Barbell Shrugged - [Biometrics] How to Use Data to Build Your Own Nutrition and Supplementation Program w/ Pratik Patel, Anders Varner, Doug Larson, and Travis Mash #733

Episode Date: February 7, 2024

Pratik Patel is a health and performance coach, speaker, advisor, and consultant to sports teams, startups, and VC groups in the health, wellness, and performance realm. Pratik brings unique perspectives gained from his time in high level elite sport (NFL) to enhance the health and performance of individuals in the real world. Using his internal and external health approach and stress adaptation frameworks along with technology and wearables Pratik helps his clients implement effective health improvement strategies for long-term sustained success.   For the past 20 years, he has studied health, nutrition, fitness, recovery, and the interplay between these and health and performance and has had the opportunity to implement his strategies with multiple elite college teams and most recently the New York Football Giants (where they experienced the least number of games lost due to injury in their history during his tenure). Pratik is highly regarded in the field of sports, health, and wellness and teaches his concepts to dozens of other elite college and NFL teams along with presenting to numerous Fortune 500 companies. He is also one of the most featured coaches in the sports, health, and wellness space with features in USA Today, Outside Magazine, ESPN, and has been sought after as a guest on over 60+ podcast episodes. Pratik is also the author of 4 scientific publications through peer reviewed journals. Pratik is a Registered Dietitian and board Certified Specialist in Sports Dietetics (CSSD) through the Academy of Nutrition and Dietetics (AND) as well as a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association (NSCA).   Pratik resides in the Kansas City area with his family and two children (newborn son) and can be reached on his X/Twitter, Instagram, or LinkedIn social media accounts @pratikxpatel.   Follow Pratik on Twitter Anders Varner on Instagram Doug Larson on Instagram Coach Travis Mash on Instagram

Shrug family, this week on Barbell Shrug, Prateek Patel, registered dietitian, is coming into the show. Many people inside Rapid Health Optimization, they know who he is and have heard his voice and seen his videos talking about nutrition, supplementation, because he is the registered dietitian inside Rapid that many people are currently working with. Brought him on the show today because we want to talk about how you can use data, running labs on your own self and start to take action on building optimal nutrition and supplementation protocols for yourself

which is very cool because Prateek has been in the NFL working with the New York Giants for a while and has just recently moved into working with us over at Rapid Health Optimization and great to have him on the team and I think you're going to very much enjoy today's show. As always, friends, you can head over to rapidhealthreport.com. That's where Dr. Andy Galpin and Dan Garner are doing a free lab lifestyle and performance analysis that everybody inside Rapid Health Optimization will receive. You can access that free report over at rapidhealthreport.com.

Friends, let's get into the show. Welcome to Barbell Strug. I'm Anders Varner. Doug Larson for Teak & Tell. Dude, should I tell all the people that you were the trainer for the New York Giants and dietitian, or should we just say inside rapid health optimization? How about a little bit of both? Which one makes you more famous and cool?

The Giants? Well, see, if they would have won anything, then I would be like, yeah, talk all about it. But when I was there, it was what? They're still going on. Yeah. Year 12 of a rebuild. The tribalism of the NFL.

You could be like the greatest trainer, nutritionist. You're like, but I did it for this team. They're like, oh you're off you're terrible that's how it goes so um on today's episode barbell shrug we're going to be digging into um exactly what you could be doing as far as lab testing uh the data that you're going to be collecting and how you can use it to kind of build your own nutrition and supplementation programs um and then how to really like use the data to make educated decisions. And dude, I would love to just kind of kick it off. I feel like the ordering of labs

has gotten really, maybe not hard, but there's so many companies that are kind of like getting into this space now, realizing that this feels like kind of like the next wave of how are we using lab data to inform decision making. And now people are able to do it on their own. So these companies are popping up all over the place. At the highest level, like what should people be looking for? And what kind of tests should they be looking to order to start making some better decisions about nutrition and supplementation? Yeah, I think, as to your point, all these companies are available, which is good and

bad. It's good because people now have the opportunity to take complete control of their own health without having to always go to a doctor. And sometimes the doctor might not have the time or the resources to be able to provide a full panel, or insurance isn't going to a doctor. And sometimes the doctor might not have the time or the resources to be able to provide a full panel or insurance isn't going to cover it. So what they're going to be able to provide is going to have to come out of pocket anyway. So you're going to spend a lot more and the doctor might not have the time to interpret it because they're so busy. You know, it's not necessarily exactly what they're aiming to do in terms of preventative medicine. It's like, okay,

they have a ton of patients to see. They can't spend an hour or two hours going over data points with everybody. So I think that's the good part about these companies coming up. Now, the bad is people are just confused. They don't know exactly what to get. So when I'm working with a client, I'm working with somebody, whether it's an athlete or non-athlete, I think the goal is just to learn as much as I can about their health status, regardless of what they do. Because there are a lot of people that say they're healthy, especially coming from the

sports background where everybody has a preconceived notion of these athletes are super healthy. Well, in reality, they're fit. You know, they can handle the ins and outs and the demands of the workload of being able to perform their particular sport. But it doesn't mean they're healthy. So if we look at health, one of the big areas is what's going on inside the body. Like, are all the systems optimized or at least they're working together? Is there something that might be deficient, something that might be overloaded? Is it putting stress in one area versus another? And honestly, over time, without knowing that data,

something is going to actually going to end up happening. For the average person, it's you're going to develop some type of chronic disease, whether it's diabetes, high blood pressure, cardiovascular disease, the potential for cancer, dementia, all these other things. For athletes is, you know, hey, you're just overloaded with way too much stress, the body's constantly breaking down because you're training at a high level, and injuries. And we know that injuries have plagued athletes at every level, even though we have so many advances in sports medicine and strength and conditioning and data monitoring and all the injuries to keep happening. So that's why one thing we're able to do with the Giants is, you know, really look at things objectively, like, who do we have? And what is their health status? You know, I don't care how much he benches, how fast he is, you know,

all that stuff is great, all the external metrics. But if I only have a finite amount of time to make a big impact with this athlete's health, I need to learn as much as I can and be able to bring it to their attention to say, hey, you love individualization. Now I'm going to give you an individualized nutrition program based on all the data points and the assessments we're doing on you. I'm going to be able to tell you exactly what to supplement instead of just the generic stuff that a lot of athletes come to the table with. That way it's more intentional about keeping them healthy. So the truth of the matter is doing very advanced blood panels, you know, potential for urine and saliva and cortisol, if that is something that is necessary,

can provide a huge amount of insight to somebody's own health, regardless of age, because now we know people in their thirties and forties are having heart disease, heart attacks, prediabetes, diabetes. You know,

a lot of my family members, a lot of the niche population that I work with, you know, South Asian Indians, we have horrible health for a variety of reasons. Yeah. So understanding that is so powerful, because it gives you the opportunity to actually do something about it before something happens. Or before, hey, the doctor found out that you've had an A1C over six for a year, and nobody actually flagged it. And now, hey, he wants to put

you on metformin, or you're at the point where you need to go on insulin. So, you know, and it's not just the standard stuff that docs like to look at, like a CBC and Chem 10, like that stuff's great. But I've seen so many panels of athletes and people where they come to me and say, hey, my doc said I was healthy. They brought just the generic, you know, 20 biomarkers or whatever it is, not anything really flags because a lot of these things are tightly regulated serum wise. So if there is a deficiency or discrepancy, the body's going to be able to adjust. But then you go a little bit deeper, you look a little bit deeper in the glucose control insulin, you look at hormone panels, you look at inflammatory markers, you dive a little bit deeper into lipids, you know,

getting things like CRP homocysteine. Then you start seeing like, hey, there's a lot of things that are not where they potentially need to be. And it kind of explains why you're going through what you are. So let's not go crazy and have to throw you on a bunch of meds. Let's objectively just look at what can we do right now? Like your current habits, where you need to be, and how can I bridge that gap and take you from A to B based on smart supplementation and based on good nutrition? Yeah. I have, I feel like just enough information to be extremely dangerous when it comes to, uh, analyzing a, a blood panel and extremely dangerous is, is the, the key words there because, um, there's real pros in this game. So how is somebody supposed to kind of like dig into their own labs

when a doctor just looks at them and says, hey, you're good and kicks them out. And now they're now they've got this 20, 40, 100 biomarkers sitting in front of them to start actually being able to analyze things on their own and put a plan together. Yeah, and that can be really tough because sometimes the marker might be at a certain level. And it's not just because there's a lot of context that goes behind it. So all these systems was super high and my you know glomerular filtration rate was super low i have kidney disease was like well well no you you train you know six seven days a week and that's totally normal so you're going to have an inflated uh or you're going to actually have a deflated gfr reading because your creatinine is high but that's already known in the literature doesn't mean you have kidney issues it means we just have to look at a different marker to get kidney function like cystatin c uh it's stuff like that

it's if somebody has the opportunity to work with somebody that's why some of these companies are doing a much better job of being able to either provide interpretations of the data based on where somebody falls in line you know if you have uh lipid levels that are out of whack or you get an ApoB that's high or, you know, your hormone panel is it is what it is like. They do a great job of just kind of explaining like, OK, this is where your marker is and this is where what you could potentially do about it, which I think is the lowest level of entry for most people, because they might not have the ability to or they might not want to hire somebody to go through all the labs for them. So that's, again, one of the benefits of a lot of these companies. Some have it built into their consumer model where it's like, hey, you subscribe to us for the entire year. We'll give you two to three blood draws. We're going to look at a hundred biomarkers to start. And then it progressively gets shorter and you'll have access to a you know, a medical professional or one of our coaches that have been trained to take you through figuring out and interpreting why your blood

markers are the way that they are. That way it just takes the guesswork out. Because the truth of the matter is people just want to be told what to do. They don't want to have to figure this stuff out on their own. They don't have time. You know, that's why they go to doctors to help the doctors to tell them what to do, but the doctors are so busy. It's just like, okay. They also don't have time. Yeah. They also don't have time. They like take this script everything's going to be good and you know the average person's like okay my doctor told me this is what i need to do so i'm going to get on this statin i'm going to get on this beta blocker or whatever it is not knowing that it's probably not the best course of action if they have the ability to take control of their health themselves and

they want to do that you know for like the most standard markers like glucose a1c lipids etc like from a nutrition perspective like which which markers do you have the most control over actually affecting by by the foods that you choose to eat and the volume of food that you choose to eat yeah i'd say the glucose control ones for sure the lipids as well you know obviously there's a genetic component to it where some people just are gonna have elevated ldl elevated um total cholesterol uh but for the most part those are the ones that are very tightly regulated and then the ones that you know we're talking about uh kidney function um those are the ones that if you understand what you should be eating and why based on your specific situation, your genetics, your lifestyle, they can have a big impact on changing those, you know,

vitamin D. Others, depending on where you're currently at, they might need a little bit of extra support. Now, it's not always just having to do with the supplement. Some of it could just be to increase your exercise. Some of it is you were super stressed and you were sleeping really poorly. You just need to kind of shift and try to figure stressed and you were sleeping really poorly. You just need to kind of shift and try to figure out what's the lowest hanging fruit that provides the highest ROI. Shark Family, I want to take a quick break. If you are enjoying today's conversation, I want to invite you to come over to rapidhealthreport.com. When you get to rapidhealthreport.com, you will see an area for you to opt in, in which you can see Dan Garner read through my lab work.

Now, you know that we've been working at Rapid Health Optimization on programs for optimizing health. Now, what does that actually mean? It means in three parts, we're going to be doing a ton of deep dive into your labs. That means the inside-out approach. So we're not going to be guessing your approach. So we're not going to be guessing your macros. We're not going to be guessing the total calories that you need. We're actually going to be doing all the work to uncover everything that you have going on inside you. Nutrition, supplementation, sleep. Then we're going to go through and analyze your lifestyle.

Dr. Andy Galpin is going to build out a lifestyle protocol based on the severity of your concerns. And then we're going to also build out all the programs that go into that based on the severity of your concerns. And then we're going to also build out all the programs that go into that based on the most severe things first. This truly is a world-class program. And we invite you to see step one of this process by going over to rapidhealthreport.com. You can see Dan reading my labs, the nutrition and supplementation that he has recommended that has radically shifted the way that I sleep, the energy that I have during the day, my total testosterone level, and my ability to trust and have confidence in my health going forward. I really, really hope that you're able to go over to rapidealthreport.com, watch the video of my labs, and see what is possible.

And if it is something that you are interested in, please schedule a call with me on that page. Once again, it's rapidealthreport.com and let's get back to the show. Yeah, no, like as an example, I have a family member that has high cholesterol and they've been taking medications for it for a long time. And I'd imagine anyone sitting in a doctor's office when the doctor says, okay, take these drugs, they're thinking, do I really need to take these drugs? Or can I actually, can I actually handle this on my own? Even if it's difficult, like what's the, what's the trade-off with, with something like high cholesterol, where how do you know if you should be taking a medication, especially if you're a person who's kind of just like, just generally opposed to medications, unless you absolutely need to have them.

Yeah. I think that's the tough thing where you can definitely improve cholesterol levels. The main big rock things is just increased fiber intake, just kind of watch, you know, your extra ultra processed food intake and a lot of ultra processed fats, get plenty of like antioxidant type foods, more vitamin C, those things have a big beneficial effect. Uh, and then you have some baseline supplements that can improve that, like turmeric or cumin, um, exogenous vitamin C supplementation, uh, nice and B3, some of these things that are very cheap, like they're not very expensive that most people would get a benefit taking and even seeking out those food groups, uh,

and trying to implement them. I just don't feel that that's talked about enough. It's just me like, hey, actually, the funny thing is, for the first time in over 15 years, I went to the doctor because I was sick for a couple of weeks. We got kids at the house. I'm like, look, I don't want to get them sick. I want to do whatever I can to finish this out.

So I saw a doctor, did standard makeup, all that. They took some blood. And I know I have elevated cholesterol. It's a genetic thing. I've done the CAC score, so I don't have any calcification. Triglycerides are low. HDL is high. Some of those ratios are definitely a lot more applicable with cardiovascular risk factors instead of just looking at, hey, just straight up LDL and cholesterol. And LPA is low. ApoB is a little high, but I can monitor that just through diet and lifestyle stuff. So I got a call back from them today, actually just about an hour and a half ago.

She said, Hey, are your, are your lipids look good, but your, your LDL cholesterol was a little bit high, 20 to 30 points higher than what we'd like it, you know, we'll test again, but these are the recommendations for you. And if it doesn't go in that direction, we'll, you know, we'll recommend putting you on medication. And I'm like, well, looking at everything as a whole, my risk factors are very low, even though that's elevated and high. And I try to do as much as I can from a controlling standpoint to try to prevent that. So it's tough when most people aren't completely aware of what it is that they can do. But I think the more people end up talking about it and empowering people to just learn more, don't just use just very superficial markers,

try to dive a little bit deeper, you know, take stock of what your family history is like too, because that's going to be a big indicator of are you going to be susceptible to this or not? Yeah. How do people kind of know if nutrition or supplementation is a better route to go down from kind of whatever lab work they get done? I think just being honest with, is somebody actually going to implement these nutritional recommendations into their normal daily routine? Or is it easier to just say, hey, if I can get this in one or two supplements and it's not going to cost, you know, $1,500, $200 a month, it's going to be like, hey, it's $20 a month, which you break it down, it's less than a dollar a day versus what this is, what the medication could potentially cost you versus you need to eat, you know, 15 to 20 grams more of fiber per day.

You need to cut this out and you need to include this. It's for most people, it's like, what's the easiest route? What's the lowest hanging fruit that I feel like I can be consistent with? Versus like, oh, I have to do something I'm not normally used to. I haven't done it in a really long time and I don't foresee myself sticking with it. So I think it's really either and or. Yeah. I always feel like nutrition is the long game and supplementation is the short game. For me, it's really hard to just stick to a supplement plan for any really long period of time. At some point, I just go, am I even doing anything anymore? Like, did I solve this problem three months ago?

Or I get in that thing where Momentus continually sends me the same supplement because I'm on subscription and then I have an entire cabinet full of magnesium. And I'm like, it's going to take me a year to eat this. How can people get into, because if we were to kind of drill down all the way into where the dietary kind of deficiencies in the micronutrient status, what do they need to be looking at to understand where their current numbers are? What is, say, optimal or sufficient? And then be able to put those meal plans together besides just hiring you. Yeah. I think a simple thing is there are a lot of free resources and software out there. I think one of the best ones is Chronometer. Obviously,

we use that at Rapid where you don't have to sign up for a full plan, but if you want to take a typical day of how you eat, you know, like, let me just learn more about what it is that I do outside of, it can be very informative about how many calories you're actually eating, how much fluid you're actually consuming versus what most people think. You know, most people that aren't very health conscious or at a healthy body weight, they generally underestimate how much they're eating. They overest weight, they generally underestimate how much they're eating. They overestimate, you know, how much they're drinking and what their activity level is. But very simple interface.

You just plug in like, hey, breakfast, I had this. Lunch, I had this. Snack was this. Dinner was this. I drank, you know, these fluids. And then the beautiful thing is it populates everything for you. Very easy to read. So total number of calories, breaks down the macros, talks about fiber.

But then it looks at each one of the micronutrients. Now, obviously, there's essential micronutri breaks down the macros, talks about fiber, but then it looks at each one of the micronutrients. Now, obviously there's essential micronutrients that the body needs because it can't make it. So we have to get these things from food. That's why multivitamins, you know, AG1, a lot of these powders and pills are very popular because the truth be told, the average American's diet is going to be very deficient in micronutrients because, you know, there's a lot of ultra processedprocessed foods, hyperpalatable foods. There might be some, you know, single ingredient, better quality foods, but for the most part, the average person isn't likely isn't eating exactly how they probably shouldn't or would want to, if we're talking about getting towards better or optimal health.

And it spits everything out. So you get more of an idea of out of all these micronutrients, where do I stack up? Like, what am I falling deficient in? And it gives you ratios. Does calcium to oxalate, calcium to magnesium, omega six to three ratio, things that are really, really great to know. And you can look at that and see like, where am I missing? What am I missing from a macro perspective, from a micro perspective? And what are simple things that I could do? Now, if you're not very knowledgeable on food sources and where micronutrients lie, I mean, just go to Google, you know, what are good sources? Yeah, chat GPT. What are good sources of copper? What are good sources of magnesium? What are good sources of selenium, manganese, you know, iron, and boom, it'll spit everything out for you. And I think most people will realize,

truth be told, there are very similar things that you start to see. Leafy greens, really high quality lean animal products, fruits and vegetables, and really high quality oils can cover the whole gamut of all these different micronutrients. And when we start to stray away from that, that's when we start seeing a lot of these deficiencies. As important as micronutrients are, I understand you go to your general practitioner, you get a basic CBC, CMP blood panel that we've all likely gotten many times. Like why, why aren't micronutrient testing done as a standard thing at this, in this day and age? I feel like that, that really should just be like a normal thing that as, as important as vitamins and minerals are, they should be tested regularly for everybody.

Yeah, I think the accessibility of a lot of these tests, now you can go to companies directly, these third-party companies, and they have a variety of different panels, which is great. I think the biggest barrier of entry is the cost associated with it. And then doctors themselves within their network, they just don't have direct connections that have been built in, unless you go to a more advanced, progressive type of practice that has a lot of these things, but then you're going to be paying for a little bit of more of a premium instead of your insurance

provider, just assigning you the PCP that you just go, you get your general checkup and it takes care of it because that's a part of what your insurance is covering. So I think that's one of the biggest like missteps is people just don't know, you know, they don't know, oh, I should be testing my macronutrients. I should be getting a hormone panel. You don't have to do this quarterly, but at least at a minimum once per year, if you're an adult who is in your 30s or in your 40s, who has a busy lifestyle, who might not be getting as much sleep, or you have a lot of stress on your shoulders, you know you don't eat very well, and the exercise you get in is very broken, or it's not consistent at all, or you're just overweight, and you feel very tired and run down. Because I think the insight

you can get from it can be very eye opening. And one of the things I found out working with athletes at this level is, instead of just telling them like, hey, you need to sleep, you need to do this, you need to do that, you need to hydrate, you need to eat, they've heard it just the same way that, you you know a normal person's heard it all the time you know it just gives them one ear not the other but the second you start showing them their own personalized data be like hey this is you this is nobody else it's like oh you start seeing you know light bulbs turn on and they start getting interested because they may have thought that they were quote-unquote healthy and they had preconceived notions of where they potentially were and then you actually show

them what reality is and this was one of the the biggest things with the players were like we we customized very high level panels with close blueprint for athlete we were doing very individualized things and athletes were like oh i'm good i'm good i've already talked to a doc i've already done everything and i'm like your vitamin your vitamin D is 11. Your CRP is over 2. Your omega-6 to 3 ratio is 25. And you constantly complain about sore joints and this and that. I've worked with players that have A1Cs upwards of 6. And these guys are very lean and fit, but they're not entirely healthy.

But being able to show them that data and then ask questions about, okay, I don't want to misinterpret it. And I don't want to create preconceived notions. I want to ask what's going on behind the scenes, because then it's like, oh man, you know, I'm just dealing with stress at home. You know, my sister's sick, my mom's sick, kids, the financial situation, I might get cut. I've been bouncing around team to team, you know, I'm drinking every night and I don't sleep very well because I'm just worried all the time. And then you start saying, OK, let me create some interventions for you. Let me create a program for you that at least whatever I can do to help you out, you know, kind of resurrect or improve some of these markers and give you some guidance on doing that. Instead of, you know, just setting them on their way and letting them just find a pen for their own devices.

Yeah. Yeah. The A1C is an interesting one to me where my wife has an example. Um, she's been doing CrossFit for like 15 years, very consistently. She's like, she's lean. She has good amount of muscle mass. She eats pretty dang well, but still it's not her A1C is not six, but it's like, it was like five, six. I want to say something like that, which is still like right at the top or the top end of the, of the end of the range, even a little bit outside of it. I think the lab we had was 5'5", was the higher end there. How does that happen with someone who's basically been healthy their entire life and always trains and eats pretty dang good and is lean, etc.? I think that allows the question to ask what's going on behind the scenes because everybody always points to…

She's married to Doug. That's what's going on she's stressed to the gills there's no there's no biomarker for that the kids are running around crazy just chaos she poked her head around the corner like you fucking talking about me i think that's a great question i think it speaks to the fact that the exercise and nutrition is good. You know, everybody wants to point the finger at carbohydrates, like, oh, carbohydrate, then carbohydrate insulin model. But I think it also goes to show that being more sympathetically activated automatically increases the cortisol response of somebody that takes a lot of stress and wears it on their shoulders. And it's funny because a lot of the my family members,

more so the women in the Indian households are the ones that like always constantly are worried and they don't sleep very well. And the men are the ones that are just kind of like, Hey, everything's going to be good. We're all right. And so some of that can actually keep glucose levels elevated too much blue light in the evening, not getting enough sleep, you know, mouth breathing things that can stimulate the sympathetic nervous system, independent of what your fitness levels are, if the weight is good, if you feel very strong, and if you eat really well. So I think looking at everything from a very well-rounded perspective is very important. And I think that's one thing that we definitely, like, hopefully bring to the table when people say, like, oh, I'm healthy. It's like, well,

what is your definition of health? And what can you show that actually qualifies or proves that you are healthy, independent of, hey, I work out, I look good, my weight's not too high. It's like, okay, that's great. Those are two really important parameters, but it's not just the full picture. Yeah. When it comes to, call it like specific lifestyle actions, whether it's sleep, stress, maybe if we even dug into just sleep specifically, if you sleep poorly, how is that going to show up on your labs? Generally, one night of poor sleep can actually influence glucose control. Now, A1C won't be changed because that's a snapshot

of a few months versus your fasting glucose levels will be uh changed some of your um inflammatory markers might be uh elevated acutely especially if that poor sleep leads to dehydration then you'll have confounded like sometimes red blood cell markers might be a little bit higher if you do a urinalysis as well, some places, if you do, you get like an advanced panel, you go to the Quest Diagnostic Center, they might just give you a urinalysis, you can pee in a cup. So you can see what the specific gravity is. The funny thing is their cutoff is like 1.030 and below. I'm like, well, actually hydrate is 1.020 and below. So you got people that are coming in, getting told that they're

hydrated and they're not, which I think is kind of interesting, but everybody's cutoff points are going to be really different. That's another kind of, you know, kicking the nuts about some of these companies where everybody has these different ranges. One company says, hey, you're good. Another's like, no, that's not good. So then it's like, okay, again, interpreting it appropriately is really important. Ultimately, when you do get a test done, you know, obviously you want to be fasted, you want to be hydrated, you don't want to have had like intense exercise, you know, one or two days leading up into it, because then you're just going to have the inter metabolites, everything that happens that gets elevated when you do a really hard training workout.

I guess that's one thing that a lot of docs in a lot of places might not account for. You know, hey, have you eaten? How was your sleep? Are you hydrated? You know, what have you done over the past 24 hours or 48 hours? Is it just kind of like a normal day? Do you feel good? Or have you experienced any additional or undue stress?

Because, again, these things acutely can influence some of those markers. And then when the doctors get back and they're interpreting it, they just look at it at face value. So then they're going to make an assessment or judgment based on that too. So it could be right. It could be wrong. We don't necessarily know without looking at everything as a whole. Yeah. As far as kind of more extensive testing, saliva, urine, stool, is there kind of a a path that people should follow if they're if they're trying to dig deeper than just blood work yeah blood work is is generally going to be the best way because you can get almost everything specifically through blood work um you'll get more markers than you will through saliva obviously saliva is good more so if you're

trying to get you know cortisol levels at different time points throughout the entire day. Very easy. If you're looking at looking more at nutrition and health and predispositions, saliva is going to give you the genetic, like the different SNPs and variants that you have. Again, very easy. Stool is going to give you more of just what's going on within the microbiome. Like, is there any dysbiosis? Is there overgrowth? That's specific to In and Of Itself, which also is very great.

There's more companies coming out with easy at-home solutions for people to be able to utilize that. And they provide some context about what's going on, which I think is great. Like, obviously, Genova Diagnostics is the biggest player in the game, but you have, you know, like, Viome, Tiny Health. Thorne has an at-home wipe instead of actually having to dig into a bag and take a piece out.

It's always fun. But urine's great too, so urine can provide you with some unique things as well. And it's so much easier to just provide those types of samples versus giving blood. Now, some people just do not like giving blood. And the tough thing about getting some of these more advanced panels that give you some really great insight is you're going to have to give up a lot of vials. So you're going to be sitting there for a good amount of time. You know, for some people, it's just very uncomfortable. They don't do really well with needles. They have like a vasovagal reflex, which needles are okay, but then they ended up passing out too. I experienced that in person and seen it it's kind of freaky when you see somebody do that but uh blood for sure one that always freaks out a little bit not like a freak out but every time like are you about

to stab me and i'm supposed to let this happen there's always it's always like a weird thing someone's sticking something in you that's all for science though come on yeah right but but yeah blood for sure is the top end uh stool if you're looking at more insights into the gut in your own gut health in the microbiome saliva for genetic purposes and or you just want to do uh cortisol time points at four different time points throughout the day and then then urine for everything else, different metabolites, different markers, which are a lot easier to get. It's easier to pee in a cup and send it away than it is to sit there for 10, 15 minutes getting blood drawn.

Yeah. I'd love to dig into the genetic testing side of things. I've heard so many different things on the kind of like science behind it are the results 100 percent uh real probably isn't like the best best word but um like how how valid do you uh do you feel like that testing is and then uh what can people draw from from their results yeah i think it's pretty valid if you go to a place that's pretty reputable and they're not trying to look at everything, they have a specific number of SNPs and gene variants that they are looking at because they know that they are big players.

And those that they're choosing have a lot of literature backed behind it between this is the gene, this is the variant, this is what it means when you have the variant. So if their process is true, then that's good. An easy way to tell if a company is legit is, you know, maybe you get two kits, you put it under two people's names, but you send your own data at the same time. And then you look and see what the information comes back. So I've known people that have done this. I've actually done this too.

And when you get the, almost the exact same thing back, then you're like, okay, they're not blowing smoke. I've known another coach that send like his dog's data. Like, hey, I'm going to swab the dog's mouth and send it. And then he got legit results back, which you shouldn't because it should be based on human DNA. So you know, hey, that company's not one we're going to invest any money in. So I think it's getting better and better. You do have players in the game that know that it is a hot topic.

So they're like, hey, let's just get in and tell people we're doing genetic testing for, you know, 400 bucks, 500 bucks. We're going to give you this massive report and people look at the report, get overwhelmed. They don't even know what to do with it. So they throw it away. Yeah. But I think the insights are really useful when you're looking at some things people do when they, but they don't necessarily know about. Looking at, you know, can you do methylate properly? I think that's a big one.

The next is what is your caffeine metabolism? Like, you know, everybody in under the sun is a huge consumer of caffeine. I'm a big fan of it. I did multiple genetic tests, realized like, luckily I'm a fast metabolizer, but I have a top end with how much I can consume. And my adenosine clearance is not as fast. So later in the day, if I dose caffeine again, it's going to keep me up. And I used to be one of those evening workout bros like, yeah, I'm going to get my pre-workout. I'm going to go lift. It's 5pm, 6pm. And then nighttime came and I wasn't thinking about the benefits of sleep. You know, this is

years ago. I first started working in team sport. And then over time, you start realizing, like, I'm worn down. I just need more caffeine in the afternoon. Like, that wasn't necessarily the answer. Others can be looking at your predisposition for certain micronutrients like zinc, vitamin D, magnesium, things that are very important that a lot of people are just deficient in. So if you're already predisposed to not being able to utilize it very well, you don't get enough. You're already, like, falling behind the eight ball quite a bit predisposition for like vascular health like blood pressure cholesterol obviously you know working with the south asian indian population that's something that is very prevalent knowing

that we already know we're all predisposed so we have to do things on the front end to be able to at least negate that it doesn't mean any of these variant results you're like oh you're going to be completely unhealthy it's like look you can still live a healthy and successful life and you can reach your health and physical goals you just have to be a little bit more mindful about certain things some people have increased adipogenesis they have decreased resting metabolisms and they just don't necessarily know some of these things. So it's like, if the more you understand where you're currently at, and what you need to do to get to where you are, versus I'm just following these generic plans, they're not working, because they

don't necessarily speak to my individual genetic and my lifestyle and epigenetic situation at home. I think, again, individualized data can provide a lot of meaningful insights. So people can be like, okay, now I know can provide a lot of meaningful insights. So people can be like, OK, now I know exactly what to do. That speaks to me. You gave us a great overview of kind of the whole landscape of different testing available. What's kind of your standard package that you just if someone's coming in, there's like a normal person, you want to just get a good lay of the land for

how healthy this person is. You can write them protocol, meal plan, et cetera. What are, what's kind of like your, your base package as far as labs go? Yeah, mine is, I do like, because the majority of people I work with is either athletes or like a South Asian Indian population and knowing that they have very unique things going on under the hood. So I want to know predisposition. So, you know, like, like not a crazy expensive genetic test, but just learning about the individual predispositions there, from a blood biomarker perspective, anything that can give me insight into, obviously, CBC Chem 10, that's usually included in almost every panel. But then I want glucose control insulin, you know, like C

peptide, more in depth lipids. So not only just your cholesterol, LDL, HDL, triglycerides. I want to know LPA, apolipoprotein A1 and B, lipid particle and size, homocysteine, CRP. So we're looking at cardiovascular risk factors, the things that are associated with that. Everything involved with kidney health. So, I mean, you're going to get your standard, you know, BUN, albumin, you know, sodium chloride, potassium, bicarbonate. But then instead of just using creatinine to calculate GFR, which mine's elevated, by the way, because I supplement with creatine. I've supplemented with creatine since I was a sophomore in high school. And, you know, no glucose control issues. So I'm not worried about it but every time i get a panel they're like your gfr is so low and your creatinine is so high i'm like well the literature

shows you can get a false positive there so getting cystatin c to calculate that instead is really important full like hormone panel so testosterone free testosterone, DHEA, sex hormone binding globulin, everything associated with that, estradiol, IGF-1, and then mega 6 to 3 ratio, RBC mag, zinc, copper. I can't start naming it. The full panel. Yeah, again, the full panel because, again, it provides a lot of really good insight. And to even complement that, getting something like dexa just to show you know body composition where

things might be distributed you know athletes love learning about their body composition and seeing how much muscle mass and body fat that they can lose over the course of an off season i think for more at-risk populations so people that have higher stress jobs who haven't worked out very well you know a lot of ethnic groups that have high blood pressure, cholesterol issues, they have a lot more visceral fat. So visceral fat, the fat that accumulates around the organs is very strongly correlated to disease risk factors, especially for cardiovascular disease. When people are a little bit more apple shaped versus pear and not finding that fine balance between. So there's a lot more fat in and around the stomach. I mean, that's just going to going to shoot up insulin resistance right there or pretty much confirm that fine balance between. So there's a lot more fat in and around the stomach. I mean, that's just going to shoot up insulin resistance right there

or pretty much confirm that you have it. So again, being able to show somebody like, look, this is where you are, but it doesn't mean this is where you're going to end up. So for me, those are the three main ones that I like to get. And obviously, if somebody is really interested in doing in-depth stuff like, hey, I'm constantly bloated I don't feel really good like yeah we'll definitely do like a stool panel uh if they want to keep going a little bit more in depth they're like you know I don't live in a very healthy environment I live in a

big city and I'm always bombarded by you know radiation and this and that it's like okay let's look at heavy metals and just make sure that you don't have anything accumulated in there too because then again just knowing knowing that is hugely powerful. Yeah. I'd love to kind of dig into just the total amount of information that exists just out in the ether, out in the internet. And how can people really know who to listen to? Like if you Google cortisol, you're going to get literally probably a billion results on any number of ways to fix it. What those ranges should be. Besides barbell shrugged, what is like a kind of like, how do you find really like the signal and the that on when it comes to anything or biomarkers or or health and that's tough because the truth of the matter is science when when it comes to

health and nutrition it's constantly uh conflicting with each other so you have published data saying if you eat this you'll get this and then you'll publish data say if you eat this you don't get that and truth be told i think trying not to just have general associations and understanding you know if somebody's making claims or somebody's providing evidence like what is it based on what has been studied what are the populations that have been looked at and is that applicable to your case you know is a study done on this supplement in pro soccer players probably going to be the best thing for you to follow or should you actually just look a little bit deeper and realize like okay i don't live that lifestyle i don't do what they do i do what i do so it's it's an almost impossible answer

or question to answer because even people you might not agree with or because everybody has biases might be saying something correct, because there's so many different ways to attack and assess somebody's health. There's a million different ways people can eat. There's not one right way. There are a lot of wrong ways. But again, I think when people are more empowered

about understanding what their health situation is, instead of, oh, I think I'm stressed, I need to take ashwagandha. It's like, well, why do you need to take ashwagandha? Like, what proof do you have that you're actually stressed? You know, or I need to sleep better. I need to take this melatonin or I need to do this because somebody else told me to. It's like, what is the reason why you can't sleep? You know, is it just because you have poor circadian health? Are you just taking in a bunch of coffee and alcohol late into the evening? Is that the easy fix that maybe you push it earlier in the day? But again, just having people that can speak to the science,

but also know how to artfully apply it and not say like, Hey, there's not one silver bullet that works for everybody. It's just, we need to learn more about everybody's individual situation before you start providing recommendations. And then, then you can say, okay, this person is definitely more likely credible versus certain camps, certain gurus, certain factions that say, this is the only way to do it.

Anybody else who tells you otherwise is wrong or incorrect. When the truth of the matter is there's a lot of different ways to improve health and nutrition. Yeah. On the kind of supplementation side of things, I follow you on Twitter. You're big on creatine. I'd love to kind of dig into just recommendations on that. And I would assume that there's something specific about the populations that you're working with, where they very much lack that. And supplementing is a really important piece for them. Yeah, so creatine, you know, has gotten a bad rep in certain circles for a really long time. There are factions in sports that say if you take creatine, then you're going to get a muscle strain or you're going to have a soft tissue injury, which is kind of funny because

some of the research that's been done has actually shown it to be preventative helps decrease inflammatory markers but creatine is just a naturally occurring compound in meat so when we actually eat animal products we get creatine the average size person that might be anywhere between 70 to 80 to 90 kilograms has a standard breakdown of about two to three grams of creatine per day. So most people, if they do eat, you know, more of an omnivorous or animal type diet, you'll get, you know, maybe two to three grams tops through that. Some people might have more breakdown depending on the size and if you're really active. So if you supplement creatine exogenously, it's made up

of just kind of the standard three essential amino acids. It stores in the muscle, but it also stores in the brain, the heart, and a variety of different organs. So from a physical standpoint, when you store more creatine in the muscle, it also stores a little bit of water. So that's where the water weight comes in. It just allows for more high-intensity actions. So it delays fatigue, so you can do more. The more work you can do, you know, over time, the better you can end up improving your strength, your power, your sprinting ability, things of that nature. But they've also started looking at it not only from a strength and power perspective, but does it have utility in clinical populations? So they have shown it to actually assist with glucose

control in those with type 2 diabetes, those with heart failure, because it is a mechanism to provide quick energy, can be a positive attribution to those that are experiencing severe heart disease. Now, since the brain's creating stores in the brain, it does have a role with cognitive function in people that might pose having issues with sleep deprivation uh just excessive fatigue because it does create energy really quickly that and they've also studied it in its role with bone health because bones made up of a lot of different stuff calcium magnesium vitamin d protein collagen phosphorus you know potassium uh creatine so you know supplementation of that has been shown to help improve bone mineral density and bone mineral content over time.

So it's you can kind of call it the Swiss Army knife of supplements. Now, the way you'd want to take it is, you know, beforehand it was, hey, if you want to take creatine, you got to load it. You got to take, you know, 20 grams a day, split up in five gram doses over the course of four times for five to seven days just to load and saturate the muscle. Now we know that you can get the same result just by taking a single serving every day and you can saturate it over the course of about three weeks or four weeks. So one single dose, five grams, or if you want to use the kilogram conversion, it's 0.03 kilograms per pound body weight. So if you're not a massive individual and you're like, I just need a couple of grams, two to three can do that for you. Um, again, it can take it before or after training, you know, people, uh, have a specific preference, the study. So there's no benefit

either way. It's just whatever you feel most comfortable doing. And really, if, if I could get all my Indian family members on it, I would, it's just, you know, when you're dealing with people you love, they're probably the most stubborn and the last to adopt your recommendations. They don't want to listen to you. They don't. They don't. Everyone eventually learns not to try to train their own family.

It's a losing battle. You never have a profit in your own land. It's true. It's very true. Unless they reach out. Yeah. profit in your own land it's true it's very true unless they reach out yeah i've heard the the 0.03 grams per kilo thing for for a long time in relation to strength and power uh we were talking with darren kandow um creatine researcher out of canada he was saying that specifically for the cognitive benefits a higher dose seems to be working better than that like on the on the order

of more like instead of more like three to five grams, more like 10 grams, like kind of double the dose. Do you have any any sense of what the research says around kind of independent of strength and power, the other benefits of creatine, whether it's cognitive, like I just said, or like the bone health you just mentioned, etc? Yeah, they have higher recommendations. I think they've done some sleep deprivation studies looking at maintaining cognition. i the i think the gram amount was about seven grams for bone it's about nine to ten um for again for general strength and power the three to five will kind of check the boxes for for most people but the interesting thing and i've thought about this for a long time the the average person the average strength and

power athlete isn't going through an extensive amount of breakdown like somebody like a football player who is practicing for an hour and a half to two hours or playing for upwards of three hours on game day just knowing the the volume of work that they end up doing and how like it's just a disaster you know football is just getting battered by a car so to speak especially if you're in the trenches of alignment and those guys are huge too so in my head i'm thinking man maybe that three to five grams isn't enough for them because not only do they need it cognitively but they need it you know physiologically in the muscle too so maybe they're probably better off you know nine ten grams for specific times when their workloads are super high

i feel like the downside of overshooting is very low like the like the side effects low costs low like it's it's easy to take in doesn't have a taste I feel like just overshooting it is an easy win yeah that's one of those things there are a few other things too that if you end up taking a little bit more than the body can process you know it you generally going to end up peeing it out and obviously you want to knowing what their kidney health status is too is important just because we just don't want to have a ton of muscle breakdown and then all this extra supplementation and a lot of these guys just don't have good glucose control too so you know just being mindful of that but i think there definitely is something to increasing their dose as well what are your

other go-to supplements kind of just in general for most people that you recommend across the board in the vast majority of cases? Yeah. And I think a lot of it has to do just with saying a lot of blood panels of where people are deficient. I think vitamin D is one of those where, you know, I think the NIH said, I can't remember if it was NIH or somebody else said, Hey, 30 is sufficient. Anything beyond that you don't necessarily need. But again, you have papers that are coming out to show that there are stronger associations with improved immune function, improved muscle function, a better or a greater decrease risk in all cause mortality for heart disease and cancer when you

start going upwards of like 50 to 75. So, you know, if you are somebody that has darker skin and isn't spending a lot of time outside to be able to synthesize vitamin D, and that's pretty much everybody, let's be honest, we're not frolicking outdoors from 2 to 3 p.m. in Florida getting, you know, perfect sunshine on our bodies. So we're not going to be able to synthesize the amount of, you know, IU of vitamin D every day so vitamin d is one depending on where your blood levels are the next is looking at most people's like serum and rbc magnesium levels so you have a tightly tight range where generally i'd want most people above six for that rbc mag range and rarely have i seen many people that are actually at that level they're generally on the lower end

so you know magnesium is involved in hundreds of thousands of different reactions in the body dealing with energy production, glucose control, stress resiliency. It does help vitamin D get absorbed into the body. It's also co-factor in a variety of different reactions in the body. So most people aren't eating well enough to get enough in the diet. So supplementation of about 400, 500 milligrams to start is definitely warranted. As you mentioned, creatine is one of those. Fish oil. So looking at most people's omega-3% index and 6 to 3 ratio, we know that when that ratio starts skewing a lot higher, then that is very strongly correlated to just whole body systemic inflammation, elevated blood pressure, insulin resistance, glucose control issues, cardiovascular disease risk factors, because most people aren't eating enough threes

and they're just overdoing the sixes because they're so easy to consume. Not to say that all six sources are bad. You know, all the extra virgin olive oil, avocados, nuts and seeds, those are all great. But most people just aren't eating enough threes. So to be able to resurrect that, supplementing with omega-3s is helpful.

And omega-3 is linked to cognitive function because the brain is made of DHA. For men, you know, increased sperm count, you know, greater, you know, ball size, decreased DOMS, improved muscle protein synthesis. So again, it's kind of like one of those Swiss army knives. So it's not just omega-3 fish oil, it's just omega-3 status in the body is ideal. You want to get it to a certain level. They had a study looking at omega-3 supplementation and bench and squat strength. And, you know, the placebo group had, I think like a sunflower oil or something very similar. And the group that supplemented with omega-3s just had greater strength gains in both of those, you know, standard barbell lifts.

So those are kind of like the big rock things. I mean, we can get in the weeds of a lot of others, but again, everybody's individual situation will kind of guide what it is that they need. Awesome, man. Dude, where can people find you? Besides hanging out with the Rapid team. Right.

Come hang out with us. Yeah, we're cool. On social media quite often, Twitter, Instagram, LinkedIn. The account is at PratikXPatel. Just trying to share insights, things that I've learned, things that hopefully provide value to people in a different way. So just not regurgitating a lot of the same stuff that all the new popular health gurus are putting out there.

Just hopefully just being a little bit different i enjoy your twitter i'm glad i enjoy it doug larson at what point are you gonna make the switch to calling it x you feel like you feel like you're like ah it's so weird i'm not calling it they're tweets they're not it just sounds weird. Like a tweet. It's hard to have a company that's been around for 25 years and you just change the name. Like what? Facebook went to Meta and nobody calls it Meta anymore? Nobody calls it Meta.

Was Facebook still called Facebook though? Meta is just like the parent company? It's still called Facebook, right? It is, but everybody talks about the company as the company is Meta. Yeah, because the stock name changed to Meta, but the product is still

there, so okay. When you go to the app store, it's still the Facebook app. It's not the Meta app, right? Meta knows everything about you. I do very little on the social medias these days. Meta knows the deepest, darkest secrets of your life because of Facebook. 100%.

Right on. I am Doug Larson or Douglas E. Larson on Instagram. Prateek, dude, stoked to have you on the show today. Love having you on the Rapid team. You are a monster, my friend, so good to have you with us. Absolutely, man. I'm Anders Varner at Anders Varner.

We are Barbell Shrugged at Barbell underscore Shrugged. And make sure you get over to rapidhealthreport.com. That's where Dr. Andy Galpin and Dan Garner are doing a free lab lifestyle and performance analysis that everybody inside Rapid Health Optimization will receive, as well as nutrition programs from Fatigue. You can access that over at rapidhealthreport.com. Friends, we'll see you guys next week.