WHOOP Podcast - How To Take Control Of Your Health and Maximize Longevity with Dr. Darshan Shah

Episode Date: April 29, 2026

In this episode of the WHOOP Podcast How To Series, WHOOP Global Head of Human Performance and Principal Scientist, Dr. Kristen Holmes, sits down with renowned longevity expert, Dr. Darshan Shah, to break down how to maximize longevity. The episode focuses on what truly drives healthspan, drawing from Dr. Shah’s own experience as a trauma surgeon. Dr. Shah explains why most chronic diseases are preventable and reversible and why lasting change comes from mastering the fundamentals: sleep quality, daily movement, nutrition, stress management, and consistent data tracking. The conversation explores key biomarkers, the dangers of sedentary living, the role of toxins and environment, and the importance of habit formation, purpose, and emotional health. Together, Dr. Shah and Dr. Holmes reframe longevity not as living longer, but as living better— extending vitality, resilience, and performance throughout life.(00:47) Intro to Dr. Darshan Shah, Longevity Expert(01:14) How Chronic Illness Impacted Dr. Shah Firsthand(06:15) Dr. Shah: From Trauma Surgeon to Longevity Focused Lifestyle(09:30) Building Next Health: Dr. Shah’s Impact on the Longevity World(13:10) Biggest Barrier For Patients: What Trends Dr. Shah Is Seeing (19:50) The Influence of a Morning Routine on Health and Longevity(21:36) Looking At The Biggest Game Changer: Movement Throughout The Day(24:26) Eliminating The “All or Nothing” Mentality(28:23) Beyond Sedentary Behavior: Habits Declining Longevity(37:18) Best Biomarkers Promoting Longevity(48:04) Optimization Beyond Nutrition, Sleep, and Exercise (Advanced Advice)(52:28) Combatting Trauma and Understanding The Nervous System(56:18) Dr. Shah’s Wellness Wheel: 12 Aspects of Health(58:52) Technological Development In Health and Longevity(59:43) Menopause and Longevity: How Women Can Mitigate Symptoms(01:08:18) Policy Changes That Will Aid Health and LongevityFollow Dr. Darshan ShahInstagram WebsiteDr. Shah’s Guide to Minimizing Toxic ExposureDr. Shah’s Guide to Biomarkers  Support the showFollow WHOOP:Sign up for WHOOP Advanced LabsTrial WHOOP for Freewww.whoop.comInstagramTikTokYouTubeXFacebookLinkedInFollow Will Ahmed:InstagramXLinkedInFollow Kristen Holmes:InstagramLinkedInFollow Emily Capodilupo:LinkedIn 

The whole medical system was never built to keep you healthy. As doctors, we were told that once you develop a chronic disease, it is a lifetime sentence. A lot of people are frustrated with that system because it does not address the why of how we get chronic disease. So you look at the CDC's top 10 causes of death, all of them can be reversed and prevented. Why does it every doctor learn this? I did trauma surgery for 10 years, operating 5 to 7 days a week sometimes. What I want people to understand is that in the next few decades, people are going to have much more control of their health on their own through a combination of wearable devices, more access to their own biological blood markers and artificial intelligence. That's going to save your life.

Dr. Shaw, welcome. It's such an honor to have you here today. It honors all mine, actually. I can't believe I'm here in this beautiful building with you. Thank you for having me. We're very proud of the headquarters here at Woop. We like to say it's gritty yet pretty. It's kind of got this like really nice. It does feel that way. Like it feels it feels super premium and you feel like, I feel like I need to go work out right now. I know. I know.

There is like a lot of that kind of vibe and energy in the building. But yeah, we're so happy you could make it in person. I know you're really busy. I mean, when I think about, you know, just your, well, just your level of expertise and just everything that you've done to bring yourself up to speed kind of, you know, going from. traditional Western medicine and really evolving yourself as a practitioner as an expert. So you could really be in a in a position to bring precision health and, you know, this notion of longevity to more folks. Talk a little bit about that transition for you from Western medicine to kind of, you know, focusing on longevity. For sure. I mean, it came very accidentally,

actually. So I was a fully functional surgeon for many, many years. I'm operating five to seven days a week sometimes and doing very complex procedures. Like I did trauma surgery for 10 years. And, you know, when people come in after a car accident or a gunshot wound, it can be anything. And so you are sewing together vessels sometimes with like macrobascular sutures. And I did that for many years. and then I decided to move into reconstructive cancer surgery, which is also extremely complicated surgeries, and we would do these huge surgeries called flaps. I would take 14 hours.

And then I did some cosmetic surgery on the side as well. And then I did this for 20 years, and I found myself becoming, number one, I just was very skilled at surgery, but also just very skilled at medicine. I spent a lot of time in the ICU taking care of people. people, a lot of time in the emergency room taking care of people, and I really understood medicine deeply. But then what happened to me personally was I myself got very sick. So it was basically 25 years of treating my body terribly. I was 50 pounds overweight. I had multiple medical problems. And then on top of that, I got an autoimmune disease that was pretty severe and rare.

It's a disease called Coup de Sabre. And this is where your own... French. Yeah. Kupti Sabre means like a hit of a sword, basically. And basically what it does is my own immune system was attacking the skin of my forehead and the side of my face and also my skull. And basically, it was eating away at it to where my skull is now like paper thin on one side of my head. Yeah. And I saw a rheumatologist, the best one in L.A.

And I saw another rheumatologist, another of the top rheumatologist in L.A. And they basically said that I don't need to be on immune-suppressive medication for the rest of my life. And at the same time period, my son was being born. So I was a little bit older of a dad. I was 42 and my son was born. And my mortality rate for having this autoimmune disease plus all the other medical conditions I had was about 50% in the next 20 years years, all-caused mortality. I was like, this is ridiculous. I'm 40-something years old.

And in 20 years, I might be dead before my son even like, graduates from college, maybe, you know? And so I knew it was a time to make a change. And the reason I said I was skilled in medicine and surgery was I did not have the knowledge, despite being board certified in surgery and having deep knowledge in medical interventions on how to get myself healthy. In fact, my perspective back then was very similar to most of medicine, which is once you develop a chronic disease, it is a lifetime sentence. You just have to mitigate the symptoms with pharmaceutical and also with surgical procedures, et cetera. And I thought that was like my destiny.

But I knew that I had to do something differently just to get healthy. And so, you know, you hear this all the time. You know, you get one hour of nutrition education and medical school. And it's all about how does nutrition affect the drugs that you're taking. That's all you learn, you know. And so nothing on exercise physiology, nothing on sleep, nothing on anything. Yeah, not at all, right? And so I did not have the knowledge.

And so, you know, we talked before the podcast that I'm a big fan of formal education. I need to get formally educated. Took a nutrition certification course, took a personal training course and just learned everything deeply. And I was like, this is what I should be doing. Like, this is the path. Exactly. Like, why does it every doctor learn this, right? Because now the way I think about it is chronic disease, most of them are absolutely reversible.

especially the... And preventable. And preventable, right. Reversible and preventable, right? So you look at the CDC's top 10 causes of death. All of them can be reversed and prevented, you know? And so you just got to really change your mindset as a physician. And once I had that mindset shift, that just led to a complete change in my career path.

Yeah. Dr. Shaw, it's incredible. You know, you mentioned trauma surgery. So 10 years as a trauma surgeon, you're not going to believe these data. So we published these in annals of surgery, but I did a study with 270 acute care surgeons over the course of a year. And the mean age of the participants in the study was 43 years old. He said you were 42 when you transitioned out. Mean age 43.

Their resting physiology looked like that of a 60-year-old. 17 years older. Yep. Yep. Absolutely believe it. Isn't that just wild? It's wild, but it's expected because, you know, when you, have no respect for your circadian rhythm because trauma's happened any time of the day.

Of course. Yeah. And it's an unbelievably important service. And I just like every day, I literally thank our first responders and healthcare workers. Like it's just, what they're doing for our society is it's, it comes at a cost. Right. And yeah. Yeah. And you know, that's not the tangent too much here, but like, you know, thank God we have this system of hospitals and first responders and trauma surgeons and, you know, the whole medical system, thank God we have it, because when you get into trouble with a trauma or stage four cancer that needs surgery or even, you know, a heart attack, right? Yeah.

That's going to save your life. But a lot of people are frustrated with that system because it does not address the why of how we get chronic disease, right? Why are we getting so much chronic disease? It doesn't address it. It wasn't built for that. And so, you know, what I always tell people is like, look, I understand you're frustrated. with your primary care doctor and the whole system, but that system was never built to keep you

healthy. It was built to treat emergency issues and big problems. So I think once my patients have that mindset shift that they need to find and create a new system is when the real transformation starts beginning, because they get out of the mindset of whatever my health insurance provides me is all I need to do. Yeah. Right. And I think we could probably make the case or feel confident in the statement that if we were to adopt the path that we're going to talk about today, your path to longevity and increased health span, we could also simultaneously maybe reduce the accidents that are happening, right, that, you know, a trauma surgeon invariably ends up seeing, right? The accidents that are happening on the road, right? Like a lot of it has to do with how someone is

sleeping. And frankly, the food that they're putting in their body, right? Like, affects cognitive it affects decision-making, affects reaction time, right? Absolutely, yeah. So true. I mean, you know, the reasons we have accidents, so many accidents on the road is because people are not paying attention or they're sleepy, right? And then there's also, obviously, they're drinking. Yeah, yeah.

All of these stem from also lifestyle issues, right? And so once you get your lifestyle right, you're absolutely right. I think, you know, I wish someone would do a study about the number of people that are in car accidents, how many of them, what are the number of chronic medical diagnoses they have. There's probably a correlation there. Yeah, I know there's some data around, obviously sleep and alcohol consumption, sleep deprivation alcohol consumption, but yeah, it'd be really interesting to know how many of those folks are actually struggling with chronic disease or multiple disease as well. Yeah, that'd be interesting. So we're going to talk about longevity.

You know, you really have been on the front end of a really redefining longevity. When we say that word longevity, what does it actually mean to you? Yeah. So, you know, it does not mean trying to live forever or trying to live to be even 150 or 160. But I will say, I believe the science will push the upper age limit of what humans can achieve. But really, if you look at time, you expand time if you're present and enjoying the moment that you're in, right? And how do we create more moments like that through the amount of time that we are given, whether it be 80 years, 90 years, or maybe you become a centenarian, the way you expand the number of those moments is by fully increasing your health span to match your lifespan. So what I tell people is, to me, my definition of longevity is that you stay healthy and present enough until the very end, maybe the last three months or best case scenario, you just die in your sleep after a great workout and a beautiful meal the day before,

you know? And so it's really about expanding health span as long as possible. Yeah. You come across lots of patients, I presume, in your clinics. Maybe first before we get to the question, just talk a little bit about your clinic setup. Because I think it's the fact that you've been able to kind of go from a place of like, wow, there's a problem here. And I'm going to get myself on the other side of this problem personally. And now I'm actually on a mission to help other folks. You've created this network of clinics. That is just absolutely sensational. So maybe just we'll ground to this next part with that as an intro. So Next Health, which is my clinic system, is basically an offshoot of that mindset shift that I had, that I will no longer rely on the traditional Western medical system, keep me healthy. That's only for disasters and emergencies. Kind of like, you know, a car, right? You have car insurance, but you don't use your car insurance to pay for every car wash and tire change, right?

It's only when you can do an accident that you use your insurance. So I decided to start a new system of clinics that creates a completely new model. And when I started this, I really wanted to rethink why people don't enjoy going to the doctor in the first place. It's normally, you know, a 45 minute to an hour wait. It's usually in a tiny waiting room. You're around other sick people and you just don't want to be there. The first thing you want to do when you get to the doctor's office is get out of there. And that's why we have even white coat syndrome where you walk in and you're immediately, your blood pressure, your heart rate go up, right?

And I wanted to create a place where you have the opposite of the way. White Goat Syndrome. You walk in and your HRV gets better and you feel relaxed. And we hired one of the best architects we could find to create a beautiful experience around going to the doctor. And the other piece of that is this is also an experience. So when you walk into Next Health, there are things you can do like hot, cold contrast therapy, hyperbaric oxygen, intravenous nutrient treatments.

But it all comes down to getting people in on a frequent basis because health is a habit. and when you create a habit around your health, like coming into a clinic on a monthly basis, and checking your biomarkers every quarter, you can truly accelerate the journey. And so Nex Health is a system of clinics where it's a membership program. People come in on even a weekly basis, but at least quarterly to get their blood test done. And we have medical practitioners of every single one of our clinics that help people reverse chronic disease and feel their most vital self. I love that.

When you engage with patients and now you have obviously like thousands and thousands of repetitions under your belt, what is the biggest barrier you see to change? Yeah. I think there's a few biggest barriers. One of them is the lack of data. People are either feeling fine, but they don't really know if they're fine because they just have no data to tell them. And they might have accepted a lower level of functioning, right? And that's exactly what happens, right? Because, you know, feeling fine changes as you go from your 20s to 30s and your 40s and your 50s.

And the culture just tells us that it's normal to not feel vitality after your 50s. It's normal, you know, to slow down and not do the things you used to do when you're in your 20s and your 30s when you reach 50. And so because of this gradual change, we just don't really know what's going on with our biology, right? And so I think one problem that I face with a lot of people is getting them to really look at their data, whether it be from their biomarker blood testing. We also do a lot of tests on site, like we do V-O-2 max. We do strength testing. We do balance testing. And then, you know, we are huge believers in wearable data as well.

And once we can paint the picture for someone about what is actually going on in their physiology, but also we're very positive. Like, you know, I'm a very optimistic, positive person. And so what we always tell people about their data is like, don't worry about the numbers where they are now. Here's where we're going to aim for where you're going to be in a year, right? And then we're going to show you how to get there. And that's how we kind of empower our patients. I also think that people feel very disempowered because for many years until just recently,

people were not given access to the data. In fact, they were gaslighted when they were asked for a blood test. for example, like, why do you need that? You don't know anything, usually with their primary care doctor or whatever. And they just weren't given their data, right? And so I think now the mindset shift that's happened since the pandemic is people want their data and their big companies that provide that. Yeah. Woop being one of them. Yeah, that was kind of an incredible moment or inflection point for us as a company was COVID. You know, number one, we were the only wearable in the market that actually tracked respiratory rate and had it validated by a third party,

we're within one breath of the gold standard. And we found out, of course, respiratory rate was the canary in the coal mine as it relates to COVID. So, you know, all of a sudden, when we were able to build an algorithm really quickly that basically could detect COVID three days prior to symptom onset. Yeah. It's pretty remarkable, right? So before you even got any symptoms, we were able to tell you, hey, we think you might actually have COVID.

And to self, you know, you'd isolate at that point, get yourself tested. And sure enough, you know, we were right 80% of the time, which is kind of cool. Very cool. Yeah. So, you know, I think for that reason, I think having those baseline data and, you know, and kind of being a part of the evolution in terms of what we can detect and predict, I think is pretty exciting, you know, when it comes to wearable data and obviously super useful, especially in a time like COVID.

But, yeah, that was an incredible inflection point for us in terms of shifting the mindset of like, oh, wow, these data actually can be super useful and should be a part of my. how I think about aging. Yeah. You know, I think it's even bigger than that. I think when people started using wearables like Loop and getting their data, and it was predictive and it did tell them what's going on with their biology, they became more likely to then go and actually get a needle poked in their arm to get blood test data because now people

were finally empowered by data that they could interpret for themselves. And the other critical element was the education behind the data. Like, why is respiratory rate tied to a diagnosis? Why is HRV important? Why is resting heart rate important? Like, people started to understanding which made a big difference. Such a great. Yeah, because there's like this forcing function in the background that, like,

motivated people to look into it. Yeah, I love that. And there's so many more conversations. Yeah, and in some ways, you know, COVID was a blessing in that regard, you know. When you think about, you know, so you've got these mindset shifts that are happening, you know, what are some of the misconceptions that folks have around just aging? You know, because I think that that's probably another, you know, big piece of the conversation when folks are coming into your clinic, the baggage that they come in with, you know,

in terms of what you have. I think, you know, there's a few of them, actually. I think the biggest one, though, is that there is one particular intervention that will slow the aging process, that maybe it's a stem cell treatment. Maybe there's a peptide. And they just do this one thing. Right. and they will slow aging.

And we have to truly flip that model and say, look, anti-aging is actually going to be come from the base of the pyramid, which is your recovery, your sleep, your movement, and your nutrition, right? Yeah. Everything else is on the top of the peptide, stem cells. You can't build the top of the pyramid first. You've got to build the base. And I think that's where people sometimes come in and get a little bit disappointed when they visit

with me because I'm like, sorry. You know, there's not one prescription I can give you that's going to move the needle enough. And that's where we have to really get people refocused. And then also, you know, anti-aging is not easy. It's hard work. Like you've got to get your habits and routines. You got to participate. You have to participate, right?

Exactly. Yeah. I think the third thing is that the, I think the challenge to participating in your own health is not having the knowledge and the ability to build good habits. And so we always start with a little mini course on habit formation first before we even launch into any advice. I love that. Yeah, I think it's building the efficacy around understanding what it is that you need to do is kind of everything, right? Because then you can give yourself a chance to repeat that because that's really what it's about, right? It's just repeating those behaviors over and over and over and over again.

I was so excited when I stepped into your office during the tour and I saw the walking desk and the kettlebell. And it's exactly like my office. I love it. I love it. And so, you know, part of good habit formation is surrounding with yourself with the things you need to do the things that you have to do. And so creating the environment to make it easy. And, you know, we've done that. And I think if everyone did something to that, you know, just made as easy as possible for them to get a quick workout and to get some good nutrition.

And it would really move the needle for people. So awareness, understanding, making it easy. easy. Is there anything else that you do to kind of cultivate this mindset shift and get people engaging with the behaviors which we're going to get into that you talk about? Yeah, you know, I think also around the kind of the whole topic of good habit formation is we really sit down with people and create a very specific, easily obtainable morning routine for them. I really feel, And this is not true for everybody, but for at least 80% of my patients, that the morning time is when they still have a little bit of control over their decision making and what's going to happen. And even if I can fit in 15 minutes, you know, 10 air squats and do a journal entry. Let's just do that.

And then it will build from there over time. And I think that's, that is such a quick win for everyone to get in the first part of their day that you give someone one quick win and they feel so good about it. and it builds up over time and they'll add to it. Yeah. Morning routines are a big piece of kind of the whole package of advice I give people. I love that. Yeah. I always try it like in the morning. Like I do a couple, a few gratitudes.

You know, I do 20 pushups, 20 sit-ups and 20 squats. And then I know, I'm like, at least I've done something, you know? You're like so similar. Like that is basically my exercise routine every morning as well. It just like, it doesn't mean that I'm not going to do maybe a consolidated workout out later and I'm not going to move throughout the day. But it's just like to your point, I think this is I think something that folks who are listening can really take away. You shout this from the rooftops all the time, you know, make it easy and just have a morning routine that gets you

off on the right foot that you can build on. Right. Yeah. I love that. Yeah. And you know, like we maybe now's a good time to talk about this too. Movement is so much more effective in maintaining good health and reversing chronic disease even is if it's movement that occurs throughout the day versus just that one blast of exercise three times a week, right? And so the more you can incorporate movement into your day-to-day routine, it's just such a bigger priority to me than even going to the gym, you know? And we can get into that now. You know, when we think about just the biology of aging and what actually creates decline,

sedentary behavior is probably at the very top, right? There's a massive meta-analysis of 275,000 people that showed for every hour you spend sedentary after four hours, which is like 90% of the population. Yeah. You add 15% to your all-cause mortality. It's a massive number. And so to combat sedentary behavior, there is a very research trick called an exercise snack. And so as long as you can build in some sort of exercise every 45 minutes or so, you can complete. completely combat that sedentary behavior decline in your all-cause mortality.

Now, what doesn't effectively combat it is going to the gym three times a week. It does help, obviously, but it does not fully reverse the detriment to your all-cause mortality by being sedentary all day. Yeah. This is how I think about it. And we were talking offline about this. We're busy, right? We have kids. We have a lot of demands on our time, right?

As most folks who are listening do. And there are just days that I'm just not going to be able to get into the gym for whatever. reason. Like I'm not going to build you a consolidated workout. So these exercise snacks are a beautiful alternative. Right. Right. And that's why you go in my office and there's kettlebells, there's resistance bands and there's a walking desk just because some days I just need to build it and throughout my day. So I'll just do a little planning. When I get to my desk, I'll be like, all right, I'm going to do, you know, 10 sets of, you know, five gobblet squats over the course of a day and or, you know, 10 sets of kettlebell swings or whatever it might be. And I just do those throughout the day.

And I put a little checkmark after I do one. And it's between, you know, meetings or whatever. And by the end of the day, like, I've done plenty of movement, right? And I've done everything that you just outlined is so critical for better metabolic functioning and, you know, helping obviously stave off all of the dilatory effects of sedentary behavior. Yeah. And the other side benefit of that is it gets your blood flowing throughout the day. Brain. Yeah. You're more creative. Your stress levels go down throughout the day at work. I'm actually a lot more productive when I'm on my walking desk versus sitting, you know? Yeah, yeah, because your blood is flowing. You're moving. Yeah. Yeah. And it's just, so it's just these little

things, you know, it's just mindset shifts, you know, and I love that the movement snack, exercise snack, literature is becoming more robust, you know, because I think that gets us out of, and you talk about this all the time, Dr. Shaw, the all or nothing mentality. And that's another, I think, big mindset trap. Maybe say a little bit about that. Yeah, I mean, I think that the problem with all or nothing mentality is if for whatever reason you end up missing like your, you know, your one hour gym session that you planned for three or four times a week and you miss it, the psychological hit of that is so massive that you're more likely to miss your next one too. And then if you miss two in a row, there's almost 100% chance you're going to miss the third one,

right? And so it's really easy to slip out of a exercise routine. But what's not easy to to slip out of is 10 exercise snacks a day, right? Because then even if you get five or six in, you feel like you've won, right? And so the next day, you're going to get them in, and the next day you're going to get them in, especially if you feel good. And so the ability to maintain kind of like a positive feedback loop versus a negative feedback loop comes a lot easier when you have multiple opportunities throughout the day to succeed. Amazing. Just to close the loop on setting your behavior before we go to kind of the next thing, When we think about the negative consequences of sedentive behavior, obviously all cause mortality,

but what are some of the more acute kind of issues that arise or short-term, you know, inflammation, metabolic, you know, this sort of thing. Yeah. So there's definitely a hit on your metabolism. And so people that are sedentary have a much higher risk of getting diabetes, but also even the beginning stages of poor metabolic health. And so that's trackable with blood tests like hemoglobin A1C, fasting insulin. levels. There's also a lot more inflammation that can happen. People will sometimes feel this as

joint pains and aches. And there's a lot of also acute damage that can happen with a lot of sitting to your lower back and your neck. And we see that a lot as well. The amount of back and neck pain that we see is massive right now. And a lot of it just comes from being sedentary and sitting. And so these are kind of the more acute consequences that build up over time as well into worsening problems. You know what's crazy is in our data for the low fit folks and the sedentary folks, because there's obviously a relationship between low fit and sedentaryism, right? So they have moved much, much less. They actually spend a lot more time in bed, but obviously the quality of that sleep is not as good. So the body is feeling like, God, I've got to deal with this inflammation.

I got to deal with all of the things that are not going right. As a result, your body is desiring to kind of spend more time to restore and recuperate, but it can't restore and recuperate because you've got the systemic inflammation and just this low-level kind of chronic disruption and, you know, heart variability. You know, so just physiologically, you've got all these things happening that are not allowing you to drop into these deeper stages of sleep. So it's this really vicious circle. So vicious cycle, right? Absolutely. You even think about humans, like I'm a big fan of like evolutionary biology, right? And so our genes have been locked in. We haven't had a major genetic change in our overall makeup for 50,000 years, you know.

And so if you look at our genetics that were locked in kind of at the dawn of humanity, that's when humans, all they did was walk around all days. It was searching for food, searching for water. That's why humans migrated from... They were averaging 10 miles a day. Exactly. Women, I think, were seven, men were 12, something like that. This is wild.

Yeah, we were not built to stay still. And in fact, when you stay still, your body senses something is wrong. your cortisol levels go up. You start preparing for like a long winter. Yeah. And, you know, right now our bodies are stuck in that long winter mode all day, every day with office work. Yeah. That's crazy.

Okay. So other drivers of decline. So sedentary behaviors at the tippy top probably. What else? Yes. You know, what I would say is obviously, you know, going beyond kind of what is obvious for people. Yeah. People know that they need to get seven, eight hours of sleep.

But while people don't focus on a lot, it's a quality of that sleep. I can't tell you the number of people that I see. And I ask them, like, how are you sleeping? And they say that, oh, I sleep fine, I get eight hours. And then we have them wearable. And then we look at the data in, you know, two to three weeks. And we're like, you're getting like 10 minutes of deep sleep a night. You're waking up multiple times in the night.

And they don't even know. And so I think, you know, poor quality sleep, even though you're feeling good in the morning and you're not tired and you've spent eight hours in bed, your body's very resilient before it develops symptoms of that poor quality sleep. So if you're feeling symptoms of it, usually it's been going on for a long time. And just like with anything, once you have the data and you correct something early, the easier it is to correct and also you avoid the long-term damage of poor sleep.

So I think sleep is very important. Nutrition is obviously very important. But Jeffrey Bland wrote a book in the 80s. called Disease Delusion. And he's one of my favorite people in the world. Actually, that's conference I'm speaking at tomorrow is IHS Integrative Health Symposium. That's his conference. Oh, no way.

Yes, yes. And he developed this whole idea about functional medicine, right? And functional medicine is root cause medicine. And we know the root causes of why we get disease in the first place. Those root causes are all the things that we've talked about already, you know, movement, lack of movement, sleep, but there's a few others that at a biological level and a cellular level that we need to be looking at. The next part of my evolution as a doctor was to go learn everything I could about functional medicine, and that's what really moved the needle for me. So I'm talking about

things like your gut health, your microbiome health, your hormone health, right? That's another big piece of this, inflammation, right? Mitochondrial activity. And so there's about eight different factors that he's identified as being the biological reason of why we age. And so once you get past the kind of the base of the pyramid, which is nutrition, sleep exercises, stress management, the next level up is building functional medicine evaluation and correction into your life. And that's how we kind of take people through their journey. And that's just where you then know where to apply your effort, right? Exactly. What's up, folks, if you are enjoying this podcast or if you,

care about health, performance, fitness, you may really enjoy getting a whoop. That's right. You can check out whoop at whoop.com. It measures everything around sleep, recovery, strain, and you can now sign up for free for 30 days. So you'll literally get the high performance wearable in the mail for free. You get to try it for 30 days, see whether you want to be a member. And that is just at whoop.com. Back to the guests. How do you think about from a kind of a cellular perspective? There's a paper that just came out basically linking air quality to Alzheimer's. Yes.

And to the degree that I think it was causal. Like there's causal relationships here. So it's quite powerful. And I actually, that prompted me to look at, you know, where, what cities have the best air quality? And it was Bozeman, Montana, Bangor, Maine. And this one was surprising, Asheville, North Carolina. Yeah. So those are the three top.

Oh, Hawaii, too. Lots of trees in Nashville. And Hawaii, yes. It got me thinking, I'm like, wow, you know, it's one of those things that we don't think about a lot as we think about health span. So I don't know if you want to say anything about just air quality and how to think about that, how you measure it maybe in your clinic. Oh, my gosh. I mean, I could talk about this forever. I love this topic.

Can I zoom out a little bit, though, first? Yes, please, please. So one of Dr. Jeffrey Blan's core reasons that we age and get disease is our level of toxic exposure, right? We live in an environment that humans have created that has 155,000 named chemical toxins that are put into our environment that did not exist 80 years ago. Okay. Okay. Say that again. 155,000 named chemical toxins that did not exist in our environment 80 years ago are now in our environment. They're made by companies like Dow Corning and, you know, all these chemical manufacturers.

Those are just the chemicals that are in clothing, in our cosmetics. There's also chemicals in our food from companies like Monsanto and others. And then now, obviously, there's chemicals in the air. There's pollutants in the air, right? And so I really don't like to scare people by saying all that because that does sound very scary and you can feel very defeated. Like, how am I going to avoid all this? I'm just going to give up.

You have to realize that your toxic exposure, it's invisible. It doesn't cause symptoms, but it does lead to chronic disease, almost at the same degree as having poor nutrition, poor sleep, and being sedentary. That's the Alzheimer's data. I was like just blown away. Well, there's that other studies showing that the closer you live to a golf course, the higher your risk of Parkinson's disease because of the chemicals they use for the grass. Yeah.

Power lines. Yeah. There's another one. Yeah. And it kind of can seem very like an insurmountable mountain to climb, but it's not because, you know, you've heard me talk a lot about the Pareto principle, right? Yes, yes. There's 20% of actions that you can.

do that will detoxify 80% of your life. Okay? And so let's break those down. Air. The way I think about air quality is you always need to realize the air quality inside is always going to be worse for the most part than the air quality outside. So all of our phones now have an air quality index. If it's in the green, open your windows, you know, getting that air exchange is really powerful. If the air quality outside is bad or you just don't want to open your windows, there's something very easy that you can do. The two places you spend the most time, your office environment and your bedroom where you sleep, get a really good quality air purifier for those two areas. And that's going to take care of your air for 80% of your life. And that's it.

With water, always drink out of glass as much as possible to avoid the microplastic exposure from plastic models and drink filtered or what's even better, reverse has a moseousal. water. So again, where do you spend the most time? Get the most water. Maybe your kitchen sink and your office sink. Invest in a high-quality reverse osmosis system. Food, try to eat organic as much as possible. Try to eat food that's not in packaging. You know, get yourself educated about what is real whole food. And that'll help you detoxify most of your food. There's a great website called an environmental working group, EWG.org, that regularly publishes what they call the Dirty Dozen. And then lastly, there's another place that is kind of a silent killer, which is the cosmetics that we put on our body. Okay? And so, you know, on average, almost all of us are using somewhere between 8 to 14

cosmetics on our body. They are laden with Phafos and other chemicals that are both endocrine disrupting and immune disrupting. And it's really easy again, Paredo Principle. We can do one thing that will completely eliminate this for the rest of your life. Pick up a good app like Yucca or Think Dirty. These are apps so you can scan the barcode. It'll tell you how toxic it is. Replace it with a product that is non-toxic. And then I don't know about you, but I don't change my soap every week. You know, I'm using the same soap for years now.

And ever since I've changed it, I love it, you know, and I'm no toxins in my cosmetics anymore. And so, you know, like little actions like this can be incredibly powerful to move the needle of your health. Yucca and think dirty. Yeah. That's great. We need to put those in the show notes. I have a great resource for your show notes if you want to put this on there. If you go to my website, Dr. Shaw.com slash toxins.

I have a 52-week guide to detoxifying your life. Amazing. Just pick one thing a week, check it off. Some of them are harder, like get a reverse osmosis filter. Some of them are really easy, like, you know, open your windows, you know. I mean, I just, I love the idea of like just being able to look at the barcode and just get a toxic, you know, like, toxicity, like kind of evaluation. Right.

That's phenomenal. Yeah. Your makeup, your soaps, your lobes. your lotions, just scan it all and pick something different. I put on so many products. It's just like an unending litany. I know. I know.

And these groups have done a very good job of testing the products and making sure that, you know, you're not putting some of these chemicals on your body. And, you know, a lot of people say like, oh, I'm sure those products are really expensive. You'll be surprised. Some of them are actually cheaper than the stuff that you're buying, you know, at Sephora or wherever you go. Yeah, totally. That's super helpful.

When we think about biomarkers, you know, what do you feel like? Like you mentioned HBA1C as a really important biomarker. What are some other biomarkers that you look at to help a person to understand how they're aging? Right, right. So what I want people to understand is that there are thousands of biomarkers we can potentially check. 98% of those are all biomarkers diagnosed diseases. And you're not going to use them practically to track the course of your health. So track the course of your health. There's probably about 20 of them. And I would say five or six of them are numbers that people should really know what they are for themselves, right? Like everyone knows their bank account balance, for example, right? Everyone knows what temperature they like to have their house thermosat set at. With the same degree of precision, you should know what your hemoglobin A1C level is, what your HSCRP level is, what your testosterone level is, both men and women should know these numbers. And that's the kind of Dutch test, the stress test.

Sorry, the APRs issues. HSCRP is a measure of your inflammation. So it's highly sensitive C-reactive protein. Right. And this blood test costs like a dollar. It's ubiquitous in medicine, but it's never checked on your standard medical panels that you get at your primary care doctor visit. Right. But you should always insist for it.

And, you know, there's a lot of places now you can just get them online. Yep. In HSCRP, you want that as close to zero as possible. Once it goes over one or two, it means that there's some source of inflammation in your body. and you have to kind of become a detective and figure out what it is. 90% of the time is going to be coming from your gut. And your gut is where 90% of your immune system lives. And if you have poor gut health, your immune system stays overactivated,

causing a condition called chronic inflammation, which is one of those root causes of chronic disease. And so that's why HSCRP is another incredibly important number. And you always want to try to optimize that to be as close to zero as possible. I love that. Yeah. Any other biomarkers that you feel like are really central, like blood biomarkers? Absolutely.

So hemoglobin A1C we mentioned. That's a three-month average of your blood sugar. And it tells you if you have diabetes or not, if it's over 6.5, pre-diabetes is over 5.7. But what I always tell people is you never want to wait to get to 5.7 before you start raising alarm bells. You want to be as close to 5.2 or below. 5.2 or below is metabolically healthy. Okay. Now, another important biomarker in your metabolic health is also your fasting insulin level. This is a one-time measurement. It's not like a three-time average, but it's also very sensitive

for getting insulin resistance. So you want to optimize that to about eight or less. Okay. And then I would say another important biomarker is APOB. I'm very familiar with that one. Yeah. So this is the new kind of like singular biomarker of cardiovascular risk. L.P. Little A is. another one that no one's checked until just recently. That's another genetic biomarker of cardiovascular risk. And then hormones are so important, and especially for men and women as they start approaching, you know, 40s or so. You know, unfortunately, over the last few decades, as doctors, we were told that hormone replacement therapy or even just considering hormone replacement therapy is a really bad idea. It can cause cancer. It can cause cardiovascular disease. We now know

that this is not true, and people can dramatically change their health if hormone deficiency is contributing to poor health. And so we try to get people to really monitor those numbers as well. I love that. A few of my friends who are covered in these hard-charging professions, one, actually a trauma surgeon, and I encourage them to get a continuous glucose monitor. And two of the three women were in normal ranges in terms of their fasting glucose levels, but got their blood done and actually were pre-diabetic, both of them. And the third one was in line with what we'd expect with. So why does kind of the fasting glucose levels from a CGM not always line up with

what we see from an insulin perspective? Yeah. So a fasting glucose level that you get first thing in the morning is the last thing that's going to change until you get diabetes. Okay. So the way the physiology works is that if you're putting a lot of glucose into your system, your body secreting insulin. So once you start secreting insulin as such a high level that your cells are like,

I can't stuff any more glucose in here. Your insulin level has to start going up and up and up. So actually the first thing that's going to rise is your fasting insulin level. And then the second thing that happens is over the course of the day, your glucose levels stay high and they spike more often. Okay? That does not get picked up in a fasting glucose. That gets picked up with a continuous glucose monitor, all right?

So a continuous glucose monitor is going to tell you, okay, even though your first morning fasting glucose was normal, over the course of the day, you had like 10 glucose spikes and they lasted for two hours each because you're eating a bunch of like, you know, packaged snacks all day long. And you've got to stop that. And so the continuous glucose monitor is a tool that I use a lot for people that have a high hemoglobin A1C. Because remember, hemoglobin A1C is a three-month average of what's been going on throughout the entire three months of your glucose. And so the first thing that changes is fasting insulin. Second thing is your hemoglobin A1C.

And the last thing that changes fasting glucose. Okay. So you can have normal levels of fasting glucose but still be insulin resistant. Exactly. Do not even consider fasting glucose unless it's high, then you have a severe problem. Okay. You should still be checking fasting insulin and hemoglobin A1C. And what I do for people is if either one of those are elevated, I'm like, you should do a continuous

glucose monitor a few weeks and just go through that educational journey. journey of having a CGM. So listeners, advanced labs, you need to get these markers checked. Okay. So all of these markers, what they are, why they're important, what is optimal range, and how to get it there. I have in another guide at dr. shaw.com slash biomarkers. Nice.

Five page free PDF, how to do this for yourself and how to ask your doctor for these as well. Amazing. I love that. It's so empowering. You know, like that I think just the way you approach everything, then the number of resources on your website is just, it's kind of mind-blown.

Yeah, because I give these all my patients and they're like, they're like, I'm going to give it to my mom and my friend who lives in, you know, this state. And I'm like, oh, let's put online, just tell them to download it. Oh, I love that. Yeah, it's great. I mean, a lot of folks just don't, don't have access to be able to make it accessible is so phenomenal.

Yeah. Do we miss anything in terms of just like the drivers of health span? Aging. Yeah. aging. So I would say, you know, we talked about toxic exposure. We talked about sedentary behavior. We talked about also inflammation, right? I think that, you know, another driver of aging that's really critical that a lot of people don't consider is their mental, emotional health and also their levels of stress, right? I think out of all the areas of

our physiology that are resilient, I think that chronic stress exposure, for most people is the last thing they notice as a driver of aging, right? Because we're just so used to being stressed all the time. Right, right. So this is where the whole conversation around recovery comes in very, very important, right? Because I think finally we have wearables that can tell us how recovered we are. And using metrics like HRV, we can finally understand what's going on in our physiology when our physiology is not really pointing to symptoms of the accumulation of the damage of stress

is doing. You know, there's lots of kind of personal inner work an individual can do. But the other kind of toxic thing that contributes to all of everything that you're talking about in terms of low level, like stress is toxic people. Right. You know, so that's another, you know, having connections in your life that are supportive and nurturing of your values and your goals. And because, you know, it's so funny.

Well, oftentimes people will write in to me right in and talk about, hey, I'm doing everything right. And then I realized it was nothing to do with like my sleep or my, my behaviors. Like it was really to do with just the people of my life or not like, you know. And the flip side of that is also kind of powerful bit of knowledge too, is loneliness can also be extremely detrimental to people's health. Yeah. Yeah. Yeah. I just had we just spoke to, I just spoke to Lori Santos from Yale. Yeah, Dr. Lori Santos. She was wonderful, but just talking about the, you know, the connection between long-term happiness, fulfilling life and connection. So it's obviously huge.

It really is. And having a sense of purpose is also extremely important. There's all these soft things that we don't consider that I put in this bucket of emotional health. Yeah. But it's incredibly important to also be while you're working on your exercise routine and not being sedentary, you'll also be working on that part of it. Yeah, yeah.

And I think connecting those things to your purpose, your larger purpose and the meeting that it brings to your life. And really, I think a source, like all the things that we're talking about, just allow us to live our values with more joy and more energy, right? So it's, it's, I think, seeing, you know, these things not as a drag, but as a path, you know, to being able to live a healthier, more beautiful life. Yeah. I think, you know, for me personally, that was very evident because I was so burnt out with doing surgery. I was in the operating room every single day, 12 hours a day. And it just felt like I was on a treadmill, not getting anywhere.

And when I had this kind of career change, I took a massive bakeout to do this. But I just felt so much more fulfilled seeing people get healthy. And I had lost my purpose and then I redeveloped it and just contributed, I think, dramatically to the state of my overall health, just having a sense of purpose again. Yeah. Yeah, it's a huge driver of longevity for sure, you know. So you mentioned at the outset, Dr. Shaw, that, you know, folks will come into the clinic and they're disappointed because you're giving them the stack of behaviors that seem not as sexy or glamorous as things like an intravenous NAD or the hyperbaric chamber, whatever it might be, you know, enter in sexy modality as the magic bullet or pill. That said, some of these modalities really are phenomenal, but they should be layered on top of the foundation. the basics.

Absolutely. The majors, right? So what would you say? Let's say a person, you know, is really on average doing the things that you would recommend in terms of their nutrition, sleep, stress management, and exercise. And what would you then recommend they layer on top to further optimize? Just to highlight the fact that these are all things that I'm going to be talking about that can move the needle, but definitely won't.

not move the needle as much as you're going to pay for them if you don't have the basics down, right? But once you have the basics down, which we do for a lot of our patients, you know, they do their year membership with us. We got all their biomarkers like really dialed in. Their nutrition is good. They're working out. They're not being sedentary. They're like, Dr. Shaw was like, what's next? What else can I do? And at our facilities, we have hot, cold, contrast therapy. So sauna is very beneficial for detoxification. It creates heat shot. proteins, which can also have mitochondrial benefits as well. And there's large studies that come out of Europe and Denmark showing that there is definitely a longevity benefit for people to use the

cardiovascularly. It is a huge upgrade. And also preventing dementia. There's a huge study out of Denmark showing that the people that do sauna therapy regularly, they have less rates of blood flow. Is that the really? And maybe even it helps the sleep too. And decrease inflammation as well. I think there's a lot going on there. Potential benefits to it. So, you know, I love hot cold contrast because you get the benefits of the heat sauna. And then cryotherapy or cold therapy or cold plunge, there's not as much data around it. But what I will tell you is that I use hot, cold therapy as a moment for you to start learning how to regulate your nervous system and your vagal tone.

And so if you go into a heated environment or especially like a cold, plunge and you go in very mindfully regulating your nervous system, you will see benefits that will add up in the long term with your HRV score, for example, and your resting heart rate, for example. And I think this is like another one of those newer kind of biohacking technologies that we're just now really understanding and learning is our ability to regulate our vagal tone has a lot to do with our overall physiological health. And so I like how, for that reason a lot. The other things that we can kind of talk about too are hyperbaric oxygen therapy.

This is giving people oxygen an increased pressure, which can hyper-oxygenate your tissues, which is beneficial, but also it creates a low level of stress, actually, to your cells, which can help kind of clear out damaged cells as well. And then we have LED light therapy, for example. This can also increase nitric oxide, which can help diet. blood vessels, improving blood flow. There's all sorts of these little technologies that people can use. And then people are always asking a lot about peptides. And so peptides are a new class of compounds that are not really new insulin as a peptide. We've been using peptides for, you know, decades now.

But there's a lot of attention now with the GLP-1s and their massive change in how we think about medicine now. And what I tell people is that peptides are not really in the same category as pharmaceuticals because peptides are natural biological signals that our bodies have been making through our entire evolution, like insulin, GLP-1. We make this stuff. They're slightly modified to have a bigger effect. And so peptides have a lot of physiological effects throughout our body. And we don't even know all of them, all the effects that GLP-1 has, for example. GLP-1s like there's epitide and some of glutide, there are receptors on our immune cells that can help our immune system work better as well.

So there's a lot of physiologic potential benefits. And so I think there's a lot of science that needs to be done on peptide therapy and kind of like how to use them correctly and appropriately. Because we don't know there's in terms of sourcing, dosing, like I mean, there's a lot of complexities with peptides that I think are underappreciated by the general population. And obviously you are operating very cautiously, which I appreciate. But yeah, I mean, I feel like peptides, certainly on the Internet is just the Wild West right now. It's so much the Wild West on the Internet that I would think is dangerous to buy anything off the Internet.

And you just got to work with a skilled practitioner that is looking out for your best interest. And, you know, they're taking the same peptides that you're going to be taking. What are they putting in their body themselves? I would even say some of the vagus nerve stimulation technologies also should be done in in conjunction with a registered therapist. I mean, I've seen that go really south as well. This is actually what I was going to say. We were talking offline about,

I was talking with the head of performance for England football. And we were talking about Vegas nerve stimulation. And it sounds great. Oh, I'm going to get this huge flood of like parasynthetic activation, you know, and I'm going to deactivate my nervous system like really quickly. But that also can come at a pretty big cost, right, especially for someone whose nervous system is not regulated. Right.

And as a physiologist, I think a lot about this, right, and have a lot of repetitions in this space. And I've seen these vagus nerve kind of stimulation whereby a person's, they skyrocket their HRV, which, again, skyrocketing HRV, like variability day to day is not a good thing, right? So if you go from like a 50 millisecond HRV, all of a sudden to 150, that's generally not a good thing, right? And that's an oversaturation that leads to what will be a, precipitous decline in in HRV for days and days afterwards.

I experienced this personally. So I think like a lot of these therapies are understudied, right? And have like real implications in this case to the nervous system that we need to be smart about. I'm so glad you brought that up because I think, you know, when you're looking for a shortcut that is just too good to be true, it definitely is. It definitely is, right. I mean, you know, your vagal nerve tone and your regulation of your parasympathetic

and sympathetic nervous system is something that you should be doing every second of every day. Like, this is something that you need to be living in it, not doing it with a one-time device, you know, for a few minutes a day or whatever have you. That is so well said. And I will say, you know, people who are carrying trauma, for example, who have dysregulative nervous systems need to build slowly into these various modalities. Like the shock is not necessarily good for someone who is holding a lot of these tensions and is highly dysregulated. Exactly. Yeah.

And you brought up another really good topic, which is part of kind of that emotional health part of our lives is addressing traumas that have not been addressed. Because if you have a low HRV and it's just not moving, this is something that you really should look into. And I think people are just so used to just suppressing traumas from child. and even adulthood, that they never get past it, you know, and it can add up to massive consequences to your biology. And it sounds counterintuitive. Like, how does a traumatic event from when I was a kid add up to, like, me getting chronic disease?

Well, it does. And it's through HRV and vagal nerve and sympathetic and parasympathetic imbalance. That we're able to measure, you know, too, like, you know, it gives us a really good window. It's a great proxy. You'd help us understand where there might be these latent. kind of issues. Yeah, I devote, you know, my book, I have a whole chapter on, on trauma for this very reason, you know, it's, if it's unaddressed, like anything that we try to put on top of it will be that much more friction-filled, that much harder, right? Like, exercise is harder. Like,

everything is harder when we have unaddressed trauma. And understanding, of course, that trauma is an injury to the nervous system, right? So if we, if we don't address the nervous system, you know, we end up kind of trying to push water uphill, you know? Exactly. Exactly. So, yeah, I love that you address that in your clinic. That's, that's beautiful. and I think really important, you know. Yeah, we have this kind of diagram that everyone sees on the wall. I call the wellness wheel. And it's basically, it's an infographic that I created.

These year 12. Yeah. Like that, oh, I love this wellness wheel. 12 aspects of LEL to add into four categories. Because, you know, health can become overwhelming when you start talking on all these things that we talked about on your podcast. But people should understand that it's, it might seem overwhelming in this moment because it is complicated.

And there are a lot of aspects to it. But there's not an unlimited number. There's 12 aspects of your health. If you address those in a mindful sequence, you can get through all of it. It's not going to happen in one day. It might take you six months, eight months a year. It took me about a year. But it's so worth it because once you do, then the benefits just keep building up upon

themselves. And I always say like this wheel is a flywheel. Like every category affects every other category. So when you improve one, you're actually improving all of it, you know? And the reality is everything on that wheel, doing anyway. So we're already sleeping. We're already eating. We're already socializing. Right. So it's figuring on, okay, what about those dimensions of the wheel are going well? What are the dimensions of the wheel where I need to work on? And you don't have to do everything all at once to your earlier point, right? Start small.

Right. Just do one thing, you know, across each dimension. Yes. You know, that you can control. That's low barrier to entry for you. Like for eating, for example, I always tell people, don't change what you're eating, just change the timing. Right. And you can get 60% of the way to your metabolic goals just by literally consolidating all of your calories in one window of time. So true. Right. So true. Like little things like that. Yeah. Little things that don't take up much time and might actually save you time. Yes. Everybody can move the needle in the right direction. Yeah, do the simple things first and then knock those out and then then you can start focusing on the bigger things. specialized panels, an all new way to dial deeper into your health available through

WOOP Advanced Labs. Whether you want to understand your cardiovascular risk, get to the root of energy crashes, or make sense of hormonal symptoms, choose from five panels of bloodwork that help you understand what's driving how you feel. Unlike other tests, WOOP integrates your lab results with your WOOP data. See how your habits and behaviors influence your biomarkers and get clear guidance on what to change to improve your results. To join the wait list, visit our website or the health tab in the Woop app. Is there anything else with regard to some of these like fancier modalities? I love that you are a proponent of sauna and cold therapy.

Definitely see in the data that they have an outsized positive benefits to the folks who engage. You know, hundreds of thousands of data points of folks who are logging these activities. So we see that they have positive. results on both sleep and recovery, which is really cool. Is there anything else that you feel like folks should be aware of that really provide an outsized impact on health span? People should be aware of what's coming in medicine. And unfortunately, like we've lived in this country, the United States, has lived in this

mindset that if it's not FDA approved and it doesn't come through the pharmaceutical industry, it's snake oil, right? Yeah. I mean, the HRT conversations on Instagram are pretty, like, vicious. You've got the menopause society and you've got the ones, the people who I think you're talking about are, who are, okay, these aren't FDA proof, but women are suffering and need some relief. There's some good preliminary data and evidence suggesting that these help for some folks. Maybe just talk about that conversation. I would love to talk about. Let's talk about hormone therapy, especially for women. Yes, let's go. I'll tell you my mom, okay, it's a perfect example. She's 80 now, and she asked for hormone therapy when she was going through menopause, and the doctor said, absolutely not.

You're crazy, you're going to get cancer. And so she just never did it. And that bit of advice came from the woman's health initiative study, which is a study that was done on synthetic hormones that were given to women that were over 60 years old, and these women had a higher rate of getting cardiovascular disease. And so the data was totally misinterpreted. it also was done with a synthetic hormone that was not akin to like a biodetical hormone. That knowledge spread like wildfire through the media.

And then physicians thought that they would get sued or their license affected if they gave hormones. And so for 30 years, we were under the impression as doctors that doing hormone therapy was going to be negative. It's a very similar story for male hormone therapy as well. But the reality has been, there's hundreds of studies now that show hormone replacement therapy for men and women can be a lifesaver in many ways. It can reduce your rate of many chronic diseases, including cardiovascular disease and cancer. And also, it helps to preserve muscle mass, has a preserved bone density. And my mom, she's like six inches shorter than when I was born. And she's had every joint in her body replaced pretty much.

and is because of osteoporosis that she did not have to have if she had been put on mindful hormone replacement therapy. Never mind the effects. Did she lift weights? No, she's also of the generation that like, you know. Just didn't know that that was the thing to do. You knew that like cardio, cardio training was probably the way to go. Yeah.

And so did much more cardio than she did any weight lifting. Like, you know, this was the generation back then. And look, like I think that hormone replacement therapy is. not for everybody. Right. But it should be considered a lot more than it is being considered right now. And so I think, you know, the ties is definitely changing now. You see it with a black box warning being taken off the hormone replacement therapy and etc. Would you say for individuals who are not experiencing any symptoms and have a good stack of habits, would the default be to engage in hormone therapy, men and women? Or would you say hold off until you have symptoms?

I would say don't hold off until you have symptoms. I would say just get your levels checked. And if you're in menopause, it's a really good idea for women to consider at least some estrogen therapy, you know, when they get to menopause. And even in pari menopause, the best thing to do is it's hard to give blanket advice is just to see someone skilled, right? Of course. See someone skilled, they'll measure your hormone levels. There's another test that we're doing called a Dutch test that also measures hormone metabolites. And we can form a really good plan that's personalized to what your body needs.

Now, hormone replacement therapy is one way to get your hormone levels normalized, but there's also many other things that you can do, such as weightlifting, et cetera, that can increase testosterone levels and reduce symptoms. Would you say, you might not be able to answer this, but prior to kind of hitting perimenopause, if you are engaging in, you know, doing kind of all the things right, can you bypass that stage? If you're doing all things right, can you bypass paramedopause? Yeah. Can you bypass the symptoms that are associated with it? Now, presumably, you know, you'll end up having in a regular period and you'll have those kind of symptoms, right? I would suspect. But maybe they're not as egregious or detrimental. Absolutely. I mean, I think my answer is absolutely. I will say there are many women that pretty much never experienced perimenopausal symptoms. And they're like, what are you guys all talking about? And then there's some women that experience the perimenopausal symptoms to a very high degree. Now, if you're experiencing the symptoms to a high degree, there's a lot of things you can do. The first thing you should do is get your nutrition right, avoid ultra-processed food. Alcohol, alcohol, alcohol. Right, exactly.

Watch your sleep. Women don't admit. I'm like, I'm like, that to me, like that is one of the biggest accelerators of, I mean, I just, I see the data. And I know people probably hate me for talking about all the time. But I'm just saying if you want to stave off all these really horrible symptoms, stop drinking alcohol. Absolutely. Yeah.

It's a huge accelerator and also, you know, creates many more symptoms. Gas on the fire. Right. Exactly. It's gas on the fire. Yep. But yes, I mean, I think the idea for paramedopausal symptoms is hormone therapy is one option, but there's many other things that you can do.

Yeah. Yeah. So maybe it's in, you know, it's certainly not either or. You know, it's a kind of in combination with someone who knows a lot about the topic. Yeah, you know, all the things we're talking about, it really just takes sitting down with someone to just have a full discussion around all of it. And unfortunately, you know, what happens to a lot of women is they see their OBGYN for perimenopausal symptoms and they're not given any of the other coaching around lifestyle, but they're given, you know, some sort of estrogen.

Yeah. And they're disappointed generally. They're disappointed, right? Exactly. Because you really have to dial in the dose and you really have to dial in the other hormones as well, progesterone, testosterone. And for some women, monotherapy is fine. But most women, they'd benefit even more from progesterone or testosterone, depending on what their symptoms are. Yeah. What about men and testosterone? You have a guy, let's say, he's 38 years old.

He's got low testosterone. You know, it seems to be doing all the lifestyle of things relatively well. Do you go the trauma route? Do you go, what's your direction? Yeah. So, unfortunately, because of many factors, sedentary behavior, chemicals in food, chemicals and cosmetics, like endocrine disrupting chemicals. Men are experiencing lower and lower testosterone levels now than ever before at a much younger age. Crazy, crazy, crazy.

And so, you know, the normal lab value for testosterone has changed in the last 50 years for men. It used to be, you know, at an age of like 50, something like 500 would be normal. And now they're saying as low as 300 is normal. And it's not normal because you don't feel great. You don't feel. And, you know, there's this kind of precipitous decline of muscle mass in men after the age of 40 that happens because of the low testosterone levels. Now, is it testosterone lowering because of, we know that there are percentage declines in testosterone, but you can really slow that by strength training. Yes, absolutely.

And like getting that right. Absolutely, yeah. Right. Yeah, strength training and I think also not, being sedentary all day. Because I think we say it's age, but like I've seen no changes in my levels. Yeah. You know, I'm 51.

You know, like, so I just think it's the age. I feel like it's just this crutch that we use. And we can slow that decline with just how we live every day. Exactly. Yeah. I agree. I mean, I think, you know, we have this story that's told to us that as we age, we're supposed to decline.

Right, right. And we just have to rewrite that story. Totally. Right, completely. I mean, that's what you do every day, which is so exciting. And you rewrote it for yourself. I did, yes. In a way that it's just so inspiring.

Thank you. Thank you. Yeah, I'm super excited about what we're doing. And, you know, the other piece of the story is that as I started to look better and have more energy and feel great and be more optimistic, my patients were noticing. And they're like, Der Shaal, what are you doing? I'm like, let me tell you what I'm doing. And so like my 30-minute surgery visits would turn into like an hour.

and a half of conversation. Because you're so excited that you just want to share. Yeah. And then they would do it and they would get better just based on a conversation. That's what made me open my first clinic. Yeah. And I was like, I just want to have more of these conversations. It's so inspiring to see people get better. How do we change medical school? So maybe just to shift the policy, just for a split second. Dr. Shaw, obviously having gone through, you know, medical school, you know, and everything that you've talked about today, you're changing people's lives by having conversations on how. to prevent disease, how to reverse disease. How do we need to think about medical school curriculum today to just, you know, we need people treating the disasters, right? And the

catastrophes, of course. But is there a way to rethink medical school to kind of, so we just can shift the collective mindset of folks around health? I think we have to because what's going happen in the next few decades is people are going to have much more control of their health on their own through a combination of wearable devices, more access to their own biological blood markers and artificial intelligence. And people are going to get healthier. And this is not because of the medical system is because we finally have access to data and technology. And so doctors are not going to be as busy as they are right now, right? And so we have to rethink what is the role of a doctor going to be moving forward in this new world that we're going

to be living in? And so I think doctors need to really look at do we want to function a new role, which is not just in taking care of disasters, but also reversing chronic disease and helping people stay healthy. And if we want to be a part of that part of medicine, we're going to have to get trained in it, educated in it, right? And so I think if any doctors listen to this, is like they should insist, or medical students, insist on their medical school educating them on this. I think it's not to be from the ground up, because the way our medical institutions are formed in this country is based on a report back in the 1950s called the Flexner Report. Flexner Report was commissioned by the Rockefellers, and basically, Flexner was an educator

that went around to every medical school and found one problem, that the medical schools were teaching lots of holistic methods that didn't have, in quotes, air quotes, science behind them. Okay? And so when this report got brought to Congress, they decided that the only things that should be taught in medical school are research science-backed methods. Well, the only research science-backed methods that have developed through, you know, the next 100 years were pharmaceutical trials, right? And so that's why we teach mainly pharmaceutical interventions. but I think there's going to need to be a reversal of how we structure these particular educational institutions based on what we now know is also even though you know you can't do massive studies

on nutrition right because they're so hard to do right and we both know this but we have to rethink that kind of mantra of the flexor report so that we can have medical schools number one like doctors are going to need jobs in the future and unfortunately you know there's not going to be as many jobs as there are right now or fortunately yeah fortunately right exactly fortunately right I always said the best thing that I can do as a doctor has put myself out of work totally because everyone's just healthy now I know I know yeah I mean I feel like the tides are definitely changing and I think the medical system is going to be forced to change the health care system is going to be forced to change because there's this movement happening you know that you're a part of

My buddy Mark Hyman always says that like people are sick and tired of being sick and tired, right? And so people are looking for solutions. And if they're not getting them from one place, they have a place now to get them from, from their data and AI. Yeah. Yeah. I love it. Mark is wonderful. Yeah.

And one of the kind of OGs, you know, in this movement, I feel like along with yourself. Thank you so much for this conversation. Oh, thank you. It's been so much fun talking about longevity and health span and getting your perspective on everything and definitely want to congratulate you on Next Health because I just feel like these clinics are so critical for so many people. And I think to your earlier point, too, it's you get one person who goes to your clinic who's like, oh my gosh, I need to share this, you know, this insight. And boom, they can go to your website, which is.

So our clinic website is Next-health.com. Okay. And my website is Dr. Shaw.com. Dr. Shaw.com. Okay. Great. So lots of resources for folks to read about everything that we talked about today. Your wheel is in there. And yeah, so just thank you for making everything so accessible and for coming on this podcast and sharing your wisdom. It's been a joy. So much for having me. And I can't wait to have you on my podcast. Talk about your new book. Thank you so much. We'll make it happen. Thank you. Okay. Perfect. If you enjoyed this episode of the Woop Podcast, please leave a rating or review. Check us out on social at Woop at Will Ahmed. If you have a question was answered on the podcast, email us,

podcast at whoop.com. Call us 508, 443, 4952. If you think about joining whoop, you can visit whoop.com, sign up for a free 30-day trial membership. New members to use the code will, WI-L, to get a $60 credit on Woop accessories when you enter the code at

checkout. That's a wrap, folks. Thank you all for listening. We'll catch you next week on the WOOP podcast. As always, stay healthy and stay in the green.