May 28, 2025 • 51 mins
Staying ahead of your health doesn’t have to be hard—or expensive.
In this episode of Let’s Talk Local, Sarah Zubiate Bennett sits down with Dr. Manik Aggarwal and Matt Lindenmeyer—two experts in proactive medicine who have personally impacted her life. They break down how you can take control of your health without the overwhelm of time, cost, or insurance red tape.
If you’ve ever felt stuck in a reactive cycle with your health, this conversation will change how you think—and act—going forward. Medicine is evolving fast. Don’t get left behind.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Alright, I'm really looking forward to exploring
(00:03):
this entire episode with you.The reason that I wanted to
interview Doctor. Agarwal andMathew Lindenmeyer, a physical
and rehabilitation specialist,is because artificial
intelligence is drastically andrapidly changing the entire
medical industry. The way thatwe take care of our bodies, the
information that we're able tolearn about ourselves before
(00:24):
seeking any type of treatment ischanging swiftly. And because
I'm predisposed to a few thingsthat a lot of my genetic testing
showed me, I really wanted tobring it to your homes.
There's different tests that youcan have run. You can approach
(00:44):
your doctor and make sure thatyou're understanding the fulsome
parts of your body, your health,and you can run things through
different types of AI, whetherit's Grok or ChatGPT, to ensure
that your supplement routine isnot conflicting with natural
(01:06):
parts within your body. Eitherway, I just think this is a good
episode that will help open youreyes, it will help you take
control of your health, it willhelp you understand the
landscape in which it's changingvery rapidly in front of us. As
an example, the one particularreason that I had my genome
sequence ran through NewAmsterdam was because I have
(01:29):
extreme muscle stiffness andsoreness after workouts and it's
been a huge part of my life tobe active and physically fit.
But in really pressing myconcierge doctor, Doctor.
Froedter, to have my genomeprocessed so that I could have
that full understanding of it, Iwas left with this understanding
(01:50):
and insights to what Brody'smyopathy is or Brody's muscle
syndrome. And it's pretty rare,but then it helped me understand
the regimen that works for mybody. And if you or your family
have some type ofpredisposition, me, I'm adopted.
I've never met my biologicalfather, don't know who he is, so
(02:12):
there's an entire part of my DNAthat I just have no
understanding of. I used to havea 23andMe, I've since deleted
it.
But what someone mentioned tome, which I believe is really
interesting, is that if you hadyour kid's DNA ran through
23andMe, if your child had anydesire of serving in secret
(02:36):
service positions or some typeof higher military capacity or I
guess country leadership, thetype of risk that those people
would be predisposed to if thatinformation was readily
available through something like23andMe, it would exclude them
(02:59):
from being a viable candidatebecause a lot of the weaponry
that's being actively exploredtoday is that which relates to
specific genetic targeting. Soyou can wipe someone out pretty
quickly by having anunderstanding of what their
genome is comprised of. Againthe reason I wanted to record
(03:21):
this particular episode wasbecause it's an interesting
dynamic and shift that's beforeus. You see someone like Matt
Lindenmeyer who is hands onworking with his clientpatients
to ensure that they're beingtreated as best as they possibly
can but whatever type of genomedata is handed to him doesn't
(03:44):
really or materially shape theway he interacts with his
clientpatients. Yet someone likeDoctor.
Agarwal, he can absolutely usegene site mapping to ensure that
whatever type of prescriptionsare prescribed to his patients
are actually prescriptions thatare going to work well with
(04:07):
whatever their predispositionsare. Their genetic makeup, it
will actually process andmetabolize in a friendlier way
than just going through basictrial and error which was kind
of the way that people have doneit in the past. By the way I
hope you find this episode to bereally useful. I absolutely love
the science and if you have anyquestions feel free to reach out
(04:29):
to us. Gentlemen, it's Friday.
I'm so happy you're here withme. I have Doctor. Monique
Agarwal who was my mother'sconcierge doctor. My mother has
(04:53):
since passed, but I'm so curiousto delve into a lot of the
specifics that you work with ona day to day basis. And then I
have Matt Lindenmeyer here who'sbeen an angel and a godsend to
me.
He's a rehabilitation and afitness specialist and has
helped me in wonderful ways. Sothe combined expertise of both
of you gentlemen is what Ireally wanna delve into today.
(05:16):
Thank you for being here.
Speaker 2 (05:17):
Perfect, thank
Speaker 3 (05:17):
you for having us Yes. Glad to be here.
Speaker 1 (05:19):
Manik, I loved walking into your office because
as you know, I belong to aconcierge clinic myself with
Doctor. Froedter and all that.My husband is at M Squared. And
so I'm pretty well versed in theconcierge space. And you were,
(05:40):
like I said, just so wonderfuland patient with my mother when
at the end of her life withdementia and Parkinson's, it was
the biggest blessing.
So thank you.
Speaker 2 (05:50):
It's my pleasure, thanks for trusting me.
Speaker 1 (05:52):
Yes, absolutely. In both of your realms of more
boutique relationships withclients and patients, do you
find yourself speaking with morepeople who are very interested
in genomic screenings to have anunderstanding of what their DNA
(06:12):
is presenting and how you canwork with it?
Speaker 2 (06:15):
Yeah absolutely. So a lot of the things that we try to
do in the office is to figureout what the diagnosis is and
what's the best treatment forthe patient on that particular
day. And it turns out that noteverybody responds to the same
therapies and not everybody hasthe same diagnosis or they're
not all diagnosed the same way.And so when we use the word
genomics, I try to kind of takea step back and say, how do we
make this personalized for you?And how do we stratify you in
(06:37):
terms of your risk?
I've got some patients who havean elevated cholesterol, but
they never have heart disease,and I've got other patients that
have the same exact elevatedcholesterol, and they've got a
lot of heart disease. There'ssomething going on behind the
scenes and it's our job to nowutilize the science to say, this
is why we have to be much moreproactive with you, whereas for
yourself we can kind of lay low.And so that's to me where the
personalized kind of precisionmedicine comes into play.
Speaker 3 (07:00):
You know, with the the people that I see, that's
not the thing that I'm lookingat because I Sure.
Speaker 1 (07:06):
Of course.
Speaker 3 (07:06):
Primarily with, you know, soft tissue and and how
the body moves. Mhmm. And but Iwill say that when it comes to
you know, I always talk aboutpillars that we're trying to
focus on with fitness. Andthat's, you know, how can we
control sleep? How can wecontrol, nutrition?
How can we control stress? Andthen the exercise bucket gets
(07:28):
gets to be pretty big. So Ifocus on those four things
initially. And once we makestrides in those, if we still
feel like there's areas that aredeficient or there's areas where
we are progressing the way we'dlike, then that's where I would
refer out to a physician,somebody that's more
(07:49):
knowledgeable about the genomicspace. Because, you know, I'm a
firm believer too in being anexpert in what you're an expert
at and then referring out toquality people when you're not.
Speaker 1 (07:58):
I'm really advocating for I guess a bunch of my
friends and telling them, youall have to start here at the
genome level. It'll really helpyou understand what you're
predisposed to, what's right,what's wrong. And the way this
even came up for me was backwhenever 23andMe launched,
that's whenever I found out thatI had some predisposition to the
(08:19):
Factor V Leiden mutation, whichis not great. And after that,
it's kind of been a hobby ofmine to become more well versed
in how that prohibits me fromdoing certain things or not. And
now it's the Brody's musclesyndrome that is aggravating.
(08:45):
My body basically has a wholebunch of ripples after I work
out, doctor. The amount of painand pressure that certain
massage therapists have to applyto my muscles to experience any
relief is abnormal. And it'sjust so much. That's why I
pushed my now doctor to say, howcan I figure out exactly what is
(09:10):
going on with my muscle tissue?I just want an understanding of
a full panel of it all.
That's when New Amsterdam cameup in the practice. So do you
proactively offer this to yourclients? Is this part of a
regular conversation?
Speaker 2 (09:27):
It is in terms of organ specific things. So I
haven't gone through the processof New Amsterdam before because
that's a comprehensive analysisof the genome. I think the
struggle that I've seen withthose analyses are we don't know
what to do with some of thatinformation. It's not always
actionable. See.
And so when I start orderingthose personalized tests, order
them specifically for heartdisease, specifically for
(09:48):
cancer, and specifically for therisk of Alzheimer's disease. And
so that's a lot of riskstratification. So I had a
patient recently in the officewhose mom and dad both had
Alzheimer's. He's 60 and he'sfeeling some memory loss. That's
a big conversation.
If I order this particular teston you, we will know if your
risk of Alzheimer's is thebaseline risk or if it's 10 x.
Speaker 1 (10:09):
That's
Speaker 2 (10:09):
right. That's a philosophical conversation at
that point. How much do youwanna know? How is it gonna
affect your life?
Speaker 1 (10:13):
That's
Speaker 2 (10:13):
true. This particular patient went through with the
test, had the abnormal gene, andnow is really starting to shift
the way he thinks.
Speaker 1 (10:19):
That's right.
Speaker 2 (10:20):
Right? In terms of what he wants to do with his
kids, he wants to do with hisbusiness, what he wants to do
with his day to day life.
Speaker 1 (10:24):
That's right.
Speaker 2 (10:25):
Because he knows that at 60 he's okay, but 65, 70, or
what age? And so that's where Iorder more organ specific
genomics as opposed to acomprehensive panel.
Speaker 1 (10:35):
And for me because of the outcomes of my screening or
my panel, I realized that I amat high risk for some
gastrointestinal issues, colonissues. I went and I had a
colonoscopy and I had threeprecancerous polyps. I'm at 40.
I mean that's, I was so gratefulfor that. And so for me, that's
(10:58):
I think why I'm such a believerin this stuff, and now it helps
me to have a betterunderstanding of my own work.
So okay, alright, this is goodto know. This is good to know.
And the age bracket of people,Matt, that you are particularly
dealing with, What is your whatis your I I know you do a lot of
work with kids as well, but I'msaying your practice, what is it
(11:20):
comprised of age wise?
Speaker 3 (11:23):
Oh, I'd say the most the mean age is probably
somewhere in the probably midsixties, early sixties. Ah. I
see a lot of people probably intheir sixties and seventies. And
I think part of that is, youknow, you as you get older Yep.
(11:46):
You have you know, you reach astage where you've tried a bunch
of different things and yourbody really just stops working
the way you want it to work.
And you've had enough time toaccumulate potentially some bad
movement patterns, some badlifestyle decisions have
compounded. And next thing youknow, you you wake up one day
and it's hard to not just beathletic, but just move around
(12:10):
in your daily life Mhmm. And,you know, participate with your
kids or your grandkids maybe inthis case. And so and then you
start to try things. Yep.
And I I feel like when I startto see people, they've tried a
lot of different things thatmight not have had the benefit
that they were looking for andthey find their way to me at
(12:32):
some point. So, I'd say I'm Ipredominantly work with people
at this at this point that arein their sixties. But, I've, you
know, I've worked with I'veworked with some pro athletes.
I've worked with some highschool athletes and some younger
people. But, my sweet spot'sprobably in that, you know,
sixties and seventies range.
Speaker 1 (12:49):
Matt, can you tell, Shannon, what some of the kind
of the disciplines of study thatyou focused on and why you have
this breadth of understandingthat I just haven't encountered
before with a lot of my otherrehabilitation and physical
specialists.
Speaker 4 (13:05):
Worked with some really great people when I
started, started working inbusiness that taught me a ton
about kind of assessing the bodyand you know, how to look for
weaknesses asymmetry, reallyfocus on quality, movement
(13:27):
patterns and how to really getpeople to learn how to train and
make those movements as strongas as humanly possible. So
learned a lot there and I got,you know, licensed by the state
in massage therapy, but youknow, I've taken muscle
(13:49):
activation techniques, I'vetaken active release techniques,
I've taken integrated kineticneurology That. Which is where I
a lot of the current I've usedit to kinda help that current
modality to kinda help with alot of the newer isometric
(14:10):
positions I get people in. Mhmm.But it's a blend of it's a blend
of a lot of differentmodalities, studying a lot of
about, you know, the mechanicsof the body, how how joints are
designed to work and then justkind of coming up with a
(14:31):
framework and being creative,trying to be creative too with
individuals with where they'reat and and how to get them to
respond to what I wanna do, do alot of soft tissue work, but
Uh-huh.
I still feel like movement isking and I'm I'm doing this type
of work, especially in likeSarah's case, I want her heel to
(14:54):
work better. I want hersubtailors to work better. I
want her trunk to be able torotate more and all the things
that I'm looking at currently inthis one acute moment in time.
But ultimately I'm doing all ofthat to prepare her to get up
and move on her feet better andteach her how to be more
efficient and stronger themovements that she's designed to
do which is squat, hinge, push,pull, flex, extend, and rotate
(15:18):
because if she can do all thosethings well, she's gonna be
feeling pretty good and able todo pretty much whatever she
wants to do in life. So themovement piece, which is what I
transition everybody into themovement piece is going, okay, I
gotta be able to fully maximallyload my limbs individually to
(15:41):
the best of, you know, everybodyhas a kind of a an individual
ability to load that whereverthey're at on the on the
spectrum.
So, Sarah's case, I'm trying
Speaker 3 (15:51):
to get her to load
Speaker 4 (15:53):
her limbs in in every way she possibly can safely so
she can get stronger, gain moremobility, gain
Speaker 3 (15:59):
more
Speaker 4 (15:59):
agency in her own life. So the therapeutic arm
which is this is just one pieceof trying to get somebody in a
position where they can movebetter. Oh, there we go.
Speaker 2 (16:14):
That feels much better. So as a concierge doc, I
take care of people as young as15, just at the end of high
school. Oh. And my oldestpatient's 101. And so I see
really everything from start toend.
I would say my average age isprobably late 40s, early 50s,
and that's consistent with mebeing about ten years out of
practice.
Speaker 1 (16:32):
So the
Speaker 2 (16:32):
goal is over the next twenty five years that these
folks will grow with me as I getolder. I would say majority of
my patients, probably two thirdsare male. I would say about half
of my patients see me once ayear because things work quite
well, and the other half of mypatients see me multiple times a
year because they're either veryproactive and they're making
lifestyle changes and wanting toget labs done more frequently,
(16:54):
or they're just chronically sickpeople. And we know we need to
be on top of their medicationsand monitoring images and so on
and so
Speaker 1 (17:00):
Okay, so two thirds are male. So do you do any work
with women and their hormones?
Speaker 2 (17:08):
I do. So I've started checking hormone levels over the
last couple of years because themore that we learn about hormone
deficiency, the more we realizethat it affects more than just
your mood or more than just hotflashes. It turns out it affects
your sleep, and it affects yourdrive, and it affects your blood
pressure, it affects yourcholesterol, and so on. And so
where I start my practice interms of hormones is I'll assess
(17:29):
the hormones, I'll identify adeficiency, and I'm comfortable
managing the early stages ofhormone therapy, so patients on
estrogen or progesterone. I'vegot a lot of men that take
testosterone and manage all thatvery comfortably.
Once I handle that portion, ifthe patient isn't doing as well
as they need to be doing, that'swhen I know what I know and I
know what I don't know, I'mhappy to refer out to a
(17:50):
specialist who's gonna help withhormone management. On the male
side, that's certainly in mywheelhouse, and so patients that
are taking growth hormone, HCG,testosterone, estrogen blockers,
that stuff is really important,but for all the listeners, I
would really encourage them togo to a trusted doctor to manage
it as opposed to a men's clinicbecause unfortunately those are
(18:10):
not as well run and they're notas well monitored, the patients
are not. And so I've hadpatients that have had poor
outcomes due to excess amountsof testosterone. Or I've had
patients that have had fertilityissues because they weren't on
HCG at the time when they weretaking testosterone.
Speaker 1 (18:24):
How is it that you work with kids, let's say our
youngest, or your youngest son'sage, my oldest son's age, when
it comes to training, because Iknow you're constantly like,
uh-uh uh-uh. They should not bedoing this at this age, they
should not be doing that at thatage. Talk to me about how you
approach prepubescent young boysor girls, and then how you
(18:51):
approach someone who has ahormonal shift much later in
their Yeah.
Speaker 3 (18:57):
It's interesting, especially in our culture in
Dallas.
Speaker 2 (19:02):
Yep.
Speaker 3 (19:02):
We have a very sports forward, sports centric
environment for our kids, andthey're encouraged to specialize
earlier and train earlier. AndI'm just not a big fan of
prepubescent children puttingexcessive loads to their body to
(19:23):
try to build muscle when they'reprobably really not, you know,
physically and genetically and,you know, ready to do that. Yep.
So I'm a more of a fan ofencouraging kids that are are
boys' ages to play a lot ofdifferent sports, run, play, you
(19:44):
know, climb, sprint, do all thethings. I have worked with my 12
year old on, you know, some bodyweight movements just to kinda
work on having an idea of how tocontrol his body in space.
Yep. But that's controlling hisbody. I'm not adding any
external loads to his body. AndI do think that there's value in
(20:05):
that. I think that there's youknow, I'll touch on it at some
point, but there's some basicfundamental human movements that
we're all designed to do.
Not my opinion. It's just howwe're made. Yep. So if we can
get our kids to just be reallygood at doing those movements
Mhmm. Just with their own bodyweight, they're gonna be set up
(20:27):
for success later when theyactually do start training with
loads more.
Now when they start reaching 14,15, they start puberty, they're
actually, you know, haveincreases in testosterone growth
hormone. They have the capacityto build muscle, then I think
that's when you can start havinga conversation about what that
(20:47):
should look like.
Speaker 1 (20:48):
What about kids who start puberty at 12? Because
there's some of that out there,as you know. I mean, you know,
right, doctor? It's How doesthat change the conversation for
those parents and kids?
Speaker 3 (21:00):
I think it definitely makes it a little bit more of a
conversation when they developearlier. Yep. I still look at it
though, you know, I'm veryconservative when it comes to
training, and I'm I just I'mvery wary about the application.
Speaker 1 (21:16):
Mhmm.
Speaker 3 (21:16):
You know, there's a very there's a there's a range
that, you know, people shouldtrain in based on the their
individual abilities. That'ssomething we can discuss more
later. But I'm just a little bitconcerned with young kids, even
if they start puberty early, ofknowing having the guidance and
(21:37):
the coaching of knowing how muchload they should put through a
young body Mhmm. Even if it'sstarting to develop early.
Speaker 1 (21:42):
Why do you think we see so many darn injuries in
kids who I mean, there it'scrazy to me. But the amount of
exercise, athleticism that'sdemanded, required, it just
seems like it's so much moreadvanced and part of today's
(22:03):
culture than it was when I was achild. Again, I wasn't raised in
a hyper competitive hub of theworld, but
Speaker 3 (22:11):
I think sports specialization is part of it
where these kids don't have anoff season. And they play, an
unbelievable amount of of games.And especially, you know,
because of the sports culturehere and the climate Mhmm.
Outdoor sports kids play all thetime. Yep.
I mean, I'm looking back to whenmy kids were younger, and
they're encouraged to specializeat nine years old. Mhmm. You
(22:34):
know, I don't wanna say back inmy day, but we used to have
seasons and you would play. Evenif you had a favorite sport, you
had a there was a seasonality toit. And you would you would you
play football or whatever yourfall sport was.
And then you'd you'd had a goodtime with that. Then you
transitioned to your wintersport, and then your spring
sport. And then you maybe youtook some time off in the
summer. And your body just notonly did it have a chance to
(22:58):
recover, but it had a chance toget into a different set of
movement patterns because youhave different sports that
require different loads,different velocities on your
spine or your hips or yourknees, different ways that you
move side to side. Some are morehave a lateral component.
Some are more straightforward.And, you know, it's it's a
bigger it's a bigger conceptthan just, oh, I need to rest.
(23:22):
It's you can theoretically restyour body from one sport to the
next because you're kind ofmoving it in different ways.
Mhmm. Now, though, heavy sportsspecialization, kids are
training, you know, good or badat a younger age.
And I also just think as youlook at the sports spectrum in
general, kids are bigger,stronger, and faster, and they
(23:45):
just are able to put more torqueon muscles and tendons that I
think we're seeing just don'talways have the capacity to
handle that that stress. Andthey they break.
Speaker 1 (23:56):
I mean, do you think kids are bigger, stronger,
faster? Or do you think we justhave a concentrated amount of
hyper athletic families thathave gravitated to one
particular place in America, whopush that on their children? Is
that? And I'm in what you haveto say about this.
Speaker 3 (24:16):
I would say that in my observation, I think that
it's more I think you're seeingit across multiple cities and
multiple places. I don't thinkit's just an area a Dallas Mhmm.
Moment. I think if you lookedacross, you know, especially the
major sports states, California,Florida, where you have great
(24:36):
climate, lots of people doingit, I still think you're gonna
see a propensity to have greateramounts of injuries. Mhmm.
Speaker 1 (24:44):
Yeah. I I agree with that. What about you, doctor?
What are your insights?
Speaker 2 (24:49):
So I've got patients that have young kids, and they
ask me these kinds of questions.Uh-huh. In addition to what
Matt's referring to, which Iagree with, I try to emphasize
the importance of nutrition andsleep. Mhmm. Because a lot of
these kids are going fromschool, which is obviously an
important part of their day, andthey're going from sport to
sport to practice.
Speaker 1 (25:04):
The most important part
Speaker 3 (25:05):
of it.
Speaker 2 (25:05):
The most important part, yes.
Speaker 3 (25:06):
And then
Speaker 2 (25:07):
they're going from practice practice to sport or to
the game or to so on, and sleepgets compromised. And then their
nutrition, they're just eatingon the go from one practice to
the other practice. Mhmm. And atsome point, you do need a good
balance of your proteins andyour fats and your carbs. It's
not just a high protein diet fora young kid.
Right? They need the cholesterolfor brain development. They need
the cholesterol for sex hormonedevelopment.
Speaker 3 (25:25):
Mhmm.
Speaker 2 (25:26):
So it's not that I push and say, start having
protein shakes on a regularbasis, but it's just being
aware. Like, having McDonald'son the way from one practice to
another doesn't make you a goodathlete. That's just not
appropriate. And then sleep isthe other element here is is
that after a long day of usingyour brain the entire day, but
then also using your body forthe entire afternoon, you've
gotta get rest. Right?
(25:46):
You've gotta have restorativesleep.
Speaker 3 (25:48):
Mhmm.
Speaker 2 (25:48):
And so I've got some families who are the multi sport
athletes, and they've got threekids doing all the great things.
Speaker 1 (25:53):
I know.
Speaker 2 (25:54):
But But then they're not sleeping. They sleep at
midnight, they wake up at six,and that's not adequate for an
adult, much less a grader. Mhmm.
Speaker 1 (26:01):
It's tough because I believe all parents are
hopefully trying to weigh thepros and cons constantly of
okay, if my kid is going to getinto x program at x school, what
do they have to do now in orderto be able to play? Sure. Okay.
(26:22):
So that's a good think toe dipat least on the hormonal piece.
I've always had lowprogesterone, high testosterone.
And then I had the factor fivelead mutation which prevented me
from being able to carrypregnancies full term. I had a
ton of miscarriages. Not a ton,but a few. And so that is
(26:47):
interesting because I know mysleep has never been excellent.
And as I get older and mybiological mother, she's still
alive, my biological mother.
She is very young, but shestarted and went through
menopause I think by 44. So thisis where I am starting to
(27:11):
notice, at least in my body, I'mprogesterone I've been
historically progesteronedeficient, and I'm here noticing
a lot of these patterns startingto creep up in my body. So what
do you say specifically on thesupplement side, things to
consider? For someone, I know mysituation is a little bit
(27:32):
unique, but who has thesedifferent layered factors
involved with their health, butwho wants to stay away from
hormone therapy, as much as Ican, but to not devolve into
this space of absolutely nosleep and hormonal hell? And
(27:59):
then how I also want to dip overinto the physiological space
with you, Matt.
But how would you even tacklethis?
Speaker 2 (28:07):
So the thing I do is I'm a big advocate for wearable
technology. Okay. So we have alot of tech now that helps us
monitor our sleep.
Speaker 1 (28:13):
Yep.
Speaker 2 (28:14):
And three or four years ago, would have never
given you that answer becausethe data just wasn't very good
or the output wasn't veryhelpful. Presently, some of the
brands out there are really,really good. And so I'll have
patients come back and tell me,I had that one tequila on Monday
night, and it disrupted my sleepfor two nights in a row.
Speaker 1 (28:29):
That's right.
Speaker 2 (28:30):
And when I'm That's worked differently. Less for
several nights, I sleep reallygreat. Yeah. And so identifying
those patterns is I think veryhelpful with sleep in
particular. In terms ofhormones, so there's good data
on magnesium intake forhormones.
There's a new drug out thererecently introduced by the FDA
that's a non hormonal medicationfor menopausal symptoms, and so
I've advocated for that for acouple of patients. And then I
(28:53):
think the thing is, and this iswhere I think Matt is the expert
on it, is your kind of mind bodywellness. What are we doing with
our muscles, with our joints,going back to the restorative
sleep side? A lot of thepatients that come to me with
menopausal symptoms, it's justprofound fatigue. And I'll order
all the labs, and then I'llorder all the other labs, and
all the other other labs, andit's all normal, but you're in
(29:13):
menopause, and you went from ahormone positive state to now
hormone deficient state.
And so I think that's where Irely on really good folks like
Matt to say, how can we helpthis person feel stronger? How
can we help this person identifywhich joints or which muscle
groups are the problem, and thenmove forward?
Speaker 3 (29:28):
You know, the biggest thing like I talked about
earlier is, you know, sleep,nutrition, stress management.
Speaker 4 (29:36):
Mhmm.
Speaker 3 (29:37):
And then the bucket of exercises are really the the
focus points for me. Anyadditional, like I said, you
know, testing or hormonal thingsI would refer out to somebody
that was specialized in that.But I do feel like there's, you
know, a giant avenue that peoplekind of want to skip past and
(29:58):
that is really, do I want tofocus on nutrition? Do I want to
focus on sleep, stressmanagement and actually going
through and consistentlycommitting to doing, I'll call
it exercise, but it's really,you know, improving
cardiovascular health, know,musculoskeletal training, really
improving all of those bucketsgives you, I think, a pretty
(30:20):
good idea of if you can committo those, how good can I feel?
And if I still feel like I'mlacking, that's where I think
additional testing would be,incredibly valuable.
And that's not to say that, youknow, I would ever say that, you
know, getting testing done offwhen you start a, a new plan, a
(30:41):
new goal, a new lifestylecommitment of going, okay. I
wanna go get a full blood paneldone. I wanna see where I'm
deficient in, you know,vitamins, minerals, hormones,
all the things. I think there'sincredible value there, but I do
think that a lot of people willsometimes skip to that before
wanting to kind of invest in thethings that they might have more
(31:02):
control over but are a littlebit harder
Speaker 2 (31:04):
Yep.
Speaker 3 (31:04):
To invest in. So I think that's, you know, it's
kind of where I've alwayslanded.
Speaker 1 (31:10):
What I'm interested in whether you all are provided
this from patients, like a okay,here are the supplements that
And then I ran them all throughchat GPT because I thought,
alright, I want to know what totake at night, what to take in
the morning, but I sleep with myOura Ring, then I have my my
(31:31):
fitness scale that reads all ofthe different data every single
morning. And I love data. Loveit. I thrive on it. And so I
know most, I don't know if a lotof people are this way, but I
love it.
And so I know what supplements Ishould take in the morning. I'm
acutely aware of what they do tomy body at different times of
(31:53):
the day. Love magnesium. Butagain, how often are you all
suggesting that people go backto their doctor and revisit this
blood work? Do you find thatonce a year is sufficient?
And how often are yourecommending your patients to
revisit their supplements withyou to be able to build a
(32:17):
certain amount of muscle?Because I find muscle is so
important in our aging, theretention of it. And so I'm
constantly fighting despite allof the pain and discomfort that
I've been in because of myBrody's muscle stuff and then
this herniation tear in my backand all the hip stuff. What are
(32:40):
these conversations like? Howoften are you requiring that
your patients and your clientstalk to you about this?
Is it once a year, twice a year?
Speaker 2 (32:52):
So it's at least once a year for sure. A lot of my
patients, and I think why Ireally enjoy practicing
concierge medicine is I have alot of patients who are very
invested in their health.
Speaker 1 (32:59):
Yes, I know some of your
Speaker 2 (33:01):
They come twice a year, they come three times a
year, and they'll say, you knowwhat, I'm gonna try intermittent
fasting for the next ninetydays, but before I do it, I
wanna get my lipids and mydiabetes things checked out. Not
that they have elevated lipidsor diabetes, but they wanna see
how intermittent fasting forninety days makes a difference,
or they wanna do an intenseworkout regimen for six months
and get pre and post labs. Andso two comments that I wanted to
(33:23):
make previously was there's thisbig push for using things like
liquid IV, which is a greatthing, but I've had more
patients Elements and otherthese big brands. I've had more
patients in the last twelvemonths who have come in for
screening labs that haveelevated calcium and potassium
levels
Speaker 1 (33:39):
Of course.
Speaker 2 (33:40):
Than I've ever had in my Yeah. And when you ask these
patients, they're like, oh, I doliquid I eat twice a day. Oh
Speaker 1 (33:46):
my gosh. Do liquid I
Speaker 2 (33:47):
eat twice a day. I understand if you're
particularly dehydrated, ifyou're hungover,
Speaker 1 (33:50):
all of habits If coming out of your sauna or
something. But
Speaker 2 (33:53):
the idea of I don't drink water, just drink liquid
IV or Element is just an odd wayto go. I really encourage
patients, I hope all my patientswould agree with me, when they
step foot in my office, nomatter what they're there for, I
review their medicines becausethey'll start adding things on
their own or they'll come inwith a particular problem. Well
it turns out that these twosupplements don't agree with
(34:14):
each
Speaker 1 (34:14):
other. Correct.
Speaker 2 (34:14):
That's You have a toxicity of vitamin D and
therefore your calcium went upand therefore you had a kidney
stone. So they'll ask like, thisis the worst pain I've ever been
in my whole life, and it turnsout that they kinda did it
themselves because they sawsomething on TikTok to take a
bunch of vitamin D. In someways, it's very educational. I
think that's a lot of the coreof what I do in the office is,
hey, do more of this, do less ofthis. I think the push for
(34:38):
vitamins is aggressive.
Speaker 1 (34:39):
It is.
Speaker 2 (34:40):
We try our best to be evidence based, get the labs. If
your labs are good, then you'regood. You're getting your
vitamins through your nutrition.And if you happen to have a b
twelve deficiency, we'll treatit. But I think the idea of
everybody needing to be on a aplethora of meds is just not the
way we should operate.
Speaker 1 (34:55):
I agree with you. I agree with you.
Speaker 3 (34:59):
I also agree with you. When it comes to all you
know, when it comes to bloodwork, you know, obviously,
that's not something that Ipersonally do. So I would say,
where whoever I refer to, I letthem kinda obviously be the the
quarterback when it comes tothat. Mhmm. You know, the the
things I said earlier stillapply as far as, you know,
feeling that, you know, to yourpoint exactly, like, let's test
(35:22):
to see where we're deficientMhmm.
And then supplement. That makesvery logical sense to me. Just
to touch back on your pointabout muscle, which is probably
one of the most underappreciatedaspects in the field is not just
the building, but themaintaining of muscle as we age.
So, you know, one thing I amvery adamant about talking to my
(35:45):
people about is that they ingestan adequate amount of protein on
a daily basis. Mhmm.
And that actually, as we age, wehave to increase our protein
supplementation even a littlebit more because we become a
little bit more inefficient at,you know, being able to
metabolize it. So the two two ofthe the best ways that we can
(36:07):
maintain, preserve, you know,for younger build muscle mass is
eat adequate amounts and trainour bodies to, you know, a
certain degree. Putting a lot offorce through our our joints and
our muscles so that they arethey have the stimulus to wanna
grow and and and maintain itbecause muscle is a very, very
expensive resource. And so, youhave to prove to your system
(36:32):
that you need it in order tomaintain it or build it. And in
the absence of that, you loseit.
We are woefully deficient in ouringested protein as a
population. So that's somethingI really try to encourage people
to do and be and be aware of,you know, because that's I know
education is probably importantthing that we're trying to
(36:52):
provide for the people that wework with. And that's one where
I think people really have noidea how important it is.
Speaker 1 (36:58):
What kinds of protein, added protein in either
shake form or supplement form.What are your favorite brands?
Speaker 2 (37:12):
I don't know if I have a favorite brand. What I
advise patients is get a mix ofanimal based and plant based and
natural. For my vegetarian orvegan patients, the animal base
is out of it. And so that makesit a little bit more difficult.
Some patients that reallyinundate their system with a lot
of eggs or a lot of dairy basedproteins, it just becomes a lot
or they get skin issues as aresult of it.
Ah. And so I try my best to tomix pea protein, whey protein,
(37:35):
and the natural proteins. For mymeat eating patients, it's a lot
easier. I mean, just having meatas a
Speaker 1 (37:41):
as a
Speaker 2 (37:41):
food is a bulk of it. But I find Fairlife to be a good
brand if if I had to pick onejust because it's a small shake
and it's Mhmm. You know, 32 or38 grams of protein, it's easily
accessible. In fact, going backto the kids for a I have my kids
split that a lot of mornings.Oh, cool.
Speaker 4 (37:59):
Because they
Speaker 2 (37:59):
like it. For them, it's chocolate milk, so they
think they're having a treat. Mywife and I, we think we're
having a treat. Yes. They'rehaving protein to start their
day.
Oh. And so that's been a niceaddition in our house.
Speaker 1 (38:08):
Great. Thank you. And what about you, Matt?
Speaker 3 (38:11):
When it comes to recommendations, I mean, I wanna
meet people where they're at. Itypically refer people to some
type of whey is my kind of goldstandard. And it depends on kind
of their tolerance to, you know,conscience whey protein
concentrate is gonna be, alittle bit more for those with
the sensitive lactose Yep. Kindof, you know, medium, they're
(38:35):
gonna have a little bit moretrouble with that. Isolate, I
think, is a little bit more it'skind of the the whey is broken
down a little bit more.
So it's a little bit more easilydigestible, but then you have to
also take into the account ofcalorically, some of them have
Speaker 2 (38:47):
Yeah.
Speaker 3 (38:48):
More calories, more more fillers, more other things.
I tend to go for the mostboring, unflavored, one
ingredient as possible proteinthat I can possibly find. I'm
the the brand's escaped me. I'mhappy to give them to you later
if you wanna put them in yournotes. But, but like I said, if
I had a vegetarian or a veganclient, I would promote a plant
(39:13):
based protein under the the guysthat we wanna make sure that we
have a complete, amino acidprofile because that's the only,
you know, issue when we havevegan, vegetarian Yeah.
People that we work with is thatnot all vegetable or plant not
vegetable, plant based proteinsare complete.
Speaker 1 (39:32):
Toggling back over to the genomics portion that are
perhaps a little bit moreaffordable than New Amsterdam.
That's I know the concierge it'skinda concierge based. It is, I
think, only, and the cost rangegoes up to about $3,500. But
there's Genomine, Nebula,Genomics, Self Decode, Gene by
(39:56):
Gene, Veritas Genetics. Do youwork with any and all of these,
or is there one in particularthat you work with, doctor?
Speaker 2 (40:05):
So like I was saying before, I don't use one of the
brands that does genomics forall organs. The ones that we do
are more organ specific. Sothere's a cancer, a big cancer
company called Ambry, and so wework closely with them for
cancer genetics. I'm thinkinglike BRCA one and BRCA two, but
about 90 other cancer causinggenes. So I've got a patient
that I take care of right nowwho has a particular gene that
(40:26):
increases their risk of melanomaand pancreas cancer.
And so the guidelines for thatare we gotta do annual scans on
her pancreas. We have to domelanoma screens every couple of
months because her risk is justthat high. In terms of the
brands that you mentioned, Idon't have an affinity towards
any particular one of them. Iwould say, I think this is an
opportunity to mention that onetest that we do order a lot of
(40:46):
is food sensitivity testing.Yes.
And so there's this push tothink about something called
leaky gut syndrome
Speaker 3 (40:52):
Yep.
Speaker 2 (40:53):
Which is fancy to say that in a in a normal person, if
any of us can actually benormal, but a normal person, the
gut is its own environment. Andnothing should leave the gut,
and nothing should enter thegut. Well, we have understood
that there are certain chemicalsor certain things that you can
consume that cause stuff fromthe gut to leave, and that can
cause systemic inflammation,feelings of fatigue, bowel
irregularities, and so on. Andso a test that's been really
(41:15):
helpful for patients is foodsensitivity testing, and
identify very healthy thingslike a patient that could have a
sensitivity to asparagus and todifferent fruits and vegetables,
and it turns out that that's whythey're not feeling well, or
that's why they feel morebloated and cramping. So it's
not genetics by any means, butclearly there's something about
their genetic makeup that is notprocessing eggs well or white
(41:36):
wine well or what have you.
And so I certainly believe inthe personalized piece of it. I
don't have enough experience tocomment on one particular brand
or the other. We feel like we'vegot a good handle on the groups
that we do use, it's a veryactionable set of outcomes and
we can do something with that.
Speaker 1 (41:51):
Do you have anything that you wanna add there to any
of these types of tests that arerun for the gene site mapping
that give people insights intowhat type of medication they're
predisposed to work better withand how that has translated to
any conversations or possibleconversations with your patients
(42:14):
or clients.
Speaker 3 (42:16):
Yes, clients. You know, I don't, like I said, deal
a lot with genomics or geneswith the type of work that I do.
I do think it's interesting,though, when you look at the
research on some of the diseasesthat we're talking about, being
Alzheimer's, dementia,Parkinson's, that one thing I do
(42:39):
try to educate my clients on isthat my current understanding of
the research is that one of thebest things that you can do to
reduce your risk of all of thesediseases is to not only
exercise, but to do heavyresistance training and have
strong cardiovascular health. Sowhen you look at, you know, all
(43:03):
of these diseases, one of thetop three recommendations from
all experts in all of theseMhmm. These fields is you need
to do shrink training and youneed to have good cardiovascular
health.
So because that's my strong suitand my expertise, I tend to make
(43:23):
sure I educate people on thevalue of what we're trying to do
in that regard because it it issomething that concerns me as
well. Mental, you know,dementia, Alzheimer's are things
that are on top of mind. I'vehad it in my family. So one of
the reasons why I'm sopassionate about the type of
work that I do is because ithasn't, in my opinion, one of
(43:48):
the the biggest benefits fordecreasing that risk. To say
that there's no risk, I'm notsaying that, but it gives you a
better chance of of decreasingyour risk of developing some of
these diseases based on, some ofthe research that I've seen.
Speaker 1 (44:04):
Can you talk a little bit about just some of your
clients, especially the ones whoare in their 80s and doing
competitions, liftingcompetitions, and the vitality
that these people exhibit? It'scrazy how how you're, I guess,
Speaker 4 (44:23):
your Well, the the
Speaker 3 (44:24):
biggest thing I tell anybody that comes in Mhmm. I
might have a, you know, anaverage age in the sixties and
seventies, but the body, thedesign of the body is the same
Yep. For everyone. Now it mightstart to function differently
and there might be some morerestrictions as we get older.
But if we train it to itspotential always, and that
(44:47):
means, you know, everybody in myopinion has a a potential that
we can try to get to.
And if we can train it to a highlevel and keep it there Mhmm.
Age will be a factor, but lessof a factor. I have some of my
strongest clients areapproaching 80, and they're just
as strong as any 40 year oldthat I mean, I I'll put that up
(45:12):
there. It's just as strong asany 35 or 40 year old that
you're gonna run into as far astheir ability to express
strength, mobility, no painMhmm. Highly functional and have
little to no restrictions onwhat they want to do on a daily
basis.
Speaker 1 (45:28):
What about over to you, doctor, as far as this
framework of patients in yourpractice?
Speaker 2 (45:35):
Our goal every day is to make healthcare easy. I think
it's really hard to navigatewhich doctors to see, how to get
labs done, which tests to getdone. Because if you Google it
or throw it into chat GPT, youjust don't know what the
difference is between A versus Bversus C. Correct. And so I hope
our patients would agree or mypatients would agree that we try
our best to promote their healthand prevent disease, and if we
(45:57):
catch something, we treat itaggressively.
And I think knowing what we knowand knowing what we don't know.
So an important part of mypractice is having a Rolodex of
specialists who are really topnotch, that if I don't know how
to manage something, I'll givesomebody a call and get that
patient in quickly.
Speaker 1 (46:12):
I believe, or hopefully, that over the course
of the evolution andintroduction of AI into our
lives more and more, that yourtype of setup, I guess both of
you in more of a conciergeboutique space, will hopefully
(46:33):
be the norm as accessibilityhopefully becomes more possible.
What are your thoughts on that?
Speaker 2 (46:43):
I hope that's the case. I think the challenge is
that corporate medicine is themainstay of health care in this
country. You have to have themega groups in order to support
the hospitals and the surgeons.And so will that ever go away? I
don't think it will.
The way that insurance is setup, and certainly in this
conversation we're not gonna beable to solve that problem. No,
(47:03):
no, no. But I think what I wouldsay is that in the world of
concierge medicine, it'sbecoming much more normal. Even
five years ago when I startedit, it was like, oh, so what is
that? What does that mean?
And now five years ago it'slike, oh yeah, several of my
doctors are concierge, I knowexactly what that's like. I
would tell you from the caredeliverer standpoint, I've seen
what care is like on my end ofit compared to what it used to
be when I was not in it, andit's night and day. It's not a
(47:25):
coincidence that I got myparents and my in laws into this
world because I'm confident thatthey're gonna get better care,
more attentive care, more timelycare because of it. And the
other comment that I would sayabout AI is a big part of what
my nurse and I do on a regularbasis should be replaced by AI,
And that would be really nicebecause we'll be able to spend
more time thinking about ourpatients, being with our
(47:45):
patients, researching about ourpatients, so on. And I think
that's gonna play even a biggerrole on the corporate side
because obviously the volumesthat they see are much different
than what we do.
And if you're able to get AI tojust replace these very mundane
things like prior authorizationsand pre certifications, that
stuff is very time consuming andreally doesn't require a lot of
(48:05):
education. It's something thatjust has to get done. And so I'm
an advocate on the consumerside. Obviously AI will help you
understand what your supplementsare, but on our side I think it
will replace a lot of tasks thatotherwise don't need to be done
by us.
Speaker 1 (48:19):
That's right. That's right. Well, gentlemen, is there
anything else that you wanna addin for our viewers and listeners
with respect to wearabletechnology, your practices, your
patients, clients, anything?
Speaker 3 (48:33):
I would just say that when it comes to AI Uh-huh. I
think in my line of work, Ithink it's gonna be hard to have
AI provide a lot of value andjust that like the type of work
being very subjective. And soI'm a big proponent of, you
(48:55):
know, I guess the the thing Iwould say the most is that
people need to commit a lot oftime to truly educating
themselves not just on, youknow, supplementation and
nutrition and things like that,but really, from my standpoint
with what I do, a lot of people,most people don't really
(49:16):
understand how their bodies aresupposed to work
Speaker 2 (49:18):
Mhmm.
Speaker 3 (49:19):
And how they're designed to work. Yeah. And that
there's a frame and amethodology to go about trying
to learn, analyze, and start toperfect movement that you were
designed to do to the best ofyour ability. And that's where I
think the type of work that I dois a little bit different in
(49:40):
that. I don't think that peoplehave an idea of that there is a
particular way that they'redesigned to move and that the
further they get away from it,the the less quality, the less
efficiency they have, the worsethey feel.
And so, you know, having aneducation and a knowledge and a
plan of attack to bring you backinto to your own design, not my
(50:05):
opinion, your own design, givesyou the best chance to feel as
good as you possibly can becauseI think that something that's
lacking in a lot of the peoplethat I come across Mhmm. And
work with initially at least isthey don't understand how their
body is supposed to work. And Ifeel like that is something that
(50:28):
everybody should be able toeverybody should know, have an
idea of how their body'ssupposed to work.
Speaker 2 (50:32):
Yep. I think my last comment would be just
encouraging patients to be anadvocate for themselves. Yes.
The number of patients that comeinto our office who don't know
what medicines they take or whythey take them, that's an
important part of your ownhealth. You have to know why you
take what you take and how youcan try to avoid taking certain
things.
And ask questions to yourdoctor. We're here to help you
(50:54):
ultimately. Every one of mypatients at the end of a visit I
say, is there anything else youwanna talk about? I really mean
that because sometimes the mostimportant thing or that one
thing that their wife asks themto ask me, that's when it comes
up. It turns out that that'sactually the most critical part
of the whole conversation.
And so I would always encourageyou that when you have a
doctor's visit coming up, matterif it's with your cardiologist
or your internist like myself,have a list of questions or have
(51:16):
a list of thoughts to say, youknow what, this thing is
bothering me, or what do youthink about this medicine, or
hey I read this. And I wouldargue that most doctors enjoy
that conversation. We enjoytaking care of people that wanna
be in good health. Yep. And sojust being prepared going to a
doctor's visit, I think, isreally critical.
It'll it'll make your healthoutcomes that much better.
Speaker 1 (51:35):
Thank you for being here.
Speaker 2 (51:36):
Of course.
Speaker 1 (51:36):
Thank you. Yes.
Speaker 2 (51:37):
It's fun. Yes. Yes.
Speaker 1 (51:45):
Yes.
Alright, I'm really looking forward to exploring
(00:03):
this entire episode with you.The reason that I wanted to
interview Doctor. Agarwal andMathew Lindenmeyer, a physical
and rehabilitation specialist,is because artificial
intelligence is drastically andrapidly changing the entire
medical industry. The way thatwe take care of our bodies, the
information that we're able tolearn about ourselves before
(00:24):
seeking any type of treatment ischanging swiftly. And because
I'm predisposed to a few thingsthat a lot of my genetic testing
showed me, I really wanted tobring it to your homes.
There's different tests that youcan have run. You can approach
(00:44):
your doctor and make sure thatyou're understanding the fulsome
parts of your body, your health,and you can run things through
different types of AI, whetherit's Grok or ChatGPT, to ensure
that your supplement routine isnot conflicting with natural
(01:06):
parts within your body. Eitherway, I just think this is a good
episode that will help open youreyes, it will help you take
control of your health, it willhelp you understand the
landscape in which it's changingvery rapidly in front of us. As
an example, the one particularreason that I had my genome
sequence ran through NewAmsterdam was because I have
(01:29):
extreme muscle stiffness andsoreness after workouts and it's
been a huge part of my life tobe active and physically fit.
But in really pressing myconcierge doctor, Doctor.
Froedter, to have my genomeprocessed so that I could have
that full understanding of it, Iwas left with this understanding
(01:50):
and insights to what Brody'smyopathy is or Brody's muscle
syndrome. And it's pretty rare,but then it helped me understand
the regimen that works for mybody. And if you or your family
have some type ofpredisposition, me, I'm adopted.
I've never met my biologicalfather, don't know who he is, so
(02:12):
there's an entire part of my DNAthat I just have no
understanding of. I used to havea 23andMe, I've since deleted
it.
But what someone mentioned tome, which I believe is really
interesting, is that if you hadyour kid's DNA ran through
23andMe, if your child had anydesire of serving in secret
(02:36):
service positions or some typeof higher military capacity or I
guess country leadership, thetype of risk that those people
would be predisposed to if thatinformation was readily
available through something like23andMe, it would exclude them
(02:59):
from being a viable candidatebecause a lot of the weaponry
that's being actively exploredtoday is that which relates to
specific genetic targeting. Soyou can wipe someone out pretty
quickly by having anunderstanding of what their
genome is comprised of. Againthe reason I wanted to record
(03:21):
this particular episode wasbecause it's an interesting
dynamic and shift that's beforeus. You see someone like Matt
Lindenmeyer who is hands onworking with his clientpatients
to ensure that they're beingtreated as best as they possibly
can but whatever type of genomedata is handed to him doesn't
(03:44):
really or materially shape theway he interacts with his
clientpatients. Yet someone likeDoctor.
Agarwal, he can absolutely usegene site mapping to ensure that
whatever type of prescriptionsare prescribed to his patients
are actually prescriptions thatare going to work well with
(04:07):
whatever their predispositionsare. Their genetic makeup, it
will actually process andmetabolize in a friendlier way
than just going through basictrial and error which was kind
of the way that people have doneit in the past. By the way I
hope you find this episode to bereally useful. I absolutely love
the science and if you have anyquestions feel free to reach out
(04:29):
to us. Gentlemen, it's Friday.
I'm so happy you're here withme. I have Doctor. Monique
Agarwal who was my mother'sconcierge doctor. My mother has
(04:53):
since passed, but I'm so curiousto delve into a lot of the
specifics that you work with ona day to day basis. And then I
have Matt Lindenmeyer here who'sbeen an angel and a godsend to
me.
He's a rehabilitation and afitness specialist and has
helped me in wonderful ways. Sothe combined expertise of both
of you gentlemen is what Ireally wanna delve into today.
(05:16):
Thank you for being here.
Speaker 2 (05:17):
Perfect, thank
Speaker 3 (05:17):
you for having us Yes. Glad to be here.
Speaker 1 (05:19):
Manik, I loved walking into your office because
as you know, I belong to aconcierge clinic myself with
Doctor. Froedter and all that.My husband is at M Squared. And
so I'm pretty well versed in theconcierge space. And you were,
(05:40):
like I said, just so wonderfuland patient with my mother when
at the end of her life withdementia and Parkinson's, it was
the biggest blessing.
So thank you.
Speaker 2 (05:50):
It's my pleasure, thanks for trusting me.
Speaker 1 (05:52):
Yes, absolutely. In both of your realms of more
boutique relationships withclients and patients, do you
find yourself speaking with morepeople who are very interested
in genomic screenings to have anunderstanding of what their DNA
(06:12):
is presenting and how you canwork with it?
Speaker 2 (06:15):
Yeah absolutely. So a lot of the things that we try to
do in the office is to figureout what the diagnosis is and
what's the best treatment forthe patient on that particular
day. And it turns out that noteverybody responds to the same
therapies and not everybody hasthe same diagnosis or they're
not all diagnosed the same way.And so when we use the word
genomics, I try to kind of takea step back and say, how do we
make this personalized for you?And how do we stratify you in
(06:37):
terms of your risk?
I've got some patients who havean elevated cholesterol, but
they never have heart disease,and I've got other patients that
have the same exact elevatedcholesterol, and they've got a
lot of heart disease. There'ssomething going on behind the
scenes and it's our job to nowutilize the science to say, this
is why we have to be much moreproactive with you, whereas for
yourself we can kind of lay low.And so that's to me where the
personalized kind of precisionmedicine comes into play.
Speaker 3 (07:00):
You know, with the the people that I see, that's
not the thing that I'm lookingat because I Sure.
Speaker 1 (07:06):
Of course.
Speaker 3 (07:06):
Primarily with, you know, soft tissue and and how
the body moves. Mhmm. And but Iwill say that when it comes to
you know, I always talk aboutpillars that we're trying to
focus on with fitness. Andthat's, you know, how can we
control sleep? How can wecontrol, nutrition?
How can we control stress? Andthen the exercise bucket gets
(07:28):
gets to be pretty big. So Ifocus on those four things
initially. And once we makestrides in those, if we still
feel like there's areas that aredeficient or there's areas where
we are progressing the way we'dlike, then that's where I would
refer out to a physician,somebody that's more
(07:49):
knowledgeable about the genomicspace. Because, you know, I'm a
firm believer too in being anexpert in what you're an expert
at and then referring out toquality people when you're not.
Speaker 1 (07:58):
I'm really advocating for I guess a bunch of my
friends and telling them, youall have to start here at the
genome level. It'll really helpyou understand what you're
predisposed to, what's right,what's wrong. And the way this
even came up for me was backwhenever 23andMe launched,
that's whenever I found out thatI had some predisposition to the
(08:19):
Factor V Leiden mutation, whichis not great. And after that,
it's kind of been a hobby ofmine to become more well versed
in how that prohibits me fromdoing certain things or not. And
now it's the Brody's musclesyndrome that is aggravating.
(08:45):
My body basically has a wholebunch of ripples after I work
out, doctor. The amount of painand pressure that certain
massage therapists have to applyto my muscles to experience any
relief is abnormal. And it'sjust so much. That's why I
pushed my now doctor to say, howcan I figure out exactly what is
(09:10):
going on with my muscle tissue?I just want an understanding of
a full panel of it all.
That's when New Amsterdam cameup in the practice. So do you
proactively offer this to yourclients? Is this part of a
regular conversation?
Speaker 2 (09:27):
It is in terms of organ specific things. So I
haven't gone through the processof New Amsterdam before because
that's a comprehensive analysisof the genome. I think the
struggle that I've seen withthose analyses are we don't know
what to do with some of thatinformation. It's not always
actionable. See.
And so when I start orderingthose personalized tests, order
them specifically for heartdisease, specifically for
(09:48):
cancer, and specifically for therisk of Alzheimer's disease. And
so that's a lot of riskstratification. So I had a
patient recently in the officewhose mom and dad both had
Alzheimer's. He's 60 and he'sfeeling some memory loss. That's
a big conversation.
If I order this particular teston you, we will know if your
risk of Alzheimer's is thebaseline risk or if it's 10 x.
Speaker 1 (10:09):
That's
Speaker 2 (10:09):
right. That's a philosophical conversation at
that point. How much do youwanna know? How is it gonna
affect your life?
Speaker 1 (10:13):
That's
Speaker 2 (10:13):
true. This particular patient went through with the
test, had the abnormal gene, andnow is really starting to shift
the way he thinks.
Speaker 1 (10:19):
That's right.
Speaker 2 (10:20):
Right? In terms of what he wants to do with his
kids, he wants to do with hisbusiness, what he wants to do
with his day to day life.
Speaker 1 (10:24):
That's right.
Speaker 2 (10:25):
Because he knows that at 60 he's okay, but 65, 70, or
what age? And so that's where Iorder more organ specific
genomics as opposed to acomprehensive panel.
Speaker 1 (10:35):
And for me because of the outcomes of my screening or
my panel, I realized that I amat high risk for some
gastrointestinal issues, colonissues. I went and I had a
colonoscopy and I had threeprecancerous polyps. I'm at 40.
I mean that's, I was so gratefulfor that. And so for me, that's
(10:58):
I think why I'm such a believerin this stuff, and now it helps
me to have a betterunderstanding of my own work.
So okay, alright, this is goodto know. This is good to know.
And the age bracket of people,Matt, that you are particularly
dealing with, What is your whatis your I I know you do a lot of
work with kids as well, but I'msaying your practice, what is it
(11:20):
comprised of age wise?
Speaker 3 (11:23):
Oh, I'd say the most the mean age is probably
somewhere in the probably midsixties, early sixties. Ah. I
see a lot of people probably intheir sixties and seventies. And
I think part of that is, youknow, you as you get older Yep.
(11:46):
You have you know, you reach astage where you've tried a bunch
of different things and yourbody really just stops working
the way you want it to work.
And you've had enough time toaccumulate potentially some bad
movement patterns, some badlifestyle decisions have
compounded. And next thing youknow, you you wake up one day
and it's hard to not just beathletic, but just move around
(12:10):
in your daily life Mhmm. And,you know, participate with your
kids or your grandkids maybe inthis case. And so and then you
start to try things. Yep.
And I I feel like when I startto see people, they've tried a
lot of different things thatmight not have had the benefit
that they were looking for andthey find their way to me at
(12:32):
some point. So, I'd say I'm Ipredominantly work with people
at this at this point that arein their sixties. But, I've, you
know, I've worked with I'veworked with some pro athletes.
I've worked with some highschool athletes and some younger
people. But, my sweet spot'sprobably in that, you know,
sixties and seventies range.
Speaker 1 (12:49):
Matt, can you tell, Shannon, what some of the kind
of the disciplines of study thatyou focused on and why you have
this breadth of understandingthat I just haven't encountered
before with a lot of my otherrehabilitation and physical
specialists.
Speaker 4 (13:05):
Worked with some really great people when I
started, started working inbusiness that taught me a ton
about kind of assessing the bodyand you know, how to look for
weaknesses asymmetry, reallyfocus on quality, movement
(13:27):
patterns and how to really getpeople to learn how to train and
make those movements as strongas as humanly possible. So
learned a lot there and I got,you know, licensed by the state
in massage therapy, but youknow, I've taken muscle
(13:49):
activation techniques, I'vetaken active release techniques,
I've taken integrated kineticneurology That. Which is where I
a lot of the current I've usedit to kinda help that current
modality to kinda help with alot of the newer isometric
(14:10):
positions I get people in. Mhmm.But it's a blend of it's a blend
of a lot of differentmodalities, studying a lot of
about, you know, the mechanicsof the body, how how joints are
designed to work and then justkind of coming up with a
(14:31):
framework and being creative,trying to be creative too with
individuals with where they'reat and and how to get them to
respond to what I wanna do, do alot of soft tissue work, but
Uh-huh.
I still feel like movement isking and I'm I'm doing this type
of work, especially in likeSarah's case, I want her heel to
(14:54):
work better. I want hersubtailors to work better. I
want her trunk to be able torotate more and all the things
that I'm looking at currently inthis one acute moment in time.
But ultimately I'm doing all ofthat to prepare her to get up
and move on her feet better andteach her how to be more
efficient and stronger themovements that she's designed to
do which is squat, hinge, push,pull, flex, extend, and rotate
(15:18):
because if she can do all thosethings well, she's gonna be
feeling pretty good and able todo pretty much whatever she
wants to do in life. So themovement piece, which is what I
transition everybody into themovement piece is going, okay, I
gotta be able to fully maximallyload my limbs individually to
(15:41):
the best of, you know, everybodyhas a kind of a an individual
ability to load that whereverthey're at on the on the
spectrum.
So, Sarah's case, I'm trying
Speaker 3 (15:51):
to get her to load
Speaker 4 (15:53):
her limbs in in every way she possibly can safely so
she can get stronger, gain moremobility, gain
Speaker 3 (15:59):
more
Speaker 4 (15:59):
agency in her own life. So the therapeutic arm
which is this is just one pieceof trying to get somebody in a
position where they can movebetter. Oh, there we go.
Speaker 2 (16:14):
That feels much better. So as a concierge doc, I
take care of people as young as15, just at the end of high
school. Oh. And my oldestpatient's 101. And so I see
really everything from start toend.
I would say my average age isprobably late 40s, early 50s,
and that's consistent with mebeing about ten years out of
practice.
Speaker 1 (16:32):
So the
Speaker 2 (16:32):
goal is over the next twenty five years that these
folks will grow with me as I getolder. I would say majority of
my patients, probably two thirdsare male. I would say about half
of my patients see me once ayear because things work quite
well, and the other half of mypatients see me multiple times a
year because they're either veryproactive and they're making
lifestyle changes and wanting toget labs done more frequently,
(16:54):
or they're just chronically sickpeople. And we know we need to
be on top of their medicationsand monitoring images and so on
and so
Speaker 1 (17:00):
Okay, so two thirds are male. So do you do any work
with women and their hormones?
Speaker 2 (17:08):
I do. So I've started checking hormone levels over the
last couple of years because themore that we learn about hormone
deficiency, the more we realizethat it affects more than just
your mood or more than just hotflashes. It turns out it affects
your sleep, and it affects yourdrive, and it affects your blood
pressure, it affects yourcholesterol, and so on. And so
where I start my practice interms of hormones is I'll assess
(17:29):
the hormones, I'll identify adeficiency, and I'm comfortable
managing the early stages ofhormone therapy, so patients on
estrogen or progesterone. I'vegot a lot of men that take
testosterone and manage all thatvery comfortably.
Once I handle that portion, ifthe patient isn't doing as well
as they need to be doing, that'swhen I know what I know and I
know what I don't know, I'mhappy to refer out to a
(17:50):
specialist who's gonna help withhormone management. On the male
side, that's certainly in mywheelhouse, and so patients that
are taking growth hormone, HCG,testosterone, estrogen blockers,
that stuff is really important,but for all the listeners, I
would really encourage them togo to a trusted doctor to manage
it as opposed to a men's clinicbecause unfortunately those are
(18:10):
not as well run and they're notas well monitored, the patients
are not. And so I've hadpatients that have had poor
outcomes due to excess amountsof testosterone. Or I've had
patients that have had fertilityissues because they weren't on
HCG at the time when they weretaking testosterone.
Speaker 1 (18:24):
How is it that you work with kids, let's say our
youngest, or your youngest son'sage, my oldest son's age, when
it comes to training, because Iknow you're constantly like,
uh-uh uh-uh. They should not bedoing this at this age, they
should not be doing that at thatage. Talk to me about how you
approach prepubescent young boysor girls, and then how you
(18:51):
approach someone who has ahormonal shift much later in
their Yeah.
Speaker 3 (18:57):
It's interesting, especially in our culture in
Dallas.
Speaker 2 (19:02):
Yep.
Speaker 3 (19:02):
We have a very sports forward, sports centric
environment for our kids, andthey're encouraged to specialize
earlier and train earlier. AndI'm just not a big fan of
prepubescent children puttingexcessive loads to their body to
(19:23):
try to build muscle when they'reprobably really not, you know,
physically and genetically and,you know, ready to do that. Yep.
So I'm a more of a fan ofencouraging kids that are are
boys' ages to play a lot ofdifferent sports, run, play, you
(19:44):
know, climb, sprint, do all thethings. I have worked with my 12
year old on, you know, some bodyweight movements just to kinda
work on having an idea of how tocontrol his body in space.
Yep. But that's controlling hisbody. I'm not adding any
external loads to his body. AndI do think that there's value in
(20:05):
that. I think that there's youknow, I'll touch on it at some
point, but there's some basicfundamental human movements that
we're all designed to do.
Not my opinion. It's just howwe're made. Yep. So if we can
get our kids to just be reallygood at doing those movements
Mhmm. Just with their own bodyweight, they're gonna be set up
(20:27):
for success later when theyactually do start training with
loads more.
Now when they start reaching 14,15, they start puberty, they're
actually, you know, haveincreases in testosterone growth
hormone. They have the capacityto build muscle, then I think
that's when you can start havinga conversation about what that
(20:47):
should look like.
Speaker 1 (20:48):
What about kids who start puberty at 12? Because
there's some of that out there,as you know. I mean, you know,
right, doctor? It's How doesthat change the conversation for
those parents and kids?
Speaker 3 (21:00):
I think it definitely makes it a little bit more of a
conversation when they developearlier. Yep. I still look at it
though, you know, I'm veryconservative when it comes to
training, and I'm I just I'mvery wary about the application.
Speaker 1 (21:16):
Mhmm.
Speaker 3 (21:16):
You know, there's a very there's a there's a range
that, you know, people shouldtrain in based on the their
individual abilities. That'ssomething we can discuss more
later. But I'm just a little bitconcerned with young kids, even
if they start puberty early, ofknowing having the guidance and
(21:37):
the coaching of knowing how muchload they should put through a
young body Mhmm. Even if it'sstarting to develop early.
Speaker 1 (21:42):
Why do you think we see so many darn injuries in
kids who I mean, there it'scrazy to me. But the amount of
exercise, athleticism that'sdemanded, required, it just
seems like it's so much moreadvanced and part of today's
(22:03):
culture than it was when I was achild. Again, I wasn't raised in
a hyper competitive hub of theworld, but
Speaker 3 (22:11):
I think sports specialization is part of it
where these kids don't have anoff season. And they play, an
unbelievable amount of of games.And especially, you know,
because of the sports culturehere and the climate Mhmm.
Outdoor sports kids play all thetime. Yep.
I mean, I'm looking back to whenmy kids were younger, and
they're encouraged to specializeat nine years old. Mhmm. You
(22:34):
know, I don't wanna say back inmy day, but we used to have
seasons and you would play. Evenif you had a favorite sport, you
had a there was a seasonality toit. And you would you would you
play football or whatever yourfall sport was.
And then you'd you'd had a goodtime with that. Then you
transitioned to your wintersport, and then your spring
sport. And then you maybe youtook some time off in the
summer. And your body just notonly did it have a chance to
(22:58):
recover, but it had a chance toget into a different set of
movement patterns because youhave different sports that
require different loads,different velocities on your
spine or your hips or yourknees, different ways that you
move side to side. Some are morehave a lateral component.
Some are more straightforward.And, you know, it's it's a
bigger it's a bigger conceptthan just, oh, I need to rest.
(23:22):
It's you can theoretically restyour body from one sport to the
next because you're kind ofmoving it in different ways.
Mhmm. Now, though, heavy sportsspecialization, kids are
training, you know, good or badat a younger age.
And I also just think as youlook at the sports spectrum in
general, kids are bigger,stronger, and faster, and they
(23:45):
just are able to put more torqueon muscles and tendons that I
think we're seeing just don'talways have the capacity to
handle that that stress. Andthey they break.
Speaker 1 (23:56):
I mean, do you think kids are bigger, stronger,
faster? Or do you think we justhave a concentrated amount of
hyper athletic families thathave gravitated to one
particular place in America, whopush that on their children? Is
that? And I'm in what you haveto say about this.
Speaker 3 (24:16):
I would say that in my observation, I think that
it's more I think you're seeingit across multiple cities and
multiple places. I don't thinkit's just an area a Dallas Mhmm.
Moment. I think if you lookedacross, you know, especially the
major sports states, California,Florida, where you have great
(24:36):
climate, lots of people doingit, I still think you're gonna
see a propensity to have greateramounts of injuries. Mhmm.
Speaker 1 (24:44):
Yeah. I I agree with that. What about you, doctor?
What are your insights?
Speaker 2 (24:49):
So I've got patients that have young kids, and they
ask me these kinds of questions.Uh-huh. In addition to what
Matt's referring to, which Iagree with, I try to emphasize
the importance of nutrition andsleep. Mhmm. Because a lot of
these kids are going fromschool, which is obviously an
important part of their day, andthey're going from sport to
sport to practice.
Speaker 1 (25:04):
The most important part
Speaker 3 (25:05):
of it.
Speaker 2 (25:05):
The most important part, yes.
Speaker 3 (25:06):
And then
Speaker 2 (25:07):
they're going from practice practice to sport or to
the game or to so on, and sleepgets compromised. And then their
nutrition, they're just eatingon the go from one practice to
the other practice. Mhmm. And atsome point, you do need a good
balance of your proteins andyour fats and your carbs. It's
not just a high protein diet fora young kid.
Right? They need the cholesterolfor brain development. They need
the cholesterol for sex hormonedevelopment.
Speaker 3 (25:25):
Mhmm.
Speaker 2 (25:26):
So it's not that I push and say, start having
protein shakes on a regularbasis, but it's just being
aware. Like, having McDonald'son the way from one practice to
another doesn't make you a goodathlete. That's just not
appropriate. And then sleep isthe other element here is is
that after a long day of usingyour brain the entire day, but
then also using your body forthe entire afternoon, you've
gotta get rest. Right?
(25:46):
You've gotta have restorativesleep.
Speaker 3 (25:48):
Mhmm.
Speaker 2 (25:48):
And so I've got some families who are the multi sport
athletes, and they've got threekids doing all the great things.
Speaker 1 (25:53):
I know.
Speaker 2 (25:54):
But But then they're not sleeping. They sleep at
midnight, they wake up at six,and that's not adequate for an
adult, much less a grader. Mhmm.
Speaker 1 (26:01):
It's tough because I believe all parents are
hopefully trying to weigh thepros and cons constantly of
okay, if my kid is going to getinto x program at x school, what
do they have to do now in orderto be able to play? Sure. Okay.
(26:22):
So that's a good think toe dipat least on the hormonal piece.
I've always had lowprogesterone, high testosterone.
And then I had the factor fivelead mutation which prevented me
from being able to carrypregnancies full term. I had a
ton of miscarriages. Not a ton,but a few. And so that is
(26:47):
interesting because I know mysleep has never been excellent.
And as I get older and mybiological mother, she's still
alive, my biological mother.
She is very young, but shestarted and went through
menopause I think by 44. So thisis where I am starting to
(27:11):
notice, at least in my body, I'mprogesterone I've been
historically progesteronedeficient, and I'm here noticing
a lot of these patterns startingto creep up in my body. So what
do you say specifically on thesupplement side, things to
consider? For someone, I know mysituation is a little bit
(27:32):
unique, but who has thesedifferent layered factors
involved with their health, butwho wants to stay away from
hormone therapy, as much as Ican, but to not devolve into
this space of absolutely nosleep and hormonal hell? And
(27:59):
then how I also want to dip overinto the physiological space
with you, Matt.
But how would you even tacklethis?
Speaker 2 (28:07):
So the thing I do is I'm a big advocate for wearable
technology. Okay. So we have alot of tech now that helps us
monitor our sleep.
Speaker 1 (28:13):
Yep.
Speaker 2 (28:14):
And three or four years ago, would have never
given you that answer becausethe data just wasn't very good
or the output wasn't veryhelpful. Presently, some of the
brands out there are really,really good. And so I'll have
patients come back and tell me,I had that one tequila on Monday
night, and it disrupted my sleepfor two nights in a row.
Speaker 1 (28:29):
That's right.
Speaker 2 (28:30):
And when I'm That's worked differently. Less for
several nights, I sleep reallygreat. Yeah. And so identifying
those patterns is I think veryhelpful with sleep in
particular. In terms ofhormones, so there's good data
on magnesium intake forhormones.
There's a new drug out thererecently introduced by the FDA
that's a non hormonal medicationfor menopausal symptoms, and so
I've advocated for that for acouple of patients. And then I
(28:53):
think the thing is, and this iswhere I think Matt is the expert
on it, is your kind of mind bodywellness. What are we doing with
our muscles, with our joints,going back to the restorative
sleep side? A lot of thepatients that come to me with
menopausal symptoms, it's justprofound fatigue. And I'll order
all the labs, and then I'llorder all the other labs, and
all the other other labs, andit's all normal, but you're in
(29:13):
menopause, and you went from ahormone positive state to now
hormone deficient state.
And so I think that's where Irely on really good folks like
Matt to say, how can we helpthis person feel stronger? How
can we help this person identifywhich joints or which muscle
groups are the problem, and thenmove forward?
Speaker 3 (29:28):
You know, the biggest thing like I talked about
earlier is, you know, sleep,nutrition, stress management.
Speaker 4 (29:36):
Mhmm.
Speaker 3 (29:37):
And then the bucket of exercises are really the the
focus points for me. Anyadditional, like I said, you
know, testing or hormonal thingsI would refer out to somebody
that was specialized in that.But I do feel like there's, you
know, a giant avenue that peoplekind of want to skip past and
(29:58):
that is really, do I want tofocus on nutrition? Do I want to
focus on sleep, stressmanagement and actually going
through and consistentlycommitting to doing, I'll call
it exercise, but it's really,you know, improving
cardiovascular health, know,musculoskeletal training, really
improving all of those bucketsgives you, I think, a pretty
(30:20):
good idea of if you can committo those, how good can I feel?
And if I still feel like I'mlacking, that's where I think
additional testing would be,incredibly valuable.
And that's not to say that, youknow, I would ever say that, you
know, getting testing done offwhen you start a, a new plan, a
(30:41):
new goal, a new lifestylecommitment of going, okay. I
wanna go get a full blood paneldone. I wanna see where I'm
deficient in, you know,vitamins, minerals, hormones,
all the things. I think there'sincredible value there, but I do
think that a lot of people willsometimes skip to that before
wanting to kind of invest in thethings that they might have more
(31:02):
control over but are a littlebit harder
Speaker 2 (31:04):
Yep.
Speaker 3 (31:04):
To invest in. So I think that's, you know, it's
kind of where I've alwayslanded.
Speaker 1 (31:10):
What I'm interested in whether you all are provided
this from patients, like a okay,here are the supplements that
And then I ran them all throughchat GPT because I thought,
alright, I want to know what totake at night, what to take in
the morning, but I sleep with myOura Ring, then I have my my
(31:31):
fitness scale that reads all ofthe different data every single
morning. And I love data. Loveit. I thrive on it. And so I
know most, I don't know if a lotof people are this way, but I
love it.
And so I know what supplements Ishould take in the morning. I'm
acutely aware of what they do tomy body at different times of
(31:53):
the day. Love magnesium. Butagain, how often are you all
suggesting that people go backto their doctor and revisit this
blood work? Do you find thatonce a year is sufficient?
And how often are yourecommending your patients to
revisit their supplements withyou to be able to build a
(32:17):
certain amount of muscle?Because I find muscle is so
important in our aging, theretention of it. And so I'm
constantly fighting despite allof the pain and discomfort that
I've been in because of myBrody's muscle stuff and then
this herniation tear in my backand all the hip stuff. What are
(32:40):
these conversations like? Howoften are you requiring that
your patients and your clientstalk to you about this?
Is it once a year, twice a year?
Speaker 2 (32:52):
So it's at least once a year for sure. A lot of my
patients, and I think why Ireally enjoy practicing
concierge medicine is I have alot of patients who are very
invested in their health.
Speaker 1 (32:59):
Yes, I know some of your
Speaker 2 (33:01):
They come twice a year, they come three times a
year, and they'll say, you knowwhat, I'm gonna try intermittent
fasting for the next ninetydays, but before I do it, I
wanna get my lipids and mydiabetes things checked out. Not
that they have elevated lipidsor diabetes, but they wanna see
how intermittent fasting forninety days makes a difference,
or they wanna do an intenseworkout regimen for six months
and get pre and post labs. Andso two comments that I wanted to
(33:23):
make previously was there's thisbig push for using things like
liquid IV, which is a greatthing, but I've had more
patients Elements and otherthese big brands. I've had more
patients in the last twelvemonths who have come in for
screening labs that haveelevated calcium and potassium
levels
Speaker 1 (33:39):
Of course.
Speaker 2 (33:40):
Than I've ever had in my Yeah. And when you ask these
patients, they're like, oh, I doliquid I eat twice a day. Oh
Speaker 1 (33:46):
my gosh. Do liquid I
Speaker 2 (33:47):
eat twice a day. I understand if you're
particularly dehydrated, ifyou're hungover,
Speaker 1 (33:50):
all of habits If coming out of your sauna or
something. But
Speaker 2 (33:53):
the idea of I don't drink water, just drink liquid
IV or Element is just an odd wayto go. I really encourage
patients, I hope all my patientswould agree with me, when they
step foot in my office, nomatter what they're there for, I
review their medicines becausethey'll start adding things on
their own or they'll come inwith a particular problem. Well
it turns out that these twosupplements don't agree with
(34:14):
each
Speaker 1 (34:14):
other. Correct.
Speaker 2 (34:14):
That's You have a toxicity of vitamin D and
therefore your calcium went upand therefore you had a kidney
stone. So they'll ask like, thisis the worst pain I've ever been
in my whole life, and it turnsout that they kinda did it
themselves because they sawsomething on TikTok to take a
bunch of vitamin D. In someways, it's very educational. I
think that's a lot of the coreof what I do in the office is,
hey, do more of this, do less ofthis. I think the push for
(34:38):
vitamins is aggressive.
Speaker 1 (34:39):
It is.
Speaker 2 (34:40):
We try our best to be evidence based, get the labs. If
your labs are good, then you'regood. You're getting your
vitamins through your nutrition.And if you happen to have a b
twelve deficiency, we'll treatit. But I think the idea of
everybody needing to be on a aplethora of meds is just not the
way we should operate.
Speaker 1 (34:55):
I agree with you. I agree with you.
Speaker 3 (34:59):
I also agree with you. When it comes to all you
know, when it comes to bloodwork, you know, obviously,
that's not something that Ipersonally do. So I would say,
where whoever I refer to, I letthem kinda obviously be the the
quarterback when it comes tothat. Mhmm. You know, the the
things I said earlier stillapply as far as, you know,
feeling that, you know, to yourpoint exactly, like, let's test
(35:22):
to see where we're deficientMhmm.
And then supplement. That makesvery logical sense to me. Just
to touch back on your pointabout muscle, which is probably
one of the most underappreciatedaspects in the field is not just
the building, but themaintaining of muscle as we age.
So, you know, one thing I amvery adamant about talking to my
(35:45):
people about is that they ingestan adequate amount of protein on
a daily basis. Mhmm.
And that actually, as we age, wehave to increase our protein
supplementation even a littlebit more because we become a
little bit more inefficient at,you know, being able to
metabolize it. So the two two ofthe the best ways that we can
(36:07):
maintain, preserve, you know,for younger build muscle mass is
eat adequate amounts and trainour bodies to, you know, a
certain degree. Putting a lot offorce through our our joints and
our muscles so that they arethey have the stimulus to wanna
grow and and and maintain itbecause muscle is a very, very
expensive resource. And so, youhave to prove to your system
(36:32):
that you need it in order tomaintain it or build it. And in
the absence of that, you loseit.
We are woefully deficient in ouringested protein as a
population. So that's somethingI really try to encourage people
to do and be and be aware of,you know, because that's I know
education is probably importantthing that we're trying to
(36:52):
provide for the people that wework with. And that's one where
I think people really have noidea how important it is.
Speaker 1 (36:58):
What kinds of protein, added protein in either
shake form or supplement form.What are your favorite brands?
Speaker 2 (37:12):
I don't know if I have a favorite brand. What I
advise patients is get a mix ofanimal based and plant based and
natural. For my vegetarian orvegan patients, the animal base
is out of it. And so that makesit a little bit more difficult.
Some patients that reallyinundate their system with a lot
of eggs or a lot of dairy basedproteins, it just becomes a lot
or they get skin issues as aresult of it.
Ah. And so I try my best to tomix pea protein, whey protein,
(37:35):
and the natural proteins. For mymeat eating patients, it's a lot
easier. I mean, just having meatas a
Speaker 1 (37:41):
as a
Speaker 2 (37:41):
food is a bulk of it. But I find Fairlife to be a good
brand if if I had to pick onejust because it's a small shake
and it's Mhmm. You know, 32 or38 grams of protein, it's easily
accessible. In fact, going backto the kids for a I have my kids
split that a lot of mornings.Oh, cool.
Speaker 4 (37:59):
Because they
Speaker 2 (37:59):
like it. For them, it's chocolate milk, so they
think they're having a treat. Mywife and I, we think we're
having a treat. Yes. They'rehaving protein to start their
day.
Oh. And so that's been a niceaddition in our house.
Speaker 1 (38:08):
Great. Thank you. And what about you, Matt?
Speaker 3 (38:11):
When it comes to recommendations, I mean, I wanna
meet people where they're at. Itypically refer people to some
type of whey is my kind of goldstandard. And it depends on kind
of their tolerance to, you know,conscience whey protein
concentrate is gonna be, alittle bit more for those with
the sensitive lactose Yep. Kindof, you know, medium, they're
(38:35):
gonna have a little bit moretrouble with that. Isolate, I
think, is a little bit more it'skind of the the whey is broken
down a little bit more.
So it's a little bit more easilydigestible, but then you have to
also take into the account ofcalorically, some of them have
Speaker 2 (38:47):
Yeah.
Speaker 3 (38:48):
More calories, more more fillers, more other things.
I tend to go for the mostboring, unflavored, one
ingredient as possible proteinthat I can possibly find. I'm
the the brand's escaped me. I'mhappy to give them to you later
if you wanna put them in yournotes. But, but like I said, if
I had a vegetarian or a veganclient, I would promote a plant
(39:13):
based protein under the the guysthat we wanna make sure that we
have a complete, amino acidprofile because that's the only,
you know, issue when we havevegan, vegetarian Yeah.
People that we work with is thatnot all vegetable or plant not
vegetable, plant based proteinsare complete.
Speaker 1 (39:32):
Toggling back over to the genomics portion that are
perhaps a little bit moreaffordable than New Amsterdam.
That's I know the concierge it'skinda concierge based. It is, I
think, only, and the cost rangegoes up to about $3,500. But
there's Genomine, Nebula,Genomics, Self Decode, Gene by
(39:56):
Gene, Veritas Genetics. Do youwork with any and all of these,
or is there one in particularthat you work with, doctor?
Speaker 2 (40:05):
So like I was saying before, I don't use one of the
brands that does genomics forall organs. The ones that we do
are more organ specific. Sothere's a cancer, a big cancer
company called Ambry, and so wework closely with them for
cancer genetics. I'm thinkinglike BRCA one and BRCA two, but
about 90 other cancer causinggenes. So I've got a patient
that I take care of right nowwho has a particular gene that
(40:26):
increases their risk of melanomaand pancreas cancer.
And so the guidelines for thatare we gotta do annual scans on
her pancreas. We have to domelanoma screens every couple of
months because her risk is justthat high. In terms of the
brands that you mentioned, Idon't have an affinity towards
any particular one of them. Iwould say, I think this is an
opportunity to mention that onetest that we do order a lot of
(40:46):
is food sensitivity testing.Yes.
And so there's this push tothink about something called
leaky gut syndrome
Speaker 3 (40:52):
Yep.
Speaker 2 (40:53):
Which is fancy to say that in a in a normal person, if
any of us can actually benormal, but a normal person, the
gut is its own environment. Andnothing should leave the gut,
and nothing should enter thegut. Well, we have understood
that there are certain chemicalsor certain things that you can
consume that cause stuff fromthe gut to leave, and that can
cause systemic inflammation,feelings of fatigue, bowel
irregularities, and so on. Andso a test that's been really
(41:15):
helpful for patients is foodsensitivity testing, and
identify very healthy thingslike a patient that could have a
sensitivity to asparagus and todifferent fruits and vegetables,
and it turns out that that's whythey're not feeling well, or
that's why they feel morebloated and cramping. So it's
not genetics by any means, butclearly there's something about
their genetic makeup that is notprocessing eggs well or white
(41:36):
wine well or what have you.
And so I certainly believe inthe personalized piece of it. I
don't have enough experience tocomment on one particular brand
or the other. We feel like we'vegot a good handle on the groups
that we do use, it's a veryactionable set of outcomes and
we can do something with that.
Speaker 1 (41:51):
Do you have anything that you wanna add there to any
of these types of tests that arerun for the gene site mapping
that give people insights intowhat type of medication they're
predisposed to work better withand how that has translated to
any conversations or possibleconversations with your patients
(42:14):
or clients.
Speaker 3 (42:16):
Yes, clients. You know, I don't, like I said, deal
a lot with genomics or geneswith the type of work that I do.
I do think it's interesting,though, when you look at the
research on some of the diseasesthat we're talking about, being
Alzheimer's, dementia,Parkinson's, that one thing I do
(42:39):
try to educate my clients on isthat my current understanding of
the research is that one of thebest things that you can do to
reduce your risk of all of thesediseases is to not only
exercise, but to do heavyresistance training and have
strong cardiovascular health. Sowhen you look at, you know, all
(43:03):
of these diseases, one of thetop three recommendations from
all experts in all of theseMhmm. These fields is you need
to do shrink training and youneed to have good cardiovascular
health.
So because that's my strong suitand my expertise, I tend to make
(43:23):
sure I educate people on thevalue of what we're trying to do
in that regard because it it issomething that concerns me as
well. Mental, you know,dementia, Alzheimer's are things
that are on top of mind. I'vehad it in my family. So one of
the reasons why I'm sopassionate about the type of
work that I do is because ithasn't, in my opinion, one of
(43:48):
the the biggest benefits fordecreasing that risk. To say
that there's no risk, I'm notsaying that, but it gives you a
better chance of of decreasingyour risk of developing some of
these diseases based on, some ofthe research that I've seen.
Speaker 1 (44:04):
Can you talk a little bit about just some of your
clients, especially the ones whoare in their 80s and doing
competitions, liftingcompetitions, and the vitality
that these people exhibit? It'scrazy how how you're, I guess,
Speaker 4 (44:23):
your Well, the the
Speaker 3 (44:24):
biggest thing I tell anybody that comes in Mhmm. I
might have a, you know, anaverage age in the sixties and
seventies, but the body, thedesign of the body is the same
Yep. For everyone. Now it mightstart to function differently
and there might be some morerestrictions as we get older.
But if we train it to itspotential always, and that
(44:47):
means, you know, everybody in myopinion has a a potential that
we can try to get to.
And if we can train it to a highlevel and keep it there Mhmm.
Age will be a factor, but lessof a factor. I have some of my
strongest clients areapproaching 80, and they're just
as strong as any 40 year oldthat I mean, I I'll put that up
(45:12):
there. It's just as strong asany 35 or 40 year old that
you're gonna run into as far astheir ability to express
strength, mobility, no painMhmm. Highly functional and have
little to no restrictions onwhat they want to do on a daily
basis.
Speaker 1 (45:28):
What about over to you, doctor, as far as this
framework of patients in yourpractice?
Speaker 2 (45:35):
Our goal every day is to make healthcare easy. I think
it's really hard to navigatewhich doctors to see, how to get
labs done, which tests to getdone. Because if you Google it
or throw it into chat GPT, youjust don't know what the
difference is between A versus Bversus C. Correct. And so I hope
our patients would agree or mypatients would agree that we try
our best to promote their healthand prevent disease, and if we
(45:57):
catch something, we treat itaggressively.
And I think knowing what we knowand knowing what we don't know.
So an important part of mypractice is having a Rolodex of
specialists who are really topnotch, that if I don't know how
to manage something, I'll givesomebody a call and get that
patient in quickly.
Speaker 1 (46:12):
I believe, or hopefully, that over the course
of the evolution andintroduction of AI into our
lives more and more, that yourtype of setup, I guess both of
you in more of a conciergeboutique space, will hopefully
(46:33):
be the norm as accessibilityhopefully becomes more possible.
What are your thoughts on that?
Speaker 2 (46:43):
I hope that's the case. I think the challenge is
that corporate medicine is themainstay of health care in this
country. You have to have themega groups in order to support
the hospitals and the surgeons.And so will that ever go away? I
don't think it will.
The way that insurance is setup, and certainly in this
conversation we're not gonna beable to solve that problem. No,
(47:03):
no, no. But I think what I wouldsay is that in the world of
concierge medicine, it'sbecoming much more normal. Even
five years ago when I startedit, it was like, oh, so what is
that? What does that mean?
And now five years ago it'slike, oh yeah, several of my
doctors are concierge, I knowexactly what that's like. I
would tell you from the caredeliverer standpoint, I've seen
what care is like on my end ofit compared to what it used to
be when I was not in it, andit's night and day. It's not a
(47:25):
coincidence that I got myparents and my in laws into this
world because I'm confident thatthey're gonna get better care,
more attentive care, more timelycare because of it. And the
other comment that I would sayabout AI is a big part of what
my nurse and I do on a regularbasis should be replaced by AI,
And that would be really nicebecause we'll be able to spend
more time thinking about ourpatients, being with our
(47:45):
patients, researching about ourpatients, so on. And I think
that's gonna play even a biggerrole on the corporate side
because obviously the volumesthat they see are much different
than what we do.
And if you're able to get AI tojust replace these very mundane
things like prior authorizationsand pre certifications, that
stuff is very time consuming andreally doesn't require a lot of
(48:05):
education. It's something thatjust has to get done. And so I'm
an advocate on the consumerside. Obviously AI will help you
understand what your supplementsare, but on our side I think it
will replace a lot of tasks thatotherwise don't need to be done
by us.
Speaker 1 (48:19):
That's right. That's right. Well, gentlemen, is there
anything else that you wanna addin for our viewers and listeners
with respect to wearabletechnology, your practices, your
patients, clients, anything?
Speaker 3 (48:33):
I would just say that when it comes to AI Uh-huh. I
think in my line of work, Ithink it's gonna be hard to have
AI provide a lot of value andjust that like the type of work
being very subjective. And soI'm a big proponent of, you
(48:55):
know, I guess the the thing Iwould say the most is that
people need to commit a lot oftime to truly educating
themselves not just on, youknow, supplementation and
nutrition and things like that,but really, from my standpoint
with what I do, a lot of people,most people don't really
(49:16):
understand how their bodies aresupposed to work
Speaker 2 (49:18):
Mhmm.
Speaker 3 (49:19):
And how they're designed to work. Yeah. And that
there's a frame and amethodology to go about trying
to learn, analyze, and start toperfect movement that you were
designed to do to the best ofyour ability. And that's where I
think the type of work that I dois a little bit different in
(49:40):
that. I don't think that peoplehave an idea of that there is a
particular way that they'redesigned to move and that the
further they get away from it,the the less quality, the less
efficiency they have, the worsethey feel.
And so, you know, having aneducation and a knowledge and a
plan of attack to bring you backinto to your own design, not my
(50:05):
opinion, your own design, givesyou the best chance to feel as
good as you possibly can becauseI think that something that's
lacking in a lot of the peoplethat I come across Mhmm. And
work with initially at least isthey don't understand how their
body is supposed to work. And Ifeel like that is something that
(50:28):
everybody should be able toeverybody should know, have an
idea of how their body'ssupposed to work.
Speaker 2 (50:32):
Yep. I think my last comment would be just
encouraging patients to be anadvocate for themselves. Yes.
The number of patients that comeinto our office who don't know
what medicines they take or whythey take them, that's an
important part of your ownhealth. You have to know why you
take what you take and how youcan try to avoid taking certain
things.
And ask questions to yourdoctor. We're here to help you
(50:54):
ultimately. Every one of mypatients at the end of a visit I
say, is there anything else youwanna talk about? I really mean
that because sometimes the mostimportant thing or that one
thing that their wife asks themto ask me, that's when it comes
up. It turns out that that'sactually the most critical part
of the whole conversation.
And so I would always encourageyou that when you have a
doctor's visit coming up, matterif it's with your cardiologist
or your internist like myself,have a list of questions or have
(51:16):
a list of thoughts to say, youknow what, this thing is
bothering me, or what do youthink about this medicine, or
hey I read this. And I wouldargue that most doctors enjoy
that conversation. We enjoytaking care of people that wanna
be in good health. Yep. And sojust being prepared going to a
doctor's visit, I think, isreally critical.
It'll it'll make your healthoutcomes that much better.
Speaker 1 (51:35):
Thank you for being here.
Speaker 2 (51:36):
Of course.
Speaker 1 (51:36):
Thank you. Yes.
Speaker 2 (51:37):
It's fun. Yes. Yes.
Speaker 1 (51:45):
Yes.
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