Today, Explained - Hacking our health

Episode Date: August 17, 2025

We track our steps and our sleep, guzzle supplements and protein shakes, and even inject hormones – all in the name of wellness. This episode was produced by Hady Mawajdeh, edited by Naureen Khan and Miranda Kennedy, fact-checked by Melissa Hirsch, engineered by Andrea Kristinsdottir, and hosted by Jonquilyn Hill. Photo by Jeffrey Greenberg/Universal Images Group via Getty Images. If you have a question, give us a call on 1-800-618-8545 or send us a note here. Listen to Explain It to Me ad-free by becoming a Vox Member: vox.com/members.  Learn more about your ad choices. Visit podcastchoices.com/adchoices

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I'm Henry Blodgett, and I'm launching a new podcast called Solutions, where we're where every week I'll talk to an innovative enterprising expert to cut through the doom and focus on how to build a better world. Follow Solutions with Henry Blodgett wherever you get your podcasts. The first episode will be out Monday, August 18th. Supplements often have really concentrated doses of these vitamins and nutrients that we didn't evolve to consume. I woke up in my 40s, sore all the time.

unable to recover as quickly as I used to. At high doses, testosterone in certain individuals does cause aggressive behavior. I'm John Glenn Hill, and this is explaining to me from Box. In our last episode, we talked about wellness, what it is and why we're so obsessed with it. Here are five tips from a dietitian that will actually improve your overall wellness. We're wellness girls. Of course, we're going to know the difference between a regular massage, lymphatic, massage and body work. The wellness industry is a $1.8 trillion business. Y'all, that's a ton of money.

Today, we're going to talk about some of the high-tech gadgets that people are using to biohack their bodies, starting with wearables. I've just about tried everything. Fitbit, Apple Watch, Garmin, the Google Pixel Watch, and currently it's the order ring. I wear a fitness tracker every single day and I have for probably 12 years. It is not hyperbolic to say that my Apple Watch saved my life. Vox Tech reporter Adam Clark Estes has been thinking about wearables and how they relate to his own wellness. I think that we're all pursuing a state of wellness and I think that what that means to each person varies a little bit. And it has varied for me as I've gotten older. When I was young. I was an athlete and I really wanted to be like top performing. And now I'm a young dad

and I just want to make it through each day. So wellness is something that encompasses physical wellness, mental well-being. And increasingly, I'll be honest, digital well-being. With that in mind, at the beginning of the year, Adam decided to go all in on health and fitness trackers. And he wrote about the experience. You know, your watches that remind you when to stand, your rings, that give you a sleep score. He even tried a pair of headphones that monitor your brain. So why did he do this big experiment? I did it because I'm interested in how technology and especially gadgets can make our lives better. But I'm also well aware of the fact that they can sometimes make our lives a little bit worse. And I wanted to try to figure out what the right balance

would be. I started this experiment of testing a lot of wearables. And I wondered if all of these futuristic monitors and trackers could tell me more about how what I was eating or how much I was exercising or sleeping, how that was really affecting my body and how it was making me feel. Which wearables did you decide to wear? Can you run us through the list and like what each one did? There is a long list of wearables that I tried. and I don't even think I can remember the name of everything. But the list of the wearables that I really sort of stuck to and frankly liked included the aura ring, which is a smart ring.

I like that it tells me when to go to bed, but I also could do that for free. I think my favorite thing about it is that you can track what you're feeling that day. So far, a lot of my tracking has been fatigue. A similar ring made by a company called Ultra Human. There was the Woot Band. Which is basically a, it's like a smart watch without the watch part. So just a band that you wear that has a little tracker on it. This will track its senses immediately when my activity level has started and it's so accurate down to the minute for when it ends.

I'm actually like confused and shocked and awed by it and it's like almost creepy how accurate it is. The Apple Watch, which I had before this, it was just my watch and still is. And then I tried a couple different brands of continuous glucose monitors. Which ones felt useful and which ones were like less useful? It's difficult for me to describe what useful means for a health tracker because you literally do not need to use it. What I found to be useful were the things that met my needs and helped me towards my goals. And those two were the Apple Watch, which I already had. And then the aura ring, which is a newer piece of tech and can do kind of all the same things that an Apple Watch can do health tracking wise, but is a lot more comfortable when you wear it for sleeping.

What Apple does with fitness tracking is also fairly standoffish. Like, the main thing they have are rings. Like, you're supposed to close your rings every day. One is for how long you're standing. One is for minutes exercised. And one is vaguely defined as move. It's how much you move. And if you close those rings, then you've had a good day.

Orra takes it to a degree that I would not quite call woo-woo. But there is, it is. is definitely a little bit more connected to your feelings and connected to kind of like a way of thinking about healthy living. And at the same time, like Apple, it's not giving you too much data. Some of what, some of these health trackers give you just way too much data, but or it gives you these scores and getting a score is definitely like getting a grade in school. But it like, as someone who went to school, it made immediate sense to me. Yeah. I mean, and I get that. Like, I'm a person who wants the A, and we had lots of listeners who called in and said that

it sort of made them obsessive about their health and things like that. I did become fixated on closing my rings, meeting my calorie goals in a way that it did seem, it was unhealthy. I constantly check my stats, calories, steps, everything to the point where I was using that data to justify whether or not I was allowed to eat that day. I would go down our apartment, which is on the fourth floor, and go up and down our flights upstairs at like 10 or 11 p.m. and night just to close either my exercise rings or my calorie rings. So I wasn't so obsessed. Knowing my hourly and daily step count did something weird to my brain that I couldn't turn off.

Did you have that experience at all? I would say by the end of it, that was the experience, the experience of being obsessed with checking these apps. and of trying to make sure I closed my rings and got a good score here and a good score there. And it gets really out of control if you're doing it on multiple platforms. And it also, like the utility of it gets drowned out by just the attention it takes to keep up with all these scores and metrics. I do the thing where I forget to wear my watch to the gym all the time. And I don't think that the workout counts. And I think that that is like tapping into some part of my brain that I would like to leave alone.

Yeah, it does seem like there's something in us that wants to win at health in a way. I mean, who wouldn't want to win at health? It's like kind of the whole game. But what I realized in what this experiment taught me is that those scores can be more useful than that. It's not just about getting a good score or about completing the planned workout every time you do it. I think that the data that health trackers can offer you is really feedback about how your body's doing. And it can tell you when you did a really great job in a workout. It can also tell you when you are feeling tired and would probably benefit from like a less intense workout.

And that's something I've taken away from this now. I used to have a pretty set workout schedule. And now I actually respond to that readiness score. sleep score and plan my workouts around that. So America has this reputation of being pretty unhealthy. And, you know, these sorts of trackers have been around for a while and they're growing in popularity. But, you know, there's diabetes, there's heart disease, there are all these ailments that we have

that aren't necessarily going down among Americans. Do you think that means trackers are just a dream? Like, do they not work? The real answer there is there is no one thing to do to be healthy or one thing that we can do as a nation to all become healthier. It's an incredibly complex problem. I think that a lot of our problems with health in the United States have to do with our health care system and how it works. But I will say that health trackers are a very American solution. It is a gadget.

It's a product that you can buy that puts you in the driver. seat of looking after your health. I think it does make a lot of people feel empowered, and I think that these devices are actually life-saving for some people. There is tons of research that have showed that the rise in fitness trackers and health trackers has led people to move more and walk more. So I think that's all promising, but at the end of the day, I don't think that there's a great substitute for a health care system that is open to as many people as possible and available, and that delivers good outcomes and treatment. So that's what goes on our bodies.

But what about what goes in them? Next up, when fitness levers take hormones. This week on Criminal, at 6 a.m. on August 29, 2005, Hurricane Katrina made landfall. in Louisiana. People in the Fisher housing projects were trapped without food, water, and electricity. It didn't seem like anyone was coming to help.

And then 20-year-old Jabbar Gibson found about a dozen park school buses. I decided right then and there that I was going to drive one of these buses, but I didn't know how. Listen to the latest episode of Criminal to hear what happened next. Listen to Criminal, wherever you get your podcasts. Okay, so earlier we talked about all the tech people are using to track sleep and fitness

all in the name of biohacking. But what if you're trying to do that with the help of hormones? Hormone replacement therapy exists for a reason. And that reason is it makes you feel way better. It makes your body work way better. I try testosterone replacement and it just gives you so much virility. I mean, it'll make your penis reach for a damn deck of cards. We all have naturally occurring hormones in our bodies. These regulate everything from mood to muscle growth. But more and more men have been looking to boost their testosterone levels lately. Prescriptions for testosterone grew from 7.3 million in 2019 to more than 11 million in

2024. Dude, it's awesome. I feel alive. I'm stronger than I've ever been in my entire life. I'm healthier than I've ever been. I'm on an anti-aging protocol from my doctor. That includes testosterone replacement. But I don't take any steroids.

So is testosterone really the secret weapon for getting all jacked and living forever? That's the question I posed to Dr. Ruth Wood. She's a neuroscientist and chair of the Department of Cell and Neurobiology at USC. She spent four decades researching the effects of steroids like testosterone. Okay, steroids are a class of molecules that are derived from cholesterol. And they're naturally produced in the body in the gonads, which means in the ovaries, in women, in the testes in men. So testosterone acts throughout the body and it is muscle building, which is it's anabolic, and it works very well to increase muscle mass. And it's also lipolitic, which means

it's fat metabolizing. So it produces more lean mass and less fat mass. And so this is what many people are looking for when they're either taking testosterone therapy or they're using anabolic steroids. I think there's often confusion between anabolic steroids and therapeutic testosterone. Can you talk about the difference between the two and why that distinction matters? When we're talking about anabolic steroids sort of out there in the cultural landscape, we're usually talking about abuse of very large amounts of exogenous testosterone. and other related compounds.

Anabolic steroids can be taken via a variety of different methods, either injection or oral or even a gel that can be applied on the skin. When we're all talking about testosterone replacement therapy, we're often talking about lower amounts of testosterone, and it's frequently being prescribed for men as they age, who naturally will have reduced levels of their own testosterone. I think what's happening nowadays is that there are med spas and low-tie clinics that will not require a blood test. And so a man can come in and say, hey, Doc, you know, I'm feeling kind of low energy and I'm not really at myself and I'm frustrated by my lack of strength.

And can I get some TRT? What about the cultural impact of testosterone and steroids? I think one of the really interesting. phenomenon is that there's a lot of media attention to the idea that men need to be really cut. Yo, it's about damn time. I'm going to get my body fat percentage, baby. Yo, 10% body fat. If your physique looks like this, then you are what is commonly known as skinny fat. You're fatter than you think.

that is to having bigger muscles and reduced body fat. And you can see this in a lot of advertising. And particularly if you look back to before testosterone had been chemically synthesized and therefore before it was widely available. The bodybuilders of that era in the 40s, the biggest guys really wouldn't even rate a second glance nowadays because that was as big as you could get at the time without exogenous steroids. Nowadays, of course, people can become much bigger in terms of muscle mass and much more muscle definition. Everyone wants to know how you get your body to look like this.

That was a washboard. So that requires some sacrifice. You don't get to eat as much as you'd like. You don't get to party as much as you'd like. You get to work out a little more than you'd probably like. The widespread availability of testosterone has made it seem normal to have relative. more muscular physique. And you see this particularly in Hollywood when you look at older stars and you think, you know, nobody puts on that kind of muscle mass just by themselves as they age. So it's

generally accepted that Hollywood, as well as the military, there's definitely a lot of low-level use of performance-enhancing drugs. Why? Because they work. What are some of the common misconceptions people have about taking them? So initially, when the scientific and medical establishment started looking into the effects of anabolic steroids, they said, no, it's really nothing, it's just water, weight, and all of the athletes went, sure, it is. And they kept using because it does work. The real question is, are there downsides that people aren't. really talking about. And that's really part of the conversation that I think we need to have

when we're looking at steroid use and testosterone replacement therapy. Because they do cause changes in blood chemistry and they can cause liver dysfunction. And so there are definitely some health concerns, particularly in susceptible people, that need to be looked at. There's an ongoing debate about hormone optimization clinics and longevity biohacking. From a scientific view, is there any credible evidence that boosting testosterone and healthy adults actually improves the quality of their lives long term? You know, I don't think we really know enough about the long-term effects of testosterone replacement therapy because it's only come into widespread use relatively recently.

The question, does it improve quality of life, though? I would say probably yes, in terms of people's sense of energy and their sense of strength, if you will, as well as their libido and perhaps zest for life. If you could advise young athletes or aging adults about these substances, what would you want them to understand before making a decision to take them? I don't think that there's really any reason for young men to take TRT therapy. At this point, they are at the peak of their own endogenous testosterone production. So the only reason to take testosterone would be essentially at a level that would be, that would constitute antibiotic abuse.

In terms of older men who are experiencing the declining effects of testosterone, then you say, well, what are the downsides of taking this? One of the key things I think to note is that once you start taking TRT, you're actually going to suppress your own endogenous testosterone production further. And that means that you really need to make a commitment to take this long term. it's really a question of, do you want to be taking a pill for the rest of your life or an injection, knowing that in some cases it may have negative effects on your health that don't show up immediately, but could end up being problematic down the road.

After this next break, we'll talk about something a lot more of us put in our bodies, supplements. Hungry Now. Now. What about now? Whenever it hits you, wherever you are, grab an O. Henry bar to satisfy your hunger. With its delicious combination of big, crunchy, salty peanuts covered in creamied caramel, and chewy fudge with a chocolatey coating.

Swing by a gas station and get an O'Henry today. Oh, hungry, oh Henry. A few weeks ago, producer Hottie Milwaukee and I went to explore the great American healthcare craze of supplements and vitamins. Okay, we are now at the Whole Foods. We're going to see what they got going on. And no, it was not just to check out the hot food bar.

Now it's time to hit that hot bar like I said, I would. Lunch was a side mission. We were there to see all the many, many varieties of supplements available for sale. I know the aisle we're looking for, though. Which one? The health aisle. Oh, the whole body, I think is what they call it. Yeah. All right.

Oh, here we go. Here we go. Antioxidants, personal care. There are so many pills. Magnesium, stress saver. Oshwaganda, it is real. It is real. Not a drug.

And powders. We got our proteins and our collagen. Oh, proteins, collagen. Okay. Which I am a protein user. I do a protein coffee in the morning. So like a college. And drinks?

Probiotic wall. Oh, this is just like a probiotic wall. You're right. A probiotic wall. A pickle kombucha. Ooh, picklebootch. I love that. Would you get that?

Yeah. Okay. I got to be honest. The picklebooch? Mixed reviews. All of these supplements, but how many of. of them do we actually need? To find out, I talked to Anahad O'Connor. He's a health columnist

at the Washington Post, and he's well acquainted with supplements. He says there's a pretty good chance. You are too. I would say that we are very, very in love with dietary supplements. I mean, the best statistics we have show that at least 60% of people in the United States alone use dietary supplements. And that's just one supplement. or more. There are statistics showing that many people use multiple supplements. In fact, the older you are, the more likely you are to be taking two, three, four, or more supplements. In some cases, there are many people who are taking dozens of supplements, believe it or not, and children. Okay, we're taking these products to feel better, but are they actually making us feel

better? You know, there could be the placebo effect where people take supplements and think they're getting benefits. But there's actually been studies by well-meaning scientists who have done studies showing that, okay, we know selenium is really good for your health and essential, and vitamin E is really good for your health, and it's essential. And scientists will say, okay, well, we need to figure out what doses we should be telling people to take and how often to take these supplements and they do these studies. And in a number of cases, they've done these studies and then found, wow,

the people who we assigned to take these supplements actually, develop side effects and are more likely to develop, you know, cancer or heart disease, prostate cancer, things like that, and have been shocked. In fact, what we know is that it's the dose that makes the poison. We need, you know, some level of vitamins and nutrients, of course, but taking more and more and more is often not good for your health and can cause a lot of side effects. Wow. Yeah. So, like, why are we allowed to take them? How come the FDA isn't stepping in. So, you know, the FDA.

Do you sound with that laugh? I was like, oh, what strap in? I mean, to put it mildly, dietary supplements are very loosely regulated in this country. They're treated almost like they're just food because they are, you know, nutrients that come from food, but then they're purified and concentrated. But decades ago, the supplement industry pushed for this law

called the Dietary Supplement Health and Education Act, which basically created what many critics call the Wild West of the supplement industry where supplement makers can make all sorts of health claims. They don't have to undergo clinical trials where they're tested to find out what doses are safe, what the side effects are, you know, if they actually work or not for what's claimed.

And the FDA really can't do anything once they're on the market unless there are reports of severe side effects. But right now, there are an estimated 90,000 different dietary supplements. That's a lot. Oh, my gosh. That is a heck of a lot. And these companies don't have to register their products at all.

And in fact, you and I can easily create our own supplement company in five minutes. Oh, my God. The Explained it to me supplement? Don't take that. Do not take that, y'all. Yeah, I mean, this is, and this happens, you know, you can just. create a website, you know, get some powder, put it in a capsule and start marketing your supplement. You don't have to register with the FDA. You don't have to do any studies or

notify any agency and just start marketing it. Oh my gosh. It's that simple. And you can make health claims as well. Okay. I think we should talk about a few of these because I feel like a lot of our listeners want to know if they're taking a supplement that is not actually doing what they think it's going to do. So I want to start with the multivitamin. Should we be taking the daily multivitamins? If you are eating a healthy diet, then it's very unlikely that you actually need a multivitamin. Although there have been some studies showing benefits, for example, in older adults, it's been shown that taking a daily multivitamin could potentially help with memory loss, for example. Okay, another thing everyone talks about is gut health.

People say it can impact you on more than just your stomach. Should we be taking probiotics? Probiotics are basically any bacteria or microbe that confers health benefits. And, you know, we think, oh, we know probiotics are good for us. They're good for our guts. And so we should be taking them in pill or capsule form. But the thing is that you want a diverse community of gut microbes. You want a healthy ecosystem. But if you take a probiotic in capsule or pill form, that can throw off the balance of your gut microbial ecosystem.

And so now you have this overgrowth, potentially, of a limited number of strains of bacteria. But probiotics are good for you, and you can get them from fermented foods. So you think about things like sauerkraut, kimchi, Greek yogurt, for example, is one of my favorite fermented foods. You know, humans have been consuming fermented foods for thousands of years, and they contain these healthy, live microbes. Okay, what about creatine? Who should be taking this beyond your Jimbrose, who are trying to?

trying to get buff. Yeah, so creatine has been around for a while, and there have been a lot of studies on its benefits, and there have been studies showing that when you take a creatine supplement in combination with resistance training, going to the gym and lifting weights, then you can get some benefits from that, particularly it'll help you grow bigger and stronger. But the benefits are not extraordinary. It might help you gain a few extra reps out of bench press or your squat, for example. There's been, you know, a lot of health claims that it can, you know, improve your cognitive health, help with dementia.

There hasn't been any real good studies demonstrating that. That's not to say that it's not true, just that it hasn't really been shown conclusively. I am not anti-sufflement. You know, I still take some supplements here and there, you know, just because, you know, just cognizant that there is a multi-billion dollar industry that wants the profit off of you by selling you their products. And there are a lot of potential side effects. So I always tell people, unless you have a documented, demonstrated deficiency, you know, you should be focusing on getting your nutrients and vitamins from your diet just by eating a lot of healthy whole foods,

which is what human beings have been doing for millennia and has always worked. This episode was produced by Hadi Mawaddy and was edited by Nareen Khan and our executive producer Miranda Kennedy. Fact-checking by Melissa Hirsch and engineering by Andrea Kristen's daughter. Explain it to me as part of the Vox Media Podcast Network. To check out other Vox Media Podcasts, many of which have won awards, visit podcast. Podcast.orghum. I'm your host, John Glyn Hill. Thank you so much for listening.

Bye. Thank you.