it should beundetectable and if there's any
in there that's a bad thing.
So those are you know threelabs and one metal that
everybody who's concerned aboutthe heart and you can get into
genes and a bunch of other stuffbut those are just super basic
things that have big big bangfor your buck.

All right so then I have to go to LDL because
everybody uses that as yourmarker because oh you've got an
LDL of 140 we need to throw youon a statin what else do you
look at before you suggest astatin?

Well the question is is what's the LDL
made of is it made of really bigfluffy healthy particles or is
it made of hard dense damagingparticles?
Is it oxidized?
Oxidized LDL is horrible that'sactually a marker for burning
actually in the the cholesterolmolecule so tell me about the
kind of LDL and the answer isthey don't check those things.
And so the LDL it's the devil'sin the details LDL by itself is

(26:35):
not bad.
It's like what's it made of andthen HDL is another one you
might have a good HDL number butis it functional or
dysfunctional you might have ayou know female with a 50 or 60
HDL but if it's if your HDLparticle number which is an
indirect way of looking at thefunctionality or now Quest labs
through Cleveland Heart Labsoffers a an HDL function test.
Is your function low right soall of a sudden all these

(26:57):
details and I can ramble onabout this aimlessly so I don't
want to ramble on too much butthe question I ask people is
what's the what's the ultimateultimate cholesterol number for
all cause mortality you know myclinical research company they
all we do studies and they youknow the question was all cause
mortality like you know dyingfor any reason right and there's
an ellipse this thing called ait's like ellipse J curve and if

(27:17):
your cholesterol is too low youhave an increased risk for
dying of all causes and that'slike more neurological
neurological in cancer.
If it's too high you have arisk for dying for things that's
more cardiovascular.
That number that you have theold the longest the best
outcomes is between 220 and 240.
So it's not 170.
Now if you're a diabetic that'sdifferent you've had a heart

(27:40):
attack that's different.
I'm talking about in thegeneral population right yeah
concern with women with statinsis that statins increase your
risk for developing diabetesmaybe up to 48%.
Why is that it's there's wedon't quite know but it's it's
in postmenopausal it'smenopausal women not less than
but it can significantlyincrease your risk for
developing diabetes.
And so I give you statin andlower your risk for heart
disease 25% I'm a good doctor Idid a good job.

(28:02):
If you get diabetes I justincreased your risk for heart
disease 400% if you're a femalestatin I want to see your
fasting insulin and your A1Csand if they're tracking up stop
it see if it comes down if itdoes then I know you're statin
the statins um well actually Iguess I do know why statins I'm
sorry I do know why um statinsI'm sorry I didn't think about
this sorry oh sorry I do know umstatins are actually toxic

(28:26):
mitochondrial toxicants theactual toxins to your
mitochondria which are thepowerhouse of your cell they
also induce cocutin which is anutrient required for energy
production deficiencies B12deficiencies folate and
magnesium deficiencies so anyone of these can actually
increase insulin resistance.
So if you're a female male oranybody taking a statin are you
supplementing with at least 100to 200 milligrams of cocutin and

(28:49):
are you taking a good Bsupplement that gets all the Bs
in there and then add in somemagnesium as well because it can
also cause magnesium deficiencyand by the way 80% of Americans
are magnesium deficient anywayright so um how many people are
doing recommending that and theanswer is very very very few.

Okay now I hear this in my in my research and
stuff that if we lowercholesterol too much it can
increase the risk of umdementias that our bodies our
brains do need fat so how do wehow do we parse that out with

(29:28):
too much is not a good thing.

To my point it's not just cholesterol like
what's your what are all theseother markers what's your LDL
particle number what's your sizewhat's your HS therp what's
your homocysteine level vitaminD status your vitamin D being
low increases your risk forcardiovascular disease.
What is your omega 3 levelthere's a thing called omega 3
check if you're here's a greatdata point for you if your omega
3 levels are low you have anequivalent risk for heart

(29:53):
disease as a smoker with anormal omega 3 level holy cow
holy so like that's the way theliterature presenting so my
question is is is taking omega3s as good for your health as
not smoking?
Like because that's what thatsuggests and how hard is it to
check an omega 3 level andreplete it the answer it's
really easy right and so thequestion you need to ask is not

(30:15):
what is your cholesterol that's20th century thinking.
21st century thinking is I meanthe three causes of
cardiovascular disease areimmune dysregulation
inflammation and endothelialdysfunction which is dysfunction
in your the belonging of yourarteries the question is what
labs correlate with those thingsbeing off oxidized LDL,
elevated LDL particle, HSCRP.

(30:36):
There are some genes like anApoE4 gene which is related with
inflammation, fibrinogen levelsthere's a lot of other labs so
we're like in the data I'mtalking about this data is like
20 some years it's old now it'sdecades old it's not new but
medicine takes decades to pickup things.
So we're still practicingmedicine and that's the standard
of care.
You know standard of care lagsthe literature sometimes 40 or
50 years.
So the questions you're askingare good questions but they're

(30:59):
just acknowledging a phenomenonthat the practice of medicine
lags the literature anywhere upto 30 to 50 years.
And so you're just your problemis you're stuck in that because
you're learning this and you'relike well I'd learned this but
why why is this the standard ofcare?
And it's like well standard ofcare is always going to be
lagging the literature bydecades.

Yeah.
All right and one otherquestion about LDL you have
apopee and you have LP little a.

Okay.

Right?

It's one of those hereditary the LP little a
so this is the mantra is um thethe science is I say science
because science you know changesall the time right so the
science is that LP little a isgenetic.
So you don't have to check it alot you check it it's high low
um to your point but I havepatients who have come with um
LP little A's 240s 250s I gotthem still elevated but down to

(31:50):
170 160 with some interventions.
So I have to ask myself self ifit's that genetic how can I can
change it with nutrients thingslike omega 3s things like
berberine things like agedgarlic how can I can change that
the the number you know vitaminC and acetyl cysteine how can I
change it if it's only geneticI think the setup like anything

(32:10):
you know the genes load the gunthe environment pulls the
trigger I have one patient hisentire like his grandmother's in
her 90s his mom's in her 70sand he's 40s and they all have
high cholesterol they all havehigh LP little A's and he's
freaking out about it and likeand his his his um family's from
the islands and like hisgrandma like your grandma she's
never had a heart attack righther cholesterol is like you know
300 huh how much your mom samething.

(32:32):
And so and they all have thisLP little a thing.
So it does increase your riskbut the point is it's not
determinative and you can dothings to lower it I think
that's the big picture.

Okay.
I had to ask that because I youknow we hear of familial
hypercholesterolemia and Ididn't know if that was
different.

That's a different thing familiar
hypercholesterolemia is actuallya genetic thing where you have
like three, four, five that'sdoesn't apply that's a different
thing.
That's actually a a differentgene thing where you have like
you know three, four, fivehundred number cholesterol and
you have a family and like mydad had a heart his first heart
attack when he was 35 or 40people are having events in your
family at a young age.
So that's a different thosepeople the PSK9s which are some

(33:17):
really fancy drugs hydostatinslike the reason we have those
drugs is for those people.
That's brilliant for them umbut that's a different creature
altogether.

All right thank you for defining that because
that I that does come up fromtime to time with clients of
mine I would cover off on that.
Okay I want to talk about thethyroid and I think this is one
of those things that gets missedvery often because we do some
general testing but we don't godeep enough.

(33:45):
On the thyroid front is TSHalone adequate and when do you
expand testing to free T3 orfree T4 or antibodies?

So TSH is adequate for screening in a
population so if I'm just goingto screen the population screen
330 million people for thyroiddisease just check 330 TSHs is
it good for figuring finding outthyroid optimization and
subclinical people that are onthe borderline for having and

(34:19):
the answer to that question isno.
And so I again I see peopleindividualized stuff I'm not
seeing 330 million people youcome into me what about my
thyroid I'm not going to tellyou what I would tell the exact
same thing to the next 339 youknow million nine hundred ninety
nine and so you everybody getsa TSH you know third generation
TSH gets a free T4 it's a freeT3 which is the actual active

(34:41):
you know free towards free T uhT4 is kind of like the storage
form it's 10 times less potentthan free T than T3 that's the
active form of thyroid though T4has some actions reverse T3
that is literally the breaks tothe whole thing when your body
has the T4 mitochondria actuallywill turn T4 into either T3 or
reverse T3.
So it's a wave your body sayingwhoa whoa whoa something's

(35:03):
going on here I need to take a Ineed to hibernate or something
so reverse T3 and then thyroidantibodies as well I'd put those
those are all part of mystandard which is TPO and
antithyroid globulin antibodypart of my standard protocol
panel because you ultimatelydon't know just know what the
brain is saying because you hada brain injury or a train brain
injury or an infection thatmight affect your your brain

(35:23):
saying I need to hibernate sowhat's your brain telling your
thyroid then what's your thyroiddoing and then what's your body
doing with what your thyroidtells it to do.
So I'll look at the whole cyclenot just one piece of the
puzzle.

If a woman comes into your office like what and
you may suspect and I know youdo these tests routinely but for
for my audience how might theyself-diagnose that they may have
some kind of thyroid issue?

Well thyroid issues can sound like hormone
issues can sound like cortisolissues can sound like a lot of
things but typically it's hairloss I'm cold my cycles are off
you can be having moremenopausal hormone cycles
related to your thyroid as wellbrain fog weight gain you you
tend to get like a littleswelling you can get like this
thing called mixedema where youget like you get kind of puffy

(36:11):
constipation um poor sleep poorresilience you wake up feeling
tired I always said hair lossthinning of your skin there's a
whole host of things that can berelated to um hypothyroid and
hypothyroid which is those sideis usually the opposite of
everything I said lots of energycan't sleep maybe a little
manic you feel hot all the timeyou get diarrhea you know you're

(36:32):
warm um your hair grows fastlike your weight you're losing
weight you feel like yourheart's racing all the time um
so not there's not a directcorrelation to like those two
but um all right well I'm notsure I'm like what which one
would I want?

Probably neither but yeah I see I see where this
can kind of mimic when yourcortisol levels are high too so
that's that that's kind of aninteresting call out.
Are there common nutrientdeficiencies you frequently see
in midlife?
I know we talked about vitaminD.
What about ferritin?

Iron deficiency and iodine deficiency
I see all the time iodinedeficiency is very related to
where you live in the countrylike there's a there's a goiter
belt in the Midwest where allthe soil is low in iodine and
people get lots of goiters soyou have adequate iodine and the
ferritin iron is a superimportant part of um of thyroid
function you need adequate ironand and those are the two most

(37:26):
important mineral well seleniumiron which with ferritin is the
active form and then um iodinethe thing about ferritin is not
standard test that's doneusually they do a blood count
which is CBC maybe withhemoglobin is 12 or 13 that's
normal but if your ferritin'slike eight or six or twenty you
have a low level of functionaliron and that could affect hair

(37:49):
skin you get little ridges inyour nails and you affect your
thyroid function as well is thatan expensive test to run a
ferritin test okay no ferritinferritin um um selenium iodine
tests are not expensive to runall right so we talked about
doing an omega 3 um it is whatabout um vitamin B levels B12

(38:09):
are those pretty standard in theregular world no all right in
my world yes yeah but I wouldyou typically order B12 level of
folic acid I also order ahomocysteine and methylmalonic
acid those are two um organicacids the breakdown products of
the metabolism of those vitaminsso you can have a blood level
normal of folic acid and B12 butnot get enough in your cells so

(38:32):
you can be functionally belowB12 functionally low folic acid
and you won't pick that upunless you do a methylmalonic
acid or homocysteine.
And the homocysteine levelbeing elevated and both of it
both it's counterintuitive bothof these are high when your
nutrients are low and elevatedhomocysteine levels associated
with automine issues,inflammation, dementia,
neurovascular disease,cardiovascular disease so just

(38:54):
knowing your homocysteine byitself actually improves cardiac
outcomes, right?
So those are standard thingsthat everybody should get as
well.

All right but back to the lab testing is there
normal versus optimal onhomocysteine?

100% there is the normal it depends like a
lab core quest normal usually isless than 12 but optimal is six
to eight same thing for TSHsyou know normal is anywhere from
0.5 to five optimal is like youknow depending on which lab it
is like one to two I like that Itry to get as close to one as
possible.
B12 is a great one because thethe normal range on that's like
250 to like a thousand but theliterature the medical

(39:30):
literature PubMed literature isthat if your vitamin B12 level
is less than 500 you have anincreased risk for neuropathy.
So I want all my patients tohave their B12 levels over 500.
So all these labs have thatthose nuances of normal range
versus optimal range.

So is neuropathy an issue beyond having diabetes?

100% you can have it from heavy metal
exposure you can have it fromtoxins and chemicals in the
environment you can have it fromum nutrient deficiencies
there's lots of reasons for tohave neuropathy.

Okay oh that's really interesting I I that
never on my radar but okay Iwant to talk about estrogen I
know this is my audience thoughwe have to talk about it I've
talked so much about estrogenthe last year I'm I'm I love
estrogen it's great and are youestrogened out but there's
there's so much opinion that isruns the gamut on when is it

(40:25):
appropriate to start estrogen.
So what are your thoughts?

So my question is when are you okay
losing your heart in your brainthen you don't need estrogen
anymore.
So just that's a little thatwas meant to be shocking.
This is an example of medicaleither blind spot or gaslighting
depending on what yourworldview is so as of um
November 2025 we can do estrogenagain right black box is gone
right according to the medicaland this is just literature this

(40:50):
data anybody can pull this offa PubMed and with AI you can
figure it out now if you havethe right prompts but hormone
replacement therapy lowers ourfemale's risk for heart disease
50% and your risk for dementiaabout 35%.
So according to the doctor umblind spots Marty McCary had
wrote a book about this calledblind spots he actually quotes
these these data points in thatbook that um potentially 1400

(41:12):
women died prematurely in theUnited States due to lack of
access to hormone replacementtherapy from 2002 to last year.
So this is a this is a big deal40 to 60 million women were
undertreated.
And I don't know why peoplearen't like really up in arms
about it because it was a big abig oops a big a big miss and
it's you know when should womenstart getting you know what most

(41:32):
of the bone loss osteoporosismost bone loss occurs during the
first two years of menopause.
So you really want to bewatching your hormones as you're
going into the change of lifethe first 10 years after that
are most important forneurological cardiac and bone
health but estrogen is importantfor brain health it's important
for your skin it's importantfor like you know tell a guy he
doesn't need testosteroneestrogen doesn't men in women

(41:54):
what testosterone does in men.
So what age do men not needtestosterone anymore you know
the grumpy old guy who's youknow you need it when you're 80.
You need it when you're 80.
And so it's the same thing withwomen women need it and they're
older and so if you want to be80 and have your mind and be
active have a have your bonesstable then you need it.
Yeah there's no limit to whenyou can get it um it's just I
think the devil's in the detailsit's how do you get it do you

(42:16):
topical do you be or do you dooral do you do creams do you do
pellets that's where I think thedetails are and um never do
oral estrogen because that'swhere all the that's where you
get in problems.
And never do oral print prowhich is horse urine estrogens
equine and never do and it hasmidroxy progesterone which is
known to cause tumors in labanimals.

(42:37):
So it's like of course ifhumans eat that that causes that
causes problems.
Don't use that.

Okay.
When you are looking at a womanwho is perimenopausal do you
ever suggest estrogen forsomeone in perimenopause?

100% depends.
I actually check the hormonelevels I don't guess typically
what happens is women late 30searly 40s their um testosterone
will start kind of going downand then early 30s to late 40s
or progesterone will start goingdown and the estrogen will
actually start going up andstart doing this kind of wavy
thing.
So what happens is is a lot ofthese symptoms that might look
like like look like estrogensupper low whatever it's actually

(43:19):
a dysregulation an imbalancebetween these.
So what happens a lot in theearly perimenopause area is
you're doing a little bit oftestosterone, you're doing a
little bit of progesterone,maybe your and this is where now
I'm gonna take a stop here youhave to you have to honor the
hormonal hierarchy and sexhormones at the bottom of the
hormonal hierarchy.
The top is cortisol insulinthyroid so if your cortisol is

(43:42):
off you're insulin resistant andyou have subclinical
hypothyroidism it's going tomake you have sex hormone issues
particularly in this age andit's gonna make them worse in
this age group group so you haveto you have to address that.
And all your sex hormones aredetoxified through your gut.
So you got your gut squaredaway so I just I don't want to
say too much about that but yougot to respect this Hormonal
hierarchy before you hop intohormones.
So that aside, with thehormones, I tend to do more with

(44:06):
progesterone, testosteroneearly on, and then just track
the estrogen.
And what I do a lot of actuallyis detoxification of estrogen
because what I see a lot isestrogen dominance, heavy
periods, fibroids, fibrocysticbreast, right?
In the face of lowprogesterone.
So you get abnormal bleeding,spotting bleeding, all that kind
of stuff.
And that also can lead to someof the things that you don't

(44:27):
tolerate stress.
Your sleep is poor.
That's a progesteronedeficiency thing.
Your libido is off, you'relosing muscle mass.
That tends to be atestosterone-related thing.
So all of a sudden it's alittle more nuanced.
It's not all just aboutestrogen, though.
Estrogen is a super, it doesgive you your superpowers.
So you have to look at allthose things.

You know, it's funny, you talked about
testosterone.
And I get so frustrated whenpeople think of testosterone as
a male hormone.
I'm like, no, we women havetestosterone too, and it needs
to be replaced.

Well, how many of your friends, colleagues
have issues with recurrentUTIs, painful intercourse,
atrophy of your externalgenitalia?
The out the outer one-third ofyour of your female genitalia
are testosterone-sensitivetissues, androgen-sensitive
tissues.
So if you're female, and I seethis a lot in my 60-year-old
range, well, they'll come in,you know, I love my husband,

(45:17):
it's painful, I haveintercourse, it's thinning, I've
got lichen sclerosis, you know,lichen planets, these things.
A lot of those actually areandrogen, testosterone, androgen
deficiency issues.
And so if you want your bodyparts to not get UTIs, not be
painful, and not to like getthese little ulcers and things
on them, you actually needadequate testosterone for that
stuff.

And vaginal estrogen, correct?

Well, you can use that as well.

Yeah.

That the vaginal estrogen, it's it's
nuanced.
The vaginal estrogen, again,the outer one-third is um more
androgen sensitive, though, ofcourse, estrogen as well.
The inner part is more estrogensensitive.
And also depends on the reasonwhy you're using the estrogen as
well.
So got it.
Test don't guess.
Just we're right now I'mguessing.
Just you can get the testingdone to figure out what's off

(45:59):
and just address it.

Do you have I have to ask you this.
Do you have an optimaltestosterone level?
So say say you put me ontestosterone cream.
Do you have an uh an ideallevel where you like to have
your female patients?

It depends on the this is what gets tricky
because every lab has adifferent reference range.
And so I look at your sex, yourtestosterone being the the the
third to fourth quartile.
So take that normal range, youknow, whether it's a blood test
or a sitbit test or um, yeah,those are the two major ones,
and you basically cut it up intofours and look at what the top
the top quartile is and justkind of put the level right in

(46:36):
there.
And then with testosterone, youwant to make sure that um, you
know, um it can turn estrogen.
So you kind of follow up onthat as well.
But I try to focus on the thethird third to fourth quartile.

Okay.
I'm I'm laughing only because Iwas um I do a topical
testosterone therapy, and I wasnoticing that I was getting, you
know, some little extra chinhair and and those sorts of
things.
So those those are nuisancethings.
I also noticed that my sexdrive was probably getting a

(47:09):
little kind of out.
Like my husband was happy, butI was like, okay, this isn't
normal.
And it I went back and gottested, and it was it was a
little high, it was out of hercomfort zone.
So we cut my dose.
So anyway, that's sometimes tooTMI went on the show, but I
don't really care.
All right.

(47:29):
I want to discuss a little bitabout detoxes.
So you you say you know, likeyou may detox someone of
estrogen.
What does that meanphysiologically when we do some
kind of a detox?

Well, your body naturally takes estrogen,
you conjugate it, making itwater-soluble, you put it in
your bile and you poop it out.
So improving women'sdetoxification is just helping
you poop better, help your liverwork better to detoxify that.
So if you're chronicallyconstipated, you're gonna have
estrogen detoxification issues.
If you've got the wrong kindsof bacteria, if you've got an

(48:06):
elevated baked betaglucuronidase, is a stool test
that you can do that showsyou're actually uncoupling this
whole process and reabsorbingthe estrogen, so it can tend
towards estrogen dominance.
Then you can improve the liverfunction.
You know, that you can do thatwith things like olive oil, DEM,
surfane.
Um, I mean, certain amino acidsactually part of detoxification
requires protein.
I mean, one of the things youprobably know pretty well in

(48:27):
your age range, you need moreprotein.
Right.
Having low protein is going toaffect this phase two
detoxification.
It'll affect how your body getsthe stuff out of your body.
Um, you know, sulfation,gluconidation, just getting more
amino acids.
So that's what you're talkingabout when you talk about
detoxification is your liverbinding it, putting it in the
bile, you know, and curcuminhelps with that, you know,
dandelion helps with that.

(48:48):
There's a lot of herbs thathelp with that.
Get it into your gut and thenget your gut to move to get it
out of your body.
That's that's what the processis.

So it's not just estrogen, it's uh, it's other
things too, that we need to havethis.
We need to have a good detoxdetoxification system just in
general.

Yeah.
And one thing, one passion Ihave, I shouldn't say passion,
one one point I make a big dealabout is sweating.
A lot of solvents, a lot ofthese neuroindocrine disruptors,
which are chemicals that actlike hormones, are actually
excreted through our sweat.
Now, the question may be to youwhen's the last time you sweat
profusely?
And the average Americandoesn't sweat at all any.

(49:25):
A hundred years ago, you wouldsweat all day long, all summer
long, depending on where youlive in the country, and the
falls well, you know.
We don't sweat anymore, andpeople forget that's one of the
ways we detoxify.
So it's not just pooping, it'snot just drinking adequate
water, it's not just eatingclean food, breathe, breathing
clean air.
It's also, do you sweatprofusely three to four times a

(49:45):
week at a minimum?
The answer is no, it's gonnaimpact your detoxification
process.

And so do you suggest a sauna?

The best way to sweat is to be physically
active outside, moving, movingyour lymphatics to sweat.
I realize that means workingoutside.
Okay, so most people aren'tgonna do that.
Saunas are awesome.
They um actually help.
There's actually lots of greatum Finnish sauna in Finland.
There's a lot of data onactually, here we go.
Back to your point.
Um, this is male data becauseyou know, the whole medical
gaslighting thing, but you canlower your risk for heart

(50:14):
disease 25% by um being on asauna three times a week and
lower your blood pressure 10points.
So literally doing a sauna fourtimes a week acts like a blood
pressure medication.
So all of a sudden, sauna hascardiovascular prediction,
protective benefits to it, aswell as detoxification.
But saunas are great.
Um, I try to use mine three,three or four times a week.
It's very calming as well, it'sgreat a part of an afternoon

(50:35):
process if you have one at home,just to get in the mood to fall
asleep.
If not at the gym, just use itafter you work out.
But yes, saunas are good.

Okay.
I told you we were gonna talkabout this because I'm curious,
but parasites.
I hear about parasites, like,oh, you need to do a parasite
cleanse.
Give me the skinny onparasites.
Are are we really at risk forparasites?

I mean, we have lived the majority, the
majority of human history, allbut actually 99% of human
history up to the month has beenwith parasites.
You know, it's interesting.
Country countries, sub-SaharanAfrica countries where parasite
infections are endemic, youdon't see autoimmune diseases,
you don't see cardiovasculardiseases.
There's a whole field ofmedicine looking at parasites as
a thing that modulates yourimmune system.

(51:22):
You know, there's a there'sactually um I've got some
patients that are autistic thathave actually given oral
parasites to to calm their gutdown for their autism.
And I got these from Duke, Ispecial ordered these parasites.
It's actually a porcene,doesn't infest people.
But um, so there's that thing.
Like, not all parasites arebad, you know.
But put that aside, the problemis you have to be a healthy

(51:42):
host.
If you're an immunocompromised,sick-inflamed host, parasites
go crazy.
Just like your gut microbiome,are all bacteria bad?
No, we need the 100 trillionbacteria and you know, are all
viruses bad?
No, 8% of our DNA actually isviruses that introduce
themselves into our DNA.
Parasites is a very similarstory.
You know, I um I don't knowwhere to go with this, but but
there are a lot a lot ofpatients I see who have chronic

(52:05):
fatigue, fibro, who havemultiple nutritional issues, B
biome deficiency, they got SIBO,gut, IBS.
Those individuals they can'thave parasitic infections that
are overgrown, that are nowactivating their immune system,
just like you can react withmeat and gluten and dairy and
soy and all this other stuff.
So, can you now have adysfunctional relationship with

(52:26):
parasites?
And the answer is 100%.
The other thing about theparasites is in the modern
culture, most parasitic exposureis actually from your indoor
pets.
So, are you gonna get rid ofyour dog or your cat?
No, so and you so and you givethem a dewormor.
It's funny, like we give ouranimals dewormors like every six
months.
When I go to um go to Guatemalaon a mission trip down there, I

(52:48):
go to this hospital in themiddle of nowhere.
Um, that's schools.
We go to schools literally andjust give the kids dewormors.

Really?
Okay.

Because they're so common.
So parasites are a thing,they're everywhere, they're
common.
That some of the gut testing Ido does look for parasites, and
when I have patients who arechronically ill, I will do an
advanced parasite test.
That's only one place in thecountry that does it.
And some people it makes a bigdifference.
But just like all bacteria arenot bad and all viruses are not
bad, all parasites are not bad.
Devil's in the details, do Itest for them?

(53:17):
Yes.
Um, and if you if I'm seeingsomeone who has health issues
who's sick and is auto-immune,do I treat them?
Yes.
But if you look for parasitesin healthy individuals, you'll
see it in a lot, a lot ofpeople.
Quick aside, most ancientcultures that have a have a
healing tradition, like Ayurvedamedicine, traditional Chinese
medicine, will have a seasonaldetox cleanse of some sort that
does a parasite cleanse, right?

(53:38):
It's usually cinnamon, clove,artemisia, oregano, which all
these things also balance yourgut bacteria.
They also improvedetoxification.
So these cleanses people talkabout are not solely, not solely
parasite cleanses.
They're also rebalancing theirgut bacteria.
They're also a detox.
So you have to keep that inmind as well.

All right.
I had to ask.
It was just a burning, burningquestion that I've had.
I want to talk a little bitabout longevity medicine in in
general.
I think we can talk aboutlifestyle all day long.
We know that lifestyle isimperative.
Good lifestyle is imperative.
Looking ahead though, whatemerging tools or therapies in

(54:20):
longevity medicine are you mostexcited about?

I think the funny thing about longevity
medicine right now is we'relooking at all these cool
things, cool gadgets, cooltechnologies, stem cells,
exosomes, peptides, you know,vibrating foot plates, clotho
gene, you know, all these reallycool this cool stuff.
If you dig into the science andlook at how they work, they're
just doing what high-intensityinterval training, physical

(54:46):
activity does, what fastingdoes.
And so I think in my mind, allthis cool stuff is cool, but
it's reinforcing to me you haveto perfect the basics.
You know, if you have a cleandiet rich in nutrient-dense
foods, you're getting accurateprotein, clean protein.
If you're if you havemeaningful, you know, meaningful
relationships, you know, bluezones, places where people be

(55:06):
100 more than anywhere else inthe world, don't have access to
cool biohacks, don't have accessto hospital and cool labs.
They say real food, they havefamily, they're outside a lot,
and they live for you knowreally long time, right?
So I feel like a lot of thecool technology stuff, it's
awesome, cool.
I love it.
I do it all.
I'm done with my daughter, youknow, we've done all kinds of
cool, you know, NMS,neuromuscular stimulation,
hyperbaric, you know, all that.
But that should always be ontop of the foundational stuff.

(55:28):
The foundational stuff is bydefinition foundational.
For me, I I get what you'resaying, where you're you know,
what's my new cool, you know, mymy cool hack right now, I
guess, is lipid therapy usingfats to heal your brain, which
is like 40 years old.
The new thing.
It's a new thing, it's reallyold, right?
But um, but really it justspeaks back to you, you need
sitting is the new smoking.

(55:49):
Literally, sitting around beinginactive is bad for your health
as smoking, right?
So all of a sudden, like, do wereally need like a new
supplement or a new peptide or anew zappy device, or do we need
to need people to be morephysically active to get
chemicals out of our food?
So I tend to focus on thethings that the average person
can do, and that's actually themost important thing to do.
And then once you're doingthat, cool, let's talk about.
Well, here we go.
I love this.

(56:10):
Here we go.
Cancer stem cells.
You can use things to actuallyremove senescent cells to remove
cancer stem cells, quercetin,crewman, uh, turmeric, um,
apogeninum.
These are really cool thingswe're learning now that
actually, when you have thesesenescent kind of old, crumpy
dead cells, you can remove themand improve telemark length,
right?
That's a cool biohack.
But if your diet's horrible andyou don't sleep and no one

(56:31):
likes you because you're amiserable person, you know what?
Yeah, you know, you probablywon't make it to 100 with all
your health, you know.

Right.
Yeah.
And I I that I think that's agreat point.
You know, I've done, you know,the resting metabolic rate test,
and I've done a, you know, awhole full body DEXA scan.
And and those things are greatfor data points, but that's not
necessarily gonna help me liveto be 105.

So I mean you wanna you want you wanna be
able to be 105 and have yourmind, have your health, and be
able to interact with your greatgreat, who knows, great
grandkids or whatever.
You know, you don't want to beslobbery on yourself.
And you know, I look at youknow, blue zones, places where
people do this on a regularbasis, and they don't have all
the cool fancy stuff we have,but real food, physical

(57:16):
activity, meaningfulrelationships, and the and the
environments by nature aren'tfull full of toxins because
they're not in the middle of youknow, New York City or Chicago,
whatever they're you know, umOkinawa, Nicoria, Costa Rica,
Sardinia, Italy, and then umOkino's.
The one that's kind ofinteresting is um Loma Linda,
California, which is Seventh dayAdventists, or their their
community is a blue zone, whichyou know speaks to faith and

(57:37):
family because that's a big partof that blue zone there.
But the point is that these arebasic things that we all should
be doing and we should allshould be perfecting.
And then let's do all thisother cool stuff as well.

Yeah.
Can you share a patient storyof a woman who was told
everything was normal?
She came to see you, and youwere able to get some
improvement by looking a littledeeper.

Well, I can talk about my I have lots I can
talk about.
I can talk about my lovelywife, who we talked about her
before in our podcast.
Um, she had a lot of chronicfatigue, barbro, brain fog.
She actually lost five years ofgot horrible debilitating
fatigue after, like, pulled a uma nerve in her neck, got in
pain, went to the doctor,nothing wrong with her, gave her
steroids, and just she was inbed for like five, basically

(58:18):
barely functioning for fiveyears.
And um, come to find out, youknow, what started this was a
stressor was the life event ofyou know actually getting our
adopting our son, bringing herhouse, and then she pulled a
nerve in her neck and they gotsteroids and it pushed
everything over.
But underneath that wasactually toxicity.
She actually, um, in anatomylab in grad school, you know,
you you were around formaldehydefor half a year and she got a

(58:39):
massive formaldehyde hit.
And during that point in time,her anxiety got really bad.
She was she thought aboutdropping out of school multiple
times and didn't.
And then as school went on, shegot better and better as she
got away from anatomy lab.
She had some issues with toxicshock syndrome as well.
She actually diagnosed her owntoxic shock, balancing hormones,
GLP ones for inflammation, yadayada.
But she's now doing great,thriving.
But there's like five years ofher life that she kind of lost

(59:00):
because she literally was just,yeah, I'd come home and she
would go to bed and sleep andI'd take over and make meals and
stuff.
And that's that's an extremeversion, but um, I can give
another here's another example.
Here's another example um ofsomeone that I started seeing in
their 70s who had chronicfatigue and fibro, brain fog for
something from her 20s.
And she came to see me.
And on our first visit, Idiagnosed her undiagnosed Lyme

(59:23):
disease.
Like no one ever thought to doa lime, uh, do to do a Western
blot Lyme titter on her.
And six months later, 80% ofher symptoms were gone.
And then we started talkingabout her hormones, and of
course, her hormones are off.
So we started replacing that.
We're already working on herand go up, and now we've been
working together for four years,and she feels great, but it's
interesting with her because inher mind, she's still like

(59:43):
waiting for the like I was sickfor 40 years.
Like, when's the when's itgonna all come back?
And so every time she has likea little setback, she's always
like, uh-huh, you know, I'mlike, look, you're doing so
well, you're doing awesome.
And it's funny how whensomeone's been sick for a long
time, you get like a traumabrain.
I see this all the time withpatients, and you gotta get
you're kind of expecting, okay,what if it comes back?
And that's one of the thingsyou have to learn to retrain
your brain.

(01:00:03):
I work with a lot of traumawith patients as well.
Because if you have if you'vebeen chronically ill for a
while, it does affect the brainwiring and does put your body in
this fight or flight situation.
And so that with a lot of mypatients, um, becomes a big part
of their healing journey aswell, once they've worked
through all the basics, thebasics, right?
Yeah, that how do we rewireyour brain and work on that
stuff as well?
So um, I mean, I have anotherstory that's popped in my head.

(01:00:24):
Um, but yeah.

Michele Folan (01:00:25):
Yeah, yeah.
You gave her her life back.
That is that's incredible.
And and so this is this iswhere I, you know, this is my
pep talk to my listeners andeven my clients and my friends
is don't put up with status quo,get answers, be curious, do the

(01:00:45):
research, but be your own bestadvocate because we can't we
can't solve issues if we're notputting it out there and and
asking for the right questions.
All right.
This is this is a question foryou.
This is a personal question.
Besides the sauna, what is yoursingle most important daily
health habit that you consider anon-negotiable?

Aaron Hartman, MD (01:01:07):
I just eat real food.
I don't want anythingprocessed.
80% of heart disease and 70% ofmost cancer can be prevented by
diet and lifestyle alone.
So um, I just eat real food.
You know, it's it's amazing howjust eating real food, how that
much of a difference.
The devil's in the details,though, because when you say
real food, you're like, well,what do you mean?
I'm like, well, it's not milkyou buy at the store, it's not
bread you buy at the store, it'snot the ultra-pasteurized that

(01:01:30):
heat it to like 280 degrees andburn the milk from cows injected
with become bravine growthhormone, you know, that are fed
glyphosate latent, you know, soyand corn that's genetically
modified.
It's like that's not the milkwe have at our house, you know.
Uh so it gets the devil's inthe details.
Now it's actually resourced inthe book as well, it's like a uh
food sourcing guide wherepeople can figure out how they
can find real food, whereverthey're out in the country.

(01:01:51):
So, but that's like thenon-negotiable is just eat real
food.

Yeah, yeah, I love that.
And then Dr.
Aaron Hartman, where canlisteners find your work and
your book Uncurable?

So I have you know a bunch of things,
podcasts, social media, YouTube,but the hub for all that is
just Aaron Hartmanmd.com.
That's a website you can go to,that'll take you to, you know,
on all those things.
Just start there and then youcan hop from there, wherever
you're including the book.
The book you can you can go tofrom aaronhartmanmd.com or
uncurablebook.com, and then youcan get the book on Amazon or

(01:02:24):
Audible or wherever you,wherever books are sold.

Fantastic.
Dr.
Aaron Hartman, this there'sthere's a lot here.
The show notes are gonna bevery important to my listeners,
but uh thank you, thank you somuch for being here and just
tying a bow around this becauseI know there's gonna be more
questions, but if if there arequestions, I'll I'll send them

(01:02:48):
your way.

Sounds good.
Thank you.
I really appreciate it.
It's fun.

Thank you.
Before you go, thank you forbeing here.
If you want to go a littledeeper, make sure you check out
the show notes for this episode.
That's where I link anything wementioned, resources, partners,
or tools I actually use andtrust.
And if you're not already onthe Asking for a Friend
community newsletter, that'swhere I share practical midlife

(01:03:13):
tips, favorite finds, recipes,and the things that don't always
make it onto the podcast orInstagram.
You'll find the link to join inthe show notes.
Take care, and I'll see younext week.

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