In this episode 47 protocols
▶ 14:21 Early Blood Work Screening Including One-Time Lipoprotein(a) Testing Behaviors “"I certainly think everybody should be screened early in life... Why we wouldn't want to know that in a 20-year-old when it can contribute to a lot of the early atherosclerosis we see in people, you know, it just, it's leaving money on the table, in my opinion."” ▷ 15:34 Repeat Blood Work if an Abnormal Result Appears Behaviors “"If something comes back and it doesn't look great, yeah, it might make sense just to recheck it without reacting to it."” ▷ 15:39 Blood Work Two to Four Times Per Year During Active Intervention Behaviors “"Typically, you know, in patients we might check blood two to four times a year, but we're also probably doing things in there to now check like, hey, you know, we gave this drug, did it have the desired outcome?"” ▷ 16:29 Follow Weight More Closely Between DEXA Scans Behaviors “"I think a DEXA, I'd rather take a DEXA annually and then maybe follow weight a little bit more closely to get a sense of it."” ▷ 16:29 Annual DEXA Scan Tools “"I think a DEXA, I'd rather take a DEXA annually and then maybe follow weight a little bit more closely to get a sense of it."” ▷ 22:52 Heavy Strength Training for Bone Density and Lifelong Function Behaviors “"So it turns out that strength training is probably the single best thing you can do."” ▷ 28:04 Leg Press Machine Tools “"I'd be happy to put her on a leg press machine and just get her doing that."” ▷ 35:51 Measure VO2 Max, Strength, and Stability Against Future Needs Behaviors “"How do you break down that into metrics that we can measure?... to do that will require a VO2 max of 30 milliliters of oxygen per minute per kilogram."” ▷ 40:21 Do Not Smoke Behaviors “"Smoking is approximately a 40% increase in the risk of ACM."” ▷ 41:39 Build High Muscle Mass Behaviors “"If you look at low muscle mass versus high muscle mass, what is the improvement? And it's pretty significant."” ▷ 42:09 Build Strength Behaviors “"When you start to tease out strength, you can realize that strength could be probably three and a half X as a hazard ratio."” ▷ 43:20 Improve Cardiorespiratory Fitness Behaviors “"If you look at cardio respiratory fitness, it's even more profound... That's probably the single strongest association I've seen for any modifiable behavior."” ▷ 45:46 Get VO2 Max to at Least the 75th Percentile Behaviors “I wish there was a rule that said, like, you couldn't talk about anything else health related, but you just, we can make that rule.” ▷ 46:36 Dead Hang Behaviors “dead hang for about a minute seems like a, a really good goal for a lot of people. At least that's our, that's our goal.” ▷ 46:46 Wall Sit Behaviors “And then, uh, we do a wall sit. We do as, as just a straight squat, air squat at 90 degrees, um, and I believe two minutes is the standard for both men and women at 40.” ▷ 47:18 Use Online VO2 Max Estimators Behaviors “There are really good VO two max estimators online, and you can plug in, plug in your activity du jour.” ▷ 47:31 Bike Tools “"There are really good VO2 max estimators online, and you can plug in your activity du jour. So be it a bike run or rowing machine."” ▷ 47:31 Rowing Machine Tools “"There are really good VO2 max estimators online, and you can plug in your activity du jour. So be it a bike run or rowing machine."” ▷ 48:08 Farmer Carries Behaviors “"We use farmer carries. So we'll say for a male, you should be able to farmer carry your body weight for, I think we have two minutes... For women, I think we're doing 75% of body weight or something like that."” ▷ 48:37 Vertical Jump Testing Behaviors “"We use different things like vertical jump, ground contact time."” ▷ 48:37 Ground Contact Time Testing Behaviors “"We use different things like vertical jump, ground contact time. If you're jumping off a box, things like that."” ▷ 51:49 Exercise for Alzheimer's Prevention and Brain Health Behaviors “"There's not one thing that I'll tell patients is more important than exercising."” ▷ 57:41 Testosterone Cypionate Supplements “So, um, the short answer is I think this stuff is absolutely a concentration, um, enhancing substance. Um, it is addictive and people need to be wary of that.” ▷ 1:16:08 Bioidentical Estradiol Patch Supplements “"Today, when we put women on estrogen, we use a, it's an FDA product called the Vivelle Dot. So it's a patch that you just put on and it's estradiol, but it's bioidentical estradiol."” ▷ 1:16:21 Micronized Progesterone Supplements “"And we use what's called micronized progesterone. So bioidentical progesterone."” ▷ 1:22:21 Annual Endometrial Ultrasound During Female HRT Behaviors “"We would like to see an endometrial ultrasound done every year."” ▷ 1:22:27 Annual Pap Smear During Female HRT Behaviors “"We think she'd be having a pap smear every year as well."” ▷ 1:23:09 Progesterone-Coated IUD Tools “"In those situations, we say, great, we're done with oral progesterone. We just use a progesterone-coated IUD. So then you get the local progesterone in the uterus for protection and the systemic estrogen."” ▷ 1:25:39 Topical Testosterone for Women Supplements “if a woman is, if her testosterone, first of all, is staggeringly low, and again, even though her testosterone is low compared to a male, we still have a range.” ▷ 1:39:03 Clomiphene Supplements “"A typical starting dose would be like 50 milligrams, three times a week... We would do it for eight to 12 weeks, and then we reevaluate."” ▷ 1:41:16 Microdose Anastrozole Supplements “"We have to have it compounded at 0.1 milligrams and we might give a patient 0.1, two to three times a week... I like to see it between 30 and 50."” ▷ 1:46:30 Human Chorionic Gonadotropin (HCG) Supplements “"And we then switched to HCG... it has the benefit that Clomid does, which is it preserves testicular function. It preserves testicular volume."” ▷ 1:54:15 5/8-Inch to 1-Inch 25-Gauge Needle for Testosterone Tools “"They're using a 5-8 inch to a 1 inch 25-gauge needle, which is about the smallest needle you can push the oil through."” ▷ 1:54:22 Zyosted Pen Tools “"And by the way, if they're real needle phobes, we use Zyastad, which is a preloaded pen."” ▷ 1:54:29 Avoid Testosterone if You Still Want Fertility and Bank Sperm First if Needed Behaviors “we don't like to use testosterone specifically in men who still want to maintain fertility. We just steer them away from that.” ▷ 1:58:08 Cycle Testosterone With or Without HCG Behaviors “"We just decided to change his cycle eight weeks on, then eight weeks on HCG, eight weeks on, then eight weeks on HCG."” ▷ 2:15:16 Treat ApoB Aggressively if You Want to Live to 100 Behaviors “"If you tell me you want to live to be a hundred, you're going to need to keep your ApoB below 30 milligrams per deciliter."” ▷ 2:18:09 Lower Carbohydrate Intake to Reduce Triglycerides Diet “"Triglycerides are generally driven by carbohydrate intake... If you restrict carbohydrates, you will reduce triglycerides."” ▷ 2:18:27 Lower Saturated Fat Intake to Reduce ApoB Diet “"Can you lower saturated fat, which tends to be the one that is most driving ApoB."” ▷ 2:18:58 Statins Supplements “"The tried and true is the statin. So statins work by inhibiting cholesterol synthesis."” ▷ 2:20:39 Bempedoic Acid Supplements “So the next tool you look at is a drug that blocks the absorption or the reabsorption of cholesterol. Remember that Niemann-Pixy-1-like-1 transporter? So that guy has a drug called ezetimibe that just mechanically blocks it.” ▷ 2:20:39 Ezetimibe Supplements “"The next tool you look at is a drug that blocks the absorption or the reabsorption of cholesterol... that guy has a drug called ezetimibe that just mechanically blocks it."” ▷ 2:21:33 PCSK9 Inhibitor Supplements “"The most potent drug of the lot is the PCSK9 inhibitor."” ▷ 2:31:04 Rapamycin Supplements “"I'm a huge proponent of rapamycin... One of the things that I hope gets a lot more attention is the use of rapamycin for preserving ovarian health."” ▷ 2:36:19 Prehab and Rehab Behaviors “"What I learned through a really amazing prehab and rehab process is like, you just got to do it... Do the work."” ▷ 2:43:00 Semaglutide Supplements “"If you're looking at semaglutide... it took about 16 weeks to get the patients comfortably up to 2.4 milligrams weekly... In our experience, when we use it, we don't even usually go up to 2.4 milligrams. We can usually get enough benefit between one and two milligrams."” ▷ 2:45:15 Eliminate Alcohol to Lose Weight Diet “"We always encourage patients who want to lose weight to really just eliminate alcohol. That's the cheapest, easiest trick to lose weight."”