WHOOP Podcast - The Science of Healthspan: How to Age Better with Emily Capodilupo and Dr. Dan Henderson

Episode Date: September 16, 2026

On this week’s episode of the WHOOP Podcast Science of Human Performance Series, WHOOP SVP of Research Algorithms and Data, Emily Capodilupo, sits down with WHOOP AVP Medical Director, Dr. Dan Henderson to discuss the key longevity habits to help you boost your healthspan and improve your WHOOP age. Emily and Dr. Henderson break down the difference between lifespan and healthspan, illustrating why decline with age isn’t necessarily inevitable. The two break down how everyday choices around sleep, exercise, nutrition, stress, and social connection can compound over time to shape how we age. This episode clarifies the habits with the greatest impact on long-term health, why many popular longevity supplements may offer less benefit than advertised, and how biomarkers and blood testing can uncover hidden opportunities to improve both health and performance. Emily and Dr. Dan explain how WHOOP Advanced Labs and WHOOP Age can help people better understand their individual health and take practical steps today to extend their healthspan to feel better for years to come.(01:25) Healthspan vs. Lifespan(03:03) Is Aging Decline Inevitable?  (04:51) The Habits and Biomarkers For Healthy Aging(08:55) The Lifestyle Choices That Reduce Biological Age(11:10) Does Stress Make You Age? (13:03) Important Health Benefits of Social Connection(14:17) What Supplements Should You Actually Be Taking? (19:30) What Lab Results Can Tell You About How You Age(28:42) Cardiac Health: Preventing Heart Health Risks(28:02) Weight Management and Insulin Resistance(32:00) How Sleep Impacts Aging(39:05) Root Cause Health Issues (And How To Avoid Them)(41:09) How To Lower Your WHOOP Age Support the showFollow WHOOP:Sign up for WHOOP Advanced LabsTrial WHOOP for Freewww.whoop.comInstagramTikTokYouTubeXFacebookLinkedInFollow Will Ahmed:InstagramXLinkedInFollow Kristen Holmes:InstagramLinkedInBuy Aligned by Dr. Kristen Holmes: Follow Emily Capodilupo:LinkedIn 

The idea that getting old has to suck is almost entirely untrue, especially if you're paying attention. For sure, people want to live a long time, but it's really about the quality. How long do you live and live well? So lots of people come into your clinic, they say to you, getting old sucks. How much of that is inevitable? It really is so much like saving for retirement. So much of what it takes involves building the systems of your body to be as healthy as possible, baking in, habits and also the right status of biomarkers and organ function to maintain that for the long term.

Health doesn't exactly accrue with compound interest, but disease sure does. Hi everybody. I'm Emily Capitaluppo, Woop Senior Vice President of Research Algorithms and Data, and today we are back with another episode from our Science of Human Performance series. Today I am joined by Dr. Daniel Henderson, Whoop's medical director and vice president of health innovation, and also my personal primary care physician, so one of my favorite doctors. Well, great to be back, and thanks for that wonderful intro. Thank you, Dan, for being here. This is going to be lots of fun. Today we're going to be specifically focused on longevity, health span, and the Whoop HealthSPAN score, so how we think about Whoop Age and all of those exciting things.

Awesome. So why don't we just get started with the easy stuff? We mentioned health span. We mentioned lifespan. Are those the same thing? And if not, what makes them different? Great question. We talk a lot about longevity. I'm in different groups of longevity docs. I think of myself as a longevity practitioner, but it is a misnomer because it really means how long you live. And that's not the point at all. For sure, people want to live a long time. But it's really about the quality. And when I think about the more appropriate term, which is health span, it's really how long do you live and live well? So I think about it as the area under the curve of how long you live, your lifespan or your age at death, and how well you live. So it's really like your total qualities, quality adjusted life

years for the non-economists out there. And why does it matter to study them separately? You know, when you think about what you really want or what you really, really want, it's not necessarily to live a very long time. For sure, most people don't want to die young, but nobody wants to spend 10 or 15 or 20 years miserable. And that is what unfortunately happens to most people. When I'm in my clinic at the Bergen Women's Hospital, I hear a lot of my patients say, oh, getting old sucks. And, you know, it's a joke, we laugh about it. Sure beats the alternative. But the current way that so many people have experienced aging, loss of function, loss of resilience, and just feeling crappy.

And so if we were only thinking about longevity in terms of the age that you attain, we would really be solving for the wrong thing. Let's like break that down a little bit more. So lots of people come into your clinic, they say to you, getting old sucks, how much of that is inevitable? Like, yeah, there's like the kind of beats the alternative, but framing it like that assumes that the alternative is like, slow and painful decline or early death. But there is actually a third path there, right? There is the

sustained function and aging well. So is that genetic luck? How much of that's in our control? Can you break that down for us? Yeah, I mean, that is a really big question, and I can make even a small question take a long time. I will say the people who say getting old sucks the most are actually the 30-year-olds, do with that what you will. But it's definitely not in a And one of my favorite patients early on in my career was this woman whose first name was Hildegard. She's probably still alive. She was in her late 70s at the time. And she would brag about how she was skiing and scuba diving and she was dating.

And she would say some things that I can't say on the podcast because I'll blush. But this was a person living an incredibly full life. She was a retired Lufthansa flight attendant. And, you know, her secrets were all the things that we know. in lifestyle medicine and longevity medicine. And to be sure, she probably was not exactly as healthy as at age 20 or 30 or 40, but her experience of being in her late 70s was incredibly good. And she would tell me that there was really no loss of function or feeling good.

So I think that the idea that getting old has to suck is almost entirely untrue, especially if you're paying attention. I think like the whole premise of your practice is that Hildegard isn't just genetically more lucky than us. That's obviously a very whoopey idea, too, that there's a lot you can do to control. Do you have a sense of sort of how much is in our control, how much is luck? And yeah, I'll let you answer that first. Yeah, I mean, my standard answer across the board is that most things are about 50% genetic and 50% not. And I think that that is true. Certainly there's a strong genetic component to how long people live.

But the things that are against you genetically can mostly be spotted early, anticipated, and mitigated. So I think that there are certainly people who are born with or acquire or otherwise affected by very serious issues that they can't do a ton about. But those are edge cases. Most of us, if we start early and and we're paying attention and thinking about really just like we're saving for retirement, investing in our functional capacity and resilience later in life, we can achieve, you know, everything we could imagine. I mean, I can never run a sub three marathon, but I can, I ran a 342 two years ago, and when I was 29, I ran a 342. Some of that was the shoes have gotten better. But, you know, I've watched people kind of be amazed at how fit and

well they can be in their 40s and 50s and 60s and beyond. And I'm curious, like, given how much, you know, you said about 50%, and I know that that's not meant to be an exact number, but given that an enormous amount of how we age is in our control, what's going on that so many people age so poorly? What do they not know that you know? It's a great question. I think since around the 2020's, we've been paying a lot more attention to the unhealthiness that happens with modern living. I think COVID was a big catalyst of this because we saw how people who were relatively healthy, but maybe had high blood pressure or were affected by obesity, we're getting much, much sicker. And I think that that catalyzed a lot of people's attention in being healthy and seeing it as an

asset to be cultivated and protected. So so much of what it does. takes, involves, you know, building the systems of your body to be as healthy as possible while they're being developed, which is sort of, you know, childhood, early adulthood, and then baking in habits and also, you know, the right status of biomarkers and organ function to maintain that for the long term. And it really is so much like saving for retirement because I think it was Richard Feynman who said compound interest is the most powerful force in the universe. So health doesn't exactly accrue with compound interest, but disease sure does. And my job as an internal medicine doctor is really about understanding the complex systems of

the body and how they interact. And almost every non-infectious disease is a form of vicious cycle where the badness of the problem increases in an accelerating fashion and then spirals into other problems. So the other side of that is if you can arrive at old age, whatever that is to you, with as much function and as much resilience and with everything in a good place, you're going to have freedom and preservation of that health for a very long time. And conversely, if you arrive at old age, and again, whatever that is, it could be 45, that's how old I am, but if you arrive later into life and you have this baggage, this sort of like health debt that you're already paying off, it's going to be much harder to enjoy that, enjoy good health for a long time.

Okay, so it's a helpful, high-level framework. Let's get concrete. What are the things, if you were going to list them that people should be doing to protect their health span? Yeah. So it's all little things. things. And the big ones are kind of obvious, but an important part about this, too, is it's going to be a little different for everyone. And if you're being honest with yourself and you have some kind of way of tracking for most people, that would be wearables and biometrics. It's going to be weird stuff for some people. What it's not is big, bold moves when it's already too late or to try to make up for lost time. Sure. So I want to just back up a little bit because you glossed over something that I think

is very important. You were saying like the big obvious things. Let's name the big obvious things. We're talking about sleep. Yeah. You're talking about exercise. We're talking about nutrition. Yeah. Maybe mental, spiritual, emotional, social health. Yeah. So, you know, I think we go back to the six pillars of lifestyle medicine. And I go back and forth about what's more important, sleep or exercise. Sure. I have medium trouble sleeping and I love running. So I often think of sleep is the most important, but probably exercise is better, is more important just because the benefit on mortality is just ginormous. You know, you can cut your risk of dying on any time frame in half by going from less exercise to much more. Sleep obviously

super important. And when we think about some of the scariest conditions later in life, especially dementia, sleep is one of the best defenses along with exercise. Nutrition is super important. And, you know, there's kind of two sides of this. One is the sort of you need to get the healthy nutrients. I think that's important, but probably the more important side is you need to avoid the kind of toxic substances, which is mostly the byproducts of processing, the things that cause you to have a blood sugar spike or triglyceride spike or can be mildly inflammatory or that just kind of hook you and make you eat more. So I think nutrition is mostly about maintaining good energy balance and good glucose disposal, but it's certainly important to eat the

rainbow and get fiber and all that. You know, beyond that, I think it's about how you handle stress. And I spent a year studying this with a tool of Gwanda's think tank, Ariadne Labs, is such a rich topic. And I think stress is one of the best predictors of all disease, even things you wouldn't expect, like infection and cancer. You know, stress is something that tends to happen to us, because of the lifestyle choices we make, you know, putting the work computer away earlier versus not, and also a lot of stuff that's beyond our control, like where we live and what's happened to us when we're very young. So a lot of stress can't really be controlled, but building up your resilience to handle it is really, really important. That is strongly genetic, and I see patients all the time who are like veterans who go running every single day and nothing shakes them.

and then I see people who get knocked over by a gentle breeze. But everybody can strengthen their resilience to stress, and we see the benefits of that very easily with whoop data because of, one, the stress zone time, but also it does show up in your HRV data, I think. So stress is a really important thing. Avoiding... It shows up in sleep data too,

especially in trouble falling asleep or, like, sleep avoidance. what we see a lot with people who have high levels of especially self-reported stress is that they tend to go to bed really late. And when they do get into bed, they have trouble with falling asleep. Yeah. And that's a huge part of what people come into the office. And I say, show me your sleep data. And they go, what's sleep data?

And then I say, I work for them. So, you know, keep that in mind, but you should get a whoop. So then another piece is avoiding toxic substances, which is sort of processed foods, alcohol, tobacco, and other things like that. Those are obviously the big ones. And then, you know, joy, social connectedness, love, fulfillment, that is a huge part of this. And for some people, that means like calling your friends and family. For some people, that means, you know, treating your marriage and your relationship as, you know, as important as any other part of your health and investing in that. Sometimes it means getting a fluffy pet, you know, or volunteering or

or something like that, we know that social connectedness is powerfully salutary and isolation is very toxic. And then after that, that's where I think having a way to see how you're doing and listening to your body and choosing whatever thing makes you feel like you're healthier, you know, within reason. If somebody says, oh, cotton candy really helps me relax, I might be skeptical. But we know that nature has powerful calming effects and also a lot of weird things we don't understand improving T-cell function with Hanokey cypress sap.

You know, we don't totally understand some of these things, but a lot of people can find on their own their way to better health. And there's always a temptation to pick things that, you know, scratch another itch. So when you have biometrics and biomarkers, that's really important. Okay. You talked a lot about things that are helpful. I want to talk a little bit about the things that people think are helpful but aren't. I think sometimes it's helpful to know what those pertinent negatives are, especially because there are so many influencers out there trying to sell us nonsense. What are some of the things that you see in your practice that people are doing in the name of health, health span, or longevity that are just utter wastes of time and money? Yeah. So I always try to

be open-minded and acknowledge that there may be truths out there that science hasn't yet found. But that being said, the biggest one is supplements. And look, I love supplements. I go shopping on the supplement store and I have so much fun with it. And then I get these things and I'm like, why am I taking this again? Does this do anything? I experiment with a lot of supplements, you know, nothing crazy, but sort of see if this will move the needle on anything. I think the important thing with supplements is to know that off the bat, almost none of them do very much with a few exceptions. And these are the obvious things, things like multivitamins to cover any different. deficiencies you might have, vitamin D, and some people really say D3 plus K2, because that's a

very common deficiency. I think something like 20% of our advanced labs users have that. And I think I love creatine. I think it creates a lot of benefits for people in terms of obviously strength and muscle building, but also just general energy and fatigue. And then I think a lot of people benefit from fiber. And when I have done blood testing in passed most recently with Woop Advanced Labs, I found that my homocysteine was kind of high. And, you know, how much does that matter? We don't totally know, but it's thought to be a risk factor for long-term cognitive impairment. And in the short term, may be associated with being less sharp, and it can be a driver of blood vessel problems. So I found a supplement for that,

started taking it, retested a couple months later, a couple months later. And my homocysteine went from like 13 to 15 to 9. And I was like, wow, nine. So there is, you know, that's an example of something working. Yeah. But most of the stuff that my patients take, and some of them are taking like 15 things, and they all have B12 in them. I'm like, oh my God, this is like a year's worth of B12. Most of these things probably don't work. Look, I would love for them to work. My job would be easier and more satisfying if I could say, take this and you'll feel better. But a lot of these things, if they really worked. You know, if NAD supplementation made all the promises that people say happen, we would know it. Everyone would be wanting this, everybody would take it. And our markets are

efficient. Like, this stuff wouldn't be a secret. I do think that most supplements aside from the ones I mentioned are probably not a great use of money and time and thought. And if you choose that instead of investing in something else like sleep or exercise, there's a real opportunity cost. Yeah, I want to double click on something you're saying because we talk about supplements fairly often on the Woot Podcast, but I think it's pretty important, which is that in almost every case, supplementing, it's called supplementing for a reason, right? It only does anything if you're like not otherwise getting what you need. And for most people, it's like, hey, this really worked for me. I fixed my homocysteine. You should take it, right?

It's actually awful advice if you don't actually know that I have that same. issue that needs correcting. So like if you're not vitamin D deficient, taking vitamin D is not going to do much for you. Right. You know, if you're not, um, vitamin B12 deficient, right? You're getting that from your diet. Taking more and more is going to turn your urine a really exciting shade of neon yellow, but not going to make you feel any better. And so I think like this is one of the reasons why, uh, you know, I recruited you to come to Woop to build advanced labs with us is because we wanted to give people a way to say, actually, what do I need me now, which is going to be different from what my body needs in six months or a year from now, and very much going to be

different from what you need or, you know, my buddy who I might be trading longevity advice with. And so I really, really do encourage people to not just take the thing that somebody said this made me feel so much better. And also to be aware that so many of these like micronutrient deficiencies show up in a lot of seemingly similar ways. And so one of the first, of the things that I see happen a lot. It's like, I have fatigue. Oh, me too. Oh, I took this. It fixed my fatigue. And then you think like, oh, because it's like two friends both with fatigue, that this is like the fatigue supplement. But there is no fatigue supplement. It's like there are, I don't know, you'll tell me a thousand different root causes of fatigue and all of which actually

need to be addressed very differently. And I think the thing that becomes dangerous is once people start these things, then it's like they're afraid that if I stop taking the Sufflement that didn't actually do anything in the first place, then I'll be more fatigued. So then it's just and and, and, and, and until they're, like, stack is, like, 20, 30 deep. And there's like, what are you taking? And how are all these things interacting? So I'd love for you to kind of like anything you want to say to that. But can you talk a little bit about Woop Advanced Labs, what we're looking for, how it can be useful?

How do you know that you might be somebody who should do this blood test? and what are some of the things we've seen? Yeah, so, you know, one of the things that I like so much about being here at WOOP is we make products that help people become experts in their own health and kind of enable them to be almost scientists in a way. You know, with supplements, it's fine to try really any supplement that's not, you know, known to be dangerous and looks reputable. But you have to have a theory about what you're taking it for and a way to assess your progress

against that. And so if you think magnesium glycinate is going to help you sleep better, which it does help a lot of people sleep better. You just see how your sleep is doing, track it, and then try the magnesium, and then continue to see how your sleep is doing. And sometimes you might even have your wife swap the capsule out with a placebo like fiber or something else and see, you know, if you want to randomize, but that may be a little too scientificity. That's advanced. And so, you know, similarly, part of my practice in primary care is, you know, around sort of standard conventional medicine. And we don't check a whole lot there. And I have shifted after seeing what's come up in our people who have done advanced labs. And we've

got, you know, many tens of thousands. So we've got a pretty rich data set. I've started testing a lot of my patients for a lot more. But there's always a concern that somebody's, somebody at the hospital is going to say, why is this person ordering all these tests? They're raising the cost of health care and especially that something might not be covered. I had a patient who's like 60 something has a strong family history of heart disease and I checked an LPA on him, which he's never had checked. LPA is this sneaky bad cholesterol that you don't hear about and don't see on the lipid panel. It's genetically inherited. So some people have none. Some people have a lot. But it explains about 20% of heart attacks and they tend to be the bad ones that come out of the blue in

somebody's 50s or 60s. So this test could not be more appropriate for this guy. And indeed, it was the month after the new cholesterol guidelines came out saying we should do this. So he writes back and says, I won't say the insurance company, but blank insurance company said that it wasn't covered. And I was kind of like, and what do I do? Do I apologize to this guy? Do I give him $75? So doctors are often afraid to check all the tests that I think can be helpful for a variety of reasons. But we've solved that. We sell these tests for as low as $150 for the whole panel. And I can tell you, I ordered about a third of these tests on a family member of mine.

And when we got the insurance bill, the hospital charged the insurer $3,000. The insurance company paid $2,000. And at the time, we had very cush insurance, so we didn't pay anything. But, you know, to think that $2,000, somebody's money exchanged hands, and we are selling this for $150. And it's actually more tests in our panel. It's mind-blowing. So, you know, the tests that we have, and in our core panel, I think it's 65 biomarkers, they're really- 75 now.

They're really powerful. And what we've seen in the tens of thousands of people who have done it, and I haven't checked the numbers in a while because it goes up a little bit every week, is that 80% of people are going to find something that is either something that most doctors would treat or would act on, so they might do more testing or give you advice or recommend something, or something that is likely to affect how you feel. And if I recall, I think it was 60% had something that would be treated, and it might be 55, and 66% had something that could affect performance, and a fair number of people had multiples. And so, you know, your doctor's not going

to check these. And, you know, quite honestly, even if they do, they're not going to necessarily know what all of the things are or sort of have the time to intervene on everything. But you can get these checked. And, you know, when I first did this, I found that my cholesterol was a little bit higher than I expected it to be. It wasn't so high that my doctor thought we needed to treat it, but I'm also a doctor. And I'm of the mindset that it's a little bit silly to die of something like high cholesterol because over many years it ultimately leads to a heart attack or a stroke. We can't prevent all of those, but we should prevent as many as we can. Yeah, I want to break down a lot of what you're saying because there's a lot of really

important things in there. And before we met, things that weren't necessarily obvious to me. And so I think might be news to some of our listeners. So one of them is that like your doctors really in a lot of ways optimizing for things that aren't necessarily you feeling awesome. It's this other standard of like you not having a diagnosable condition or like something that's going to kill you. And then there's this like sneaky, unfortunate thing of they're also trying to manage costs. And this is why it's really important to advocate for yourself and to be an active participant in the healthcare system

and not just take everything that you hear at face value, because there are these things like this LP little A test or vitamin D testing or whatever it is that aren't necessarily standard of care, but could be enormously helpful to know about, actionable, and in some ways, like very meaningfully change the way you feel, even if it doesn't change your likelihood of surviving for the next 20 years. And I think, you know, as you know, like my example like that was vitamin D where it was just like, you know, vitamin D does not kill

otherwise healthy adults, but it shows up in these sneaky ways, right? It makes you more tired, it makes you in some cases depressed and it makes you more likely to catch infections. And so it might show up in these like really hard to pinpoint ways, like you get one more cold per year, which is not the end of the world. And you could say like maybe it's not worth screening everybody for vitamin D to prevent these couple days of sneezing. But to be honest, like, it's, you know, maybe $20 for an annual supply of vitamin D supplementation, and that's if your insurance doesn't cover it.

We're not talking about breaking the bank. And frankly, how much would I pay to like skip a cold, right? A lot of money, a lot more than 20 bucks. And it's a very safe thing to supplement, especially if you're starting from sort of a confirmed low level. But my old primary care doctor that I got rid of when I found you just never tested it. Right. And so it was like this isn't a big medical emergency.

And had I avoided it, probably would not in a super meaningful way change the course of my life. But like can tell you that when I fixed it, I felt a lot better. And so I think that's where I get really excited with advanced labs is everything from like there are like little things where you can quickly feel meaningfully better. And then there are these big things. Like when we find the LP little A on almost one in five loop members who have done the testing, that's not going to change the way they feel today, tomorrow, or maybe even the next decade. But if you know that you have this elevated risk of these massive, very scary, very dangerous cardiac events in middle age, you know, you can then advocate for more testing, more screening, you know, ahead of that.

avoid these issues becoming big problems. And many of these things, like, you know, getting a stent put in prophylactically is way easier than treating a heart attack, right? So it's like a lot of these things, there are preventative things that are, you know, available if you only know, to screen for them and to ask. And so this is the first step of that. Yeah. I mean, I'm quite frankly, incredibly proud of the fact that we're like literally saving lives because people are finding out 10 years before they would have an event, a heart attack, a stroke, a heart valve failure. And now there are drugs that are going to be out in a couple of years for this. So that's really exciting. That's thrilling. I think there's also these sort of less

less X equal, Y equals X things where it's not quite so clear cut, but there is a real benefit. So the other big one is insulin resistance. A lot of people feel sluggish after they eat. They can't lose weight. You know, maybe their A1C still looks normal or maybe it's drifted up just a tiny bit. But we look at their insulin function and you see that their body is really not responding to that signal. And we see that because they might have a blood sugar of 88 or so, which is normal blood sugar. But if they're fasted and their blood sugar is normal, their insulin should be low. And instead, it's way higher than it should be. And that tells us that the pancreas is having to work really hard just to keep the sugar normal. And a couple of years later, that insulin level will be

even higher and that sugar is no longer staying down. And eventually that crosses the line to, you know, pre-diabetes or diabetes. A lot of times these people will have pre-diabetes for many, many years, and then they drift over to diabetes, and then their doctor says, maybe now we might start treating, but we could also just continue to treat with diet. And then eventually their pancreas gets tired, kind of, and the A1C goes from six and a half to eight. And now they've got the kind of diabetes that can really damage the nerves and the blood vessels. Plus, we now know that insulin is actually bad for you. And it probably causes changes in the blood vessels and elsewhere who are in the body, independent of just the blood sugar.

This is somewhat controversial, but I've seen enough studies from the diabetologists that talk about insulin resistance to believe this. So why wouldn't you want to know this earlier, especially because it's so much easier to fix insulin resistance than it is to fix pre-diabetes or diabetes. And in many cases, it's those smaller everyday choices rather than the big, dramatic moves you have to make later. but as we said, there's also a lot to figure out about how to feel better. So, you know, we're finding a huge amount of vitamin D deficiency.

We're also finding that 10% of people have a treatable hormonal issue, testosterone or low or high thyroid, and those are potentially very impactful and important. You know, people come to my office every week and they say, I can't lose any weight or I keep gaining weight. And I always say it's never thyroid. But I actually had one last week where it was. And when you fix that. Yeah, they just happened to my friend and she actually found out about it because of advanced labs. Her partner works here. So we got to her. Yeah. But, you know, and this is somebody who her entire adult life has struggled with weight and it's been like a real thing and she does everything right. She and her husband went on a diet together and we're eating the same things. The

weight fell off of him, not off of her. Like this is who probably heard the story 10,000 times in various forms. But like all of a sudden, oh, you're hypothyroid. And then it was like within week, she lost like 15 pounds. And she's just like feeling awesome. And it's just it's so maddening because I think so many people think there's something, like I'm doing something wrong. There's something wrong with me.

Why does this work for other people and not for me? And they really beat themselves up. And instead of beating yourself up, like we just need to like take a different lens to looking at some of these things because it's not your fault. These things are treatable. And I think, you know, again, it probably wouldn't have killed her. She's gone to her annual physical. She's been doing everything right. She's been asking the right questions and just not getting that help. And it's so exciting when you see people like find these little things. And then like it seems like overnight like totally change the way they feel both physically feel and then like feel about

herself, which is so cool. Yeah, it's really magical. And then for some of these markers, connecting it to your habits and your data makes it even more powerful. And I hear a lot of stories from, you know, friends who are who are whoop users or from, you know, pilot testing things we've done, of interacting with the AI coach and learning incredible stuff. And, you know, we talked about sleep. A huge amount of my practice at the Brigham is people who come in and want to sleep better. and I almost never check vitamin D or iron in those people, but I really should because in many cases, again, there are these kind of sneaky things that you wouldn't think to check, but if you have either a standard protocol or just a discipline to do more testing, and again, these are cheap tests,

cheaper than the visit by far. A fair number of people who can't sleep have undiagnosed restless limb syndrome, and a lot of times people know it. They're falling asleep, and then they have this uncomfortable urge to move their legs or their arms. and it's so unpleasant and they get up and walk around and their husband is like, get back to bed. Sometimes that is as simple as fixing low iron because iron affects the metabolism or the processing of dopamine in the brain. And these people don't always have anemia. And so if you just look at the blood count or just look for anemia or just ask them about their diet, you're not going to find the low iron. And some people think that the level of iron shortage that you need to treat somebody

to or at which you worry about this is a lot higher than the thresholds most doctors use for calling it iron deficiency. So my favorite test for this is ferretin, and it's truly, it's actually one of my favorite blood tests. If you ask the residents at the Mass General Hospital, I've told them many times it's my favorite blood test. So a colleague of mine really thinks that everyone should be treated up to 100 if they are having sleep problems. But most of the guidelines and most of the ways we practice would say 45 or even 25 is the cutoff. So you could go to your doctor and get this test and they might say, oh, you're fine, when in fact there's a big opportunity there.

And likewise with vitamin D, I'm constantly writing lab letters about it and it shows up as normal if it's 22. but I really want to see people between 40 and 60. A big difference. Can you explain what you just said in terms of the clinical thresholds versus what, because this is something that shows up in our, in the way we explain blood work in advanced labs where there's a threshold that's considered suboptimal or sort of dangerous or insufficient? then there's this like acceptable range in the middle, and then there's optimal.

But most of us who are used to getting our blood work, say, from, you know, a lab corp or a request or through your primary care physician's office, there's just one line, and it's sort of either good or bad. What are we doing there with these three zones? Yeah. So, you know, you mentioned that doctors are trying to control costs, and there are kind two big forces in how we think about over-testing. One is the added expense, and it's not just the blood draw, it's this idea of cascades of care. And this is a real phenomenon. A colleague of mine is Shawnee Ganguly, you know, brilliant, I would say sort of young, but really mid-career investigator, though she started young. She's published incredible work about the burden we put on

patients when we do testing that they don't need that leads to other testing. So that is real. But in most cases that has to do with testing that's more high risk, like imaging that might find something that then you have to think about biopsy. That's not, you know, a vitamin D level. There's no cascade from that. So that's one thing is the is the cost and downside. And then the other is about sort of medicalizing or over-diagnosing. So there's a lot of fear about giving patients' diagnoses that will make them feel like they're sick and feel less well. And that's also a real phenomenon. But if you're the patient or the customer and you're coming in with a desire to know these things and a knowledge of your body and honestly, you know, a lot of data about how you're

doing, you're, I think, at much less risk of that because it's not being forced upon you. You're seeking the information. And so I think that it makes sense to be mindful of these pitfalls, but I really, you know, eschew them in this context where we're seeking more information about our health. So along with this idea that we don't want to label people as bad or contribute to all these secondary effects, we tend to set these thresholds in a way that is conservative to not make people intervene more than we think the average person in society wants. And so a lot of my patients don't want to take statins. I don't really understand why. And so for a long time, the threshold to treat somebody with a statin was an LDL bad cholesterol of about 160 or so. And so, and so, and

190 for sure and some people even 130. They recently lowered it, I think, to 100. And of course, there's other considerations. But it's all about this idea that there's a line and over that line you have disease and having disease is bad, so you're going to feel bad. So let's, and let's make it simple. So let's have one line and let's not make it too low because then we're going to make more people feel bad. That's not the question that we're asking. We're asking, you know, all else equal. what would be the best number to have this at? And I go back to my retirement metaphor. You know, people basically want to save as much as possible. Nobody goes to their, you know, their retirement advisor and says, like, I don't really need to save that much, right? Or what's the exact right

amount? Like, more is generally better. And with this, we also want to bring our lab values to as good a level as possible. And so I think it's important to have this distinction of, of this level is considered bad or maybe even disease. This level is normal but not optimal, and this level is really probably optimal. And for some tests, you can't really make that distinction. Some tests kind of come along for the ride. I get a lot of questions about MCHC, and I always say, I don't even really know what that is. And it's often just a little bit abnormal. Nobody cares about that. But for things like testosterone, and again, there's a lot of individual difference. Some people have a testosterone that looks low and they have no problems.

Some people have a testosterone that looks normal and they can actually have the symptoms. You know, you have to recognize that every patient is a little different. But we now know that having a low normal testosterone, again, all else equal, is not as good as having a more normal one. And most of the time, the solution is not a testosterone pellet. it's more sleep, less alcohol, lifting weights, protein, those kinds of things. And those really don't have major side effects. Yeah, I think you're getting at something really interesting, which is that like one of the things people love about supplements is they feel very targeted.

But some of these things, like with low testosterone, it's a symptom of all these other things. And so if you just kind of try and treat at that symptom, you're ignoring the fact that that poor sleep, poor diet, all those other things, are also showing up in other places that you may and may not have measured or be fixated on. Yeah, I think that that understanding why something's happening when you can is so important, you know, even with something like sleep, sometimes people come in and they have sleep issues and I give them medicine for sleep like trazodone. You know, it's safe, it's moderately effective. The main reason I don't like to give people medicine for sleep is, one, it doesn't work that well. But the real thing is it really takes away

some of their power and their agency. But, you know, I'm also not checking that vitamin D. So imagine you take Trazadone for 20 years. And Trazodon is perfectly safe. But it makes people sometimes have dry mouth. It can make people dizzy. You know, people feel groggy after the first dose. What if you just need to take vitamin D?

Or what if it's something about your pre-bedtime routine? I really like blue light blocking glasses. My kids think I look like a weirdo, although they always want to put them on. and at least for me, and some of this, you know, I haven't done controlled study myself. I don't know how I would do that, though. Hard to blind, pardon the pun. But, you know, for me, they work. And it doesn't really matter.

So Woop has validated because we do make our own blue light blocking glasses, and we validated them relative to, like, other leading brands. Well, that's right. And then optimized ours to be the best for sleep. So you can do a blinded interventional study, but you have to be. to use other blue light blocking glasses as your control because you can't really placebo it otherwise. And in fact, I bought mine because I saw the data on our website. And especially I was trying to fix my HRV and I think it was three or five HRV improvement. And I was like, works for me.

Yeah. Dan, I feel like we could keep going on all of this forever. But as we run up against the clock here, we have a lot of members who are thinking about reversing their biological clocks and reversing their age. And I'm wondering if we could wrap by you sharing, what are the three most effective things that people can do if they want to reduce their woup age or biological age and increase their health span in doing so. Yeah. So my whoop age is two years older than my chronological age, which I'm working on. I met a guy who was 63 and he got his down to 50 and he was appropriately really psyched. You know, I think the first is sort of a meta habit. So most people have things that they're doing well and things that they have

opportunities on. And I would say really look at your whoop age and, you know, look at the things that are affecting it. So for me, it's mostly sleep. And I think that for the average user, that's probably a big part of it, is increasing your sleep time and sleep consistency, which will tend to also increase the sleep quality and has beneficial effects on everything else. You know, your resting heart rate, your HIV, your ability to exercise and perform the next day. For other people, it may be exercise. You know, if you've got a long commute, it can be hard. But getting in some, you know, moderate intensity, zone two style exercise will tend to move it.

And also lifting weights or doing some kind of resistance tends to move it. And I think a lot of people tend to choose one habit, like one kind of exercise. So if you're a runner, lift some weights. If you're a weightlifter, do some running or biking or something like that. I think mixing that up is important. those are probably the things to do. I think that's a pretty good list. And I also just appreciate that nothing on there is a crazy or expensive supplement.

It's sleep, it's exercise, making sure that you're doing both cardio and strength training because they're actually good for you for different reasons and then cleaning up your diet, all that good stuff. Well, Dr. Dan, thank you so much for joining me on the podcast. My pleasure. Thanks for having me back.