WHOOP Podcast - WHOOP Advanced Labs: Using Data To Take Control of Your Health with Dr. Dan Henderson

Episode Date: November 5, 2025

On this episode of the WHOOP Podcast, Emily Capodilupo, WHOOP SVP of Research, Algorithms, and Data, sits down with Dr. Dan Henderson, Primary Care Physician and WHOOP Medical Advisory Board Member, to dive deep into the development and impact of WHOOP Advanced Labs.Emily and Dr. Henderson break down the WHOOP Advanced Labs blood testing panel and how it integrates into your WHOOP data and insights. WHOOP Advanced Labs gives you a more complete picture of your health and this episode dives deeper into the influences of biomarkers like lipoprotein(a), Vitamin D, insulin resistance, and more.Dr. Henderson shares his perspective as a primary care physician on why regular blood testing is important for everyone – not just those experiencing symptoms. This episode breaks down how your biomarkers can help optimize your energy, recovery, and longevity to aid symptoms like fatigue, brain fog, and weight fluctuations. (00:39) Meet Dr. Dan Henderson, WHOOP Medical Advisory Board Member(01:02) WHOOP Advanced Labs & The Opportunity in Healthcare(08:38) Why Is Bloodwork Important?: Understanding Your Biomarkers(11:31) Vitamin D: Health Benefits and The Prominence of Deficiency(15:13) Normalizing Fatigue and What It Actually Means For Your Health(21:18) Insulin Resistance: What You Need To Know(25:28) Interpreting Results & Finding Solutions to Symptoms(32:10) Setting New Standards: Why Regular Bloodwork Is Essential(36:50) What is Lipoprotein(a) & What Does It Measure?(39:16) Life Changing Aspects of WHOOP Advanced Labs(42:52) Reaching A Larger Number of Patients with Technological Advancements  (48:29) Key Takeaways For The Audience(50:05) Using WHOOP Labs to Advocate For Care(54:12) Top 5 Symptoms That Can Be Understood with WHOOP Advanced LabsFollow Dr. Dan Henderson:LinkedInSupport the showFollow WHOOP: Sign up for WHOOP Advanced Labs Trial WHOOP for Free www.whoop.com Instagram TikTok YouTube X Facebook LinkedIn Follow Will Ahmed: Instagram X LinkedIn Follow Kristen Holmes: Instagram LinkedIn Follow Emily Capodilupo: LinkedIn

If a patient comes into my office and says that they feel sluggish, they feel tired, trouble losing weight, I have to spend 15, 20 minutes, that might be the whole visit, asking questions to suss that out. My whoop already knows all that stuff. I like to say that I'm known best by my dog, my wife, my whoop, and chat GPT in that order. The system already knows how much I'm sleeping. Is that normal for me? Is that less? How much my exercising? What kind of exercise? It knows how stressed I am, and I can tell you it's shockingly accurate. And so all of that means that the insights that surface are really powerful. Hey, everybody.

I am Emily Capitaluppo, WOOP, Senior Vice President of Research Algorithms and Data. And today I am joined by an incredible guest, Dr. Dan Henderson, to talk about a feature that just launched our Advanced Labs offering. So first off, thank you, Dr. Dan, for joining us here on the Woop Podcast. Really happy to be here, and thanks for inviting me. So if you've been following the buzz, you know that WOOP recently launched our Advanced Labs feature. Woop is offering a blood testing panel, which for the first time ever lets you look at your wearable data and all of the different daily objective markers of your health alongside this totally new inside view of what's going on inside of your body.

We were so lucky to have you, Dr. Dan, join us in building out that panel and understanding how to interpret all of those blood tests in the context of your whoop data. So I'd love it if you can just share a little bit of the story about how you got involved with this project and why you were the right person to be involved. Well, happy to, yeah. It is a really exciting project and something that I think is going to help a lot of people. And it's really fun for me because it unlocks a lot of the things that as a doctor who practices mostly in mainstream academic health systems, I find to be a major limitation

of conventional primary care. And I can talk about why that it's not necessarily a bad thing that primary care is like that, but it can be very frustrating. Just going back a little, so I'm a primary care doc and have been for the last 12 or 13 years, mostly clinical, although I've also taught a Quality Academy, ran a startup for a couple of years, and done a lot of things. Most of what I do is see patients in the exam room. And just through totally dumb luck, a lot of that time was in a practice that was serving employees and their family members at the Mass General Hospital. So again, sort of dumb luck, I ended up with several hundred Harvard doctors as my patients, and it was very different from what I'd seen before. It really opened my eyes. The fact that

doctors wanted not radically different, but a little bit different. You know, different testing. wanted to treat things more readily. It opened my eyes and made me think about the way I was practicing differently. So that led to a number of things, including starting a concierge practice to make that more accessible along with a very different, more high-touch model of care. You know, I've come to think that although the standard approach to blood testing is pretty good for most people and might be the best way to make sure that most Americans enjoy good prevention, it leaves a lot of opportunity on the table. And much of this opportunity, as labs get cheaper, as telehealth and general, I think, health knowledge have increased, there's really no

reason why people should be held back from learning more about what's going on inside their bodies. So it's super exciting to see this come to be. You know, I'm a whoop user. I love waking up and seeing what my recovery score is and sometimes feeling a little guilty about that second glass of wine or working late or whatever. Today, I think I had an 80, which is pretty good for me, actually, and was green. I got a 94 earlier this week, which was sort of like a recent best. In clinic, I would have patients come in, you know, doctors, research scientists, they'd be showing me their data and asking to check labs. And at first, I thought it was a little bit crazy until I saw the logic.

You know, I've diagnosed hyperthyroidism from people's wearable heart rate data. So I love that these two powerful data sources are coming together in a way that I think we haven't really seen much before. To add to that with stuff that you probably can't share, but I can, as part of your concierge practice, you're actually my primary care doctor, and that's how you got involved in WOOP. And I think, you know, the thing for me and why I'm so, so excited about this feature finally being out and have loved working on it is that so much of what you get in the traditional

health care system is all about are you sort of acutely unwell right now? Is there something clinically wrong with you? And it kind of paints this false dichotomy that like either you're sick or you're healthy. And it ignores this reality that Woop has been playing in for a long time, even if we haven't necessarily used this language, that like there's a lot of gray between what's sick and what's healthy and a lot of control that somebody has in terms of like where they fall in that, you know, are you close to sick or far from sick? Are you likely to get sick? And, you know, a big story of the progress of health care over, you know, the last hundred years is kind of it used to be that when people got sick, it was mostly something

infectious. So they kind of went from, you know, not infected to contracting something. And then, you know, 24 hours later, they are sick. And then when antibiotics came out, you know, you treat the antibiotics or whatever. You treat the infection. And then you are no longer sick. But now, like most people who are degrees of unwell, it's these chronic illnesses. It's these things that you think about, like, heart disease. You think about, you know, diabetes and things like that. And we still use a lot of that same language, like, with infectious disease, or it's like, oh, I got diabetes. And it's like, well, you didn't get diabetes. There's no contraction of diabetes, right? And actually, like, the person who gets diagnosed with diabetes at, say, 60 years old was probably pre-diabetic for,

and you're the doctor, but 15 years before that. And maybe pre-pre-diabetic as a there were some metabolic dysfunction that could have been detected maybe 20 years before that and making poor lifestyle decisions maybe even longer than that that like we're putting them on that path. And so I think a lot of what WOOP is trying to get at with our health span feature that launched in May with our 5-DOTO product is this idea that, you know, just because you're not sick and don't necessarily need to be medicated or not diagnosed with something doesn't mean that there isn't a lot you can do to put distance between where you are right now and

chronic disease. And, you know, I think one stat that we've been really inspired by is that 85% of Americans will have at least one chronic disease by the time they're 65. But the reality is is that if you look at Americans who are 30, many of them will have something that tells you that they're going to be one of those 85%, and maybe even which one of those chronic diseases they're on track for, much, much earlier. And what drew me to you as a primary care doctor and then why I brought you to Woop to help scale yourself and automate yourself here, you know, was the idea that, you know, you came to me already on whoop for a couple of years and really understanding like how to look at

my loop data and how to talk about things. You know, we kind of started from I'm not sick and then you're like, yeah, I agree. And then it's like, but life could be better. And then it was like, okay, how can we go and like make life 5% better and 10% better? And this was before advanced labs came out. So you did on me a series of blood tests that in a lot of ways overlapped what we ended up putting together for the advanced lab product and found things that could be optimized, and then we optimize them. And like, shocker, I feel better. So why is it that a perfectly healthy person should go do this exploratory blood work? Yeah, great question. And, you know, of course, everyone's a little different. And a lot of it depends on a person's individual factors

and frankly, how healthy they want to be. And, you know, thanks for mentioning that I'm your doc. And, you know, we often talk in medicine about how much we learn from our patients. I would say you're probably in the top three. And certainly all that I'm learning, being a part of the team working on this at WOOP, has been just phenomenal. So, you know, the question of labs for healthy people is a topic of fierce debate. And even down to the microcosm level like vitamin D.

D. I was looking at the vitamin D article on the internal Harvard Medical School Primary Care website the other day. And there were a bunch of bolded words and it said, this is highly controversial. I don't frankly understand why, but people have a lot of feelings about it. But the fact is lab testing is very inexpensive. I'm not going to say it's accessible to everyone. And certainly you can purchase panels that cost, you know, a day, a week, a month's pay if you want to. But I forget what you all are charging for the panel, but it's a great panel. It's pretty close to what we did for you. It covers so much and I think gets so much right. So when you go to your doctor and you say, you know, I don't feel great. A lot of the stuff I hear about is sort of a little

bit of fatigue, not as much energy, not recovering as well from exercise, you know, chasing my kids around and I just can't get out of bed. You know, a lot of things go through my mind. lupus. But typically, whatever panel, the average doctor, including me when I'm in my practice at Brigham and Women's Sends, we don't tend to find a lot. We're sending two, three tests, depending on what somebody says, sometimes maybe a little bit more. And mostly for that kind of concern, we're thinking about thyroid. And it's almost always normal. In fact, whenever somebody comes in and tells me that they're having trouble losing weight or they've gained a lot of weight, I literally always say, this could be hypothyroidism, let's check it, and I have never identified

a case of it presenting as weight gain, unfortunately. But as I've dug more into this in my practice, I have found a lot of tests that can elucidate what's going on here. And some of it is these things that are considered within the normal ranges. But if you took my panel of doctors, you know, three, 400 people and you said, what do you want your vitamin D to be? None of them say 22. right and depends on which cutoff you use but that's approximately what some of the articles say is the cutoff for sufficient i had this patient of mine who's a doctor i shouldn't say too much because you could figure out who it is but really wonderful guy super fit emergency medicine doc hikes mountains and he really wanted his vitamin d to be above i think 50 or 55 and you know part of me at

that point in my career wanted to roll my eyes a little bit but i said tell me why turned out he was an expert in it. And he was convinced that it would have a number of health benefits for him, including reducing his risk of respiratory infections. Now, again, controversial. And if any of my Brigham colleagues are hearing this, probably one of them will say, those studies are equivocal or there's a lot of, you know, asterisk to that. But, you know, the test is really not that expensive. It's totally safe. Nobody gets a vitamin D result that's abnormal and freaks out that they have cancer and doesn't sleep for five days. So I was like, of course, let's check it.

And I also have a lot of patients come in and they say, listen, I take vitamin D. So I know you may think it's dumb to check this, but I happen to be a geneticist or I have a friend who told me that people like me with South Asian ancestry or this feature or whatever, some of us have a genetic condition where we don't absorb it as well. I don't need to do the genetic test, but that's why I want you to check because the last time it was checked, even though I'm taking 2,000 a day, you know, arguably the normal amount or twice the normal amount, I'm still low. And I had one patient who was taking way too much and her level was like 95. And I was like, let's lower this a little bit. I don't want you to get

kidney stones. But these are cheap experiments to do. And it helps people in many cases feel healthier and be healthier. So I think that even though by the sort of standard definition of diseased or not diseased, most people are not going to cross the bright lines of outside that range where 95% of non-diseased people are, I think most people will find something that either is a clue or an answer. And, you know, I've gone through this myself, and I found a bunch of things, which I'm happy to speak about because none of them are embarrassing. So you've touched on a lot of interesting things, and I just want to double click on some of them. So you talked a bit about the idea of like these clinically relevant ranges, but then also that, you know, doctors were saying 22 might be

considered within range, but I want mine to be 50 or I want mine to be higher. And, you know, that's a difference between sort of the clinical threshold of, you know, are you quote unquote sick right now? And then there's this like functionally optimal range, which is, okay, like you're not sick. I wouldn't diagnose you as vitamin D deficient, but some things in your life, protection against respiratory infections, for example, would benefit from being higher. And, you know, it is very protective potentially. So even if you're not malnourished or in this like really scary deficiency level, vitamin D is like such an acceptable thing to fix. It's like $5 a month. You know, you don't want to go so, so high. Kini stones you mentioned as a risk, which is why I wouldn't say a takeaway from

this conversation is everybody should just go have $10,000 and just maximize it because there is such thing as too high. And so measuring your blood levels before adding in any supplementation. and kind of getting that information is really important, but being on the higher end within that functionally optimal, not just clinically not sick range, might benefit you in these other ways. And I think, you know, that was one of the things that when we first did the blood work, my vitamin D was really low and then fixed it. And, you know, you just, you have so much more energy and all these things. And I think, you know, one of the things that I was really struggling with before we met

and what kind of led me down that path was in a lot of the research that I've been doing at Woot for the last 12 years was really trying to understand all the different ways in which humans are really great at adapting to these lower levels of functioning. And because it is the norm to just like get sicker in these like subclinical ways as you age, we kind of look around at our friends and everybody's like, ugh, like, I'm so like creaky in the morning. Welcome to your 30s. Or like, I can't drink anymore because like the hangovers last for four days. We're welcome to your 30s. God forbid you have a baby and then you say you're tired. And everybody's like, ha, ha, yeah, wait till they go to college. Like, it is normal to be tired.

Actually, this is why I fired my last doctor and found you was I told him that I was like, you know, feeling not energetic post-baby. My daughter was two. I felt like I should be recovered from that already. And he said, yeah, most women report fatigue until their youngest is seven. And I was just like, that's not good enough. And he just told me I was healthy and to go away. And, you know, I think like, unfortunately there is a lot of that like dismissiveness in health care. And I don't necessarily blame him. We had a seven minute appointment, which is sort of standard of care. And there was quote unquote nothing wrong. You and I had a three hour appointment. It was very helpful. Thank you for your time. But, you know, it was a $9 vitamin D test that's like, oh, here's your problem. Let's go fix that. You also told me I was dehydrated, which I fixed. So thank you for that too. But, you know, there are these really little things. And, you know, all of a sudden, vitamin D and a liter of water with some electrolytes later, you kind of have this like eye-opening moment where I was like, oh, this was available to me this whole time. It's not just like an inevitable part of having a baby. And, you know, that whole experience just made me so, so excited about what I get to build here with advanced labs. And, you know, what are the things that we can tell people? Because we do look around and there's so much, like, commiserating with your friends.

And if I go and ask them, you know, my other friends who have two-year-olds, they kind of felt the same way I felt. And so you just, like, super normalized that, like, you know, I guess this is motherhood. I guess this is being in your 30s. I, you know, and then, like, menopause. everybody's like, yep, like you're done now, go sit in a corner and knit or something. And, you know, if people take like one thing away from this podcast, it's that like you don't have to just ride an inevitable decline towards death of like just decades of getting sicker and sicker and sicker until you're finally crossed some imaginary threshold of diagnosis and like, oh, now I got

diabetes, right? It's like, no, how do we actually pick up for you in your 20s, 30s, 40s that you're on this path and course correct this path and unlock these higher levels of energy and things for you. And so, you know what? I'd love for you to dive into a little bit more. We talked about vitamin D. What are some of the other things that are in our panel that are just like easy, peasy to fix? And what are some things that people might be feeling, like we mentioned fatigue, that they've just normalized as like part of being in your 30s, part of being in your 40s, part of being a parent that might actually be a hint to say, don't just say this is inevitable because all my friends are experiencing it or I'm definitely getting diabetes because, you know, a parent had it

or something like that that don't have to be inevitable and like, you know, could be discovered and that their standard primary care doctor might be missing. You know, I think you've really hit on the key issue. And, you know, I trained at a, I think, pretty good residency at Columbia. and I was actually in the primary care track, which is a great track. I don't want any of my former, you know, residency program directors to feel slighted here. But the reality is most of that time was on the cardiology service. And if you're on the cardiology service at, you know, the Milstein Hospital in Upper Manhattan, you're pretty sick, usually.

Sometimes people are there for months or even longer. or the ICU or the liver service. So I didn't see a lot of people there who are, you know, in their sort of early to mid-middle age, you know, active working people with complaints that are the kinds of things that you're talking about. And I also use the word concerns because I don't want to say people are complaining. So we're just not trained to understand the difference between, you know, feeling really great and feeling so-so. I actually had a patient who was a psychologist researcher who was studying that sort of ineffable concept of kind of psychophysiological energy. You know, the thing everyone wants and why the energy shots are

such a great business, I guess. It's tough. But people do have a good feel for their body. And a lot of times people can figure things out with the right information correlated with how they know they've felt and the right kind of symptom tracking or journaling or whatever. measure you have. You know, whoop gives you a lot of that, and mine always tells me, Dan, it's time to go to bed, which I appreciate. So one of the things I hear a lot, again, in sort of the, you know, young middle-aged person, maybe they've got one or two kids. You know, they're usually sleeping okay. They're exercising a little bit. They're trying to eat healthy, but it is tough. Modernity means like a constant stream of ultra-processed food coming at you

like you're a magnet. One of the things I hear a lot about is trouble losing weight. And like I said, I checked the thyroid test. It's usually normal. Sometimes maybe it's a little abnormal. But usually when somebody has real hypothyroidism, they come in with something different from that. But what I've seen a lot of, and not in my regular practice, because these tests are not typically done, are sometimes not covered by insurance. And for whatever reason, when you check a test that's not covered by insurance and you have to pay the sort of charge price, it can be a crazy amount of money. Those are the calls you hate to get. You know, so-and-so wants to know why they got a $500 bill for this test that you ordered that is apparently not necessary. But I do think those

tests are good and they kind of are necessary. So one that comes up a lot is insulin resistance, which you could think of as pre-pre-diabetes. So, you know, you were talking about the people who say, oh, thank goodness I haven't got diabetes yet. You know, I've had lots of conversations with people where I say, well, you know, your A1C is 6.3. And they go, do I have diabetes? I say, well, depending on how you talk about boundaries, no, you might either have it if you go up by point one or point two. And they say, oh, thank goodness, I haven't got diabetes yet. And, you know, there's an important point there about it not being black or white. But even that 6.3, you know, if I ask my patient who's a metabolism doctor, would you let yourself

get to 6.3 if you could do something about it relatively easily? I don't want to imply that people who have diabetes are, you know, screw-ups or something. But the idea is if you can see that coming and there are relatively easy interventions that fit with your goals and values and don't completely disrupt your life, almost everyone, and certainly every expert, like doctors and scientists and other health professionals would do it. So not that long ago, a close family member of mine, and I'll pick my details carefully, was talking to me about not just difficulty losing weight, but kind of this weird sweet tooth and food noise problem, a term that I learned from her, that came back sort of in the wake of her second child being born. And, you know,

she had a pretty good primary care doctor in kind of the one medical system, you know, very easy to access through the online portal, and I said, well, some of this sounds like insulin resistance. She said, yeah, but my A1C is always fine, 5.6. And I sort of roll my eyes, 5.6, it's okay. It's sort of like a B minus, you know, good enough to pass, but not optimal. But setting that aside, I said, why don't you just have them check in insulin and glucose just to see? We'll do this little calculation. Here's what you say so that they'll feel that it's valid. It is. doctors often feel that they also have to protect not just the patients from themselves and the tests, but the health system from the expense, which, you know, I pull my hair out about that

because there's a lot of doctors who just order MRIs all the time, and those costs way more than a glucose level. So she gets these back, and she actually had pretty significant insulin resistance. And in hindsight, it makes total sense because of the way her body had changed and where she had gained weight. And I wouldn't have thought genetics because nobody in our family tree has diabetes, but who knows? So that is a much more focused problem to solve than I've put on 15 or 20 pounds. It's also obviously clearer than a pretty normal but not perfect A1C. And I'm not going to say it's that easy to fix it, but it's not that hard. And there's almost an infinitude of things you can do from changing what you eat to when you eat

to how you eat to doing different kinds of exercise. And of course, you know, these days they're not cheap, but they're cheaper than people think. There are medications that can help people lose weight or improve insulin function or both. So this was a really powerful test for her and she, you know, continued to sort of lead her primary care provider who I think was happy to be helping, you know, not feeling encroached upon or anything like that. You know, I think if you're a doctor gets offended about testing, first, try to figure out if they're having a bad day. Because if the patient before you yelled at them, we all have those days. But if they really put up their guard about testing that's not, you know, harmful or terribly expensive, here I'm not

talking full body MRIs. That may not be a good person to follow with. So that's one example. Can I just share what I love about that example? Like a lot of times people get really focused on their symptom, right? The symptom might be trouble losing weight or the symptom might be fatigue. And it's important that I think people understand that these are really, really vague and can have a boatload of different causes. And it's easier to fix your symptom if we understand what the root causes. And so I think a lot of people go to social media and, you know, they're sort of looking for things that worked for a friend. But like if your fatigue is different than my fatigue, what worked for you is not going to work for me. And it's super normal for people who menstruate to be borderline anemic and not necessarily clinically anemic, but maybe functionally anemic. And, you know, their solve is going to be taking some iron or different things like that. Or there could be a thyroid issue or who knows. But there could also just be a sleep issue. And so

Like, what we're really excited about and what makes Whoop's offering incredibly unique because in most states, you can actually just go to Quest and say, I would like to do all these blood tests and get the blood test. Like, that's not the primary value at. It's that integration with WOOP because some people need to fix their circadian health. And we're looking not just at the blood work, but also at the Woop data, marrying the two. And then we're able to say, like, okay, I think you should focus on circadian health. Or, you know, I see you're focusing and doing all the right behaviors, but actually over.

here, we finally understand that you're anemic. And so this isn't just a lifestyle behavior thing. We're going to go and fix this problem that's showing up as, you know, poor recoveries or poor sleep scores. And we're going to fix it medically, supplement your iron or something like that, and then actually address the root cause. And so there's something really cool that's happening by understanding these root causes that lets us actually address the problem for you. And if you just try and say like, hmm, I'm fatigued or I'm having trouble losing weight, like I guess I'll try the keto diet or just like kind of pick random things. You're going to have like a much more frustrating go at it. Yeah, I think, you know, biomarkers should always be actionable and should

lead you to if not an intervention, at least an area of focus that can guide you to one. And that is a big part of this. You know, this is a really well chosen panel. There's probably nothing in there that's not, that doesn't have the potential to offer action. In the world of kind of infinite testing, there's a lot of stuff that we do that can freak you out, but you can't do anything about, or will always be kind of unhelpful and mysterious. And of course, there's some tests that come along for the ride. About once a quarter, somebody asks me, what do I do to improve my mean corpuscular hemoglobin concentration? I always say, I honestly don't really know what that is.

I don't know why we report it. It kind of comes along with the more important test to see if you have anemia. But you're totally right. I mean, I think the hit list of things that average outwardly healthy people will see as potentially impactful, you know, hemoglobin and mild anemia or mild iron deficiency is a big one. And that can present in weird ways. Sometimes somebody is sleeping enough hours, but it's not restful. They might see that in their data.

Where's all my deep sleep? Where's all my REM sleep? Turns out they have restless legs or restless limbs, and that can often be caused by iron deficiency. And if somebody puts it all together and goes to their doctor, they'll get that test. But you don't typically look for that in normal people. And you don't typically do a CBC. Some people do. Some people don't.

Again, fierce controversy, but most people don't most of the time. Another one is homocysteine, and I was actually surprised to see that my level was like pretty high. You know, I wasn't accustomed to checking it until I got into this world of sort of high definition medicine, but it was the same number as a patient of mine, an 80-some-odd-year-old woman who had a weird blood clot, and that was why we checked it. She turned out to have a mutation in the methyl tetrahidrofolate reductase genes, and I remembered when I saw my level that my sister told me that she thought she did too because some 23 in me or something she said. I was like, oh, maybe that's what that is. And so I started taking a B12 folate supplement that, you know, it's like 11 or 12 bucks a month on

Amazon. I chose it because it's the one Peter Attia says he takes. And, you know, for essentially the cost of Paramount Plus, I'm getting to do not just something that is a cool experiment and will help me take better care of patients, but will probably improve my cardiovascular health, my long-term cognitive health, my dementia risk, and I may get the genetic test. I don't know, we'll see. But, you know, it was a really cheap lift to figure that out. You know, you mentioned vitamin D. I think that's a really important, underappreciated one. You know, I don't think we have enough data to say, but that's probably the one that the most, you know, kind of regular people are going to find that they're low in. Yeah, so most Americans are vitamin D deficient. And, you know,

prior to launching the feature internally, we did in Alpha for employees that wanted to. And that was definitely one of the ones as we were kind of comparing results and talking about what we were learning. Everybody was like, my vitamin D is terrible. What do I do? And it's like, you know, it's funny that given how prevalent this is and how easy to fix it, that it's not standard of care, but that definitely felt like it was coming up over and over and over again. 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. I think maybe helpful for people to understand a little bit. Like, why if these things are kind of obvious to you?

And, you know, there's all these great stories that you've been telling and could continue to tell about, you know, I found this thing. We did this really cheap blood test and now I'm fixing it. Why isn't this standard? Yeah, it's a great question. and I'm going to have to be careful here so I can keep my day job at Brigham and Women's. But I will say that it's complicated, and there are a few, I think, important factors. So a big one is insurance, right? And so insurance covers some things and doesn't cover others,

and it has a tendency to make doctors afraid that the patient is going to get a bill. So if you work in a system that has a good electronic health record system, about half of the time when you see somebody who has Medicare, this little thing pops up and says, this test is not covered for this indication, pick another indication. And I don't know why, but this happens to be a very clunky interface too. So I always get frustrated. And about half the time I say, I don't want this, you know, nice 70-year-old person to get a bill for $200 for this test that I guess I don't really need. That's part of it. And some of the coverage decisions, you know, it's not like Medicare is a bunch of like mean jerks who don't want anyone to be healthy. They're basing it on preventive recommendations that come largely from specialty organizations like the American College of Physicians, American College of Family Physicians, it might be association, and the U.S. Preventative Services Task Force. These are all great organizations. I actually know a bunch of people who have been U.S.PSTF members. and, you know, you have to be very careful when you're thinking about what is the line going to be for healthfulness for everyone and for reasonable testing and prevention.

Because if they dial that up a lot, not only does it mean a lot more people are going to be told that they're unhealthy, which can be genuinely harmful. Drew Kulah wrote a great piece in the New Yorker, and he was actually a resident of mine at MGH many, many years ago. he's super smart, super charming, great piece. He got a full body MRI and talked about how a finding on there really caused him a lot of anxiety and I think we could say suffering. So people want to be careful before we overdiagnose because medicine has a tendency to do

that. And then the other thing is when something is the law of the land, it has to be paid for by Medicare and by all insurances. And so, you know, we don't necessarily want to spend taxpayer dollars. on doing this kind of testing for everyone. You know, if you are, you know, 70 and you have sort of goals and values that are different from maybe somebody who's in kind of younger age and really wants to optimize everything, we don't want to barrage you with tests and say, you know, you really got to work on this

and this and this and this and this. That's part of it. I think the other thing is that there's a pretty well-proved number that it takes about 17 years for a new best practice in the science to become common practice in medicine. And there's a sad paper, I think it's by Elizabeth McGlynn, from like 2002, which was repeated in roughly 2020, that showed that the health system achieves like a D in terms of hitting even the basic preventive thing. So, for example, hypertension control across the board is like six 68% or something like that, which in Cheshire High School was a D. And then a lot of stuff like

smoking intervention is much, much lower. So, you know, the health care system is, even though doctors are not doing one-size-fits-all, to some degree preventive guidelines are. And that, plus the time it takes busy clinicians to make sense of new science and new practice, it just takes a really long time. Some of the tests that are in the panel, I learned about five, seven years ago. And they've totally transformed my practice. Some I learned about more recently. And I'm like super curious and dialed into this and, you know, frankly, have had more time to play in this space. When you're taking care of doctors, you know, you don't always need a half hour because a lot of them are a little bit healthier and, you know,

you can kind of cut to the chase. And that's frankly how I unearthed a lot of this stuff in my own practice. You know, one of the things that really blows my mind about the panel is lipoprotein little A. So I learned about this test maybe in 2014, 2015. I started doing it, I think I remember the first patient. It was this guy, radiologist, I think he was 31 or so, maybe 38 at the time. And he had a father who had a very early heart attack, like 52 or 48 or something. And I was like, well, we don't have that much to talk about. And I have 60 minutes for this new patient appointment. It was sort of a different time. Let me think about this, and we decided to check it, and it was super high. And I think it was like maybe 150. We figured out that

that was plausible explanation, maybe not the whole story, but probably a big part of why his father had had a heart attack. I sent him to Prakash Natarajan, who's like a famous preventive cardiologist. Now I know how to handle this, so I don't have to send everyone to Prakash, although I was grateful that he could see him. So funny story, about two, three months ago, I was testing out some new lab processes and a friend of mine who's a doctor. He works in the ICU.

He said, do you want to draw my blood and test it? And I was like, yeah, that's a little better than me sending my own blood to Quest. Sure. I was like, but let me at least pay for a test for you. Why don't we do LP Little A? Have you ever had that? No, I haven't. So, and again, I want to choose my details carefully. This is a really healthy guy.

He eats a very healthy diet. He ran the Boston Marathon not that long ago. He has like the most energy and bubbly personality of anyone I know. I can't share these details because you know who he is, but he's like invented cool stuff. And he also has a family tree that's pretty much free of disease. To his L.P. Little A was the highest I have ever seen in my career. I'm not a preventive cardiologist. I'm sure they could tell better stories, but it was in the 400s. And, you know, anything above 125 is considered like dangerous. So I think that doing this test totally by dumb luck probably saved or dramatically improved his life. And I remember getting the result on a Saturday morning and I was like, oh my goodness, what do I do? And he's a friend. So I called him right up. Anyway, he's been

working with his PCP to do a much more in-depth workup and think about what to do. I think there are going to be a lot of stories like that. And, you know, that's not so much a DIY biohacker case. But there's sort of both sides of the coin where a fair number of people are going to find really life-changing stuff through this expanded testing, which even now, my colleagues at Brigham, some of them are checking that, you know, once on everyone. But a lot of the time, we only check that test after a heart attack, after a stroke. Right, and it's like very much too late there. And what I love about your example here is you're talking about somebody who objectively

is cardiovascularly healthy right there. Absolutely. of running the Boston Marathon, that's the coolest marathon there is. And yet, you know, here's this cardiovascular issue that's very easily detectable, but otherwise not going to be detected. And I think, and I love that you included, that he's now managing this with, you know, his care team and they're going to make different decisions in terms of, you know, monitoring and potentially like preventatives and different things. And so I think, like, it's just a cool example of how, if you look for some of these, And you helped us finalize our panel.

So, you know, thank you for all the work there. You know, all of these things are chosen to be actionable. They're chosen because they're things that both are consequential to not address but also addressable. These aren't necessarily like telling you here's what's going to happen. It's here's the path that you're on, but you can course correct. And, you know, I think like so empowering to think about, you know, what's the like, oh, you can just like take a staten and then like not have a hard attack. And so like amazing to be able to just like choose to not be on this path towards something, you know, really scary and catastrophic and life altering

down the road. And what I'm really excited about and what I've seen and, you know, all of my colleagues who have been doing this testing and learning things about themselves is that people are finding it really easy to action and then motivating and to kind of go back to the loop data integration, you know, they're finding that they're using loop in different and like more elevated ways. Like you gave the example of, you know, iron relating to like restless legs. Magnesium can also, low magnesium can cause restless legs. And so then, you know, people who are seeing that and saying, oh, that explains this thing. I now understand it. And then they're supplementing. And then they're looking to their whoop data. And they're saying like, you know, is my REM sleep improving?

You know, am I seeing more deep sleep? And you can kind of track and maybe get an idea of, you know, that the supplementation is working or doing something so that when you then go, say, three months later or six months later to retest, you're not totally blind to like what's going to show up. And, you know, I think so many of the things, you know, we think about, oh, what's the treatment for diabetes and it's GLP1s or it's insulin, you know, all these medication. But, you know, a lot of the treatment for pre-diabetes is building lean muscle mass. And so, okay, now people are using strength trainer in a totally new and like newly motivated way and seeing a lot of people like really caring about the strength training input to health span because they now understand

like, oh, if I don't get this out of the orange zone, I'm on this, you know, pre-diabetes to diabetes path. And so it's been really cool to see just the wild increase in health span scores as people are getting newly motivated, not only newly motivated around this day. but also able to actually address root causes and fix some of these things. That's been super fun. I'm just excited as more and more people come off of our wait list and use the advanced labs feature, what they learn about themselves. So I kind of joked with you when I was trying to convince you to come to whoop that, you know, our goal was to automate you. And, you know, you and I have had multiple multi-hour conversations and in a lot of ways deeply appreciative for it, but it's not scalable. And a

lot of what we were trying to create was how do we give people a meaningful amount of this value at a much more, you know, accessible price point and, you know, accessible lower kind of friction point of entry. I'd love to hear just from you, like a doctor who's used to everything being one-on-one, like what's it been like coming to a tech company and thinking about, you know, seven-figure member numbers scale and kind of automating yourself? And I'd love to hear about that part of your dream. Yeah, I mean, it is so cool because this is such an AI forward group of people. And I learn something every day from the various people I interact with. You know, I see on the Slack channels these

presentations about how to use AI to be a better manager or this new model is out or what's this, what's this model good for? And I've gotten to experiment with it, even for my everyday practice. I've built a lab explainer GPT that is amazing. And it saves me a ton of time. But the thing is, you know, if I have to choose between sending somebody a lab letter that says, and this is what the template says, it says, your labs are, and then you can click normal, abnormal, something else, and you put in the answer, I forget all of them. The follow-up plan is like another follow-up appointment or something else or something else. You know, I never send that one because I'm embarrassed to send it. But most people don't have the time

in medicine to spend 20 minutes writing lab letters. So I think that we already know that there are not enough primary care providers. And there's some debate about what the right level of license and training is to provide primary care and to what degree physicians are overtrained for a lot of the stuff that they're doing or to what degree people who are often called advanced practice providers may not have all of the training. I tend to think that everyone who's practicing primary care, the APPs, the physicians, you know, we all bring different strengths. And a lot of the time, the key is to focus the right provider, the right expert to the problem. But a lot of what we do really should be automated, and it blows my mind that it hasn't been. And when you automate it,

Not only do you make it cheaper, faster, more efficient, but because of what AI can do now, and I think especially with the context that is somewhat uniquely available in Woop, it can do a vastly better job than a PCP. So not just almost as good, not just faster and cheaper and as good, but like vastly better. And so when I think about if a patient comes into my office and says that they feel sluggish, they feel tired, trouble losing weight. You know, I have to spend 15, 20 minutes, that might be the whole visit, asking questions to suss that out. Or I might just say, eh, let's check some labs and we'll follow it up from there. You know, my whoop already knows all that stuff. I like to say that I'm known best by my dog, my wife, my whoop and chat GPT in that

order. And so the system already knows how much I'm sleeping. Is that normal for me? Is that less? How much am I exercising? What kind of exercise? It knows how stressed I am. And I can tell you it's shockingly accurate at knowing when I'm getting yelled at by a boss or a spouse. And so all of that means that the insights that surface are really powerful. So as we've been tinkering with the system and putting in the lab side, you know, I think it's going to blow away what normal primary care does. And I also think that, you know, the sort of high touch, highly personal, high definition medicine that I'm also practicing, in some ways, you know, you can't replace a three-hour visit with AI. But I have my patients connected to a bunch of sort of more point solution

wearables. And I have that data going into a cloud system. And it's not nearly as smart. And everything that I try to put in there, it's not really AI level. It's more algorithmic. You know, tell me if this person has a really bad night's sleep or tell me if their weight goes up or down by this much. So it's never going to be as good. You know, I think the idea of scaling concierge medicine, you know, at a vastly cheaper price, I'm all for it because we already don't have enough primary care just to do what we're doing. And using AI, enabling people to solve a lot of these questions that are on the border of medical versus wellness, it will free up our more skilled providers to tackle the really hard diagnostic questions and the really tough cases.

And also, I think, to be more present and available to help patients solve some of these things or to be the prescriber and the licensed and skilled hand when somebody wants to tackle their cholesterol, their homocysteine, their pre-diabetes, et cetera. So I think it's great, and I'm all in. What's one thing that you want everybody to take away from this conversation? You know, I think it's that it is okay to not want to pick apart every facet of your health.

I don't think we want people to feel like they, we don't want people to feel bad about their labs or their bodies or their habits. But I do think that most of us have had times in our lives, and I'm not talking about like high school prom, where we felt really good and really energetic. And as you get older, those times feel less frequent. And that's not necessarily just normal or from having kids and a job. To be sure, a 50-minute commute will take a toll on anyone's health, right? But I do think that using these tools smartly, carefully, and skillfully, most of us can achieve that feeling better than we do now. And it also is, I don't want to say fun exactly, but progress is a really powerful ingredient in taking charge of your health and

feeling good about it. So I do think that this is worth a look to most people. And, you know, like I said, I'm so excited to be part of this. I'm so excited to see it out there. I can't wait for my patients to be scheduling visits with me to talk about their homocysteine levels. Although not every doc will feel that way. I guess two thoughts. One, I'd love to get. get your take. You just said something really interesting. Not every doc will feel that way. Somebody is going to get a weird homo-sistine level on their Woop Advanced Labs panel. They're going to bring it to their primary care physician, and that physician's going to say, like, I wouldn't have done this. It doesn't really matter. You seem fine. Would you recommend to those people? Like, how do they take

an abnormal or especially sort of not maybe clinically out of range, but functionally out of range, bring that to their doctor and get heard? Yeah, it's a great question. And it is a tough one. And I think, you know, there is a little bit of taking the pulse of your provider and trying to sort of manage up a little bit. You know, one of the things that I think is so great about the platform is how much information it gives people. So it's very common to get these kinds of questions. What do I do about this MCHC? Like I said before, I don't even know what that means. You know, people Google stuff. They get scared. The platform is really, I think, well built to give people good health information without taking the place of a doctor. So that person is going to come in with fewer and better questions, I think, already than somebody who just went to a lab provider and got the standard panel and is looking at the results without that additional context and that additional educational material. I think the other piece is contextualizing it for your provider. You know, could this be why I've been feeling this way or I've noticed this issue and I'm really interested in exploring this as either

a clue or an action point in feeling better. You know, for myself, my cholesterol was not terrible and my provider has never said I need to do anything about it because he doesn't want to make me feel bad. He doesn't want to force medicines on. So I've sat with this sort of B-B-minus cholesterol level for a while. But when I saw my APOB, which is not traditionally checked, I was like, you know, I see no reason why I shouldn't try to get this to the optimal level, not just good enough. And so I said, what do you think about a medicine to treat this? You know, I'd be open to it. Looks like it's safe and reasonable. I mean, I'm a doctor, so I said it a little bit more matter factly. He said, oh, sure. I just didn't want to, you know, force that on you, but you can certainly

try that. I'm happy to prescribe it. I think you know the side effects. I always tell people all the side effects. Probably I tell them a little too much. But, you know, doctors have a really hard job, even though there are a lot of hard jobs. You know, I don't mean to say that we're like smashing boulders all day. But it is a tough job to be, you know, on stage in a service role, in a knowledge role, with a ton of stuff to do, lots of different bosses to answer for the hospital, the insurance company, the patient, and, you know, feel all this pressure. When patients simplify it for us by telling us what they want and why, so often it makes it a lot easier. I mean, I often say to a person when they come in, what were you hoping to accomplish here? Sometimes they say, I just wanted to get started

on this medicine, or I'm just worried I have cancer, do I? You know, when you clarify the reason you're asking, and the physician now doesn't have to make an extemporaneous speech about folate metabolism, but instead they can say, oh yeah, that is a good idea. I'm happy to support you in that. Not only is that easier, but, you know, nobody becomes a doctor because they don't like helping. You know, we all want to help and feel useful. And so that is a part of that kind of managing up a little bit. I think if you go in with a question, you've already got some information, and you have an idea about what to do about it, but you don't know if it's right because you're probably not a doctor unless you're one of my patients. I think that is setting up the provider

that's helping you for a win, and that's going to make their day potentially. And I hate to say it, but you're going to teach them something in that interaction that will benefit other people too. For anybody who is thinking that this is like for the biohacking stuff, can you just as a way of summary, what are the top three to five symptoms that we've kind of normalized or accepted as part of aging? For anybody who's like, do you hear yourself in these five, therefore, you know, you might be a good fit for this sort of testing. What would be the things to think about? I think the biggest one is probably weight control or the kind of related issue of appetite and eating, food noise, snacking, sweet tooth, and that all ties back to metabolism. I think another big one

is kind of fatigue, which is a tough term, you know, fatigue, tiredness, sleepiness, not being refreshed. There are all of these things that can give you clues that are, that enable cheap, easy safe experiments that you can do that will often produce a real benefit. You know, one of the things we haven't talked about in the panel is the inflammatory markers. And there are a lot of people who have low-grade chronic inflammation. And sometimes it's from too much fat around the organs. Sometimes it's from, you know, they haven't been to the dentist in two years because like me, they're scared of the dentist. Sometimes it could be from infections, including things like, you know, the viruses that cause cold sores, that takes a toll on your body over time. It's arguably one of the

most important long-term targets because it impacts heart disease, stroke risk, diabetes risk, and dementia. But also, at a relatively low level of inflammation, that can play a big role in how people feel in terms of their recoveredness or their energy. Certainly, anemia, which tends to present with more of a feeling tired or not having as much gas, especially for exercise as you used to, you know, the tank's just not as full as it once was. The other place where a lot of people will gain valuable insights is in the hormone space. And so there's a large list of hormones on the panel. But I think most important are the sex hormones, testosterone, estradiol, and then also the stress hormones and adrenal hormones, cortisol, and DHEAS. Some people will just check a plain old

testosterone level, and you can't learn that. You can, but in many cases, that will lead you in the wrong direction. So we have the full panel, including sex hormone binding globulin and free testosterone, and I'm getting a little technical here, but a lot of people will find that their level is not pathologically low. They'll go to their doctor and say, and I hear this all the time, hey, 312, I've got the testosterone of a 90-year-old. Literally, that's what they say. I say, but that's in the normal range, you know. Keep in mind, these ranges come from 18-year-old military recruits or something.

But a lot of times those things, which, again, are not pathologic, that person may not need to go on testosterone replacement or get a pituitary scan, but it may be that their diet or their sleep or their alcohol is driving that number down from, say, 515, where it is when they're feeling their best. I think a lot of people are going to be able to make sense of symptoms that might be perimenopausal or menopausal. And I've got a whole soapbox that I won't take out today on that. What would some of those symptoms be? I mean, there are a ton. Some of them are the weight-related things. A lot of it is sort of mood and sleep issues. You know, again, these aren't people having overt hot flushes that wake them up in the middle of the night.

super sweaty, but they might find that their moods are predictably unstable throughout their cycle in ways that they weren't a few years ago. And then, of course, there's things like, you know, changes in hair or skin, changes in libido or sexual function. And again, you know, they go to their doctor and their doctor will say like, well, you know, maybe you and your spouse just need to have some quality time together or, you know, you've got two young kids. You can't expect things to be like they were when you were 25. Not to say, like, kids are super easy or everyone has to feel like an 18-year-old all the time, but in many cases, there are treatable opportunities there that are safe, reasonable, and people should be having the opportunity to consider. Not saying

everyone needs to. Yeah, I love that you went there because I think just people don't realize that, like, you know, your pre-diabetic state doesn't just mean like you might be at risk of diabetes. It It also means that like right now you're getting like a little bit low blood sugar, which isn't going to kill you, but it might make you crabby, right? Because that kind of like hangary, like I'm, you know, an unpleasant person until I've had my breakfast. Like if any of that feels like you, like I'm unpleasant or rude until I eat, like that means that you're not managing your blood sugar well. And so like that's going to impact things like your performance at work. It's going to impact things like your relationships and all these things. And we sort of consider it like subclinical because it's not. destroying your kidneys yet. It's like, okay, well, like, that's good, but it doesn't mean that it's not impacting your life negatively. So it's not just this like harbinger of like something to come if you don't course correct. It's also like, you know, being hangary is a sign of like metabolic dysfunction and, you know, blood sugar, mismanagement or poor management. And so if you get into that state, even if it's like just, you know, in a PMSing type context, you know, before your menstrual period

or just, you know, under certain things, it's like that's something that you can. can address and something you can treat. And so I think really interesting to think about like, do you feel like you get crabby at different times of day? Do you feel like you know, you're looking at your friends and they're recovering better, you know, after a workout or, you know, you're going for a run and you're like, wow, I'm so much slower than I was a couple years ago. It's like all these things. Like there's some amount of inevitable age-related change, but there's also a lot of things that could be changing, some of which can be reversed or stopped. I think course corrected. It's the thing that I'm really excited about. And so, you know, I think like I really hope

that people understand that like a higher plane of functioning is available. And in a lot of cases with no side effects and for the cost of a paramount plus subscription. So again, like not saying that it's nothing, it's almost impossible to put a price on feeling better and sleeping better and having more energy. And so just really, really excited for people to uncover that. And thank you so much for being a part of unlocking this for all of our members. You know, as I said, it's been really, really fun. I have been telling all of my friends about it. And, you know, I can't wait to see the results at scale because certainly the alpha, you know, is showing really cool stuff. I personally have really enjoyed seeing some of these tests that I wouldn't have gotten checked

and responding to them. And I think that's a very good sign when the first dip in the barrel is gold. You know, the rest is probably pretty good, too. Dr. Dan, if people want to find more of you, where can they find you? So I'm pretty Googlable. I don't know if I want to mention my website because it's not great, but it's portfolioprimarycare.com is my practice website, and hopefully they'll be seeing more of me out there in other places. Awesome. Thank you so much for being here. Thank you.

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 508-443-49-5-2. 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, W-I-L-L, to get a $60 credit on W-W-Acessaries 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.