Her Discussions by Dr Faye - Why Women Live Longer But Spend More Years Unhealthy?

Episode Date: July 6, 2026

📚Fancy a FREE Book?📚Dr Florence is gifting one of YOU a copy of her book, ‘Invincible’To enter, share this podcast episode on your Instagram story. We’ll pick two winners at random and announce them on our Instagram Stories next Monday, so keep an eye out 🤍----What if you could change the way your genes work?In today's episode, we're joined by Dr Florence Comite, an endocrinologist, longevity expert and the founder of the first Women's Health Clinic at Yale. Florence has spent decades researching how women age and believes we have far more control over our future health than we've been led to believe.What you’ll learn:🤍 the hormone women start losing in their 30s🧬 the 5 biomarkers every woman should know💊 are peptides actually worth the hype?🌸 what birth control could be telling you about your future healthResources & links mentioned:Dr Florence’s Instagram: ⁠https://www.instagram.com/drflorencecomite⁠Invincible: Defy Your Genetic Destiny to Live Better, Longer: ****https://www.waterstones.com/book/invincible/florence-comite/9781529977066?utm_source=ig&utm_medium=social&utm_content=link_in_bio&fbclid=PAZXh0bgNhZW0CMTEAc3J0YwZhcHBfaWQPOTM2NjE5NzQzMzkyNDU5AAGnc2Wlim6wPJjn63TfwG1QxUmjJ7khup32XLXIVx0tVeXVh2h4p_3vROitBRg_aem_7OjeAMpR81lq7g6BCAmbegThis episode is sponsored by @larocheposay.La Roche-Posay Anthelios UVMUNE400 SPF50+ is formulated with MEXORYL400: the most efficient UV filter against the most penetrative UV rays: Ultra-long UVA Rays (380 - 400nm). UVA causes premature ageing.🔔 Join the HERd* broadcast channel here: https://www.instagram.com/channel/AbY4liwxlLnewx4H/?igsh=MWhuaXFweGtucTB3cA==📱 Find us on socials:Instagram & Tiktok - @drfayebatePodcast Instagram & Tiktok: @herdiscussionspod📩 Want to reach out?Email: [e-mail]🛑 Disclaimers:Opinions are my own. This content is for educational / entertainment purposes and not medical or financial advice.

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Consider your DNA like a rough draft that you can maneuver and you can have switches that can turn on and off. Do your genes actually determine how long you live or is that just a story we have been told? We women do live longer but not in good health. Peptides generally are... I'm honoured today to be joined by Dr. Florence Comey, the founder of the first women's health clinic, a Yale trained endocrinologist and the author of her new book, Invincible. ELP-1s are the new antibiotics of the 21st century. We're all born with a tendency to have a disorder of carbohydrate metabolism. 80% of diabetics are diagnosed in the emergency room.

It's actually not good for the body to get NAD itself. If you know what's going on, you can actually change the way genes work. If you want to understand how to actually take control of your health, then this episode is for you. What would you say are the biggest dietary mistakes that you've seen women making? So that's a complex answer. And before we get into the conversation, if you could do me a favour that literally takes you two seconds, hit the subscribe button or leave a five-star review depending on what platform you're listening on. It really helps us to continue to grow the podcast and bring you guests to help you live a happier, healthier life.

Thank you, Florence. We have had so many questions in from our community about how to live forever. But before I come onto that, whenever we have someone who is a woman in STEM on this podcast, I think it's very important to talk about your journey to where you are. And as a true pioneer, with a phenomenal career, I would love to hear a bit of a synopsis about your journey. Okay. Good. So, good. So I'd love to. So I started out, I always wanted to be in medicine from a very young age. My parents were immigrants and they had a tough time prior to coming to the States. And I remember overhearing them thinking, you know, what could I do to contribute? You know, even as a very young child, I remember thinking, one of these days, you know, my grandchildren are

going to ask me what value did you add to the world? And I think being a doctor with a stethoscope, to me, sounded like you could go anywhere and help people. And so when I started my journey into medicine, I fast-tracked a bit to medical school. And then in medical school, loved the whole area of hormones, metabolism, and how it affects the whole body. So I ended up studying both children, men and women, and trained in both in all fields of hormones, of endocrinology, is what we call it. Reproductive, which has to do with how the brain and pituitary gland affects ovaries and testicles, and women and men, men and women. And then in children, growth and development. So I kind of drew a line at geriatrics thinking it was so complicated

because as you get into your 80s and 90s and over 100, your body's complex but delicate. even more so than children that can get over things. But in the end, now we have people who are in their 90s. So the gamut runs from 10 to 90s. And I ended up at Yale after training as a clinical investigator in our country, the National Institutes of Health. I had a wonderful mentor. And I studied specifically peptides, which I know is a very hot topic too. In America, it is, I suspect in England as well.

And right from the beginning, I actually used peptides. in children, one of the first to reverse early puberty. I went on to treat women's health and started women's health at Yale in 1992. So this was for women from their 30s to their 60s. And then I went on to incorporate men's health. At first, the men, when I got to New York, it got very big for men. And the men would say, because when you looked me up, it looked like I was all women's health or pediatric. And they would say, but you take care of women. And I said, and I said, yes, women and men, and now I get asked if I take care of women. But women really helped me start the journey because they were always curious, they wanted to feel good. And sometimes in your 30s,

PMS meets perimenopause, your body is out of control and you don't know what to do about it. And in that day and age, doctors had no clue what to say or do. They kind of ignored that whole stage. Most of it was kept in a closet. Nobody talked about it. Before I came here, I was speaking to one of my friends who's a doctor, male doctor, and I was saying you were coming on the podcast. And 1992, did you say, was the first women's only health center. Yeah, at Yale. I said that to him, and he was so shocked. He said what, there wasn't a women's only center before that. You know, he's blessed that he didn't realize that that was the reality of women's health. And women's health has got so much more press now, which is incredible. But I'd imagine it was very much,

you were a pioneer at that time. It was the only one, except for a woman who's lovely, her name is Lila Noctiol, and she started, she was very into hormones as well. She was in Manhattan. It turned out her daughter was training with me. So I got to meet her. She's now in her 90s, but I think that she had somewhat of an effort like that at NYU while I was at Yale.

So we overlapped a little, but she really initiated it before I did. But it really wasn't thought about it. But here's the funny thing, you know, whereas we women weren't included in studies because every decade, I think pharmaceutical companies were concerned that our bodies change and every week is different and then we get pregnant and how could they trust it and they'd be responsible. Men's hormones were completely ignored. I mean, and the only thing that's come to be is testosterone where it's much more complicated in men as well. We women are more complicated than men. Men tend to age in a linear fashion and we women can do anything. and everything, and each woman is unique. But it's kind of interesting. There wasn't even a

department for Andrology, which I studied, which is the equivalent of gynecology for women. So in each fashion, both sexes weren't really given due process to keep their health. And that's what I was most interested in. I wanted to touch on biological age. So you've said before age is not actually your birthday. I've got a whoop. And I looked at what it told me my biological age was. And it was a year and a half older than what I am. Could you, explain what you mean by that statement? Sure. So first let's start with the day to birth. That's your chronological age. That's every year you blow out a candle and you turn one year older. What we hope with biological age that you're actually younger. So instead of getting one year for

one year in your biological age, your system in your body actually ages much slower. Let's say 0.5 or 0.7, 3 quarters of the time instead of a full year. And if you do, that, that means your body is staying healthier for a longer period. Because what happens with aging, it's not that aging is a disease to me. Aging is phenomenal. Like it's a good thing if you age because then you're here on earth, right? But what is not good is if we age and we get chronic disease. So what started that for me was my father saying to me, how do I stay healthy once I graduated Yale Medical School? And I had to look at him and say, I have no clue. We learned about disease and in medicine we're reactive, not proactive. So with,

With biological age, you want to be younger than your chronological age. That said, give you some hope about the whoop. They're not always a thousand percent accurate. None of these devices. I use like three or four devices for bed, and they don't agree with each other. So you have to be able to understand trends. And that's where the book comes in because I tried to explain patterns of aging for different people and what might run in their family.

And in that way, you can actually figure out, well, what do I need to concentrate on? The chronic disease part is interesting because sometimes the argument against putting more effort into women's health is that women live longer than men. But I read somewhere that women live, they may live longer, but they live more years in ill health. So that chronic disease part is especially crucial for women. So I can't wait to come on to some more practical ways that we can help the audience. But first, we've got a section of the podcast called Bye or Bye Bye. So I'm going to show you a sheet of paper. And I would love to know whether you would buy this thing metaphorically or say bye-bye as in goodbye. So testosterone supplements. So in general, I believe testosterone's

a critical hormone for men and women. Beginning in our 30s, we begin to lose testosterone, one to three percent a year. But to just erratically go out and buy testosterone supplements without knowing anything about your own body and what's necessary. Bye-bye. Bye-bye. LED face masks. Those can be really useful. I think if you're using them religiously, I mean, you have to put an effort into it,

which means you have to do it every day. You can help reverse fine lines and you can help with your hair as well. So wearing the mask is something to consider. Just compare the different types of masks. So you get one that's effective. I like to do mine first thing in the morning. It sets the time of 10 minutes and then I know, right, I'll get as many tasks as I do in those 10 minutes while I'm at my desk. And it works quite well. They're great pictures on Instagram where you see

people doing lots of different things. I get targeted a lot for that. Full body MRI scans. So that's complex answer. And I'll tell you why. First of all, I do them in patients when I studied patients and I found a risk, even in the 20s or 30s, a risk of cancer. And there are ways to look for that. I worked with companies that were beginning to develop it. So, but you have to be aware that if some glitch or abnormality comes up, whether in your thyroid, in your brain, in your pancreas or liver or kidney, you then might need further studies. So both the anxiety and the stress of something's wrong, along with doing additional tests, are something to be considered before you embark on that. That said, if there's a family history of diseases, particularly cancers like pancreatic cancer,

liver cancer, other kinds of conditions that are hard to diagnose and pick up early, they are worth considering. You just have to make sure you work with a clinician or somebody that can help guide you into what the next steps might be if something turns up. Like we've had to do lung biopsies and folks, we have found minor tumors in the brain called meningiomas and one patient ended up having surgery to remove it. And that was pretty traumatic to go into the brain. But finding a pancreatic cancer, finding a kidney cancer and saving a person's life, what could be better than that? I worry about some of the ones where there's not a clinician attached to it. There's no counseling before someone has the scan. There's no counseling after if they find something

you just get referred onto a clinician. And you're right. I think you need the counseling beforehand to prepare you. Yes. And to also make sure you can handle it. It's like finding out you have a risk genetically of Alzheimer's dementia or another chronic disease like heart or stroke. or Parkinson's, I think the issue of what you have to deal with in your day-to-day life means you need support. And that would be hard to find. And that is also true of families where a parent or a grandparent, but here it has those conditions and then you worry, is it going to affect you? You might not worry in your 20s because you feel invincible, but later on it bears on you that this is something I need to think about. Am I at risk? In fact, we have somebody who talks about

all the time because both grandparents, grandmothers had Parkinson's, and now her mother has Parkinson's, and they all got Parkinson's at 60, and she's only about 10 years younger. So she's talking to us about what to do now so she could put it off. And that's the good news. If you know what's going on, you can actually change the way genes work. And that's the point of invincible, defy your genetic destiny, right, to live better or longer. And if you can do that, you can actually keep your health for a much longer time, because we women do live longer, but not. in good health. Genetic testing kits. So there I would say buyer beware. Like not all of them are a good test and some of them, the information can be erroneous. When they first started coming to market,

I remember an article by a young woman in her 30s who knew certain conditions around in her family and she wanted to test. And one said to test said she had rheumatoor arthritis and the other test said she didn't. And so understanding where it's coming from and the validity of the test is really important. And again, a similar thing to full body MRIs. You might find out something that really scares you and freaks you out and what am I going to do about it. So having support lined up and knowing what you might do, it's the same question as if breast cancer runs in the family. Do you do BRCA or do you not? Do you understand if that's a positive in your family that you likely have, depending on who has it in your family, a 50-50 chance of getting it from one parent or the other?

And I've been there with lots of patients and it is overwhelming and it could traumatize a 25-year-old. in a way because they have to make critical decisions much earlier in life. So to some degree, I totally buy into genetics, but that's because I have expertise in the field of genetics and epigenetics, and I can position what we need to do. But in other ways, I would say, beware that you're getting a good test and you have a place to go to kind of discuss it. NAD supplements. So that's a great question because NAD is everywhere. The truth of the matter is that getting NAD infusions is not what everybody thinks it is. It's actually not good for the body to get NAD itself. And a lot of times the infusions have ingredients in it that make you feel like

it's a buzz. And that's because they may add things like caffeine or B vitamins or something of that nature. But taking the pre-supplements, for example, epigen or aschwaganda, can build NAD in your own body. And so it's worth considering. In the 20s, it's worth testing for what your body is doing with vitamins and supplements and hormones, because that's when we generally peak in an optimal way. Actually, at 27, so 25 to 30, and of course, it's not absolute because, as I've said, everyone is unique, but that's when we feel pretty invincible and we think that we can go on living forever and we're immortal. We know very rapidly in our 30s, that's not the case. And so I would avoid NAD itself, but take the precursors and that won't, that will only help you. It'll

either be neutral or help you. I'm 27 now. So that's it. This is, yeah, this is the perfect time to be doing this interview. Exactly. I have so many questions. The first one is I'm going to add on my own buy or bye by by that I don't have a piece of paper for because it's very topical at the moment. And you mentioned it earlier, peptides. Yeah. Peptides, buy or bye by by with cautionary notes. It's not something you want to go and just do arbitrarily because they can be harmful to people. They're not necessarily they're pharmaceutical agents. What's so brilliant about them is that they're very simple proteins in general made up of a string of amino acids if you go back to biology and you've trained and you have a master's so you know. And I love them because they work with your body

physiologically. And in fact, I used them and brought them to market many decades ago in children with early puberty where we can reverse puberty or use it in people who are undergoing IVF, where you need to treat the ovary in such a way to maximize the number of eggs you're going to get. And these are called GNRH peptides, and they work to help the body turn on and off in the way they operate. But if you just take peptides arbitrarily and you have a gene that puts you at risk for certain conditions, cancer or other conditions, you can inadvertently trigger that. The other risk that you run into is because they're so hot and popular, you can get them from anyone and anywhere, and some of them have toxic material in it, or just because they're

inexpensive doesn't mean they're good for you. And so you want to be careful about where you might go and what's specific for you. And that requires clinically understanding how your body functions. Just feels completely unregulated and people are buying them off the internet and almost they're being treated as this big homogenous lump of peptides. Are there any peptides that start? are standouts for you that you really love? Sure. I, because I use them all the time in patients. I use them myself. It helps heal injuries. You can use it to promote growth hormone. And it's, again, what I like about it is it works with the body. It's GLP1s, for example, Ozempic. Well, in the States, it's Majaro or Ozempic. Those peptides are phenomenal because we actually make

a version of those peptides. It doesn't last as long in our own body. We don't make ones that last for a week, but the ones that we use just magnify that effect, and as long as someone's managing it. So there are other peptides called BPC 157, which is for inflammation, thymacine 500, which comes from a longer string of a peptide that actually helps promote healing. So when someone has an acute pain or an inflammation or arthritic kind of condition, or they injured themselves, those are amazing. BPC is relatively safe as long as you're getting it from a qualified you know that it's certified for what it is and what it has in terms of the activity. So that would be one that I would say is very useful, has been around 200 years.

It was actually discovered in gastric juices of dogs in Russia. And there are other ones is one called cerebrilicin that is hard to get, but it's also been used for a very long time. I have a patient, and she remembers her mother, who is a physician injecting her grandmother to prevent the risk of dementia. And so these peptides generally are phenomenal, but again, very specific to the individual. Okay. My next question as a follow on, testosterone supplements. So you mentioned that there's no supplements that increase testosterone. Right. There is a peptide for men that we use that will increase.

It doesn't work in women in the same way because we have different hormones. We have all this, just about the same hormones, but they act very differently. And they're used and they trigger the body's release of, let's say, testosterone or estrogen or progesterone in different ways in men and women. But there are no supplements that I've tested that actually increase testosterone directly. None. The peptide that does is human corionic an antotropin for men. And sometimes when men have some degree of infertility and you need to help them make more

sperm or in older men, beginning in their 30s or 40s, actually, it actually helps to trigger testosterone naturally from the testes, which to me is. a brilliant way of going about it because you're actually encouraging the testes to be healthier for longer, just like we women, when we can get pregnant later in life, when we have eggs, we actually live longer. So it's a biological benefit if your testes are working a long time and if your ovaries are working a long time. So fathering children or getting pregnant actually means that you will have a longer life. It's like one of those signs. Oh, wow. So it's what I work towards when I take care of men and women.

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Please play responsibly. I didn't know that. That's really interesting. And women rapamycin is another drug. It's an immunologic agent that I'm sure you've heard about. I was reluctant to really use it very broadly because it does sort of suppresses the immune system in some ways. What they've actually shown at Columbia University in New York, the medical school, is that rapamycin can slow the release of eggs so you don't use up all the eggs because that's why we women go into perimenopause and menopause. We are using up the eggs. We actually are born as little babies with fewer. eggs than we had in utero. So every month we're losing eggs. And when we go into menopause, which is one year after, you know, our periods have stopped, we have no more eggs left. And that's

it. So rapamycin has been shown to extend that period of time. So let's say for women who want to have a more extended period that they might conceive, they might consider taking rapamycin. Again, with oversight. That's the fake risk. The fake overall. It's a prescription drug in the States, I'm sure it's a prescription drug in England because of where they use it. So you'd have to have a doctor work with you. That's a big one. The biological clock is for women is huge. And when you see that graph, the graph of the eggs decreasing as you age, it can be terrifying. Yes, it is. And a lot of women, I don't know if this is true in the UK, but in the States, a lot of women in their 30s, they save their eggs. They undergo a stimulation process. It usually takes a month just to protect their

future. What is also interesting is that a lot of Silicon Valley companies do a couple of things. First of all, they underwrite that so the women don't leave because they're pregnant and then have babies and need maternity leave and they want to postpone it. They also do peptide stacking where there's peptides in the refrigerator and Fridays everyone can go and get whatever peptides they want. So that's not necessarily the best way to do it. It's not what I would encourage. The commercial linking with the egg freezing is a really, really, really interesting. Have you heard of that as well? Is it? Yeah, I froze my eggs in November. Yeah, so I just documented the process. My egg count was a little bit low, which I know is not an indicator of your facility, but my fiance is a little bit younger than me. So I thought,

you know what, I'll freeze them and I'll document the process. And hopefully, I never use them, but they're better. How do you feel doing that? What was the process like for you? Was it overwhelming? or could you take it one step at a time and you were, you did well with it? My recovery was fine afterwards. There was, after my trigger injection, I had a bit of a mood swing. But otherwise, my symptoms were pretty good. It's a really, really interesting conversation because I think there's one element of an equalization of biological autonomy.

You're not under a ticking clock. Yeah. And as much as it's not an insurance policy, it does feel empowering in some ways. But then there's also these existential questions. It's still a very contentious issue, I would say, in the UK. When I said I was freezing my eggs, a lot of people were very annoyed at that. I think maybe it's to do with the cost of it. Yeah, the cost is probably prohibitive.

It is in the States too. You really need to figure out how you're going to do it. And mostly in the States, you were young to do it. I understand that you actually were smart to do it in your 20s because that's when health is the most optimal it's going to be. That's when it peaks, really, as I mentioned. and a little ahead of the curve. Then there's a question of what are going to happen to those eggs if you don't use them.

I'm assuming you didn't have them fertilized. They were just the eggs themselves were frozen. We were planning to do one round eggs, one round embryos. But I went to Brazil, so I couldn't do the embryos until after a sea care. I'm still hoping to do one round of embryos. I've got the robustness of the embryos, but then, God forbid, anything happened. I broke up with my partner, I have the eggs as well. Yes, that's good.

One little tip if you didn't have a lot of eggs would be check your sugar. Like one of the things in Invincible defy your genetic destiny to live better longer. If there's any heart disease in the family, stroke, diabetes, what I have found in a lot of young women is their sugars are not quite staying optimal. And that affects the health of the eggs and how many eggs you actually make can perform. You got HCG. That was the triggering shot that you got when you released the eggs. So I would look at that before going through the embryo stage and see if you can optimize your sugars using a continuous glucose monitor on your arm. And you can see what foods do to you, what anxiety, what working out, sleep is a big one.

Because I have a lot of women like you who are in fabulous shape and they have terrible IVF cycles and they don't know why. And I generally test them in that way. and it's almost always because they become hypoglycemic. Their sugars go too low, which is also another indication of future diabetes. So if anything like that runs in the family or for any of your listeners, it's worth seeing what your sugars do

before you actually put yourself through a cycle, particularly because it's expensive too. I'm so glad you mentioned the continuous glucose monitors because they are also a really controversial issue in the UK. There's a big company that a couple of years ago they started selling continuous glucose monitors and doctors were furious on social media in the UK saying this is pointless unless you have diabetes. I was in medical school at the time and really bought into this idea that continuous glucose monitors were a con and then I started doing my

master's and I had this phenomenal lecture from obstetrician who specialises in stillbirths and was looking at the relationship between stillbirths and women with undiagnosed. gestational diabetes by looking at the placenta after the stillbirth. Pathological findings of these placenters suggested there was undiagnosed gestational diabetes. But the way that we test gestational diabetes in this country, we look for a hyperglycemic response, not a hypoglycemic response. So for listeners, we look at a raised blood, yeah, an elevated blood sugar, not a low blood sugar, but actually the low blood sugar shows that the system is not working properly. Exactly. And internationally, the guidelines are slightly different,

but here we haven't course up. You know, the increased awareness of women with PCOS, just women's health in general, it's really switched my perspective recently on continuous glucose monitors. I would love to hear why you advocate for them. So there's a few things. I hope I remember all the points because you raised so many great points. First of all, when gestational diabetes is diagnosed, you're usually already pregnant and it's done in a fashion that doesn't give you all the answers. You really need an oral glucose tolerance test, which you can mimic using a continuous glucose monitor. So I can tell you about that. But generally, it's a half an hour, or an hour maybe, and you don't really see those fluctuations in sugar. And insulin, which is another

big aspect of it. Why I would disagree with the doctors, and I would have disagreed 30 years ago, but the continuous glucose monitor came about just like six, eight years ago. And I've been using it almost continuously. And teaching my fellow endocrinologist, Why it's useful in every person. And I mean every person, because we're all born with a tendency to have a disorder of carbohydrate metabolism. As a trained endocrinologist, I question that. But what's obvious is we survive from people who had famine, whether it's the Irish famine

or Holocaust or cavemen, right? You had to live off your own body during lean times. And if you couldn't put on weight during the good times, you weren't going to survive the lean times. So we've inherited genes that make it so that each one of us has a disorder of carbohydrate metabolism, which is basically diabetes. I don't even call a diabetes type 2 anymore because there's so many types. Each ethnicity in different combinations, different gene variants, there are thousands that affect the way sugar engages in our body. And it's not like sugar is evil. I have a sweet tooth. I love sugar. But I keep it in moderation and I keep my blood sugar in a certain standard way.

So I think the notion is, and the reason it came about that the doctors were furious or up in arms, is that we diagnosed diabetes way too late. We can see it decades before people get diabetes. You don't wake up one day with diabetes. You've had it, and it just becomes, the symptoms become evident. In the States, 80% of diabetics are diagnosed in the emergency room. And during COVID, eight times as many diabetics were hospitalized and four times as many died. They were hospitalized on respirators.

So it is a very bad condition that leads to almost every chronic disease of aging you can name. So things like heart attack, stroke, Alzheimer's, even osteoporosis and cancer because insulin is an inflammatory molecule. So if you have insulin resistance, you can have problems. So I would strongly encourage women now. It's over the counter and I believe in UK too. There are variations. You don't need a prescription.

But you learn a tremendous amount about how your body fluctuate. and what your sugar does. For some people, a banana causes sugar to go sky high like in me, but I can eat ice cream and I'm fine. And certain kinds of ice cream are better than others. So I think there's a lot of studies on that. There was one out of the Weissman Institute. I think the principal investigator was a Ron Siegel. And they showed that exactly. They studied a thousand people and they showed the differences, dramatic differences, where one would have an elevated sugar with a cookie, but not a banana, the other one would be the exact reverse. So those are very important reasons why the continuous glucose monitor can help you control

the way you age and sort of defy your genetic destiny because even if you're hardwired in your genes and your DNA, consider your DNA like a rough draft that you can maneuver and you can have switches that can turn on and off. So even if your mother had diabetes, if your father had a heart attack, if your grandfather had dementia, you don't have to go down that path, which is exactly why I do this work. What you said about your health destiny, so most of us grew up thinking that our health destiny is set out and we're likely to follow the pattern of our parents, there are ways that you can sort of change that destiny.

Yes. So looking at your blood glucose is one of them. Any other ways? There's this continuous glucose monitor. There's the five biomarkers that I've identified as being critical. I've not seen one person that have optimal biomarkers, and that's glucose, hemoglobin A1C, which is the average of your glucose for 100 days, insulin, all fasting, cholesterol risk ratio, which gives you a sense of your heart patterns, your lipid patterns, and those are a standard

lipid test, which divides your total cholesterol by your HDL or the good cholesterol. And the final one is free testosterone. And by combining them, we can see together with what I think of as your health story. More than a chief complaint, because you all know as physicians, we're trained to what is your chief, why are you in the office to see me today? Because that's reactive medicine. It has to be a problem, right? My way of thinking about it is your health story and the way you live life. Have you done resistance training? Do you put on muscle? How do you eat? What do you eat? Are you an intermittent faster the way you exercise or don't? Restorative practices like meditation, which can turn off

cortisol. Those kinds of practices make you who you are. And by combining and understanding that, the easiest thing is to check in your family. Now, even if you're adopted or you don't have a close relationship or a small family, you can still figure it out looking at biomarkers. And that's where the future is. I have done it for a couple of decades, but I think other groups are trying to get there as well and understand what the biomarkers. And hopefully the book will not only help your listeners, but doctors as well and clinicians, because there's a lot of information that's based on real world research. I actually develop the model I did based on studying people in an end of one fashion, meaning by collecting data

in a regular fashion, I could see prototypes of people. One example is the classic 30 to 35 year young woman who feels fine, but all of a sudden maybe putting on weight and wondering if it's her birth control pill or the way she's living life. And it may well be a birth control pill because it suppresses testosterone. So a diagnostic test of diabetes is if you've gained weight on birth control pills, even in your 20s, you are very likely on a path to diabetes. It actually, you can solicit that response because you're suppressing testosterone with birth control pills. And we women don't have a lot of testosterone.

And so there's lots of ways to look at how you turn switches on and off and the kinds of tests you can do. La Roche Pose is a brand I've worked with for a while now, and it's what I recommend to my friends and you guys all the time. When we talk about preventative health, we can forget that it includes skincare. too. I'm sure you've heard me talk about the incredible Anthelios facial sun care range before. It's an SBF you can trust to protect your skin every day recommended by dermatologists and for anyone concerned about aging like I am after one too many night shifts as a doctor.

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That's so, that's really interesting. Yeah, because you're only getting estrogen and progesterone in general, although some birth control pills are only progesterone, but you're shutting down a whole system. And that system is vital to take care of us. So birth control pills, if managed correctly, so I have women in their 20s, and if they are in birth control pills and they're happy with that and they're protected, then I would give them a testosterone cream if their testosterone's low. you've spoken about testosterone and glucose and I know that a lot of our listeners have

PCOS. So I was wondering if you could talk a little bit about the relationship between sugar, testosterone and if you have any particular advice you would give women with PCOS. So you know we're renaming PCOS. Yeah, PMOS. Sorry. Right. And it's always been a metabolic disease. So what's wonderful in some ways is it will be recognized as such, not just cysts in the ovary, but because some women have it and don't have cysts in the ovary. There's a whole syndrome where you can have sisters and one could have no sign of it at all. The weight is not an issue. They don't have high cholesterol. They're not infertile. Their cycles are regular and they still have the gene. So another sister can have

a combination of all the variety of changes that you can get metabolically. And here's why testosterone is critically important because testosterone helps us put on and maintain muscle. Muscle packages sugar in a way that's protective. So the reason sometimes we don't see the emergence of symptoms for diabetes or heart attack or stroke until our 40s or 50s is because we have adequate testosterone going into our 30s, but in the 30s it begins to fall by 1 to 3% a year. And by doing resistance training, eating enough protein, and that's 1 gram per kilogram at a minimum, you can go up to 2 grams if you work out more vigorously, but if you do two or three sessions of resistance weight training a week along with moving at least 30 minutes a day, something aerobic, and adding high-intensity

training, you're protecting your health for the future and for today. And so you can package sugar more effectively. You can learn to eat in a certain order so that you actually can prevent glucose from going up. And you don't need to check blood glucose. That's the whole beauty of the continuous glucose monitor. instead of just going into a doctor and getting a test once a year, if at that, and only knowing that moment in time, it can change every day. I did a lot of tests back in 2020 compared to different kinds of continuous glucose monitors and showed in the same person one day you're fasting, sugar can be 70 and another day it could be 100. And it depends on how you're living life,

the food you ate, if you drank some wine, a number of variables. And so it's complex. And by understanding yourself or know thyself, you can bring that to the table and make a huge difference in the way you age and how you keep your health for life, a long life, hopefully, because many of us are living above 100. I'm hoping that 120 and 150, exactly, I'll knock wood to, is where we're aiming at. But there are so many people in America now over 100, they can't even wish them happy birthday, which they used to do on one of the morning shows, because there are too many. And so, but protecting your health is absolutely paramount. much.

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Free of charge. BetMGM operates pursuant to an operating agreement with Eye Gaming Ontario. So your book is called Imensible, and we've spoken a bit about it, and you argue that even in midlife, you can reverse the trajectory that you're on. Do you have any of the most dramatic examples of someone reversing their aging? Yes. So we have patients, a woman that I see, for example, whose sisters died of a heart attack in their 50s. She's not going to get a heart attack, again, knock wood, because of all the work that we're doing with her and what she does to take care of herself. And frankly, if you look at her, she's in a group of women who look perfect and actually test very well.

So her endurance on a treadmill where we look at something called VO2 Max or metabolic equivalence, which that translates into, she has 13% body fat. So it's not just the variables of what you appear to the outside world. Like you can be thin and have significant diabetes that already shows up. particularly we see women, young women, like I remember another young woman who was in terrible shape and didn't understand she would have a brand muffin and a banana for breakfast. And then a couple of hours later, she felt very exhausted. She'd actually put her head down on the desk and want to fall asleep by teaching her how to eat and increasing protein and starting with protein. So having eggs or cottage cheese or some version of protein before you have a brand muffin or bread or carbs help modify

the way you release sugar and the way you release insulin. Another good example are early heart attack in young men and women and stopping that. So we have a group of patients, for example, who have all signs that they will have at 30, they look like they could be 50 in terms of their biomarkers. And when you dig into their family history, you find out that there's a very strong history of heart disease in the men and women that preceded them, parents and aunts and uncles and grandparents, and many die in their 60s. So by looking at those numbers and then changing that what we do with them and how they live life and the choices they make in baby steps. It's not like do this all at once and your whole life turns inside out. It's these are the

small steps you can take by eating protein before having pasta, for example, or keeping the pasta overnight so you get more resistant carbs on fibers so that you change what can be increasing your sugar to a very high level with pasta. Instead, it acts as a prebiotic in your gut. So there are a lot of tricks that I think are not as well known that we talk about in Invincible to defy your genetic destiny and kind of live better longer. And it's really true. You can do a lot of this. and see a lot of our patients who do not have to suffer with what they came in with. Brain fog, difficulty thinking clearly, which is what we call it, fatigue. Energy seems to be the biggest complaint I hear from women in their 30s.

And a lot of times they ascribe it to working out too much or taking care of children or career advances and they don't have time to take care of themselves. But largely it's usually because they're not getting enough sleep or they're not getting quality sleep, they're not working out effectively, and they're not eating enough protein. A lot of times we women starve ourselves. In fact, there were studies in the past why women became anorectic or what a normal body woman would do. They couldn't find enough women who didn't watch what they ate in terms of calories, which effectively are almost meaningless to me because it's the way you put the food together that counts. D diets to me, it's almost a bad word.

things that help some people might not help another person. So I believe in eating effectively foods that are good for you, leaning in towards more Mediterranean-like meals and eating in a certain order so that you're always, whether it's a snack like an apple, take a few nuts before it. Or if you're going to eat a banana, put some nut butter on it, cottage cheese, dropping the alcohol if you do, if you're used to a couple of glasses of wine at night, maybe you cut back a little. Don't eat for a couple hours before you go to bed because it allows your metabolism, and the waste that we create at night to be washed out of your system. And that's a very important factor in terms of protecting our brain as we age and also feeling good when we wake up in the

morning. I feel like nuts come up in almost every single episode of this podcast. And I have to admit that I was very guilty of a couple of years ago subconsciously being influenced by content on social media, which said, here is Nutella on toast and it's X amount of calories. here is peanut butter on toast and it's way more calories. And in my head, I'd really seen nuts as this hugely caloric food. And then I should have, you know, known better. But then it's only through interviewing so many guests where they talk about the power of nuts, even if they're caloric.

How many much of those calories have absorbed or how much of it's such incredible nutrition. And you're so right about women just have this. There's so much pressure on women. to be constantly smaller, we're limiting our food intake. What would you say the biggest dietary mistakes that you've seen women making? Probably eating too little and subsisting on things like salad thinking that that's healthy. In fact, if you don't put dressing in the salad, you can't absorb the nutrients. So you need some olive oil in the salad to absorb like e-vitamins. You need to protect the nutrients to build bone in your body so that you don't end up shrinking

with age. So many diseases come about because we're not sustaining sugar because, as we pointed out before, it's not just high levels, it's low levels. It's like, think of the framework like temperature. Our temperature should be around 98.6, even though that's just an average. So some of us like me, my temperature is usually 97 when I'm healthy. Okay, fine. So maybe like 36 Celsius. I think that understanding that we all have this range that we could maintain, that it's not difficult if you just know a few rules, I'll use peanut butter as an example. Peanuts are actually legumes. They're not nuts themselves, like walnuts.

So walnuts, and I don't particularly love nuts, but I make myself eat them because they are good. So walnuts have high content of omega-3. So you're hitting a lot of avenues. All the nuts have fiber. They have oils in them, and whether it's almonds or cashews or macadamia nuts. Peanuts are my least favorite just because they can have a lot of fungus associated with. it. And because they're legumes, they're not really nuts. But they're still good for you. It's just in moderation. And I think that's the other. When you're afraid of the calories,

they played on your fear of calories when that's kind of meaningless because one calorie doesn't equal another calorie. And the reason for starting with protein as opposed to starting with a carb for a meal and the macronutrients is that the minute you have a carb, it absorbs very quickly. We use something called the glycemic index, which is equivalent to a slice of white bread, absorbed causes your sugar to go up, like you use 100. That's the standard. And if you have foods that have high carb content, you are going to cause your sugar to go up immediately. And then it takes a little while for insulin to follow. So that's why you feel good for an hour or two, but then your sugar plummets. Your insulin is still elevated. And that's why you don't feel well and you feel

jittery. And at 10 o'clock, you're going for a donut and a cup of coffee because you're not sure why you're sleepy, tired, and you don't feel well. Whereas if you have eggs or cheese or something to start, you know, the morning breakfast. And if you do oatmeal, then you want to put protein in that oatmeal or nuts, let's say. Then you're going to slowly absorb the carbs or the sugar, slowly release the insulin, which follows each other, and you feel full for much longer in your body's healthier. Having you on the podcast talking about longevity, it wouldn't be right to not talk about Brian Johnson and also mention talk about OZNPIC as you're an endocrinologist. But first, we are going to move on to the section called Real or Not Real. I'm going to show you a clip

from social media and I would love to know what your thoughts are on it based on... This is a fun podcast. Yay! That's what we like. If you go to the doctor and your blood pressure is high and they can't find anything wrong with your heart, they're going to say, let me look at your family history. They're going to go, oh, you know what, your uncle and your mom's side had it, your grandfather had it. You have genetically inherited hypertension. I spoke to a room full of 900 board certified endocrinologist and I looked out across the room and I said, how many of you right now are treating patients for these genetically inherited diseases like hypothyroid, like hypertension, like drug and alcohol addiction or type 2 diabetes? I got through five conditions and every hand

in the room was up. Keep your hand up. If you can tell me what gene causes any of those diseases, every hand went down. I said the reason why you can't tell me what gene causes any of those diseases is because that gene does not exist. And if that gene doesn't exist, then that disease does not exist. We do not pass disease from generation to generation. We pass the inability for the body to refine a raw material, which causes a deficiency, which leads to that disease. Real or not real?

Just partially real, but mostly unreal. I actually, in my family, I've been on blood pressure meds for 20 years. So I found out my mother had high blood pressure, my father had high blood pressure, my sister, I'm not sure about my brother. I don't think he has high blood pressure. And I've treated blood pressure for many decades before the newest guidelines came out that said it should be 120 over 80, but no higher. And because it can actually also lead to dementia. What happens is you get resistance in your arteries. You don't feed your brain enough oxygen. So keeping your blood pressure in a good range and being careful that it doesn't go too low or too high is vital.

What he's explained is a little confusing. There are genes that cause all of these conditions. But our genes are raw material. And he kind of alluded to that, I think, of the genes as a rough draft because they can lead you down this trajectory where you get disease. Or you can work on by yourself even with your physicians or by reading the book, Invincible, and understand the kinds of things you could do to prevent those diseases from emerging. So yes, if somebody has a blood pressure today in their 20s, that's over 120 over 80, and if they think, well, they're a little overweight, they're going to try to lose weight first and then, no, let's reduce the blood pressure, particularly if it's high. Now, if it's just barely, okay, give you some time to lose some weight and hopefully get some help with it, particularly fat, not muscle. But yes, those are the kinds of the understanding is not completely there yet. Genes do have an impact on who we are completely. Not every gene emerges. There's a gene that causes Louis Bodies Parkinson's, which is a form of dementia that then leads to Parkinson's. Robin Williams, the comedian, had this disorder. It wasn't diagnosed. He was so good at covering it up by being a comedian. They ended up dying without a diagnosis.

But I've diagnosed people with that gene who don't have any sign of that condition. And it's not a fun. One of my cousins had it, so I know well what it can do to ravage a family. And so genes don't always express and you can stop the expression of the genes you have by living a certain life for not everything. It's not 100%, but it's for most common disorders of aging. I've heard the phrase genes load the gun, lifestyle pulls the trigger. Would you agree with that statement? Not. Again, in a fashion, not really. My bias has always been that genetics plays a huge role, but it's the expression of genes.

It's the epigenetics. So the fact that we can change the way our genes walk and talk and whatever they do to us. And I know that innately because I'm an identical twin. So my twin sister and I, I'm not sure you knew that, but my twin sister and I are different. Even though some people feel like we look so much alike, they can't tell us apart. There are pictures I can't tell us apart either. So I know that's true. But in other ways, I'm a little taller than her.

She's now a little thinner than me. It makes her very happy. But I have more muscle, so that's good. She's a dermatologist, so people think she looks younger, she does, which is fine. Our genes don't dictate everything about us because it's the way we live life. Even beginning in utero, twins don't sit in the exact same spot. Or if you look at Siamese twins that separate, but they're not fully separated, they're not exactly alike. And that's because genes can turn on and off.

So there are people who have one blue eye and one green eye, and that's because the gene turned off. The blue eye gene turned off in the green. I and the green eye gene turned off in the blue eye, right? And so it's selective. We don't know enough about all the specifics of how to change that selectivity, but there's enough and invincible to give you a sense of what you need to look at for yourself. And since there aren't ever going to be enough doctors or other clinicians to really hold your hand, learning what you can do, that was my goal with the book.

I wanted everyone to have access to health issues that they can own for themselves. and they can see the future direction for themselves and turn it around so that they can live in great health till 120 or beyond. You mentioned a really key topic that epigenetics, which I think is just such a fascinating area of science for anyone who doesn't know what that is, would you mind explaining a brief synopsis? Yeah, so epigenetics is the way genes express. So you have a DNA, you can't change your DNA.

It doesn't change unless CRISPR in the future. and other tools that can go in and slice that a little bad corner and make it better. And there are all sorts of ramifications of that that we don't have time to even touch on. But that's fascinating to me. Epigenetics is the way our genes make RNA, so DNA to RNA to protein. And it can change the way our body responds. It's why the polycystic disease, which is now polymetabolic disease, that you can have sisters who have the same genetic underpinnings,

So their DNA is identical. Their genes are identical, but the way, like my twin and I, but the way we express it is different. So one example, I'll use my twin sister. I can even give you a couple of examples. She had her gallbladder removed because when she was under a lot of stress, my mother lived with her. And my mother was in great shape and passed away at 102. So we were very lucky. Both our parents, mother and father outlived all their siblings, I think, because they had specific attention from my sister and I.

She was under so much stress that she developed gallstones. I've not had gallstones. I don't want gallstones. And she needed an operation very acutely after my mother passed away a couple of years ago. My father, he had other conditions. The genes that I've gotten the same exactly as my sister seem to resemble more about my father. So, for example, I have something called eschemic colitis, which is an inflammatory process that when I'm under stress or when I don't drink enough water, I can get GI symptoms. It's related to, but not quite the same as like crones or inflammatory crones or ulcerative colitis.

Why is that happening? Another, a factor that I could show you as well as how we live life is I've been on testosterone, which the Daily Mail now knows and it's big header when they took part of the book and an abstract of the book and published it. The title was, this doctor has been on testosterone for 30 years. And that's true. And the reason I was on it is I knew that osteoporpeachial. process ran in my family. An aunt of each, my mother, my mother's sister and my father's sister,

each had severe osteoprocess and both died consequently because that was part of the issue. And I didn't want it. And I knew looking at bone that I was at high risk, as was my sister. But I started it and I'd been on it for three decades. She's been on it for a third of that time. She has osteoporosis. It's not very advanced, thankfully, but it's something we have to reverse now. I don't. And I want to keep it that way. So there are ways we can intervene, and that is epigenetics by putting on muscle, by making sure we have adequate testosterone, by eating protein, by starting a meal with protein or even a snack with protein fiber and fat before the carbohydrate.

By doing meditation, for example, it can lower cortisol if you tend to have high cortisol, which leads to diabetes and particularly fat around the middle. So there's a lot of ways we can look at how we live life that changes the expression of those genes and that's the field of epigenetics. As far as genetics loading the gun and lifestyle pulling the trigger, there was an interesting study a while ago that feeds into my concepts and the work I've done that showed when they studied thousands of twins, identical twins, they looked at the degree genetics plays a role in your health and it was greater than 50%. And the old kind of saying was more like 25, 30, 35%, and lifestyle is like 65%.

I never like those numbers because some disorders are tightly connected to genes and others are tightly connected to the environment or the way we live life or not sleeping. If you don't sleep enough, you're going to get these diseases. So a lot of people think they'll sleep when they die. You'll die sooner. And a lot of studies have shown taking sleeping pills, for example, that is definitely, leads to early death, but it's not the sleeping pill. It's that the people can't sleep. Or when you are shift workers. So if you have listeners out there who are flight attendants or work shifts

in a hospital and constantly change hours, they're changing their body dynamic and it's not as healthy for them. They have to look at how to counter that. We talk about that in the book as well. This episode is brought to you by Activya. You might already be eating yogurt, but not all yogurts are created equal. Activia contains over one billion probiotics per serving to survive and reach the gut alive. When it comes to gut health, Activia is the number one family doctor recommended probiotic yogurt brand. Choose Activia, feel good from the inside out.

Visitactivia.ca for more details. For shift workers, because I know what there's a lot of doctors, nurses, healthcare workers who listen to the podcast, that's a question that comes up so many times. Or even if you fly often for your job, if you are a pilot or a flight attendant or you just have a job that takes you all over the world, you're not doing your body a favor. So you have to counter it because there are genes that actually turn on and off where you live. It's related to the longitude. And as you move in different directions, they've done studies at Harvard and Wisconsin showing that if they lock like a ward up, it's a research ward. And they've advanced the clock, your body will change. You will get to. diabetes. It will reverse, but if you're in your 20s, it reverses rather quickly, like within a week. But at each decade of life, it takes longer and longer to reverse. So shift workers are in a difficult position because they have to kind of compensate for the job they have and make sure they can make up the sleep, make up the difference, and live in a certain way that keeps their health.

As an endocrinologist, do you have an opinion on melatonin? I think melatonin is valuable. I think for some people who might have low melatonin and need it and for sleep, it's a great antioxidant besides related to sleep. Does it work for jet lag? Does it reorient the body or the pineal gland that secretes it? Not for everyone. So I think there are lots of ways to treat sleep beyond melatonin. Taking a little bit of melatonin, not as a growing child in puberty or anything, but later on is not going to hurt you. It will help you. But not megadoses of it. And there's some people who do take mega doses of it. And I'm not sure that's physiological or works with the body effectively. Do you have a limit of how long that you would take if you did find a small amount of melatonin

useful? Is there a cap on when you were to try and stop? No. No. I mean, if it works for you, there's not a rule. That's the issue. I'll use myself in magnesium. We tend in my family to have high magnesium in red blood cells. So magnesium in serum is a little meaningless, but magnesium in cells count a lot. They're part of like 300 interactions in the body. When I take magnesium, if you go on social media, it's everybody needs magnesium, not true. If I take it, it causes a side effect that's not much fun. It's itching. And I don't need it. Neither do my sons, but it's not common. And there are other people who can't absorb any magnesium in their gut. We do genetic testing because we find people who say, I take magnesium. I'm not sure why it doesn't

help me, and we look at their numbers and it never changes. And we know because we give them active ingredients of magnesium. And they have variants in their gene that says you can't absorb it orally, but they can take it through the skin. They can take creams. They can do Epsom salt with baths, which is very relaxing and helps people fall asleep. So that is another, you know, that would be worth looking at if sleep is an issue. And there's a form of magnesium that's great for sleep that I actually would go to first before melatonin, particularly in 20-something, 30-something you're young folks, it would be magnesium trionate that crosses the blood brain barrier because magnesium, blicinate, succinate and citrate are really good for the GI tract.

So if constipation is an issue, those are great. And it's great to take it night because they'll all help you sleep. Before we come on to Brian Johnson and Ozzympic, the contentious issues that they are, we have some community questions that listeners have sent in. So first one is if you've had a high stress lifestyle and nois, it's affected fine lines, aging and dullness, is this something we can bounce back from? Absolutely. I think there's always hope. We have 90-something year-young patients who fly around the world and do great and work and feel fantastic. So it's never too late. For a lot of the patients as you're going along, a lot of the people as you go along,

you just want to protect the muscle in your body and you want to do little baby steps. Like if it's hard for you to sleep or you're not sleeping enough, try going to bed 15 minutes earlier. Try putting away the phones. Don't eat for a couple hours. So you can reverse. I haven't had one patient who's become a diabetic in thousands of patients I've seen as an endocrinologist. We reverse it all the time at any age. And so some people come in with fluorid diabetes with a very high hemoglobin A1C.

It's even eight, nine, or above. And you want it under five. And they have abnormal sugars and insulin. But in today's world, you can reverse these conditions and you can reverse a bad lifestyle. You just have to make positive choices and take baby steps to get there. Next, community question. What is the normal age to start getting gray hair? How can I prevent it?

So gray hair also can be hardwired into your genes. And so there's some people that will see gray hair in their 20s. More often than not, people will see gray hair later on in life, like starting maybe in their 40s or 50s. Some people don't get a lot of gray hair. and they are 70 or 80s and they pretty much have the same color hair they had when they were younger. There is a supplement that I've taken since 2009 that has been shown in 20, 25% of us when we take it, we reverse gray hair. It's called root of astragalus. And there's a particular variant I use because it's been tested called TA 65.

It's not inexpensive. And getting substitutes for it, I'm not sure that works. because I don't know if the testing has been done to prove they operate. But I was one of the first four to try it in my own practice. It also helps reverse telomere aging, which is the caps at the end of DNA, which you want to keep as long as possible. And they shorten as we age, keeping them longer protects our health as well. And I was the one person, lucky me, that had that effect.

So my hair didn't gray at all. It reversed. My eyes, actually, I stopped using reading glasses. And skin lesions, that little brown spots, I never developed them. And that was something that really bothered my mother. And I was fully expecting to get it because I sort of saw the beginning of it. I don't get it. So I think that root of astragalus is an amazing supplement. And I hope there are more tests that are being done on it for the future. But the data has held up over the last decade or so, a couple of decades. Yeah. The final community question is, does a scientifically

perfectly perfect routine really exist? Or is it just marketing? What are the simple changes we can make today? There's no scientifically perfect routine because we're all end of one. I didn't really speak to it a lot here, but it is in the book, Invincible. So I urge all your listeners to get the book. It really makes a difference in how you make choices for yourself. What might be right for me might not be right for you. For example, I can fast all day and it doesn't bother me. And my body tolerates it. My sugar doesn't go down very low. There are other people who can't fast for more than three hours and they must eat again. So I have seen that full range of people. There are other people who can fast and it's a no win for them. Nothing happens. And there are genes that dictate that. So each one of us,

because that's a form of like being healthy if you choose and you can. Typically the tip off would be is if you're someone who never could eat breakfast. Like I noticed it in my nieces as well. I remember going out with Laura and saying, are you, you know, like, aren't you going to, don't you have breakfast? And no, I'm never hungry. And I used to be told my whole life, not by my parents, because they were the same. But as me, I was similar to them. We could all fast. We never ate first thing in the morning. And when I went on trips with my father, I still remember him pulling me aside when I was first married. My husband was along in a couple of my children. And he's like, what is this about three mails a day. And that's when I finally click for me that some of us can do it and some of us can.

Sometimes I had au pairs and they would be like, you have to eat breakfast and I would be, no, I'm really not hungry. And then later on, the continuous glucose monitor showed me why. It also shows me if I'm not feeling well. My niece is similar. So she knows that she doesn't have to eat until later in the morning or the early afternoon. Frequently I have a shake and I don't finish it. I don't even start it until noon or one. And then I'm eating lunch at four or five. And sometimes I really don't have dinner because I'm not that hungry and I get home late from work. Not a good thing, but I do. And I don't want to eat for a couple hours before I go to bed. I think in this world where we're constantly having our attention drawn outwards,

it can be the most radical thing to actually tune into yourself, you know, and listen to your own body rather than what it seems like, endless amount of noise that we're being fed. Social media, I think, has done that for all of us. I mean, I used to read three papers. a day, newspapers. I try to now, but I get so much thrown at me wherever I go online that it's hard to focus. And I see the stories, so I feel like, okay, but I don't think I'm getting the same benefit as I used to. But that's again, I know I'm mentioning Invincible, but my dream of writing this book was to do just what we're doing here is to really help everybody understand the details of their own being to look inside, as you say, and say, well, I know this is what's

generally said, but what works for me? Who am I? And identifying the patterns that are in the book will really help people decide, even at 20 or 25, well, maybe I need to do this instead of that, regardless of what my best friend does, because that's going to help me avoid the conditions that run in my family and I can stay who I am till I'm 120. Talking about external noise and social media. Brian Johnson says he takes about 100, over 100 pills a day, and he has tested his biological age obsessively. And he's publicly aiming for immortality by 2039. What are your thoughts? What do you think is potentially useful and potentially harmful? So first, I wish him all the best. But if I had to do that, I would want to die sooner. So I could not live like that. And I've had people say that to me that they

tried what he does for four hours and they quit after four hours. It's a lot. It's a lot of It is very difficult if you listen. He's very open about it and I think what it has done is it's brought attention to longevity and the fact that there are maybe approaches that can be used. Here's the trick though. What works for Brian is not going to work for anybody else. It's about Brian and he's investing millions every year to get himself into this place. Will he actually achieve it?

Nobody can tell you. It's unknown. That's why longevity is not really the goal here. It's about your health span. and not about your lifespan, we never know what's going to happen to us, right? Accidents happen. There are things hopefully not, and everybody will live to at least 100 or longer if they choose. There are people who don't want to live that long.

I think in part it's due to feeling like you've done everything in life and maybe it's time to move on. And for some people, it's illness because they can't walk or run or do the things they used to do. And that's what I'm hoping to stop. I want people to be able to do anything they want until the last possible moment. And then you just go to bed and you don't wake up because you're really. body's tire. So Brian Johnson, I think, brought attention to the field. Do I think it's the way each

one of us should live? No. Do I think it's a marketing issue to sell extra virgin olive oil and all the other approaches? I think so. Rachel Ray did that really well on Food Network when she cooked. But I think that it's helpful to get those insights, but not necessarily, is it meaningful for you or me? So I would choose not to do it. And I just think that approaching it more scientifically as a process for yourself matters. And you don't have to spend millions to do that. It feels like a lot of the longevity landscape is quite male dominated as well. So it's really refreshing to have science backed, but also female approach.

Do you think the approach to longevity does differ based on whether you're male or female? and if so, are there any actionable tips you would give to women listening? The way our body ages is different in men and women. I think men have an opportunity. We outlive men in general. And I think we have an opportunity to help men live longer in good health as well. We women tend to get more Alzheimer's, but we live longer. It starts sooner.

We live longer. We have different combinations of hormones. All the hormones help our memory and our brain and our body, our heart, our muscle, our bones. So in we women, our body changes pretty dramatically in the 40s. Usually menopause, which is the last period a year prior. So menopause is one day and then you're postmenopausal. And that change, that era, I think, is traumatic for some women. It doesn't occur in men.

So if you're asking from the human being point of view, that would be my answer, that we age differently. Women are more different from one another than men differ in terms of metabolism, in terms of hormones from my work. I can see that men tend to age in a more linear fashion. So they're dropping, dropping, dropping. But in we women, our eggs disappear and that's it. And we have a handle on that. Men have no handle. But just like I mentioned before, testosterone is not the only thing for men, and that's what seems to be the focus. It's about their whole body and how they age and what they do. I think from the bro point of view, or as one of my colleague says, you know,

the bro in a Patagonia vest. It's about muscle. It's about working out. It's more, and we women tend to lean more into more aerobic kind of activity as opposed to muscle, although I think that's changing. From that point of view, I think it's looking at themselves as opposed to women and me, for example, wanting to look at each human being to determine what makes you, you, what makes me me, or me different than my twin sister. So that is the difference to me. And I think any doctor who studies knows that's real, that you can't sit in front of a patient and do the same thing for the next 10 patients that come in front of you.

It doesn't work that way. And I think that's the biggest misconception in the stories we now hear about longevity. It is not a one-size-fits-all. and it isn't even on the other end of the spectrum, evidence-based medicine. Evidence-based medicine is a good place to start. But when you're studying thousands, if not millions, about a new drug or a new process, you're also regressing to what we call the mean. So everybody becomes average and one size fits all.

And yet my sister wouldn't let me borrow her shoes because she thinks our shoes are different sizes and I would change the shape of it. And that is really true. We need to recognize the differences and stuff. celebrate them, but know ourselves. Study our family. That's the least cost we can do. If our family is open enough and sometimes you have to maybe be a little tricky about it because sometimes people don't want to talk about their private health issues. But maybe if worded in a certain way, if somebody's about to get pregnant, they say, oh, you know, grandma, I'd love to find out,

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that's another way to do. You have to use the bathroom, so that may be a little tricky. Even if you don't know your family history, which is the lowest lying, you know, that you can pick, the lowest lying fruit that you can understand. Getting a few biomarkers using a CGM, they're magic. They're really, to me, like a crystal ball. And that's what I hope to infuse in the book so that everybody knows how to take care of themselves. We're almost on to the final question that I ask all the guests that come on the podcast. But first, people like Oprah have been using the new weight loss drugs, OZMPEC, Monjaro. What are your thoughts?

I do think that my bias is GLP ones are the new antibiotics of the 21st century. And the antibiotics of the 20th century, which came to be in the 50s, 1950s, 1960s. To me, the GLP ones are magic. What Oprah experienced and others like her, and it's ubiquitous, there's so much. And I think it relates to we all thrive if we can live off our own body during lean times. So there's an overabundance of people who have the same issue, which is a food hunger. I've seen it in little babies who don't know any better and what they crave, little children. And you can actually see the data in children.

You can see the disorders of aging in little children who may not be developing the way, like, their sisters and brothers may be thin and in good shape. And they're not. and they're eating too much and they're craving pasta and breads. So what Oprah experienced is real and she suffered because it's like the yo-yo changes in weight is not good for your health either. So I endorse GLP-1s, not having any stake in it financially, but having used them for 21 years. I've used them since the very beginning.

The first GLP-1 was something called Bayetta that you took before a meal. You had to take it within 15 minutes to 45 minutes. and I tested it. I test everything. I don't tolerate them really well, but I test it. When I took Bayetta, I would go out to a restaurant and I love, I don't know if you know, chocolate lava cake. You know, it's like inside it's hot and love that.

And I didn't want it. My brain didn't want it because I know where it comes from the brain and part of the brain called the hypothalamus. And my belly, I was full. I couldn't, like look at it. And I realized how powerful they were. So over the years, I went from the one you take before a meal to. to test myself and my patients, the one you take daily, which worked phenomenally.

I had patients go on cruises and lose 50 pounds despite cruises having food all the time. And to go to the weekly one. I think it needs to be under the guidance of a clinician because you don't know how somebody's going to tolerate it. So, OZempic, 30% of people have trouble with it. They have reflux or they have GI symptoms, even vomiting. And they really can't take it. And Manjaro is a little bit better, or Zepound, and Wagovi, which is the Ozzypic version for obesity.

They all need to be monitored to some degree because a lot of people will take it and complain of muscle loss, which you can avoid. I have a patient who has metabolic syndrome, kind of the male version of polycystic metabolic disease. You saw him last week. He lost 100 pounds. Could never lose weight, even as a child. And one of his four children has the same condition, his daughter, his oldest daughter. And he lost two pounds of muscle, 100 pounds of fat, two pounds of muscle. Viceral fact gone, he's a completely different person than he's ever been before in his life.

You can't believe it. So you don't have to lose muscle. You just have to be cognizant of what you need to do to not have that happen. Eat enough protein, one gram to two grams per kilogram of protein a day. You have to have enough testosterone because remember you can't get it from supplements. So depending in your listeners, they're young. So they're probably doing just fine. But it doesn't hurt to be tested, particularly if they're on oral contraception.

and exercise resistant training. You know, those are all important factors, which I think I said, number one, resistance training and testosterone and eating enough protein, those three objectives to try to balance it. Because in the states, you can get it from almost anyone. And in some ways, that's a disservice. The same thing with peptides, because how do you know it's safe? How do you know it will work for you?

How do you know there won't be side effects? And then where do you go to talk about it? So those are the kinds of, that's the kind of balance I think we need to think about it. There are actually studies coming along, and we do use it in people that have risk of certain conditions because it works on the organs too. It's not just about obesity, which is why I call them the antibiotics of the 21st century. But using the right amount of dose and then monitoring someone. For example, you can get a scale at home that you can follow your body composition. I do it once a week. In the states, we're using something called in-body. We have a very advanced machine in the office that you stand on. on, but the home machine can help you stay on trend. And as long as you measure once a week, let's say, and you're nude and the only thing you can do is go to the bathroom, but no shower, no food, no exercise, you will be able to see your own trends and pick up, you know, whether you're maintaining your muscle. And again, eating enough because that's another side effect of the drug that makes you not want to eat. Or the peptide.

It is a peptide. And then doing resistance training, which is hard for some people, but absolutely is imperative. Florence, you've been an absolute wealth of information and it's been such an honest have you on the podcast. Last question that I ask all the guests, what do you wish every woman knew by the time she was 25? I think to invest in themselves. I think guilt doesn't do anything. Feeling bad because you don't get up in the morning to go work out if you need more sleep is a waste of time. So investing in yourself and maybe in particular doing the kinds of training that sometimes women are afraid of in gyms because the weights look, oh, I was, I was one of those people.

I can't do what those guys are doing. And so putting on muscle would be doing a favor. And I'll tell you the reason why, when I see men and women in their 40s and 50s who have not done that, have never been an athlete, never worked out, part of a team, played a sport, get out and move, they actually have a harder time reversing what's been going on in their body than people who do. Take that as part of your regular life. It shouldn't be, you know, I wait for it and I try to fit it in, but rather it should be one of the staples of your life. Sleep dominates. So make sure you get enough sleep. And a lot of us in the 20s are burning the can because we can. We burn the candle at both ends. Like we go to sleep late. We ski all day and we drink at night and we play cards or whatever and play. And we get up the next morning to ski again. That rapidly goes away as we age. So you can enjoy it, but make sure you get enough. lead to. Brilliant. So I would say it's not one answer. It's all of that, you know, conglomerate. Yeah. We will put the details on how to find your book in the show notes. Thank you so, so so much. Well, thank you for. This was fun. I love all the test quizzes. And I know I spoke a lot about Invincible,

but that's because I can't help it. Like to me, my dream was if I could prove this model scientifically for people, I wanted everybody to have a chance at owning their own future health trajectory. And so I know I brought it up, but it's natural for me because I've lived this book for a year and a half or two years, but I've really lived it my whole career, knowing that eventually I'd love to get the word out. And it's a brilliant message. So thank you so so so much. Thank you. This was fun.