In this episode 59 protocols
▶ 9:03 Talk to Female Relatives About Hormone History Behaviors “I think it's essential that you understand what your grandmother went through, I'd even say your great-grandmother, depending on longevity in your family. And especially your mother.” ▷ 14:15 Measure Cortisol in the Teenage Years Behaviors “In your teenage years, what I think is really interesting is to look at cortisol. To look at the dance between estrogen and progesterone in those years is less helpful because I think there's a lot of variability due to the immaturity of the system.” ▷ 15:58 Use a Copper IUD Tools “So, I like copper because it's non-hormonal. It's as effective as getting your tubes tied.” ▷ 17:00 Prefer Vasectomy as Contraception Behaviors “Now, my favorite is vasectomy. But short of vasectomy, I think the IUD is a really great choice.” ▷ 17:31 Benchmark Sex Hormones in Your 20s Behaviors “In your 20s, that's when you want to do some base casing with estrogen, progesterone, and testosterone.” ▷ 18:15 Avoid Smoking and Vaping Behaviors “I don't recommend anyone smoke, by the way.” ▷ 21:39 Do Stool Testing for the Microbiome Behaviors “I'd also like to know about their stool. So I want to know about the microbiome.” ▷ 23:38 Time Hormone Testing to the Luteal Phase Behaviors “If you forced me to pick one, I would say probably day 21 to 22 for someone in their 20s. So we're focused right now on that decade.” ▷ 24:20 Use Dried Urine for Hormone Testing Behaviors “My preference would be to do dried urine. I like to use saliva for cortisol. I like to use dried urine so that I get metabolomics in addition to the levels of these hormones.” ▷ 24:20 Use Saliva for Cortisol Testing Behaviors “My preference would be to do dried urine. I like to use saliva for cortisol.” ▷ 25:10 Do Micronutrient Testing Behaviors “A big part of the testing that I do in phenotyping my patients, I practice precision medicine. So I like to almost start with nutritional testing.” ▷ 26:32 Eat Vegetables, Especially During Adolescence Diet “Intake of vegetables. Polyphenols is such an important predictor of future risk of breast cancer.” ▷ 27:55 Drink Smoothies to Increase Vegetable Intake Behaviors “What I try to get that person to do... is to have a smoothie.” ▷ 28:17 Add Vegetables to Smoothies Diet “She's a beer, blending up broccoli or kale, cauliflower. So cauliflower is great.” ▷ 28:37 Add Greens Powder to Smoothies Supplements “They could add some greens. I like greens powders are super convenient.” ▷ 34:50 Use Replacement-Dose Probiotics After Antibiotics Supplements “If you're coming off of antibiotics, I think that's a good time to do what we call replacement dose probiotics.” ▷ 34:58 Use Prebiotics Supplements “I think what's far more interesting is prebiotics. I think the data is much better for prebiotics.” ▷ 35:03 Use Polyphenols Selectively Diet “I think the data is much better for prebiotics and the selective use of polyphenols.” ▷ 40:17 Measure Red Blood Cell Magnesium Behaviors “You asked about magnesium. You have to measure red blood cell magnesium, like whole blood.” ▷ 54:21 Aim for a Complete Morning Bowel Movement Daily Behaviors “My definition of constipation as a Western, mostly white girl, is that if you're not having a bowel movement every single morning and you have a feeling of complete evacuation, anything less than that is constipation.” ▷ 56:00 Use Physiological Sigh Behaviors “I'm a big proponent of physiological sighing, real-time.” ▷ 57:21 Practice Transcendental Meditation Behaviors “What works for me now at my age is different than the TM I did as a college student, transcendental meditation.” ▷ 57:26 Practice Yoga Behaviors “I became a certified yoga teacher when I was in my 30s. That is very effective for a lot of people.” ▷ 57:32 Do Holotropic Breathwork Behaviors “I do holotropic breath work.” ▷ 1:01:10 Avoid Alcohol Diet “If I had a magic wand, I would ask that people either not drink or drink two drinks per week maximum.” ▷ 1:02:31 Meditate Behaviors “But I want to say that meditation is obviously a wonderful tool. It's just, it's a, it's a tool, not unlike any other tool that is great for some people and less great for others.” ▷ 1:24:23 Get Basic Blood Work Done Early Behaviors “Everybody, if you can afford it... get some basic blood work done so that you have a reference point. Do it as soon as possible.” ▷ 1:24:48 Measure Insulin Early in Life Behaviors “I wish I knew what my insulin was when I was a teenager. I wish I knew what my fasting insulin was.” ▷ 1:25:04 Use a Continuous Glucose Monitor Tools “The hugest, most gigantic fan of CGMs. I've never seen any tool that I've ever used in medicine change behavior the way that CGMs do.” ▷ 1:29:32 Get Sunlight Behaviors “No magic fairy, nor the government, nor anyone was going to arrive at their door with a kit of things to make them healthy that provide sunlight, movement, sleep, and all the various aspects of nutrition.” ▷ 1:30:54 Get Enough Sleep Behaviors “I would say a few things. I'll just headline them... Number one, sleep.” ▷ 1:31:37 Lower High Perceived Stress Behaviors “I would say sleep, alcohol, high perceived stress.” ▷ 1:31:52 Avoid Eating the Wrong Foods Diet “Not enough sleep, too much alcohol, too much perceived stress, eating the wrong foods.” ▷ 1:32:07 Move More and Exercise in a Way That Fits Your Body Behaviors “And then number six, not moving enough or not moving and exercising in a way that really fits with your body.” ▷ 1:33:28 Balance Exercise Toward More Resistance Training Than Cardio Behaviors “What I really feel if we're going to be at a population level, I feel that about a third cardio, two thirds resistance training is based on my synthesis of the literature, the best combination.” ▷ 1:33:46 Get at Least 150 Minutes of Exercise Per Week Behaviors “I think there's a minimal effective dose, which for a population is about 150 minutes. I think most of us need a lot more than that per week.” ▷ 1:34:51 Avoid Chronic Cardio Behaviors “One of the mediators that I think is important, especially for people who do what I call chronic cardio... is cortisol. So we know that runners, especially marathon runners, people who do a lot of cardio and don't do much resistance training, they tend to have much high cortisol levels.” ▷ 1:35:07 Use Vitamin C to Buffer Cortisol from Chronic Cardio Supplements “They tend to have much high cortisol levels. And you can buffer that with vitamin C. Vitamin C can decrease the effect.” ▷ 1:36:36 Do Pilates Behaviors “I needed more adaptive exercise. I started doing Pilates, more yoga. That helped to lower my cortisol.” ▷ 1:37:27 Use Rhodiola Supplements “So rhodiola is very effective. It's been shown in multiple randomized trials to lower cortisol.” ▷ 1:38:47 Use Phosphatidylserine Supplements “The other thing that I think is super effective is phosphatidylserine, PS for short.” ▷ 1:38:55 Use Fish Oil Supplements “Fish oil also more modestly reduces cortisol.” ▷ 1:39:02 Use Ashwagandha Supplements “Ashwagandha is interesting... Ashwagandha is mostly based on animal studies. There's not as much human data, but it is used a ton in integrative medicine.” ▷ 1:40:27 Use Cortisol Manager Supplements “There's one supplement that I found to be incredibly helpful for people who tend to have high cortisol at night, and that's called a cortisol manager. It's by Integrative Therapeutics.” ▷ 1:49:22 Get Omega-3 Levels Measured Behaviors “What I do is I measure your level. So this gets back to nutritional testing. So for you, I would suggest an omega quant or one of my favorite cardiometabolic panels is to do a Cleveland Heart Lab.” ▷ 1:50:58 Use Specialized Pro-Resolving Mediators Supplements “There's these new supplements that you may have heard of called specialized pro-resolving mediators... And that combined with fish oil seems to be the best combination.” ▷ 1:51:14 Use Low-Dose Aspirin Supplements “I'll combine a little aspirin, small dose, just like 81 milligrams or two of those baby aspirin, together with fish oil plus specialized pro-resolving mediators.” ▷ 1:52:31 Avoid STIs Behaviors “Hopefully, they'll avoid getting any STIs.” ▷ 1:52:31 Avoid Hard Drugs Behaviors “Hopefully, they'll avoid hard drugs.” ▷ 1:52:58 Use Magnesium Supplements “Then I would put magnesium next, since so many people are deficient.” ▷ 1:52:58 Use Vitamin D Supplements “Then I'd probably put vitamin D.” ▷ 1:52:58 Eat Salmon or Other SMASH Fish Diet “My preference would be that they're having salmon or some kind of smash fish. And they're getting that as the primary source of their omega-3s.” ▷ 2:21:54 Use Intermittent Fasting Behaviors “I know you are a fan in some instances of intermittent fasting, time-restricted feeding, and or ketogenic diet to get cells sensitive to insulin.” ▷ 2:21:54 Use a Pulsed Clean Ketogenic Diet Diet “I know you are a fan in some instances of intermittent fasting, time-restricted feeding, and or ketogenic diet to get cells sensitive to insulin.” ▷ 2:23:09 Run a 4-Week Keto N-of-1 Experiment Behaviors “I prefer with a ketogenic diet that it's used as an end-of-one experiment and that you do it for four weeks.” ▷ 2:23:14 Use Stool Testing Before and After Keto Behaviors “Maybe you look at your stool before and afterwards.” ▷ 2:28:43 Get a Coronary Artery Calcium Score by Age 45 Behaviors “If people, if women went away with one thing today, it would be to do a coronary artery calcium score by age 45 and sooner, if you've got premature heart disease.” ▷ 2:29:01 Use a CT Scan of the Chest for Coronary Artery Calcium Scoring Tools “So it's a CT scan of the chest. You can self order it.” ▷ 2:30:32 Know and Work With Your ACE Score Behaviors “The last thing is, and this is for men and women is your ACE score. So adverse childhood experiences, knowing your ACE score is so essential.”