"From Surviving to Thriving": Dr. Corey Howards's Blueprint for Lasting Health

Episode Transcript
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Speaker 2 (00:08):
All right, everyone, welcome to another episode of
the Daria Hammer podcast.
Today's guest is a highlyaccomplished physician, dr Corey
Howard.
He is a board certified in toomany areas to mention, but I
just have to mention for thecontext of our conversation that
you will be part of shortly.

(00:30):
So Dr Corey Howard has a veryinteresting background.
He started with what I calltraditional medicine, but
traditional medicine not in atraditional sense, in a sense
that medicine, the way wepractice or's practicing it
today.
So he's board certified ininternal medicine,
gastroenterology, functionalmedicine with a deep focus on

(00:55):
disease prevention and lifestylemedicine.
Now we're going to talk alittle bit about what actually
functional medicine is and whatlifestyle medicine means and how
it pertains to you.
So after 10 years in practiceof internal medicine,
gastroenterology, he decided totake a different route and

(01:16):
expanded his expertise withadvanced training in anti-aging,
functional and regenerativemedicine we're going to talk
about what all of thoseencompass and also he educated
himself and got board certifiedin metabolic nutritional
medicine.
So again, I feel like I don'tthink there's anyone more

(01:38):
complete than Dr Howard here tohave this conversation, which is
mainly going to be aroundhealth, wellness, as well as
longevity and health span andsome practical changes and
lifestyle choices you can maketoday after listening to this

(01:58):
podcast that really will steeryour life into the direction
that you want it to go Now.
Dr Howard is also activelyparticipating in lawmaking.
He served as the past presidentof the Florida Medical

(02:24):
Association and currently chairsthe Florida delegation to the
American Medical Association,and his holistic approach
integrates all of the aspects ofnutrition, fitness, sleep,
stress management andcutting-edge science to help his
patients achieve their optimalhealth.
He's also a life coach, whichis very interesting.

(02:46):
I used to be actually a lifecoach, so hopefully we get a
little bit into that.
Also, he's an Ironmantriathlete I couldn't say this
for myself A musician andpublished author, making him a
really well-rounded expert inboth medicine and wellness.
So, without further ado, Ididn't even know where to start

(03:09):
with your intro, corey, but Idecided to just say everything
because I feel every experienceand expertise you have is really
significant what we are aboutto talk about, because when you
talk about functional orholistic medicine, I know some
people might cringe when theyhear holistic medicine because

(03:31):
they don't understand it, butwe're going to talk about what
that means.
I think when you talk aboutthat, it is important to talk to
someone that really hasreal-life experience and
expertise in all those aspectsand didn't just read a book
about it.
So, first of all, welcome to myshow.
It's an honor to have you.

(03:51):
I can't wait for me and myaudience to learn from your
expertise.
But I want to start thisconversation by asking you what
is wrong with healthcare today?
Why is it that our currenthealthcare system is so focused

(04:11):
on fixing what's broken insteadof preventing the break?

Speaker 3 (04:18):
Well, thank you for that.
Thank you for not actuallyreading my entire CV.
Lots of stuff.
It's actually a veryinteresting story and hopefully
we'll get into that.
But you dove in the deep end toask the big question of what the
hell is wrong with medicine andpretty much everything.

(04:39):
It starts with trainingtraining in a disease-based
model focused on medications,focused on the aspects of just
moving patients through thepipeline.
But the reality is, when I talkabout this and one thing I just
need to correct you is I justrecently retired from my
positions after 32 years workingat the Florida Medical

(05:00):
Association and the AmericanMedical Association so that I
could take my message and do itAssociation, so that I could
take my message and do it theway that I wanted to do it.
I got tired of somebody tellingme or asking me that I should
say things a certain way or acta certain way in a political
environment, and I just thinkthat that's ridiculous now,
because we all know thepolitical scene in the United
States is absolutely nuts.

(05:21):
Yeah, I call that silly, to behonest.
Yeah, and that holds true in themedical field.
But I'm going to give you alittle bit of a parallel here
and hopefully this will helpanswer part of that question.
You see, in a political raceyou have three sides.
You have people on your side,people against you and then
people on the fence, and so youalways focus on creating a

(05:46):
bigger base by solidifying thepeople that like you and you
pick people off the fence andyou never spend any money on
people who are against you.
In healthcare, you have peoplethat are already healthy, that
are interested in doing it.
You have people that areinterested but maybe need some
assistance, and then you havepeople that just won't do it for
a variety of reasons they don'thave resources.

(06:07):
They're a lot of problems, butright now we are spending all of
our time, money and effortplugging holes in that
population that's sick, insteadof making the healthy population
healthier.
Now I have pitched this toCongress exactly the same way
and they were like yes, this isexactly what we should do, and I

(06:27):
can name the congressman, butthe problem is you can't get it
done in an election cycle, sothey won't do it and they won't
put money into it.
But the reality is that if youspend enough money in prevention
and really work on the patientsthat are already interested and
make them healthier, pickpeople off the fence who are
thinking about it, teach them,educate them, show them how to

(06:48):
do it, introduce them to what isfunctional medicine, which is
root cause analysis, you willsave enough money in healthcare
to pay for everybody else.
So I have a question for you.
Yeah.
Go ahead.
I was just going to say I couldgive you a quick example of
that is simply weight managementand diabetes.
You can take 100 million peopleoff of the table just by

(07:11):
applying some very basicprinciples, but there's a lot
more to talk about.
So what were you going to ask?

Speaker 2 (07:17):
Yeah, I feel like we treat.
I mean, you're preaching to thechoir and I'm pretty sure the
audience feels the same way, asI do.
Now there's no secret that wetreat healthcare like a fire
extinguisher.
You know I mean something weonly reach for when we're
already in crisis.
But what if we treat it?
I mean it's common sense.
What if we treated it like agarden, you know Like we

(07:39):
nurtured it, watered it and, youknow, and tended to it before
the weeds or disease ever had achance to grow?
I mean this is like commonsense.
We do that in all other partsof our lives.
We do that with our garden, wedo that with our car, we do that
with our pets.
I mean we are wired to thinkthat way, think that way.

(08:10):
My question to you is you areone of the few physicians that
have really battled at the front, meaning you have really not
just talked to congressmen andwomen, but you have discussed
this matter with your fellowphysicians.
And what is mind-boggling isthat why isn't that concept even
taught in medical schools,teaching institutions that have

(08:31):
some of the smartest scientistsand physicians in the world at

(08:52):
the helm of or responsible forteaching the new generations of
physicians?
And what's astounding to me,you know I have a fellowship
program, so I mentor and I trainphysicians and surgeons that
literally just graduated withinthe past five to 10 years, and

(09:13):
when I asked them how much ofyour education was focused on
preventative care was focused on, for example, nutrition,
lifestyle, et cetera.
They look at me like they don'teven know why I'm asking that
question or what I'm talkingabout, and so I just don't
understand that.
Emil, you're someone that hasdiscussed these matters with

(09:35):
your fellow physicians andcolleagues, and so can you
explain what the sentiment is.
I just want to get an idea ofthe sentiment and of the
attitude towards it.
Is it something that's beingshrugged off as that's just like
voodoo, or that's BS, or that'sholistic BS whatever they call
it, or selling snake oil?

(09:57):
Or is it something that theysay yeah, we totally agree with
you, we understand, but look,the system is not in our favor.
So what do you want me to do?

Speaker 3 (10:08):
Well, first of all, you have to realize a lot of
funding that goes to medicalschools comes from Medicare, and
so Medicare directly fundsresidencies, and so they have to
what do you mean?

Speaker 2 (10:19):
they fund residents.
Can you explain that?
How does Medicare fundresidencies?

Speaker 3 (10:29):
The government, through Medicare, actually
proportions a certain amount ofmoney that goes to medical
schools to pay for a portion oftraining in medical school, and
so if you pay $40,000, forexample, a year for medical
school which obviously would becheap in the United States the
actual cost is much greater thanthat per year per student, and
that's co-funded by Medicare.
But that's not the reason.

(10:50):
The reason why is there are alot of acronym names like ACGME
and such, which control whatthey think you should learn, and
so I think that there is abasic, foundational knowledge
that we need to get to, andthat's we should all do it.
I mean, how many times have youbeen taught the Krebs cycle and

(11:11):
forgot it until you finallyrealized how important it is in
clinical practice?
Right, and then now you knowthe thing and why it's so
important, and we could talkabout that, but at the end of
the day, the reality is theyhave to do things a certain way.
Now I will say that a lot ofschools in the United States
have integrated someevidence-based cooking.
They've actually integratedsome lifestyle medicine, some

(11:35):
areas of mindfulness andmeditation, but that is a
minority compared to everythingelse that you have to learn.
So what I do and what peopleneed to do is they need to take
that foundation because you haveto learn.
So what I do and what peopleneed to do is they need to take
that foundation because you gotto start somewhere.
You've got to know some of thatbasic stuff, even though that
medical knowledge doublesliterally every 60 days now.
So what you learned 10 yearsago is very, very different than

(11:59):
what you do today.
But you know, what hasn'tchanged is how you communicate,
what you know and how you workwith people, and I don't know if
they teach that enough thatinterpersonal skill to really be
a person talking to anotherperson and not like I am the
doctor, you are the patient andthis what you do too.

(12:23):
That would never fly, but itworks for the masses and doing
stuff.
So I think that what you haveto do is get that foundational
knowledge and then you have todecide what kind of person do
you really want to be?
You know, I always say you lookat my wall at the office and
I've got.
You know, just like all of us,we've got degrees and diplomas
all over the place and I tellpeople that doesn't tell the

(12:47):
story of who I am or why it isthat I can treat you, or what my
background is, or how I'veleveraged the most difficult,
dark things that have everhappened to me in my life and
funneled it in a way to actuallyhelp you become a better person
.
And that's what I did, and Idid that consciously, I did it
as a reason, and that's what Idid, and I did that consciously,
I did it as a reason.
But I will say that we're notgoing to be able to solve why

(13:10):
things are the way they are, but, just like in marketing, you've
got to meet people where theyare and move them forward to the
next level.
And so we can all do it better.
We can be better physicians.
I do find and I don't know ifyou find this too, and I'm sorry

(13:31):
to some doctors that might belistening, but people got pretty
lazy and incomplete.
Workups are incomplete,diagnoses are incomplete,
patients aren't talked to, theydon't have enough information,
and I think that you have todecide as a person if you're
going to do it better.
And that's what I decided.
I decided that I needed to knowmore.
I needed to know why thishappens and how I can help you.

(13:53):
And you know, the funny thing islike if I see somebody, I
honestly don't, I have no ideawhat I'm going to talk about.
I mean, yes, if we have labsand stuff, we start on a process
, but later on we wind up going.
I may talk about theirchildhood, or I may use some
colorful language to have apattern interrupt, to change
their thought process, to getthem back on track, or I may

(14:15):
actually do therapy with them inthe middle of an appointment.
But I think you have to beproactive.
And so the schools, the systems.
They are slow to change.
There are lots of rules andregulations, but there is a
basic foundational knowledge.
As a physician, you have todecide which part is art and
which part is science, andthat's going to be up to you.

(14:38):
You can work in the system yousee a bunch of patients clock in
, clock out as an employee andbe done, or you can really do
something for healthcare andchange the trajectory of health
in America, and that's what Iintend to do.

Speaker 2 (14:52):
Yeah, and I commend you for that.
And as far as my practice isconcerned, you know, I want to
also know how you got intofunctional medicine, because
that's not where you started.
So, so, so, so, just so thatyou know.
The reason why I actually gotto know you is because of the

(15:14):
interest, my interest, that hadchanged.
You know, I come from asurgical practice aesthetic
medicine, anti-aging,rejuvenation meaning from a
specialty that is in desperateattempt to turn back the aging
clock.
Okay, that's really pretty muchwhat I'm trying to do.
And then, like in medicine, wehave two ways.

(15:36):
One is a non-surgical way, oneis a surgical way.
One involves cutting and theother one involves medication,
creams, externally applied stuff, let's call it so the way I
stumbled on functional medicineand that's how I got to know you

(15:59):
, one of these days you justpopped up on my feed and your
way of communication reallyengaged me and it was so
educational.
By the way, you have a veryclear and soothing voice that
one wants to actually listen toyou.
So I just listened to the wholething and I'm like, oh my God,

(16:22):
this guy is exactly whoeverybody should be listening to
.
And for those of you who don'tknow what I'm talking about.
By the way, dr Howard also hashis own podcast, and it's a
fantastic educational library.
If you have no clue about whatwe're talking about and just

(16:44):
wonder where to start, I wouldsay, just go down his podcast
episode from number one towherever you are now, and it's
beautifully explained.
It's even I learned so muchfrom listening to it that what I
was actually impressed by isthat the way you communicate, a

(17:04):
layman can easily understand,but that's a communication style
.
It's an ability, a talent thatunfortunately not all of our
colleagues possess, and it's notsomething you can teach or
train.
I mean, up to a certain degreeyou could, I suppose.
But really it's an art initself and I think that's what
makes a good physician.

(17:25):
But back to how I stumbled uponfunctional medicine.
Is that, corey?
I started getting old and Ididn't like it, and I used to
wake up in the morning andthinking why does my shoulder
hurt?
Why does my ankle lock up?
Yes, I did a lot of sports inmy young days and even up until

(17:49):
like three, four years ago, Iused to play pickup soccer every
Sunday for like 90 minutes likefull force, not just like I
mean we're talking about thewhole field, the whole pitch and
all my life.
I was involved in athleticsEven today I am and I couldn't
do.
I got to a point I couldn't dothe regular stuff Like walking

(18:12):
up a flight of stairs.
I was kind of worried because Iwas worried my right knee is
going to hurt.
And even when I got after I gotan MRI and MRI was negative.
It pretty much showedchondromalacia and just natural
stuff of aging, nothingpathological which was
inappropriate.
I was like, well, it stillhurts.

(18:34):
And then my left shoulderstarted hurting and then my toes
started hurting.
My ankles started likeeverything creeped up as soon as
I hit 50.
Like everything creeped up assoon as I hit 50.
So I said, well, I should go tomy primary care doctor, get
some basic labs and just seewhat the hell is going on.
Everything came back normal.
She's like see you in two years.
I'm like, wait so.

(18:55):
But I don't feel normal, I'mtired.
I have like brain fog likearound 2, 3 pm I just want to go
home and just take a nap.
I'm not the same person.
I know it because I know mybody very well.
And she said well, you know,welcome to the club, you're

(19:16):
getting older.
You're just working too hard,maybe you should rest more.
So pretty much no straightanswer, no suggestion, nothing
about lifestyle.
Not even a single questionabout my lifestyle or habits,
not even a question how manyhours I sleep, not a question
about what I eat, not a questionabout what's going on in my

(19:36):
life, my connections, humanconnections and my mental status
.
None of that and my mentalstatus, none of that.
And so I stumbled on the topicof functional medicine.
You'd be surprised, through afriend of a friend that I met at
a party, who happens to be anorthopedic surgeon that is very

(19:59):
interested in longevity,functional medicine and stuff
like that.
So I said I went up to him.
I'm like Matt, I'm really sorry.
I hate when people in a partycome up to me and ask me medical
questions because it's a onetime.
I just don't want to talk aboutthat stuff.
But I just need to pick yourbrain.
What's going on with myshoulder?
So, long story short, I wasdiagnosed with a rotator cuff

(20:21):
injury and a right labrum tear.
So pretty much I was crippled.
I couldn't lift anything, Icouldn't even wash my back in
the shower, and anotherorthopedic surgeon just gave me
a steroid shot, said yeah, I'llsee you back in three months.
And so I stumbled.
So he gave me a bunch of advice.
He's like, hey, do you do this,do you take that?

(20:43):
And I'm like, no, I don't evenknow what you're talking about.
So that night I went home, Iwent on Google, I researched the
whole damn thing.
Everything he told me andthat's how I stumbled on this
topic.
And you know what occurred tome?
That I'm treating aestheticmedicine the same way a primary

(21:03):
care or any other doctorapproaches healthcare today,
which is waiting for somethingto break and then trying to fix
what's broken instead of askingwhat is the root cause and
treating the root cause of it.
And when I did that, I did myown research, I literally
treated myself.
I changed my lifestyle I'm notkidding you Within four weeks

(21:28):
and, by the way, I just went toone of these direct-to-consumer
sites online, got all mybiomarkers, my DNA, everything.
I think it was InsideTracker.
I don't have any affiliationwith them, but it just gave me
everything and more than what myarchaic basic labs of my
primary care physician wouldeven order.

(21:51):
And I saw that about 12 of mybiomarkers were out of whack and
they weren't optimized and theones that were within the normal
.
They were at the borderline,either borderline high or
borderline low.
I changed my lifestyle.
I changed my diet.
I took some supplements that Iwas deficient in.
Within four weeks probably evenless than four weeks, I would

(22:13):
say, maybe two and a half weeksor so all my pains and aches
went away.
I would jump out of bed.
I would not get tired.
I had so much energy.
My staff was like bed.
I would not get tired, I had somuch energy.
My staff was like what's wrongwith you?
You're very hyper and energized.
You're like an energized bunny.
I'm like I don't know.
I don't know.
I feel that, but I don't knowwhy, because everything happened

(22:35):
so quickly.
So it changed my life to thepoint that I felt so compelled,
I was so juiced up and amped upto integrate that in my own
patient care, because itoccurred to me that aging this
is what it is.
So it's cellular aging is whatthe root cause of all of this is

(22:56):
, and cellular optimization iswhat needs to be performed and
done.
Now the question is how?
And so I went and dug back intomy basic science knowledge that
I had from doing two years offull-time cancer research.
I literally looked up the Krebscycle again.

(23:16):
I looked at all the cell cycle,I looked at all the cytokines,
I looked at everything and itall rang a bell.
It was kind of 25 years ago.
So I literally studied for sixmonths and now I'm integrating
in my patient care because Ifeel we're not treating our
patients the way we should,which is in a preventative

(23:37):
fashion and optimizing.
And the science is there.
So that's now what's shocking.
I want you to explain us.
The science is there, has beenthere for decades.
This is nothing new.
So why is it that colleagues ofours don't look at that?
If they're interested, if it'stheir profession, isn't it their

(24:01):
duty and obligation, or is itthat they're not aware of it?
Which one is it?

Speaker 3 (24:06):
They're not aware.
That's the thing.
So my story was a littledifferent and I'll get into it a
bit.
But they're not aware and theywere told that alternative
medicine, integrative medicine,is kooky medicine, like you
don't need supplements.

Speaker 2 (24:22):
You don't need to look at why was that?
Where did that, does that stemfrom?

Speaker 3 (24:26):
I mean, it's coming from their training,
unfortunately and then you getstuck in the mode of being a
human doing instead of a humanbeing.
Right, you just start doingstuff because that's what you
were taught to do.
You literally have to take astep back and take a pause and
say what is important here, whatis the cause, what could be

(24:47):
going on, instead of just saying, okay, this is the differential
diagnosis and these are thethings that we should do and
this is how we're going to do it.
And so in your case you knowthat's amazing.
I mean, you must have had akind of not, your diet probably
wasn't good and things like that.
But you know, doctors aren'tgoing to talk to you about your
deep sleep cycle.

(25:07):
You know how I explained it.
Let me, let me just talk aboutthat.
You know how you I explainedthe deep sleep cycle.
This is how I explain it.
I'm like the deep sleep cycleis so incredibly important to
your health.

Speaker 1 (25:18):
So think of it like this Every single cell in your
body is like a mini city, so inthe morning people are coming in
, people are chefing up food andconsuming food.

Speaker 2 (25:28):
I love your analogies .

Speaker 1 (25:30):
You know, cars are going all over the place,
Pollution is happening and, atthe end of the day, people leave
, they're restocking therestaurants, they're cleaning up
the streets, and all thatgarbage has to come out.

Speaker 3 (25:42):
Well, that is exactly what happens to your cells at
night, and so if you're nothaving enough deep sleep, you're
not detoxifying, you're notgetting rid of the products
you're not able to replenish andyou eventually will fall apart.
But it even is a little bitdifferent than that.
It goes back to the keyelements of lifestyle medicine,
because 80% of all chronicillnesses are due to lifestyle.

(26:04):
So I'm talking about nutritionhundreds of billions of chemical
reactions occurring per second,talking about your fitness your
brain fitness, heart fitness,bone fitness, cardiovascular
fitness, metabolism.
Talking about stress and howyou manage it, talking about
sleep like I talked a little bitabout it the environment
xenoestrogens, pesticides andBPA, microplastics.

(26:25):
And then relationships how areyou interacting with the people
that you're with and the groupsaround them?
And then what is your mindset?
Are you even thinking aboutthose things?
So that's just step one, andthe reason why it causes chronic
illness is because, in the1940s we found DNA.
Woo big deal right.

(26:45):
Now what do we know?
Oh, we know the map.
Okay, big deal.
No, now we know there's a setof DNA that sits on top of the
DNA, the epigenome, thatactually has switches that turn
on and off that are directlyregulated by lifestyle behaviors
.
And so when those switches turnon and off, they read regulated
by lifestyle behaviors.
And so when those switches turnon and off, they read the DNA.
They mismatch the DNA leads totelomeres unraveling the aging

(27:07):
process, which are the end capsof chromosomes, and so it's all
part of the same thing.
The problem is that people aredoing one thing hormone care
Like I'm an expert in hormone.
Well, I'm an expert in hormonecare too, but I just happen to
do everything.
And so I look at all of thoseaspects and for me it was just

(27:28):
like you, except you know youget old enough, everything does
hurt.
That's just you just kind of.
You know you get there, but itdoesn't prevent you from doing
things.
But I had the idea that therehad to be something else.
There seemed to be something.
I was a gastroenterologist.
I could scope all day, I wasgreat at video games.
It wasn't like it was supercomplicated, occasional,

(27:50):
complicated case, but it wasjust like churning and burning
through patients, but I foundthat what I really liked most is
sitting and talking to them.
And then, when I thought back,I was like you know, when I was
a medical student and resident,I realized that every day after
everybody went home I would goto the patient's bedside and sit
with them and listen to theirstories and communicate with

(28:13):
them, and I learned a skill thatwasn't taught and I carried
that skill and it just made memore interested to be like we
could do better and, believe itor not, I actually started off
in psychiatry in New York Cityand I realized after a year I
definitely wasn't a psychiatrist, but I did understand how
important it was, but I wantedto know more, just like you, and

(28:34):
how it can help, and thatbrought me to today.

Speaker 2 (28:39):
Was there a specific moment?
Do you remember that moment?
Because I remember my moment.
I had a holy shit moment.
Yeah, you know, I was like allof a sudden things connected and
did you ever have that momentor was it more?
You evolve into it?

Speaker 3 (28:56):
you know I had many moments because I can't tell you
that one thing did it.
I mean I wanted to have morecontrol.
I didn't want to be told whereto go and what to do all the
time.
I wanted to make sure that whenI talked to somebody I was
empowered with information thatcould empower them.
You know, because at the end ofthe day, for me it's not like I

(29:22):
teach my patients and train mypatients to do it themselves.
You know, we talk about healthcare and should health care be a
right and we can argue aboutthat, but you've got to go out
and put your shoes on and gooutside.
You've got to do that yourself.
So in my world the teacher risewhen the student is ready.
And at this point in time in mycareer I see people who are

(29:42):
already interested in takingthose steps, whether they have
money or don't, because I havepatients on both sides.
But I did have an aha momentdoing gastroenterology and I was
just like nausea, vomiting gas,bloating, diarrhea, pancreatic
disease, colon cancer,esophageal disease.
I'm like not what else is there.
And GI didn't change that much.

(30:04):
I mean they still really hasn'tchanged.
I like the molecular nature ofthings.
I like to know how cyclic AMPworks.
I like to know how nuclearfactor kappa beta works.
I like to know how these partintegrate and teach it to my
patients in a way that makessense to them, just like I teach
them why that little nuclearpower plant in your cells?

(30:26):
the mitochondria are soimportant because without it you
don't make energy or ATP.
And then I explain the wholething and they go like that's
interesting.
So I had a deep desire to knowmore, and the problem with
medicine and what we do besidesthe fact that it doubles so
quickly is that the more youlearn, the more there is to
learn.

Speaker 2 (30:46):
Well, not only that, but simply the fact that,
knowing that how much medicinesupposedly has evolved, let's
say, since the 70s, right, Allthe discoveries, all the papers
in these journals and science,nature, everything that was
discovered, right, we're talkingabout 50 years now since the

(31:07):
70s I was born in developed,researched has not really made

(31:28):
us healthier.
Actually, what was astoundingto me when I looked at some
statistics?
Our life expectancy has droppedby a couple of years since the
70s.
You know why that is well, yeah, you know, I think I know, but
please tell us why.
Like how does that even makesense?

(31:49):
Well, there's a bunch ofreasons why, but I will say one
thing Aren't we supposed to gethealthier?

Speaker 3 (31:55):
Well, actually, because we don't teach health,
we teach disease management.

Speaker 2 (31:58):
Okay.
So if we teach diseasemanagement, why are we dying
earlier if we're managing?

Speaker 3 (32:03):
disease Because we're not managing it well, because
people also have to be proactive.
We're not empowering people toget healthier.
See, everybody thinks it's thedoctor's responsibility to you
to be healthy.
Thank you.

Speaker 2 (32:14):
It's not.

Speaker 3 (32:15):
Thank you for saying that, yeah, you have to go out
and do it.
And I'll tell you what I wrotea national healthcare policy at
the American Medical Association, like 15 years ago, called
American's Health, and it talksabout personal responsibility
and that still is an activepolicy there nationally because
people have to be proactive andtake responsibility for
themselves.
But you have to have theteachers teaching it.

(32:35):
You know, doctor in Latin meansto teach, so you know we should
be teaching.
But you did open the door toone thing which I think is very
important.
It's research versus clinicalmedicine and right now there's
some very popular people outthere that are actually
researchers giving clinicaladvice to people, which
absolutely blows my mind becausepeople are taking it in like

(32:56):
it's gospel.

Speaker 2 (32:57):
Because they're desperate, because they don't
get that information from theirdoctors.

Speaker 3 (33:09):
But the thing is, is we as clinicians?
Yes, we take their informationfrom research, we interpret it
the way that it needs to in theclinical environment and decides
whether or not it's good.
So everything that comes outit's like you should have this
much protein or these aminoacids, or this is the science
behind this or that, and you'relike is this practical?
Is that something that you canactually teach?

(33:30):
I mean, what do we do?
So I think that there's a bitof a disconnect with that.
But back to the problem.
Like what happened in the 1970sWell, the coolest thing ever.
First of all, in the 1950s,glucose isomerase was developed.
Now I will tell y'all glucoseisomerase.
I'm in Florida, even though I'mfrom New York.
Somehow that seeped in so far.

(33:52):
Sorry for the y'all part, butthe thing is it occurred in
Japan, actually from a physician, a doctor in Hiroshima and in
the United States, independentlyin the fifties.
In Japan they needed to getsugar, but nobody really wanted
to sell them sugar after WorldWar II.
So they created a, a way tocreate a substitute, high

(34:16):
fructose corn syrup.
But they also taught in theschools how to, how to not
become obese, and that's whyobesity didn't affect them at
the time until we got there, andthen the United States, we had
it and just sat around until the1970s.
And in the 1970s the foodindustry was bitching because
sugar prices were going up andthey wanted to find cheaper

(34:38):
products.
And it just so happens that theoriginal studies in Princeton
looked at high fructose cornsyrup and sugar in rats and they
ate it.
But they realized that the ratsdidn't have the release of
leptin.
They didn't know what it wasback then, but they didn't get
as hungry so they ate through it.
So they had a higher amount ofcalories as soon as they got
into high fructose corn syrup.

(34:58):
But it also so happens in the1970s this is all fact, because
I'm actually researching thisfor another book.
I'm writing a fiction novel butin the 1970s they found corn
was a surplus in the UnitedStates.
They sold corn to the foodindustry.
That applied glucose isomeraseand boom, high fructose corn

(35:20):
syrup was introduced.
So that in the 1990s theaverage American is consuming 40
to 50 pounds per person peryear and the obesity epidemic
started to explode.
Because, just think about it,we've always had Richard Simmons
, jack LaLanne, original peopledoing exercise, so that's not a

(35:40):
new thing People talking aboutfood and diet, and you can go
back to many, many individualstalking about plant-based eating
.
It turns out they duped us.
They created food that becameaddictive.
This is not being conspiracytheorists, this is just fact.
And then all of a sudden theywere like we can make a lot of
money like this.

(36:01):
They introduced us into everysingle product.
So most of you people who haveketchup in your refrigerator, it
has high fructose corn syrup,unless you read the label and
you have to eliminate thosethings.
That is number one.
Now, of course, we're alsodoomed because advertising is
everywhere and where it used totake five or six impressions to

(36:22):
do something in the 1950s, todayyou're getting like 10,000
impressions a day of stuff.
So we have to take a proactivestance and physicians have to
empower patients to change that.
But that's just one smallaspect.
We're getting sicker, and thereason and it's not because we
don't have enough doctors ornurse practitioners or PAs, it's

(36:44):
because we're not educating thepatients to think of a healthy
lifestyle and again, go back toit.
Not everybody's going to do it,but there are enough people
that want to and enough peoplethat are already doing it to
literally change how we look athealthcare, and that's how I
focus, and it really starts withhaving this personal

(37:05):
interaction with somebody.
It's my Live Beyond Wellprogram, but having an
interaction, ordering the propertest, not because you're a
steward of the medical dollar,which is what they teach you,
but because you want to actuallyhelp them.
And so, yeah, instead ofordering a basic cholesterol
profile, you're ordering anadvanced lipid profile with
inflammatory markers, whichactually looks at your

(37:27):
lipoproteins, which are thegenetic sticky factors that are
involved in the size of yourparticles which can kind of get
between the cells, and stufflike that.
And looking at other markers,like you had done, that are not
in the traditional realm becausethey're a little bit more
expensive, although they'recoming out less expensive now,
all the way through complicatedtests which could be

(37:49):
micronutrient testing andT-limit testing and ApoE testing
and that stuff, but just thebasic stuff.
You can catch so much.
And hormones, because hormones,we can have an entire podcast on
hormones, how poorly they'redone in the United States, how
it's such a money grab, butthey're absolutely needed in men
and women.

(38:09):
And so a couple of people rightnow, thank goodness, are really
champions of their fields,although you know they've had a
varied background and they'rerealizing how important hormones
are for both men and womenthroughout the life cycle, and
so, and lots of data that wecould get into.
But in terms of for youparticularly, and and and the

(38:31):
topic here which I think isreally, really important to talk
about because my wife is acosmetic dermatologist too, so
we have these conversations ishow do you apply what we do from
as a functional standpoint, toimprove the outcomes of what you
do?
And I think that's theinterplay of where it sounds to

(38:54):
me and from what I've seen fromyour site, where that's going
gosh.
Wouldn't it be amazing if morepeople did it?
Not just for money by sellingyou stuff, but because you know
that.
You know vitamin C supportscollagen and vitamin E is an
antioxidant and niacinamidereduces inflammation and zinc
plays a role in skin repair andcollagen.
Peptides and estrogen,progesterone, hyaluronic acid

(39:16):
and CoQ10 and probiotics andresveratrol, which, by the way,
is in highest concentration ofPinot Noir.
But that isn't strong enoughthat, if you don't drink, to
start drinking.
So there's a lot of stuff likethat that we could dive into
every single one on how to helppeople and create customized

(39:36):
programs to help people manageit.
They don't have to do it all.
But if they do something andit's kind of like this and this
may be counter to something youdo and I would apologize if I'm
gonna put my foot in my mouth,but my wife has skincare
products In fact she has her ownline and stuff and I'm a firm

(39:56):
believer that if you just useone skincare line actually doing
cleanser, toner, you know, andyou know looking at vitamin Cs
and things like that andretinols if you do a line,
whatever it is, you will seeresults, as long as it's matched
to your skin type, because it'sabout consistency.

Speaker 2 (40:16):
You know everything, we do Everything about that.
Everything is you hit the nailon the head and that's something
I tell my patients.
I say I don't care what you use, as long as you use it on a
regular basis.
It's like saying which gym isthe best?
Should I go to LA Fitness?
Should I go to Lifetime?
I don't care, as long as youshow up, you do something, you

(40:36):
will see improvement.
And that's, I think, whenpeople kind of lose perspective
of what's important and what'snot.

Speaker 3 (40:46):
But you mentioned Don't you also think, though, on
the consistency thing?
Sorry to interrupt, but thething is, that's the problem in
the medical environment.
Because you don't haveconsistency, you go to your
doctor and you just said see mein two years.
Okay, go work out once everytwo years.
I mean, how does that?

Speaker 2 (41:03):
work and you know why .
She said you have no riskfactors.

Speaker 3 (41:06):
I'm like You're a person that's getting older, you
have risk factors.

Speaker 2 (41:11):
Like two years is a long time, man.
So.

Speaker 3 (41:15):
I mean.

Speaker 2 (41:16):
I just checked my lap every four months now and I
can't believe how much haschanged based on the
modifications that I make.
So I want to see real-timewhat's happening because I don't
want to do too much ofsomething Like if I'm getting,
for example, if I'm in thesummertime, I'm getting enough
vitamin D3.
I'm outdoors a lot and myvitamin D3 levels are optimal.

(41:39):
Do I really need to takevitamin D supplement?
Probably not.

Speaker 3 (41:44):
Whoa whoa, whoa, whoa whoa.
Let me help you there.
Help me there.
First of all, the efficiency ofthe sun.
Conversion to bioactive vitaminD is about as efficient as
solar energy into electricity.
Amazing, like it's just notthat good, amazing.
So I live in Florida and Iwould say 90% of my patients
even the sun, gods and goddesseshave low vitamin D.

(42:08):
Now, of course you know theendocrine society just came out
with their statement on vitaminD that we shouldn't even be
checking it.
Yeah, okay, what I'm going tocall.
I'm going to call BS there,just like the United States
preventive medicine said don'tcheck PSAs in the past and women
shouldn't have mammographies.
They're just stupid.

Speaker 2 (42:26):
But why do they say that it makes no sense?
It's expensive.
It doesn't change anything.

Speaker 3 (42:32):
The data that they see.
Endocrinologists are verybook-wise.
We have to think much bigger.
So we found, actually evenduring during COVID, how much
vitamin D is involved in yourimmune system, because so many
people died.
Now I'm not trying to get intoa political conversation.

Speaker 2 (42:48):
We're having a medical conversation.
Anybody that wants to make thispolitical, that's on there.

Speaker 3 (42:52):
Yeah, you know, but we found that a lot of people
succumb to the disease earlywhen they had low vitamin D
levels and obesity andinflammatory conditions.
And so that was like hmm, itturns out it's a powerful
antioxidant.
It's not only involved in thebone, it's involved in your
immune system, and you know howcomplicated the immune system is

(43:13):
.
I can't even touch that onebecause that's way over my head
about understanding it.
But I optimize vitamin D 100%and I would say more than 90% of
patients are on some vitamin D.
Now, how much is the question?
Personally, I think 40 to 60 isa pretty good number.
I don't think it has to be thatmuch more.

(43:34):
And remember, for every 10international uh, for every
thousand international units ofvitamin d, your vitamin d level
will go up about six to ten.
So it's, you know, not a, not alot.
So 2000 would make it go uplike 20 or so.
But you know, I do monitor andmeasure, just the same way, like
I look at vitamin d b, vitaminb12, I look at homocysteine,

(43:55):
look at meth a cheap way to lookat methylation pathways yeah,
although I can look at otherthings.
So so, I mean, there aredefinite, definite things that
we can and should do.
But anyway, you were talkingabout your vitamin D and sun.

Speaker 2 (44:07):
Yeah, so.
So my, my point is that forphysicians today to rethink the
way they treat patients or weshouldn't say treat, actually,
um, I would call it manage theirhealth.
It should be about managinghealth and not treating someone,
you're not treating someone,you're managing their health or

(44:27):
giving them advice.
You would have to send them backto school, basically, because
it's a complete 180 as far ashow you approach.
Even the approach is different.
It's not like you can go into aseminar or a lecture and then
say, oh okay, that sounds great,I'm going to do that from

(44:48):
starting tomorrow.
On Monday it's not going tohappen, so there needs to be a
requirement if it's notvoluntary, it should be a
requirement that all currentpracticing physicians have to
get trained and whether you wantto do a certification or
whatever it is to standardize it, to be able to have this

(45:14):
paradigm shift in their mindsand understand the earth isn't
flat, it's actually round.
You can't just mention it in theelevator or as a suggestive way
of treating patients.
I mean, that's on one hand andthe other thing is looking into
the future.
You have to integrate it intoevery medical school education

(45:37):
or else it's going to be thesame going forward and
policymakers are eventuallygoing to be deterred or
motivated.
You know, I mean money runsthis country, I mean money runs
the world.
I'm pretty sure I could tellyou now, and without even
knowing for certain, if we gethealthier, if people get, get

(45:59):
healthier if we have lessdisease, if we eat less junk
food.
There's a lot of powerful andrich people are going to be
pissed off, so the question isthe question is, who's going to
win that one?
I think the big answer towhether it will ever going to
change.
The big answer to whether itwill ever change is who is

(46:26):
bigger and stronger and morepowerful?

Speaker 3 (46:29):
let me just say this, because I don't disagree with
you there.
But you know, my days of tryingto change the world, to see it
a certain way, are diminishingand I am more interested right
now in people who are alreadyinterested in what I'm doing and
how I'm doing it.
And if you have an interest andyou want to know more about it,

(46:52):
that's where I'm creating myprogram, that's where Live
Beyond Well becomes a big thing.
That book should be out withina year.
Understanding it, it's not justthe functional, integrative
lectures that have been put intocontext, it's just real world
clinical medicine on how tointeract with people, like

(47:12):
people, not cookie cutter, andevery situation becomes
different.
I can't tell you how many timesI'm talking to a man, and they
could be 40, they could be 70and they're having some issues
with their marriage.
And I'm like, well, when's thelast time you guys went on a

(47:34):
date?
Or when's the last time youactually sat and listened to
your wife?
Like just literally just had aconversation.
I said do you know how tolisten?
So I'm talking to this guy.

Speaker 2 (47:46):
You're opening up a can of worms here.

Speaker 3 (47:48):
Yeah, he's like 40 and super success 45.
He's like super successful,great guy.
And I'm like so do you know howto talk to your wife?
And he's like, oh, yeah, youknow whatever.
I'm like, let me explainsomething to you.
This is what you do and I wantyou to do this when you get home
, because I'm a firm believer isyou never leave the side of a
good idea without taking anaction towards its completion,

(48:10):
right?
So if I tell somebody something, I want them to act upon it,
because that'll solidify it andthey can.
They can work on it.
So when you go home and you havea conversation with your wife,
work on it.
So, when you go home and youhave a conversation with your
wife, talk to her and listen toher and ask her clarifying
questions.
It's like, hmm, I'm like, yeah,make it so that you know that
she's listening to you byrepeating back what she said.

(48:33):
You said oh so, honey, you werejust saying that you went and
you went to the store and thisand this happened, or you
learned something at work andthis happened, or whatever.
And you're having that andshe's like, hmm, wow, somebody's
actually listening to me in myhouse.
That changes the entire waypeople interact at home, and it

(48:53):
goes both ways, but I tend tothink that men are worse than
women at that for sure.
Yeah, so I'm guilty, it canhappen at any age.
But anyway, I mean, that's justa little digression that gives
you an insight into the depthand stuff that I can get into
and, like I said, I just neverknow what's going to come out of
my mouth.

Speaker 2 (49:12):
And you know that is fair.
I mean, I think that's like thelife coach hat you just put on
and that's so important becausemental health is often not
forget about, often not actuallynever even discussed um, no um
with a patient.
I mean it's almost like taboo,it's almost like we don't talk
about that and that is on you.

(49:33):
I'm just here to manage yourbody is like the mind doesn't
have any effect over your bodyand that's kind of like the
stance currently we have.
But I want you to give us, youknow, a lot of my audience.
They've been following mycontent and I know that because
they're asking me questionsonline.
They're asking me questions onsocial media and I feel like

(49:56):
this hunger for figuring out.
Okay, they now sold on.
I need to make a change.
I need to take my health in myown hands.
It's just that there's so muchinformation out there, like you
said, every scientist is aclinical expert suddenly and
some of the stuff they say isgood, but then, like you said,

(50:19):
it's almost not applicable.
People don't know what to dowith that information.
Me and you can understand itand kind of figure things out
and make it applicable, but thelayman is confused because when
you're listening to all theseexperts, there's also a lot of
contradiction.
One says this diet is greatplant-based, the other one said

(50:41):
no, carnivore.
The other one said don't worryaboutbased, the other one said
no, carnivore.
The other one said don't worryabout fats, the other one said,
oh, fat is great.
One said cholesterol is great,your body needs cholesterol, and
the other one said cholesterolkills you.
So there is like in every avenue, in every aspect of health,
lifestyle, diet, nutrition,medicine, there is this

(51:01):
polarization.
And patients what I've realizedor people, they're desperate,
they want to change but they'rescared.
So it's like we make them drinkout of a fire hose and what
happens is they capitulate.
They're like you know what?
I'm just going to continue todo it Until I can figure out how
I'm going to do it.
I'm just not going to changeand then nothing changes.

(51:22):
I don't know if you see that,uh, in your practice I mean you
see that everywhere, right?

Speaker 3 (51:27):
you know you also see it if you read golf magazine,
right?
So in the back of the magazineyou go in there and you're like
it could be on an online form,except golf can't kill you.
But no, no, no, but it's ametaphor, I know so says okay,
so you want to hit a sand shot.
You sit here, you do this, youmove your feet here, you swing
the club this way and all thisand you should go out and do it,

(51:49):
and it's like too muchinformation.
So how do you?

Speaker 2 (51:53):
coach.
My question to you is now inyour practice, because you're
doing it every single day.
Doing it every single day, howdo you redirect the patient's
focus and attention and coachthem as to how they can make
practical changes, literallystarting tomorrow, when it comes
toward the practical changesthey can make towards their

(52:16):
health and well-being fromlifestyle changes to diet,
exercise, nutrition, stressmanagement and also, how can
they turn this into long-termhabits rather than short-lived
efforts or almost like buildingfor themselves these

(52:39):
insurmountable goals where theygive up after two weeks they're
like, yeah, I can't do that,that's not for me.
How do you lead the horse tothe water?

Speaker 3 (52:48):
Yeah, First of all, I love that whole idea, but I
would say everybody should readAtomic Habits.
That book is an eye-opener ifyou don't know anything about
habits.
But here's how I reallyapproach it in real time, in a
clinical setting, and this isvery different than probably
people do it.
I ask a question and I ask themwhat do you want?

(53:11):
What do you want out of yourwhat, what?
What is it that you want?
And they're like I don't know,Cause most people don't know.
So I have them do an exercise.
I teach all my patients thesame exact exercise.
I've done it with my kids, myfamily, their friends, everybody
.
And basically, in order todetermine what you want, you

(53:31):
have to do something.
You have to take a piece ofpaper for like 10 minutes and
you have to turn off the editingfunction of your brain I'll get
to the reasons why in a secondand you turn off the editing
functions of your brain and youliterally write down anything
and everything.
You want a jumbo jet, a tank,whatever it is, you know, and
without editing why you can'thave it.

(53:53):
Because that's what we alwaysdo.
We're constantly editing whatwe can't have.
And then I have them go backand put it into categories
Financial, physical, bucket list, relationship, spiritual,
whatever it is, doesn't make adifference and then I have them
put it in order one, two, three.
One, two, three, whatever it is.
And then you take each topthree in the categories and you

(54:14):
come up with three compellingreasons why you want that.
So if one of the things was youwant to be healthy, you have to
understand what healthy is first, and then you say, well, why
would you even want that?
Because if you don't havecompelling reasons to do
something, no matter what I tellyou, you ain't going to do it,
no matter how good I am or howgood you are.
So they have to have compellingreasons.
Once I've identified thosereasons, I can reverse, engineer

(54:37):
a way to get them to get there,and so it's a process.
It's not like a one visit thing.
I have patients that I see foryears that we it took a while to
get there.
You know, the first of all,they have to trust me because,
as you can tell, I am a straightshooter in my practice.
I am no BS.
I say it like it is.

(54:57):
I call balls and strikes.

Speaker 2 (54:59):
Have you ever fired a patient?

Speaker 3 (55:02):
say it like it is.
I call balls and strikes.
Have you ever fired a patient?
I have fired patients and Ihave gladly had patients fire me
because they weren't workingout.
But I do weed out people.
I do ask people that aren't inalignment with what I'm thinking
to seek out somebody else forsure, Because no amount of money
is going to make me seesomebody that won't work with me

(55:22):
.

Speaker 2 (55:23):
So how do you handle this lack of accountability,
sometimes from the patientstandpoint?
Let's say, patients come to you.
Obviously you're a conciergephysician.
I assume they pay you monthlyor annually or per visit.
I don't know how your structure?

Speaker 3 (55:36):
is Annually generally .

Speaker 2 (55:37):
So they pay you annually.
With that annual payment,automatically, they will have a
certain set of expectationsCorrect and usually the
expectations, at least in myspecialty is that if I don't
deliver what they expected andyou can never know what they
expect is they point a finger atyou and say it's your fault and

(56:01):
I want my money back.
You didn't give me what Ithought I would, so a lot of it
has to do with expectationmanagement.
In your case, obviously they'regoing to look for results.
And then at what point do youdraw the line in a finger
pointing?
At what point?
And how do you Because it'svery tricky to manage those, to
navigate those waters and kindof politely tell them look, I've

(56:24):
been telling you all along,you're supposed to do this,
you're not supposed to eat that,and I really don't see that
happening.
So what's going on?
And then the patient goes likewell, you told me this and I'm
going to lose that much weight,I'm going to feel better, I'm
still this, I'm still that.
So what's the deal?
How do you manage that andwhat's your?

(56:46):
Do you have a strategy orapproach?

Speaker 3 (56:49):
Oh for sure For sure.
So I actually it's severalthings.
I manage expectations from thevery first visit.
So I do a meet and greet and Ilay it out but what they expect,
what I can do, what I can't do,and I let them know that if
they're not going to participateit's not going to work, just
from the very first.
And it took a lot of years toget the balls to do that because

(57:11):
it takes a lot to take apatient that's going to pay you
a significant amount of moneyand tell them it's just not
going to work.
So I've developed that and it'shard to do and if you're a
young physician it'sexceptionally hard to do because
you pretty much got to takeeverybody.
But in real time I have hadthese patients, even recently.
You know an older woman intheir 70s who is overweight.

(57:36):
We've tried diets, we've triedstuff.
She won't do it.
She keeps eating, although nowI've dialed it in a little bit
more after, you know, being withme for almost four years, five
years, and she just wasresistant to it.
She wouldn't do it.
I know she was eating outsideof everything and not telling me
the truth.
And finally one day I was justlike listen.
I'm really sorry, but this isnot working for me.

(57:59):
I mean, I have a medicallicense and I take my job
seriously and I'm gonna considerwhat you're doing a form of
non-compliance, and if you can'tdo these things, then I don't
think this is going to work.
And most of the time, if notalmost all the time, they are
like that is enough of amotivator because they want to

(58:22):
keep me at least in one way oranother because I'm giving them
advice, to keep me at least inone way or another because I'm
giving them advice.
And it turns out that thisparticular person amazing just
was like bing, had a aha momentand just was like, let me see
how much I can begin to.
And she finally realized thatit's all about her, nothing

(58:44):
about me, it's about her.
She opened up, she startedtalking about that, they started
talking, she started talkingRemember, this is a lady in her
seventies started talking abouther childhood, what had happened
, why you know dad, and thingslike that, and I coached her
through that and now we're on apath to success and decreasing
inflammation and hopefully, youknow, a little bit healthier

(59:05):
life because you know there, youknow.
I do want to just take a quicksegue into three aspects of life
right, so there's lifespan.
Right, you live and die.
There's a health span livinghealthier, longer and then
there's longevity, which isactually living longer and
healthier, and so they don't allintersect.

(59:25):
And so you know, the reality isthat you know you're in your
seventies.
If you don't do somethingdifferent, something's going to
happen.
So I take a proactive stance.
I don't threaten them, but Igive them an idea that you know
maybe it's not going to work.
And if they really, reallyaren't interested in what I'm
doing, the relationship doesn'twork.

Speaker 2 (59:46):
And I try to do something about that from the
very beginning and that's, youknow, very well said, and I
think that's totally fair and Ithink anybody initially, if you
set the stage correctly, wouldunderstand and you can come back
to said hey, we discussed itand do you have any quantitative
measures or ways to quantifyhealth Meaning?

(01:00:11):
You know there are peopletalking about biologic age
versus chronologic age and thereis hundreds of different ways
of people claiming they canmeasure the biologic age to the
point that, like when I lookedinto it, it got really confusing
.

Speaker 3 (01:00:24):
Or that clock and a tick clock yeah all of them
exactly yeah is it?

Speaker 2 (01:00:28):
is there um any clock or any way that you try to
measure that and if so, whichone and why?

Speaker 3 (01:00:38):
yeah, I actually don't.
I mean, you're getting into thearea of, uh, what is really
considered biohacking, right,and you know biohacking is like
it's like a do-it-yourselfbiology kit, you know.
You kind of like figure thingsout along the way.
But I think at the very, verybasic part of it.

(01:00:58):
The first thing is we have tolook at lifestyle behaviors,
nutrition, fitness, sleep,stress, got to dial those in.
That is not an easy thing, youknow.
You've got to make sure thatyou're dialed in there.
I do telomere testing.
I look at telomere length.
I use a specific lab for that.
I don't have any financial tiesto them, but I use a very
specific lab to do telomeretesting to get an idea of where

(01:01:22):
they might be.
But it turns out that a lot ofthe factors that affects your
telomeres are related toinflammation, are related to,
you know, micronutrientinsufficiencies or trace element
insufficiencies and stuff.
So that's kind of that part ofit, so to speak.
But you know there's also otherkind of biohacking between

(01:01:43):
nutritional biohacking andcognitive biohacking and skin
therapy and cryotherapy and alot of different things.
But I don't do a lot more ofspecific testing because there's
so much depth and wealth insideof doing the things that I do,

(01:02:03):
that I find that if you'realready doing those, man, you
are hitting the high notes.
So I would say one of themetrics that I do that I find
that if you're already doingthose, man, you are hitting the
high notes.
So I would say one of themetrics that I have.
I think you have to look at someof the common diseases.
So A, how many heart attacks?
Zero heart attacks of mypatients in 15 years Zero, not
one.

(01:02:25):
And that's not like they didn'thave disease.
Because I do advanced cardiactesting, ct calcium score.
I'm very aggressive at, youknow, talking to them, getting
them to the right cardiologistto do.
You know either pet you knowcardiac pet, or you know stress
echoes and things like that orthese are tests that you do to
detect disease as you can,basically for those who aren't a

(01:02:48):
physician.
So I'm very aggressive at that.
But I find that you know, mostof the problems that we have
after age 40 are due to aninflammatory process and you've
got to address the inflammatoryprocess.
So that's kind of what I do.

Speaker 2 (01:03:04):
And that's and I 100% agree with you.
I think inflammation is reallywhat leads chronic disease and
aging, and it's part of thesenescent cells and adipose
tissue.
All of those contribute toincreased inflammation and that
was, for me, something thatreally reduced inflammation.
My HSCRP was to the roof assoon as I changed my diet.

(01:03:28):
Stress and cortisol was a bigfactor for me too.
Once I regulated all of that tojust make logical lifestyle
modifications cutting processedfoods, cutting saturated fats,

(01:03:58):
cutting carbohydrates I was asweet tooth and I would eat like
chocolate and candy all daylong.
Cutting all of that it justchanged everything and it's
something that anybody can do,starting today.
It's just that I think peoplearen't sold on it or people are
creatures of habit.
And then the book that youmentioned I think it's probably

(01:04:19):
a powerful one for anyone thatis interested to read about,
understand about habits.
But I want you to mention,because you're an expert in
gastroenterology, internalmedicine and functional medicine
, how important is gut health,because I know enough to know
that what we put into our bodies, what we eat, is not

(01:04:41):
necessarily what we absorb, andI know people are learning more
about the importance ofprobiotics, about gut health and
how that affects their immunesystem, their absorption of the
nutrients and, ultimately, theirhealth.
Can you speak a little bitabout the importance of it?
Is it overhyped or is it real?

Speaker 3 (01:05:03):
Well, I have given many national lectures on the
gut microbiome.
I have a great one that I'mgoing to retool and pop it on
one of my sites eventually, butit's so in-depth that it would
take probably a three-partseries just to get through it.
Well, give us the elevator pitch80% of your immune system's in

(01:05:23):
your gut.
Your gut, basically, iseverything 80%.
And the coolest thing aboutyour gut is that you're
basically born human with 60trillion cells and you die
bacteria with over a hundredtrillion cells, and so inside of
the gut, the coolest thing thathappens is that they live in
factions, right, so they couldhave 50 billion here, 100

(01:05:47):
billion there, and they'reconnected through something
called quorum sensing, which islike a connector, and they're
communicating.
But if one comes over to thewrong place, they either kill it
or they're like the Borg inStar Trek, they turn it into
themselves by injecting theirDNA into it and stuff.
But the gut is incrediblyimportant for everything and
that's why some of the peptidesthat are out today

(01:06:09):
anti-inflammatory peptides likeBPC-157 is one of them you could
take by mouth.
It's one of the few that youcould take orally and because
the gut is so vital.
So, yes, first is food, soyou've got to feed the gut
bacteria, and so the first thingyou have to know about your
microbiome, in a nutshell, isthat it is dependent on where

(01:06:33):
you are from genetically in theworld first, like where your
actual 23andMe or however youwant to look at where you're
from.
That's number one.
Number two is where youcurrently live.
Number three is what you eat.
Number four is your stress.

(01:06:55):
Number five is your sleep andnumber six is any additional
supplements, diseases and thingslike that, and that is the
makeup of your microbiome.
I mean just drinking diet sodascan change the microbiome to a
form that doesn't allow you toabsorb certain nutrients, and so
it's extremely important to getyour diet right, get enough

(01:07:17):
fiber in your diet, because theythrive on fiber, they love
fiber.
That's their jet fuel, inaddition to butyric acid, which
is found in butter.
So I'm not advocating that youeat a pat of butter every day,
but it does have butyric acid init, which is a fuel for the
bacteria.
So you've got to improve that.
The gut actually can have a lotof factors in your mental

(01:07:39):
health because it directlyconnects through the vagus nerve
, that's the vagabond nerve, soit connects to the
gastrointestinal tract.
That's how you have a gutfeeling.
You actually can cultivate that, but you have to have that
healthy.
So now we've gotten intoprobiotics, prebiotics and the
combinations, and what do you doand how do you take them and

(01:08:00):
which one should you do?
Well, the one thing that peoplehave to know is that your gut
microbiome turns over every fivedays and so you get rid of it
all.
Boom, it comes back right.
So you can actually do somegood.
But remember, if you have likea hundred trillion bacteria,
taking 50 billion is like agrain of sand.
It's not going to do a lot butit could help.

(01:08:23):
So, for example, like in women,you give a formulation that's
heavy in lactobacillus, becausethat improves vaginal health
versus men, which are morebacteroides.
So you want to kind of look atthe formulations.
There are a couple of out there.
There are a couple of reallygood brands to try.
Sometimes they cause some GIdistress and this is assuming

(01:08:43):
that you're already eating.
Then you look at what is aprebiotic.
It's like what is a prebiotic?
Well, prebiotics are likeinulin.
So inulin is a substance that'sfound in artichokes.
It's also found in okra.
So if you ever pickle okra, yougo in the jar and it's like
this slimy stuff.
You're like, oh, this stuff'sgot to be bad and you throw it
away.
No, that's inulin.

(01:09:04):
You want that.
That's the stuff that's goodfor you and good for your
bacteria.
So that actually will help yourbacteria, not only aid in
digestion, improve your immunesystem.
It's also where a lot ofinflammation begins, and so it
really is the gastrointestinaltract, and thank goodness that I
was a gastroenterologist first,because it is literally the

(01:09:26):
epicenter of everything that canhappen, including wound healing
, including making sure that ifyour gut's not healthy, for
example, you can get a leaky gut.
So, just to kind of give peoplean idea, there's leaky brain,
leaky heart, leaky gut they'reall exactly the same thing.
It's just the cells lose theirlittle tight junctions that

(01:09:49):
basically hold the cellstogether and stuff can get past
it, and so that can lead toinflammatory conditions in the
gastrointestinal tract.
And so, yes, it is an extremelyimportant part of health is
looking at your gut health, andeven fewer people know how to do
that.

Speaker 2 (01:10:08):
And so for some people, if you want to give
practical advice to the audience, if someone wants to say, okay,
dr Howard, I want to improve mygut health, tell me five things
that I shouldn't eat and fivethings that I should eat.
You mentioned several, likesoda.
We shouldn't have soda, but canyou name the five big, most

(01:10:31):
common dietary foods or you wantto call them foods, what people
eat that are bad for them, fortheir gut health, and five foods
that are good for their guthealth that people practically
have access to and they couldeasily integrate it in part of
their diet on a daily basis?

Speaker 3 (01:10:50):
Yeah, we'll take a crack at it.
I won't count the numbers, butbasically things that are good
for you Fruits, fiber, right, sofiber and fruits, vegetables,
particularly a combination, bythe way way, of both cooked and
raw vegetables, so not just rawvegetables.
So the raw people are kind ofoff, because you can't actually

(01:11:13):
absorb everything in some of thecruciferous vegetables if
they're not slightly parboiledor cooked.
People will argue about that.
Making sure that you haveadequate sleep, making sure that
you have adequate sleep, makingsure that you are addressing
stress and making sure that youhave regular bowel movements by

(01:11:34):
either the foods that you'reeating or making sure that you
have enough hydration.
So those are all very simple,basic things that we can do just
to start the process, thingsthat really affect your gut.
Alcohol, number one.
Probably.
It's a toxin that in, of course, women have less lactate

(01:11:54):
dehydrogenase, which is thething that breaks it down, and
men tend to have a little bitmore, but it is a toxin that can
affect your bacteria in yourintestinal tract.
So remember, ethanol, which isa two-carbon sugar, versus
glucose, which is a six-carbonsugar, is like jet fuel.
It also causes all kinds ofcardiovascular problems and
vascular problems and thingslike that.

(01:12:15):
So number two I mean wementioned already sodas.
Number three are artificialsweeteners.
Artificial sweetenersdefinitely can all of them alter
?
No, not not all of them, butyou know.
Aspartame, certainly saccharin,which you know I wouldn't even
give to rats these days inexperiments.
But, um, you could usesomething like stevia, which is

(01:12:39):
uh healthy, and there's severalmajor companies that make very
high quality stevia productsthese days, like Pure is one of
them.
And so another thing is thecontent of saturated fats in
your diet.
You know that actually causessome significant problems in

(01:13:01):
absorption and leads to otherproblems with inflammation in
the gut, believe it or not.
Overuse of proton pumpinhibitors.
So so many people are on thingslike Prevacid, prilosec,
imaprazole same thing.

Speaker 2 (01:13:17):
How about antacids like Zantac?

Speaker 3 (01:13:20):
Yeah, well, zantac.
I haven't prescribed Zantacsince I was a gastroenterology
resident or a fellow, becauseZantac is one of the few that
actually crosses the blood-brainbarrier and causes some
problems with depression.
So that actually should betaken off the market.
But Pepsid is a little bitbetter.
But anything that you dobecause it alters the pH that is

(01:13:44):
in the stomach, which it shouldbe an acidic environment, you
make it less acidic, which opensthe door to bad bacteria
entering into the intestinaltract and taking over certain
sections of your upper portionof your small intestine, which
were, by the way, so muchabsorption occurs, right.
So you've got all kinds ofthings coming in through the
duodenum and jejunum, which arethe upper portions of your small

(01:14:05):
intestine, and they're likethey have bacteria and they need
them, and so you can alter them.
So that's some stuff High fatdiet, especially like cheese
that can actually affect it,believe it or not, although
cheese has other properties thatmake you wanna eat cheese.
So that's just a couple ofthings.
We've got lots and lots ofother supplements that we could

(01:14:29):
talk about that are not good foryou, and supplements that are
good for you, but I wouldrecommend you know, in terms of
what else you can do is considera probiotic, and when you're
looking at a probiotic, youdon't want to get the ones that
are just one or two bacteria, ofcourse, and there's a couple
out there.
I don't want to trash anycompany's names, but you want to
look for some that have 10 or15 strains, at the at least, and

(01:14:53):
there's plenty of those, andactually a lot of them have
become shelf stable, meaningthat they don't require
refrigeration anymore, so itmakes it easier to to have them
portable.
Yeah, so that's a couple things100.

Speaker 2 (01:15:04):
I mean that segues us into supplements, because I do
want to pick your brain onanti-aging myths and supplements
that are really floating theinternet that everybody has the
one and greatest and bestanti-aging supplement, greatest

(01:15:28):
and best anti-aging supplement.
So anti-aging treatments andsupplements are everywhere, but
there's still a lot of debatearound what really works and
what's just marketing hype.
Are there any anti-aging trendsor products you see overrated
or not supported by solidscience?
One of the very common onescurrently is NMN, nr, nad, and

(01:15:49):
there's a lot of debate.
It's crazy how much laymanactually knows and reads about
this and you know I really wantto pick your brain on it, since
you also are specialized inregenerative medicine and
anti-aging.

Speaker 3 (01:16:06):
Yeah, and so I would have to say first is I do not
use a shotgun approach forsupplements, even just as advice
of like, yeah, you shouldprobably take these things.
I do functional micronutrienttesting to actually see what
your cells require, so not justin the bloodstream but what the

(01:16:29):
actual cells require, by takingyour white blood cells,
culturing them and addingnutrients to them.

Speaker 2 (01:16:34):
But what about stuff we can't measure but could be
good, based on extrapolation ofscience and animal studies, for
example?

Speaker 3 (01:16:42):
Well, I'm going to start with my most favorite,
which is in the aging population, which is hormones, I think,
hormone supplementation andcreating an environment that you
can do.
Remember there are estrogenreceptors, like, for example
we're talking about womenespecially here, but in men,
believe it or not, estrogen iswhat drives bone health in men.

(01:17:03):
So so you actually need someestrogen too.
But estrogen has receptorseverywhere, especially in the
skin, and as a woman goesthrough menopause and becomes
post-menopausal, you wind uphaving an acceleration of skin
issues and wound healing andwrinkles and thinness of the

(01:17:25):
skin, and so you need acombination of some things.
So that has to be tested bysomebody who knows what they're
doing, because it's done soincredibly wrong.
That's probably number one forme that I start with.
I also make sure that peopleunderstand the importance of
collagen peptides, I think.

(01:17:47):
Another thing for good skinhealth, and this is something my
wife and I actually do together.
She'll be on my podcast soonand you might enjoy her on yours
.
She's a brilliant woman I wouldlove to.
She's actually vice presidentof the American Academy of
Dermatologists, so she's gotlots to say, definitely put in a
good word in for me I will.
But in either event, you know,looking at collagen peptides

(01:18:11):
improve elasticity hydration andyou know the cross-linking that
occurs.
You know that's obviouslysomething.
But even at a more basic levelwe've got you know we talked
about vitamin C so lots ofnatural sources for vitamin C.
You know whether it be a citrus, but I do think that that's
another one.
Vitamin E as long as you don'ttake too much, that can cause

(01:18:32):
some problems.
That actually helps protect theskin cells.
You've got biotin right.
So a lot of hype on biotin.
One little pearl about biotinis that for women especially
taking biotin, that get hormonetesting.
The labs most of the labs thatare done are done with an assay

(01:18:52):
that is interfered with biotin.
So you will get false high andlows.
It is a complete.
You have to have people off ofbiotin and their B vitamins.
Niacinamide as you knowniacinamide there's good studies
.
The dose is like 500 BID forthat twice a day for skin cancer
.
But it also is ananti-inflammatory and helps to

(01:19:15):
help the skin barrier so thatyou can do that.
Omega-3 fatty acids another big,big one right.
So you know everybody's on thiskick of a low fat diet.
Well, just what you actuallyneed?
Some fat, some healthy fats.
Sometimes it's better to get itin oral form and that's, you
know, naturally would be, youknow, eating fish like salmon or

(01:19:38):
fish oil capsules or flaxseed.
But it comes in a vegan sourcetoo.
Actually, one is gamma linoleicacid.
So gamma linoleic acid, whichis evening primrose, actually
can help with elasticity.
So I think it's good in thepostoperative period as well.
Then, in addition to that, someof the other basics hyaluronic

(01:20:00):
acid, very, very common, that'spretty well known.
But CoQ10.
And so Co, coq10 the coolestthing about coq10, I mean you
only hear about it when peopleare put on drugs to lower
cholesterol, like statins,because you have to be on it,
because it affects theabsorption.
But it turns out that coq10 ispart of the electron transport
system to make atp in yourmitochondria and is absolutely

(01:20:22):
necessary and it improves theskin elasticity.
So kind of get a twofer there,believe it or not.
Probiotics we talked about thatbecause you are the same inside
and out, and I did mentionresveratrol before.
Resveratrol is found in certainwines.
Like I said, pinot Noir is thehighest.
It is anti-inflammatory.
I have not been convinced thatpill form resveratrol is

(01:20:47):
adequate.
But also, I don't have the dataof how much alcohol you should
drink to do it, and I wouldn'tbe advocating.

Speaker 2 (01:20:53):
Yeah, I mean, as far as resveratrol there is so much
controversy.
I know David Sinclair.
He kind of really cashed out onit big and then later on no one
could reproduce his studies andyou you know it was this whole
controversy.
And then also again, it's adose depends you, we don't know
how much resveratrol.
And and then if you have takenresveratrol in combination with

(01:21:17):
drinking pinot noir all day long, well, now you have you're
trying to get one tiny benefit,um for like a lot of damage.
You know alcohol.
You talked about gut health.
You know I think.
I look at health as like as yourbank account.
You know you, it's kind of likeyou make a bunch of, yeah, the

(01:21:40):
good stuff that you eat and doyourself.
You count them as tiny deposits, and then the bad stuff they're
like withdrawals.
So if your withdrawals are morethan your deposits, you're
making you end up going brokeand bankrupt.
So I think that's where a lotof people get confused and will
require your guidance on how tokind of manage those deposits

(01:22:05):
and withdrawals when it comes tochoices they make to get
benefit of one ingredientsversus the downside of what else
is in there.
For example, in case of fruits,you know fruits are great but
you know, if you're diabetic youmight not want to consume high
glycemic foods, like I don'tknow grapes, or you know or even
drink juices, which I thinkjuices are terrible because

(01:22:26):
you're not even getting thefiber from the food and you know
, or even drink juices, which Ithink juices are terrible
because you're not even gettingthe fiber from the food and and
and you know that.
you know I I wore for just amonth like um direct glucose
monitor just to see what foodsdo to my blood sugar, just for a
heck of it, and I was shockedlike I remember one night I used
to love eating like a bowl ofcereal at night and my, um, my

(01:22:50):
secret, um, um crave was um, umyou you'll you'll laugh right
now was lucky charms I couldn'tget worse than that I know
couldn't get worse than that.
I just loved it and so I did it.
My my sugar did not come downall night below like 110, 120.

(01:23:12):
It just didn't come down forlike four or five hours.
Wow, just because I had that.
And that was before I went onmy lifestyle change trip.
And that was like in the verybeginning because I wanted to
know what foods are good and badfor me, what should I cut out
of my habits?
And so now it's like I don'teat after 7pm.

(01:23:36):
I actually brush my teeth after7pm after I had my last meal,
so I don't eat anything, and sothat's the one way I tricked
myself.
And so now my sugar is verystable.
At night when I sleep, itdoesn't even go above 91, 92.
That's like the highest it goes.

(01:23:57):
And so with a simple lifestylemodification, that has improved
my sleep and then that hasimproved in turn my cortisol
level.
So I think if people get justsimple guidance on what are the
for someone like you, if theyget into your hands in your
office so you can identify whatare the main factors, the main

(01:24:17):
poisons to their lifestyle andjust starting with the number
one, and then slowly do onemiracle at a time they don't get
overwhelmed.
And I think you're doing agreat service to medicine and
mankind.
And you know, I'm definitely abig fan of just your philosophy,

(01:24:39):
the way you approach medicine,the way you approach a fellow
human being, which is based onpassion and real care, as
opposed to a job or a means toan end which is to make money.
I think motivation, ourmotivations, they tell a lot

(01:25:02):
about who we are as a person.
And also, they can be extremelyinspiring, and I think we don't
need million of inspiring voices.
I think 10, three inspiringpeople they can create.
It's like a spark that causes awildfire, and I really am so

(01:25:24):
happy that you're now on socialmedia.
You're spreading the word.
You have an amazing talent incommunication and I think that
is the number one part thatmakes a patient listen versus
tune out, makes a patientcurious versus bored, and I
think that's the one thing.
In the beginning, you said it'snot being taught in medical

(01:25:45):
schools.
I think it's more than that.
It's more of a talent thing.
You were born to do one thing.
In the beginning, you said it'snot being taught in medical
schools.
I think it has.
It's more than that.
It's more of a talent thing.
You were born to do one thingand, uh, we all here are here
for a purpose.
I know I'm getting veryspiritual here, but I truly
believe that and um, it's aboutinspiring the new generation,
because the new generation isextremely smart.
I can't tell you how many GenZ-lers come to my office and

(01:26:08):
asking me what can I or should Ido if I want to be healthy and
if I don't want to age?
What can I do?
They're just curious, they wantto know.
They don't want a quick fix.
They're not here to get.
They don't come to my office toget Botox.
They literally ask me what Irecommend that they should be
doing or shouldn't be doing foranti-aging purposes.

(01:26:31):
These are people in their 20sand when I ask them about what
they eat and their habits, theycheck all the boxes.
They get A plus in anythingexcept in the sleep aspect and
in the screen time aspect.
There they get like's and d'sand some, some of them, f's.
But which is sleep?
I see it as you know, like weknow what we say, stress is the

(01:26:54):
silent killer.
To me, sleep is the silenthealer, because that's where all
your repair cellular repairhappens, like you alluded in the
beginning of this podcast.
So for audience, I want them toreally get to know you.
Your podcast is amazing.
It's very educational.

(01:27:15):
It's called Howard Health andWellness, is that correct?

Speaker 3 (01:27:18):
Actually just Dr Corey Howard.

Speaker 2 (01:27:20):
Oh, dr Corey Howard, and I think if someone asked me
and I've said I started sayingit already last week to my
patients and knowing inanticipation of this podcast,
they're like where do I start?
I'm like just I sent them thelink of your podcast.
I'm like, just listen to thisand after you listen to this,
see what more questions you have.

(01:27:42):
Pick someone like him in yourarea.
If you're willing to fly ordrive to Tampa, you're more than
welcome.
We're on the East Coast, butone of the struggles, I think,
is to find your doppelgangerhere for my patients in the DMV
area.
So if you know of anyone thatyou trust, please let me know.

(01:28:03):
I would love to have someinformation and advice to send
my patients to, because I trulycare about my patients'
well-being, because when I do,for example, a facelift on them,
I want to make sure theirhealth and their body's
optimized before I even operateon them, so that they have the

(01:28:24):
best chance to heal.
And also, going forward, I wantto make sure they heal the best
possible way and also, furtherinto the future, I want to make
sure they are able to maintainthat wealth and health they
obtained, not just from theappearance standpoint, but also
from a cellular standpoint,internally, because to me,

(01:28:46):
beauty is more than skin deep.
Oh, for sure.
And that is something that Iwant to promote.
You will be my go-to guy foradvice from now on, and you know
I wish you were in my area.
I would really become yourpatient.
I know I'm raving here.

(01:29:08):
I sound like a big fan, but Iam a big fan.

Speaker 3 (01:29:16):
It's good to have a conversation, just like with
somebody, that's not just formoney.
I mean, I will have a back end.
We haven't built it yet, butwe'll have a backend where we
can open up a conversation forpeople to actually connect and
talk about this and reallyhopefully spread the word of

(01:29:36):
what health really should be inthe country, how medical care
really should be outside of thetraditional training.
And it requires a little bit ofrisk because you know people
word about the legal system,especially doctors.
But you know we have tounderstand that taking care of
people is not a static thing.

(01:29:58):
It's a dynamic environmentthat's constantly changing and
learning, and we are learning aswe go along.
And so people like you that arehelping to spread that word
just are great.
And you're doing it in yourpractice.
Good for you too.
That's fantastic.

Speaker 2 (01:30:13):
I'm just trying to apply what I learned, but I
still try to guide them.
It's hard to guide them totheir doctor because their
doctors usually don't listen and.
I literally don't listen and Idon't even.
I literally don't know anyonein my area that I could refer
them to, and so that's somethingI'm gonna have to find out.

(01:30:33):
But uh, cory, thank you so muchfor coming on, I mean there's
so much stuff that I still wouldlike to talk about.
Maybe we'll do uh and anothersession where we kind of delve
deeper into topics, and I knowyou're doing it on your podcast.
But what is the best way forsomeone where someone can reach

(01:30:56):
you for advice, for content oranything?
What is the best way to get intouch with?

Speaker 3 (01:31:06):
you.
Honestly, I think there's acouple ways Probably.
Number one is go to my website,which is
howardhealthandwellnesscom, andthere's a question area that
people can ask questions.
I also have askdrcorey atgmailcom, so you know.
There's another thing.
There's a reel I have onInstagram for that.

(01:31:27):
But asking questions, I answeralmost every single time
somebody responds, especiallywhen they're saying something in
the opposite.
On Instagram and Facebook, butmostly Instagram.
I mean, it's a pretty goodplatform for that, but I'm going
to develop it even a better way.
But if people really want toreach out, you can shoot me an

(01:31:49):
email through my website.
It's very easy Howard, healthand wellnesscom and, uh, you
know we can open up conversation.
I'm I'm actually licensed in uh, florida, north Carolina and
Utah, which are places that I Ilike and uh so, but mostly I do
everything in in Florida prettymuch.

Speaker 2 (01:32:07):
Wonderful.
Thank you so much.

Speaker 3 (01:32:09):
Thank you.

Speaker 2 (01:32:10):
Dr Corey Howard, everyone, I hope you enjoyed
this episode as much as I haveand learned as much as I did.
And, uh, please don't forget toleave me a review on Apple
iTunes podcast and you can leavecomments on Spotify.
If you have any questions, uh,I will definitely communicate it
with Dr Howard and we'll beglad to answer them.

(01:32:30):
Thank you very much and have agood night.
Bye-bye.

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