[0:00]We have here today, Dr. Sandeep Palakodetti. This is his book, The Ultimate Asset. The focus of today is this midlife reset. Oh, midlife is something that we'll worry about later. We regret to say we are approaching midlife. I'm probably already there. We have little burning fires smoldering all over our body. There's a lot of things that can cause these little smoldering fires to just be burning and even if we're healthy in a lot of ways, those fires eventually cause the forest fire. I think what you're doing is what everyone wishes every doctor would do. It is our evolutionary duty to pass along the wisdom and knowledge that we have attained throughout our entire life in this middle-age decade.
[0:46]Today we have an interesting topic and guest. Number one, because I've never thought of myself as midlife. But, but I think I'm going to have to start accepting that. What's the average age in America for a male? I feel 25. The average age of just like death. Oh, death. I remember women's, this was years ago. I remember it was like 73 and then men was 70. I think it's pull it up, Jamie. Jamie, pull that up. 76.5 76. Thanks, Nate. All right, we're not there yet. You might be old-ass man. 76. So if I'm 35, I'm 34 still, all right. I'm midlife, dude. I'm I'm exactly midlife. Yeah. We're midlife, dude. We need to reset and Dr. Deep is going to be our guest. Dr. Deep is an interesting kind of guy because he's an MD, he's an MPH, so masters of public health. And MD's and MPH's are usually operating in opposition of each other. One's administrative health, so you get like a bird's eye view of what's happening in the country and in the world. And then one is like niche down to what's happening in your clinic. And so when you have a masters of public health, you really have this like comprehensive bird's eye view of what's health trends are. And you understand the statistics and really the sociology of medicine. And so Dr. Deep has is is dual certified. He runs an immaculate telehealth platform called Velocity Health. I mean, he has a team of doctors with with Velocity, but the best part about Dr. Deep is that wherever he lives and wherever you live, he can be your doctor. Yeah, and I would say that I categorize him fully and completely as my kind of guy. He is my kind of, he's one of us. Yeah, and I just love somebody too, that goes in as deeply and as vastly as he did and he's innovating. Yes. And he's gone all the way in as you just described, multifaceted, gone all the way in and then to do that and to innovate with it instead of like stay rigid, I love it. You're my guy. Yeah. So Dr. Deep and I have, I recorded an episode on oral health on his podcast. We'll link you guys to that. But what's interesting is, you know, kind of the way he approaches medicine is really the way that I approach dentistry and it's like we're not able to get pigeon hole, so we feel homeless. We don't really get along with anybody because we've kind of carved this little corner for ourselves. We're functional, but we're not functional. We're traditional, but we're not traditional. No one likes us. Are you saying that you're a nuanced practitioner? Yeah. Whoa. I'm saying no one likes Ilan. That's all I'm saying. I'm just not a likable guy. That's I think that's false. Um, but at least I'm an independent thinker. Yes. But anyway, Dr. Deep is really good at explaining difficult concepts into really easy to understand ways and I'm actually curious to hear how he's going to explain some of the things that I even understand because I know he's going to phrase it in a cool way that I haven't really thought of. And he is really not afraid to buck the trend of like reference ranges or like all these things that most doctors have kind of just accepted as like, this is how it goes. He's not afraid to like speak out and kind of be like, actually, it goes this way.
[3:48]So, we have here today, Dr. Sandeep Palakodeti. He goes by Dr. Deep for short. This is his book, The Ultimate Asset. We're going to hold it up here. It is incredible. I'm still only like a third of the way through, but so far it's awesome and a lot of it resonates so much with how I treat my approach to patient care. But Dr. Palakodetti is the CEO and founder of Velocity Health, which is an incredible platform both telemed and otherwise. He has a great experience treating like high performers, executives, athletes, and what Deep Dr. Deep really brings to the table is that he has such a unique and what we call based approach to care, that it is such a unique blend that you really don't see. So Dr. Deep, please introduce yourself for the people who may have never heard of you. One second before you do that, I want to add something. And I I mean this genuinely. I think what you're doing is exactly how it's supposed to be. I think what you're doing is what everyone wishes every doctor would do. And that's a genuine compliment that I wanted to make sure I got out there right at the beginning because it it's we're very excited to have you on the show. Well, thank you, TJ, and thank you, Ilan. I agree. I think our approaches are so similar and I've you know, been so inspired by your outlook and how you approach dentistry and oral health and functional medicine as well. And you know, I'd say my journey has brought me here for a lot of different reasons. We look around and 70% of us are overweight or obese, 60% of us have diabetes or pre-diabetes. Cancer rates, neurodegenerative disease are skyrocketing, childhood diabetes and obesity rates are higher than they've ever been. What we're doing is obviously not working. As a physician, there's a great moral harm I think that we are all suffering when it's easy to dog on the docs out there, but we're all kind of put into the system.
[5:41]We become widgets in a machine where we have 30 people in the waiting room and we have 10 minutes to see you and get you out of the door and put you on this med. Otherwise, our overlords are going to ding us and we're not going to be able to pay for our our lifestyle that we've created. So, I'm not willing to limp through the next 20 and 30 years of life and suffer chronic disease and wither away in my seventies.
[6:21]I want to be thriving in my absolute best self for 40 and 50 and 80 more years if I can. I think science is at that point where that's not a hyperbolic statement.
[6:33]And lastly, you know, I continue to see this recurring archetype of patient who is incredibly successful.
[6:44]You mentioned, you know, these executives, these celebrities, these athletes, people who can create strategy, focus on KPIs and OKRs and create an entire plan for a portfolio for decades into the future and you ask, well, what are your systems for applying that same rigor to your health and you're sort of met with a blank stair. And so when we think about all of those things colliding and the current American health care system, TJ, it's what you said is you have to kind of strip it away. You have to start from first principles thinking and blow it completely out. So the insurance industry would never pay for a preventative full body MRI or a cancer screening in a 30 or 40 year old. We would never be able to spend the amount of time that we need to spend with patients to understand your culture and your preferences and that you're going through a divorce or a career change or whatever and how all that might impact your health. And so when you strip all that back and you rebuild the kind of clinical experience that we'd want for ourselves and our family, that's what I hope we've done at Velocity Health, which is one that's deeply individual and personalized, that knows you from the genetic code to thousands of biomarkers to the most advanced imaging tests that we have and pulls it together. Surrounds you with a team who is there to support you and to push you and be your cheerleader and to present to you the data like you said, where we meet people where they are. We are trying to be the beacon that others can follow. So pause there. No better introduction than that. It's it's incredible. I just want to I want to I want to add something onto that because I I think if I shared just a quick understanding of what my experience was with finding I I the doctor that I go to. So 2018, 2019, uh I was 27, 28 years old and all of a sudden like my hair started thinning more, which I have a genetic factor, right? Like I obviously like was not going to keep my hair, but it was just it happened pretty rapidly. I went to urologist, I went to endocrinologist, I went to like every kind of doctor I could find. I was getting my wheel spun and then finally, someone that I know that uh is enhanced was like, I have a doctor that they focus on bodybuilders. That is their main type of patient that they take. Funny enough, we all I think we all hear and know the bodybuilding forums are usually like 10, 20 years ahead of of the mainstream on like everything. So I go to this doctor and it was the first time that I had ever experienced, oh, I pay cash for this? This isn't insurance covered? I sit with you for an hour after I get my blood work and we go through everything. They caught my Hashimotos that no one else caught my entire life. They diagnosed how low my tea was. They talked to me about what was going to actually happen when I went on tea. They talked to me about HCG, how to cycle, how to get my fertility back. How to talk about all these different factors, vitamin D levels, everything that I had never had a conversation about in my whole life. It just changes what healthcare is. It changes everything. I went from like, I don't want to go to the doctor to I literally was like giddy to go talk to Dr. Jerry. Shout out Natural Medicine and Rehabilitation in Somerset, New Jersey. Dr. Keppco and Dr. Jerry, but all jokes aside, it completely changed my view of things. And then to hear that like you're doing it at the scale and at the level you are, too, it's just like, bravo, bravo. And more people need to know about this and experience this. Right. And I think Dr. Deep, can you just tell people like maybe the scale at which velocity operates? Because I don't want people to think that this is a clinic that they're geographically restricted from from visiting. Yeah, thank you and thank you for those comments, TJ. We are what we believe to be the first digitally native concierge precision medicine clinic across the country. We are available in all 50 states, we're licensed in all 50 states. We interact with our patients in their local communities through our diagnostic. We are setting up our own precision wellness centers over time. But you know, we're for the type of people who don't want to spend four hours driving downtown, parking and spending 10 minutes with a rushed appointment just to feel like you've not been heard. We're for the type of people that are, you know, busy parents and executives and who have 50 things to balance in their day and might be in Ohio one month and down in Florida the other and in a conference in Vegas and all over the world and they need their doc in their pocket to be able to follow them wherever they are and and be there for them wherever they are. We are increasingly having a global presence as well. And, you know, that's the kind of modern organization that I think we all demand, right? Like with enough density of interaction together like this, you know, when I'm spending 90 minutes with someone like this every quarter, you really get to know them and and see them. And lastly, you know, we we are having community events throughout the year that we pull together as well where individuals can sort of experience in-person retreat type events with with others who are patients of ours are in the same kind of community. But we are available across all 50 states and and even globally. That's amazing. So, just to switch gears a little bit, we, you know, the focus of today is this midlife reset and it's funny. As TJ, Calvin and I have been kind of talking about this, we regret to say we are approaching midlife. I'm probably already there. Right. And so the better part of us wants to think that, oh, midlife is something that we'll worry about later. But the truth is is that we by all intents and purposes, we are probably already in midlife. You know, it depends if if you think we're going to live much longer, what midlife really means, if the goal posts are moving. But the idea of this midlife reset, right? Is kind of a difficult conversation for the three of us because we are been in denial about the fact that we're already here. And so, um, you know, we want to kind of, um, treat this episode as maybe our first acknowledgment of our entry into midlife. And to hopefully help other people understand that maybe it's not so bad to be in midlife and how to kind of reframe and shift and how to now take care of yourself in a different modified way. I'm sure there are many people who are watching that are also in this kind of uh having a bit of a baptism moment where it's like, okay, now, now I need to start thinking about things a little bit differently.
[12:45]So let I want to kind of dive in with some quick things. I think it BS or not would be a nice segment to kind of jump into some of the meat and potatoes of this stuff. So, the first one is, midlife comes with slower metabolism regardless of your lifestyle. BS for sure. Interestingly, when you look at marathon runners, we check VO2 max in all of our patients. And you look at most athletes, they cluster in sort of the younger, early twenties is when, you know, all the star athletes kind of make their prime. You look at marathon runners on the other hand, there's an interesting distribution uh that most of those world leaders are more in their late thirties, early forties. And the thought is it actually takes that much time for mitochondrial biogenesis to get to the point where you can have an elite level VO2 max like that. And so, there's examples all over the place of midlife being the inflection point for us to achieve peak health if we allow ourselves to. It is, however, the decade, you know, 40 to 50 or so, where we start to enter peak entropy. And I think that's the part where we are constantly battling against where things fall apart faster than we were previously aware of and it takes a little bit more intentional thought to prevent that aging process. That's a that's a good answer. I like that. All right, next one is lab reference ranges are accurate for everybody. I wish, absolute BS. Lab reference ranges are often determined on population base levels. As the population distribution changes, the normal range changes as well.
[14:35]And so, you know, testosterone is a classic example of this. We used to have a normal range above 5 or 600 and the average median token testosterone for a 40-year-old male 40 years ago was in the 700 range. Now that's more in the 400 range or so. And now we've seen that our normal ranges have expanded and shifted and, you know, uh a tea of 280 or 300 is a completely different life experience for people versus a tea of 900, which are both considered in the normal range. So, we have our own velocity ranges that we use on every single lab where we have either a tighter or a different sort of explanation of what's optimal looks like. Doc, I love that you that you bring that up because I try to explain that to people all the time. Everyone's like, what are you talking about? Like, no, my doctor said 200 to 900 is normal tee. And I'm like, that's just like two standard deviations of the current population. Like, that's not what it should be. That's not optimal. Yeah. And also, I think something that's that's interesting to me again as I learn more about this that's crazy. There's no thought for ratio, right? Like estrogen and testosterone. If we're staying on the hormone track, like estrogen, yes, there is there's a range, but at the same time, you're somebody who's running hot and you have like a 1500 total testosterone, your estrogen level that you're supposed to be at is actually higher from my understanding. That everything should have been ratio, not just some biomarkers that do take ratios into account, but you're right with the sex hormones, there's not there's not a great uh SHBG2, like there's just a lot of different things that I think are interesting. And then another thing, you know, I'm sure you see this all the time is like menopausal women, you know, Like women are in such this like dynamic state that like their bodies are changing. And these reference ranges are so static that like they don't measure the changes that women's bodies go through. So, it's I'm glad Velocity has their own reference ranges. That's that's amazing. Um, all right, a spicy one. High cholesterol causes heart disease. You'll get all sorts of comments no matter what I say here. I am of the belief that high cholesterol is but one part of a larger equation, meaning you must have both atherosclerotic particles floating around at high levels. But the more important thing is probably your vascular endothelial health in order for thosetic particles to enter into your arteries and kick off the cascade that starts a heart attack or stroke.
[17:11]You need damage to those blood vessels and that's typically that happens in four ways. Through high blood pressure, smoking, diabetes or inflammation of any sort. So you have to ask about those things. You have to manage those things. When you look at the hazard ratio of having a heart attack, BO2 max, for example, has a hazard ratio of four if you have a low VO2 max versus a high VO2 max, and an LDLC has a hazard ratio of, you know, 1.2 or something. So, you know, a high cholesterol might confer a little bit higher risk, but there's so many other factors that go into that. If you can control these other factors, then there's probably a healthy medium range, like most things in medicine that is where we're supposed to exist. It's so interesting because like I have a lot of young guys that will be like, oh, my calcium score zero and it's like, well, you probably haven't had it long enough for the soft plaque to turn into hard plaque. In some ways we're moving forward and in other ways we're moving to the side because like there there's like we have a greater understanding and like a greater source of measurement. But we're also like sometimes misunderstanding those measurements, right? And it's like I think the way that you kind of approach it is pretty balanced. Way to avoid the negative comments though. All right, this one's a real tricky one and I'm honestly feel guilty even asking it for you. So, if you can run a marathon, your heart is healthy. I have a patient who is nearing 50 years old, who's in pretty damn good shape, ran a half marathon recently, had a heart attack out of the blue. Didn't die. He's okay. And he's getting better. But, you know, you look an archetype like that and think they're okay is VO2 max is probably amazing, but what he actually had were two things. One is what something we see in marathoners sometimes is you focus on your cardiovascular health, but you're not muscled up enough. Muscle acts as a glucose sink. It pushes blood sugar into compartments that now can be used in productive ways rather than glyting and products and causing damage. And so when you have low muscle mass, you can have higher insulin sensitivity. This guy was actually so high charging and overtraining that he had chronic hypocortisolmia, chronic hyperglycemia, low muscle mass, therefore high insulin resistance.
[19:35]That's the great irony with how we present statistics and all these things. We we say, okay, well, your cholesterol is fine or or your cholesterol is elevated. Here's a statin and you must be protected now. But okay, what about all these other risk factors you have? We're a marathoner and you're running, but you still have these risk factors. Just because you're lean doesn't mean that you're healthy. So unless your doctor and team actually go looking and help you quantify that risk and help understand what that actually means, then you're not going to mitigate those unknown risks.
[20:09]Um, so that's, you know, how I would say that. Interesting. Also, you know where my brain immediately went for Tachertov. People are losing weight. They're potentially losing muscle mass, the glycogen action on it as well. It kind of like the first part that you I I again, I'm no doctor, but just me putting the pieces together. That's where my brain went immediately. We have it, we don't have enough data yet, but I wonder if that's going to lead to some heart issues for folks. That's the thing. I think a lot of people they lose sight of things is that like, you can be, you can have aspects of metabolic health, but then under the hood, like Dr. Deep is saying, like you can be very metabolically unhealthy with like a lot of metabolic fires that need to be put out. And like, if you're not careful, you know, you have like 25 levels of metabolic health and you could be amazing at six of them and then the others are like in the dumpster. But I think with the way we just evaluate people with our eyes and like a very simplistic way of looking is like shallow and I think that what to to Dr. Deep's point is like, you know, you have this guy who's like, the the pinnacle of health in his fifties. But actually, you know, he's become somewhat of a chronic stress example that has led to kind of an unfortunate. I'm glad he's okay.
[21:20]Yes. All right, so the last one for BS or not, I want to ask you, is biological age a valuable indicator of aging? I think it's funny when Brian Johnson's out there at like 18 years old. Before you know it, he's going to be three years old on his biological age. I think in those ways it's stupid that I don't think the absolute number is based on any reality. I don't think this absolute number is based on any reality. There are signals that are telling us we need to check the engines somewhere. Go do that. I don't think this absolute number is based on any reality.
[22:15]There are signals that are telling us that we need to check the engines somewhere. Go do that. That's how I would do that. Great answer. I think I think it's also interesting too. It's like people say like, oh, my immune health is like 22 and then my cardiac health is 74. And it's like, well, how good is your immune health if your cardiac health sucks? Like we've we've siloed the body, right? It's like if you're well if your cardiac age dies, then I don't think your immune age is like living to tell the story. Yeah, yeah. It's like, you know, or my left ear is like 18 years old. Well, like who gives a if like everything else is is garbage. I think that just generally speaking this whole like longevity precision medicine biohacking space, we love the data. We think it's very informative. We use as much data as we can, but we also temper that with this back stop of false precision, right? Some people are trying to get so accurate like dissect every two beat difference in their HRV. It's like, we don't know, right? Like there's so many factors that go into that. You're starting to get kind of neurotic about this too. So there's a a point to which the data just needs to be used in the right way and presented with the right caveat as well. Totally. Everyone's erratic age is very high. That's for sure. One of the things that talked about when we were starting the show was like a little bit of it is we're deep in this space, all of us. You're your the deepest you could possibly be. Dr. Deep is Dr. Deep. Um, but even just like the conversation that happens on X and like a lot of like the the cutting edge stuff is, when I talk to every day folk, and I know this is not putting down anyone. They have no idea what I'm talking about.
[23:59]So we have a segment that we like to do, explain it to my mom.
[24:05]I have a few here. Uh, the first one is Apo B. Here's how I think about it. Your arteries are like highways. A heart attack is like a big crash and traffic jam that happens on the highway. When a big blockage happens like that, everything downstream from that dies. So you don't want that traffic jam or those crashes to happen. Think about cholesterol as the people inside the cars and the cargo inside the trucks. You don't actually care whether the car has one person in it or four people in it. You don't care whether the truck has zero cargo in it or is full of cargo. We care about are the number of cars and trucks on the highway because that's what's going to cause the heart attack. And so the Apo B is measuring how many cars and trucks are on the highway. Cholesterol is measuring how many people are inside those cars and trucks, which again, doesn't really matter to us. So the reason we check Apo B is because we want to get a good sense of you got this highway, how many cars and trucks are driving on it, and can we expect that there's going to be a traffic jam on here or not. That's good. It's fantastic explanation. Well done. Nice. The next one. Fasting insulin. That one's probably a little harder, but, you know, I think this one and things like hyperinsulinemia, I would I would sort of wrap together is, when we eat too much sugar, it starts to cause damage.
[25:36]We need something to push that sugar into places where it doesn't cause damage. That's what insulin does. Before we see that damage, we can get a sense of if you have something impending because your insulin is elevated and it tells us that your pancreas is working overtime to push all that sugar back into compartments where it needs to be. And so, if your fasting insulin is high, it is usually a leading indicator of impending diabetes. When we look at something like your hemoglobin A1c, that is a lagging indicator. That means that the damage has already been done, and we are now treating that. So, checking fasting insulin is a way for us to get in front of the disease process way ahead of time. I think my mom would understand that, but maybe maybe. You know what? At a bare minimum, it was good enough where they'll pretend they understood, you know. One of your phrases, inflaming. Inflaming. I'm not going to claim in yeah, I'm not going to claim credit for that.
[26:47]I mean, I don't know if it's Mark Hyman or whoever who who came up with this, but we have little burning fires smoldering all over our body that can happen from any number of reasons. Poor sleep, high stress, autoimmune diseases like lupus or rheumatoid arthritis, or having extra visceral fat and adipose on us. There's a lot of things that can cause these little smoldering fires to just be burning and even if we're healthy in a lot of ways, those fires eventually cause the forest fire. Whether all the other stuff we do is the kindling that kind of blows it up, but if we have those baseline smoldering fires put out, then it's very hard for any of the other disease processes to take place. So this is essentially just long-term inflammation that's wrecking your body. So, if you were to not stop the things that's causing the inflammation, but yet stop the inflammation, does the damage still happen with, let's say, hyperbaric chamber or any other drug or anything that can tamp down inflammation. My general approach would be we should always get to the root cause rather than treating the symptom or the outcome. Like if you're putting yourself in a situation that's causing inflammation, we should get to that. Probably the dual approach is best is find the root cause and treat that while you're also treating the symptom. Got it. And the last one for this segment, vagal tone. Our bodies exist in this constant balance of activation and depression. So when we say vagal tone, that's about this rest and digest side. This kind of chiller side of our physiology that needs to be in balance with our chronic stimulation that we are constantly all living in. We all live in a hyperstimulated environment, whether it's the blue light in our face until 12 at night, or it's the chronic stress, or it's social media doom scrolling. All of these things are leading to higher sympathetic activation that causes more inflammation, heart disease and all of these things. We need to focus more on our vagal tone, which is activating that rest and digest side. There's a lot of tactics to get to that. So let's say that I am a uh young executive that's hypothetically approaching middle-age, overstimulated, overworked, over-blue light. What are the best tactics to stimulate that vagal tone to lower the sympathetic activation? The best thing is remove the offending stimulus.
[29:27]So focusing on, you know, we'll maybe talk about sleep later, but the three-two-one rule on sleep is probably the biggest one for me. Most executives struggle with sleep, and that's where most of this starts. But three hours before bed should be your last meal. Two hours before bed should be uh no more screen time. That's probably the hardest one for most people and and one hour before bed should limit your fluids. And we really believe this is kind of the hidden unlock for a lot of people in this archetype to to return to a time of balance and uh stability as well. All right, Dr. Deep, so we're going to uh close out with this last segment called the tier list.
[30:09]So I'll let you go. Metabolic flexibility. S-tier for sure. I think this is probably the biggest thing and what we mean by that is like I think if you are excluding whole groups of macros from your diet, that's fine. A long-term strategy overall, I don't know, we'll have to see.
[30:34]The biggest thing here is, you know, avoid naked carbs, pair carbs with protein and fat, you know, consider watching your glucose trends on the CGM. We recommend that for most patients for, you know, at least a a month at some point. And so, metabolic flexibility for sure, S-tier on my list. And we got stem cells and PRP. I'll say A-tier on those. Only because it is still under investigation in a lot of ways. I'm very hopeful for this space. I see a lot of benefit. I think stem cells are going to change the world. I think we're going to cure all sorts of conditions and avoid all sorts of other kinds of procedures and downstream impacts by the use of stem cells, but it's still early and we're pioneering that. I am hopeful but we need more data.
[31:36]I'm very hopeful for this space. I see a lot of benefit. I think stem cells are going to change the world. I think we're going to cure all sorts of conditions and avoid all sorts of other kinds of procedures and downstream impacts by the use of stem cells, but it's still early and we're pioneering that. I am hopeful but we need more data.
[31:36]I'm very hopeful for this space. I see a lot of benefit. I think stem cells are going to change the world. I think we're going to cure all sorts of conditions and avoid all sorts of other kinds of procedures and downstream impacts by the use of stem cells, but it's still early and we're pioneering that. I am hopeful but we need more data. What about continuous glucose monitors? Probably A-tier as well for for a short time at least, as I mentioned, I think everyone could benefit from things like understanding how to poor sleep impacts my glucose spikes. You know, I wore one and one of the interesting things is just like, how does stress impact it? I remember like getting an argument with my partner and and I watched my CGM and it's like spiked to 180. I was like, oh, wow, there's cortisol happening in real time. It just helps you get it a little bit more. I will balance that with the fact that people can get overwrought neurotic about these as well. Overall, I think it's a helpful tool for most people. Now they're available over the counter without even a prescription. So, most people should be able to access that. And full body MRI scans. I will say A to B tier here. I am bullish on them. I'm probably one that believes in them more than most. And the arguments I hear against them are, one, you find stuff that you don't know what to do with. And two, we don't have the resources to do that for the entire country if we really wanted to. On the first part, that's a lazy way of saying, I don't have a good enough relationship with my patients to explain complicated things, which is if I have an MRI and I see a spot and it's likely a manoma that's non-cancerous. And if we go sticking a needle in it, it's going to bleed, I have to have a relationship with my patients. I should have prepped them ahead of time to say, look, we might find this, this is what we're going to do if we find it. We might find this other thing if we do, we're going to go down this route and we're going to investigate it in the proper way. When you have time and trust with patients, no amount of data should scare you because you know how to put it into context and have the right kind of conversations. On the resource side, full body MRIs used to be $2,500. Now Ezra offers them for $500. You're going to have these available for $100 just like a Lexus can on every corner in the next five years. So whether we like it or not, people are going to access that information and we're going to have to figure out what to do with it. So, I am bullish on them, but uh, I still think we probably need more protocols and more thoughtful approaches to that. It's funny you mention that. I had an incidental finding of a menoma and I was in dental school at the time and, you know, I found out I had like at the time I'm finding out I'm being told I have a brain tumor. You know, and it's like, it's this crazy thing and like you don't have the wherewith all. And I'm someone who's literate in these things and it was terrifying, right? And so if you don't have the right person holding your hand at your side, if you go get these like full body scans, you could read something that's like terrifying even if it's something not to be worried about. So, it's a good point that sometimes data in the wrong hands is like a monkey with a machine gun, you know. Last one is uh sleep trackers or wearables. Sleep trackers for sure. Again, I think for a month or so. I think I don't know if it was Andy Galpin or someone who coined the term orthosomnia, but it's gets pathologic when you allow the tracker to tell you how you feel rather than logging how you feel and correlating that data with the helpful data points. And if it's disconcordant, how you feel should win, not the other way around. And so, as long as you can have that kind of relationship with the data, I think it is important. Again, I I mentioned the importance of sleep. I think a lot of people fall asleep from sheer exhaustion, wake up at two or three in the morning with thoughts racing, have a hard time going back to bed, struggle a little bit, wake up at six and power through the day with a bunch of caffeine. Like that explains 50% of my executives. And that piece you have to unpack and measure each of those components in a structured way to really understand what's going on then. Give the right intervention rather than just, you know, throwing magnesium at that one. And I do think people need to understand too like how these things work. They're accurate. They also fill in the blanks. They're predictive a little bit too, right? So there's like especially whoop, like I was a whoop user for a long time and I'm not talking down on it. It's probably the most accurate thing that exists as a wearable. But at the same time, like it fills in the blanks. There's that because I know because I took it off to go in the shower and then I I put it back on because I didn't want a wet wrist and that data doesn't show like any any loss of data, right? It's it's a continuous going or with loose on your wrist or whatever. So everything to Dr. Deep's point, like it needs to be used as correlation and understanding, but like if you take it as like hard data and get neurotic about it, you're just going to drive yourself insane and it might not even be accurate what you're going to say. Totally. Right. Right. And the VO2 max assessment on the Apple Watch, if you actually go click in and look at what formula they use, it's from one study on like 18 bros like 20 years ago. You can't extrapolate that to general population. I stopped wearing all wearables altogether. And I still recommend them for my patients, but for me, I got what I needed to out of them and now I know how to tap into my own body and understand where I'm at. Totally. It's almost like where you, you know, you have to count your calories and weigh your food for like a month and a half or two months, learn it and then you have that skill set forever. Yeah. And understanding that like a tablespoon of peanut butter is this much. Yeah, this much. Right, right, right. You learn that like two glasses of red wine before sleep tanks your sleep score, okay? I shouldn't do that unless it's like I'm celebration or whatever. Dr. Deep, can you want to have any parting words for the people and also let us know where we can find you? Thank you guys so much for having me on. One thing I would say is we think about the midlife reset is is I write about this in the book. Why are we actually here post reproductive age? What is the reason for us to be in our fifties and sixties and seventies? Most other species reproduce, especially men, kind of die off, male species die off at that point. You look around at a few like elephants and walls and a few others that have this collective tribe and they do have elders there. And there's a thought that that institutional knowledge essentially of like the elephant mother who knows where the distant watering hole is, where there's a drought, protects that entire tribe. In that same way, I believe, it is our evolutionary duty to pass along the wisdom and knowledge that we have attained throughout our entire life in this middle-age decade.
[38:39]And so, with that context, we each need that team around us. Whether you're a DIY biohacker type, that's fine, but go inform yourself with the right information and go follow podcasts like this and really arm yourself with knowledge. For most of us though, we need a team that can actually wrap around us. We provide that at Velocity Health, velocityhealthclinic.com. Uh you can find all of our memberships and everything there as well. We we'd be thrilled to work with any of you, but thank you guys for this opportunity and uh really looking forward to seeing our ongoing partnerships here. Thank you. And we're going to link Velocity Health. We're going to link to The Ultimate Asset. And we're even going to link. I was on Dr. Deep's show as well, the Velocity Health Podcast. And so we're going to link that episode in in the notes as well. Thank you so much, Dr. Deep. I'm sure we're going to there's so much that I wanted to ask you, but, you know, we do try to keep these episodes short for busy people like us who don't have time to watch three and a half hour podcasts. So we're definitely going to have you back. Yeah, definitely. To dive in, to dive into some more stuff. But thank you so much for coming on. Love to be back. Thank you guys for having me. Take care.
[39:46]All right, Mr. Middle-aged man. How do you feel about that after we just heard? I feel old. No, so what's interesting here is, I've been trying to find a doctor, and I've popped around. I found one doctor that I liked. And then she went to like a different clinic, and I kind of followed her. And it's really difficult to find doctors that understand that you're not the normal patient. You don't need to tell me that I need to eat my macros and like do whatever. But with Dr. Deep and a lot of doctors like him, they're just so far and few between of like understanding that you're a 32-year-old man and your testosterone's 330, like that's not normal. But there's a class of people like TJ said, that are just not normal. And probably in a good way, right? They're high performing in a lot of aspects of their life, and they don't need the traditional medical system of just here some drugs. It's, I want to make sure I don't need those drugs in 5, 10, 20 years. So what do I do now? We're trying to make sure that we're not going to end up in a wheelchair, break our hip. What are we do now to prevent that instead of waiting until that happens? So I think it was great conversation and a lot I need to work on. Yeah, and as we all do. And like, to your point, right? Of talking about like how a doctor speaks to you. My brother is a doctor, right? Like I I don't I don't want to speak negatively about doctor. It's just they have no choice. Because of the timelines and people not listening, and the only way to make money is to kind of churn through in the system that we have, like that's the option. That's why medicine in this way where it's like telehealth and you can like pay a little bit more of a premium and get the longer conversations, both sides understand what's going on. And it gives an option to people that care, right? Everything in life, whether it's our products right here or whatever else you're buying is perceived value, how much do you value this thing? So this is an excellent way for someone that really values their health, okay? Now you can take care of it in the right way. This is it's amazing. So the point is is like if you make it very clear and you're vocal about what you want, the system will adapt to that, right? That's the free market speaking is that like, but for as long as you go into the doctor's office and you're like, don't weigh me, don't take my blood. This is annoying. This is irritating. You're going to get the bottom rung of the ladder of care. Yeah. Going with a list. I want to test all this stuff. Yeah. Well, that's why I mean, I started paying for my own blood work. When I would go to my primary, I don't have one anymore, so I'm not talking about anything specifically. This is more of a template state. Dr. Deep, I'm coming. But, um, and I would be like, oh, can I get the hormone panel in this and they'd be like, why? You'd ask me why? Right. And once I had that experience once, I was like, uh, then I had it twice and I was like, all right, you're done. Like I'm not, I'm not explaining myself to you. When a doctor tells you that you're a young healthy male, you don't have to test your testosterone. Like that's crazy. I'm about to show you what that testosterone is going to do, pal. Uh, but jokes aside, like I not affiliated, I use function health. Yeah. Chris Williamson influenced me on that. But, um, I just get my all my blood work and urine testing and then I also add on whatever I want. It's just so much easier. And I can get everything I want tested. Go to Quest, get it done. Boom, boom. Yeah. Honestly, the the biggest takeaway from the Dr. Deep talk we had is like that we need to talk to him more because like there's so much. We need another episode. Totally. Need another episode with him because there's such a wealth of knowledge and I think we covered a lot of uh foundational layer, but I really want to get deep with him. Deep with Deep. Honest to goodness. And one last time, just like we said at the beginning, our kind of guy. Yeah. Definitely one of us. One of us. And you know, it's great because like on X, you have this like stable, I wouldn't call it growing because the algorithm has changed, but like a stable health community. And Dr. Deep is like really such a pillar of that health community because it's so important that we have the esoteric people and the credentialed people with an MD, MPH, engaging, like having discourse with each other, speaking, rolling around, stress testing ideas. And so like it's really important that that he kind of continues to be a part of that community because when you let the inmates run the asylum with like no oversight, like it Then they start eating raw meat. Yeah, raw chicken. Thanks for stopping by. Down to hell. It's another one.
