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Now to learn more about Thorn, go to episode 323 of the Behind the Shield podcast with

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Joel Titoro and Wes Barnett.

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Welcome to the Behind the Shield podcast.

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As always, my name is James Gearing and this week it is my absolute honor to welcome on

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the show neurosurgeon and the medical director for Transcend, Dr. Richard Vayner.

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Now in this conversation, we discuss a host of topics from his own journey into medicine,

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the world of neurosurgery, Parkinson's disease, the impact of sleep deprivation on the brain,

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strokes and then we dive into the world of hormones, peptides and the other elements

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that Transcend provides.

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Now before we get to this incredible conversation, as I say every week, please just take a moment.

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Go to whichever app you listen to this on, subscribe to the show, leave feedback and

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leave a rating.

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Every single five-star rating truly does elevate this podcast, therefore making it easier for

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others to find.

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And this is a free library of well over 1000 episodes now.

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So all I ask in return is that you help share these incredible men and women stories so

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I can get them to every single person on planet earth who needs to hear them.

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And one more side note, my new book, Kinda, the audiobook version is finally out.

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It literally went out a few hours before the new year.

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So you can now find that on iTunes and Audible.

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So with that being said, I introduce to you Dr. Richard Vayner.

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Enjoy.

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All right.

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Well, Dr. B, I want to start by saying two things.

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Firstly, thank you to Corey, who is definitely my kind of go-to guy in Transcend, an amazing

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human being.

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So I want to thank him for kind of making this connection.

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And secondly, I want to welcome you onto the Behind the Shield podcast today.

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Hey, I appreciate that.

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I appreciate the opportunity to discuss some of these issues and I'm excited to talk to

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you today.

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Corey has been great at linking us together and giving us some of the background of what

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you've been doing and the things that you discussed previously.

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And like I said, I'm very thankful to be here with you today.

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Brilliant.

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And how long will Planet Earth be finding you this afternoon?

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Oh, boy, I hate to admit it, but I'm in Michigan.

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I'm just north of Detroit, about an hour.

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And it's a Arctic land up here nowadays.

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It's in the 20s and teens, got a fair amount of snow and ice just recently.

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So not really my cup of tea.

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I'm from Texas, so I'm used to the hot.

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Brilliant.

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So I've got to survive the next three months.

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So say some prayers for me.

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My wife's from Michigan originally, but she moved to North Canton, Ohio, very, very, very

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young.

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So similar kind of weather up there.

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So she enjoys Florida.

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Yep.

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As does everybody.

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So you mentioned Texas.

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Let's start at the very beginning of your timeline then.

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So tell me where you were born and give me a little bit background on your family dynamic,

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what your parents did, how many siblings?

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Oh, sure.

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Yeah, I was born and raised in Houston, Texas, kind of lower middle class.

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My two sisters growing up.

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So I was the youngest, youngest of the three of us and kind of a southwest part of Houston.

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So born and raised there, high school, went to college at Baylor University, which is

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just south of Dallas.

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I got a degree in biology there and then went back to Houston for my medical school training,

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which was good load.

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I'm getting old, but over was about 20, 25 years ago.

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So did medical school down there, University of Texas.

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And then came up for my actual formal neurosurgery training up in Michigan in the Detroit area

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and did seven years of brain surgery school.

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And then I've been a practicing board certified neurosurgeon for a lot of years, a lot of

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years now.

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And let's see, married, have four kids and four dogs now.

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I just adopted another one.

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And so we live a pretty overall busy life.

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What about your parents occupations?

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We used to random and met someone when you were a young boy or were they doing some other

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professions?

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I was not.

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My dad became a electrical engineer.

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He was initially a migrant from Mexico.

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I came over in his late teen years, was the oldest of eight children and started working

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in the garage, you know, mechanic, was very into education, loved to learn new things.

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So, he's first learned English and then, you know, started building on that, took a passion

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for electrical things and got his first and associates in electrical engineering and just

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kind of built on his career over time.

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So that was my dad and he has a couple of brothers at, eventually came from Mexico and

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also got engineering degrees, electrical, civil engineering.

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So it was a lot of engineers, nobody in the medical field, which even from an early age

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they would try to sway me to come into the engineering field.

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It was funny.

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My dad would be like, hey, come to the office with me this weekend.

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I'm going to show you some of the schematics that we draw, you know, and how we do electrical

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grids and all this stuff, which of course had zero interest in at all.

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But I'll say, sure, dad, let's go hang out with your dad for the day, have some lunch,

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whatever.

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So go to the office and they back then they did drafting tables.

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It was all these roomful of tables and they would sit there literally and draft, hand

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write a lot of these sayings, hand draw a lot of these sayings.

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My dad had just like the biggest, bulkiest calluses on his, on his elbows from, you know,

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being there all day long.

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And I just found it incredibly boring to be sitting behind a desk.

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I just couldn't do it.

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So despite their best efforts to try to sway me into an engineering career that never went

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anywhere, never gained any traction.

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So what does your dad tell you about the immigration experience in some conversations on mainstream

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television?

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There's a very negative connotation to immigration.

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I am an immigrant from England and so there's so much, I think, gold in these immigration

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stories and here you, you know, your dad comes and becomes an electrical engineer.

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I became a firefighter paramedic.

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So what does he talk about, you know, the experience and the, you know, were there any

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kind of stumbling blocks early on as he was trying to find his feet in America?

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That's a great question.

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I don't get asked that very often.

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And I would tell you it's, again, it's, there's some, there's a little bit of, what's the

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word I should use?

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You got to be, sometimes it's politically sometimes difficult to talk about because

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people are very, very passionate on one side of the immigration issue or another.

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But I, like my father, this, this country is founded on immigrants.

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No one has a problem with migration and immigrants.

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There's some great people in this country.

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My dad came over dirt poor from Mexican family to make his family better.

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And I mean, again, he dropped out of school in seventh or eighth grade, you know, because

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his dad died at an early age.

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So he was forced as the oldest child to work.

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And he would tell me he would get bananas off the trucks, unload the bananas.

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He worked as a porter at a hotel, you know, lifting suitcases, things like that, just

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to make money to help support all of his siblings that were younger.

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Right.

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So hardworking guy came over to America, lived the American dream.

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So he went from that to a son who became a neurosurgeon.

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Right.

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And he's been one generation.

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Look how he's changed our family tree.

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And I have that most respect for my father and what he did and the hard work and sacrifices.

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It's again, just the success story of how migration should work.

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And so he so he was all about migration.

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I'm all about immigrants make the country great.

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So much that we have to offer what he was not a fan of.

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And he was a very, very vocal about it.

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He he didn't pull any punches was the illegal immigration, you know, because he stood in

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line.

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He did everything the right way.

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He did all the paperwork.

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It took him years and years and years.

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I think it was actually in high school before my dad finally got his citizenship card, which

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I never him at the time shown it to me.

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He said, look, here's my here's my citizenship card.

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And I was like, oh, that's nice, Dad.

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I didn't really I was too immature.

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Maybe it's too young in life to realize what a what a tremendous deal that was.

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And so that's that's pretty cool.

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He did everything the right way.

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You know, all his siblings that he slowly brought over from Mexico all did things the

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right way.

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So he was very it would make him very angry, I guess, to see that people would hop over

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illegally come to the country without doing the things that he did because he was you

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know, he did things the right way.

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Obviously, he lived a life that was straight and narrow, loved his family, loved, you know,

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his career, always wanted to do things the right way.

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So to see people cutting line and running through on the illegal side.

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And he was he was not a fan of.

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Absolutely.

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My son actually came.

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Yeah, no, 100 percent.

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My son actually came with me to when I became a citizen.

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So he was at the swearing in ceremony a few years ago.

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So that was kind of cool.

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But I mean, I did the same thing, obviously, has jumped through all the hoops and wait

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years and years.

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But I also look at the way that we do it.

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And there obviously are some barriers to entry, especially if you're from a poorer nation.

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I came from the UK.

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So you know, I wasn't the pound was strong when I was immigrating over here.

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So you know, I think there is a happy medium, isn't there, where we can make it easier for

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certain people to actually get here legally rather than, you know, just opening borders

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and letting people flood in.

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Yeah, correct.

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Yep, absolutely.

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Like I said, it's hard to tiptoe on that tiptoe around that issues.

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People are so politically on one side or the other.

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But like you said, there's a happy medium somewhere where, you know, we can find ways

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to make it better and faster and get people here that need to be here that can really

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contribute to, you know, I mean, every aspect of our lives, you know, and make things for

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the better.

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So I'm definitely I'm definitely pro migration and pro immigrant because of my family history.

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Beautiful.

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Yeah, I find the people in the middle are the most censored.

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The common common sense voice standing looking left and right going, what about here?

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This is a little bit a little bit of both of you seems to be the middle.

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What's that?

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We can't know.

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I have to be way over here.

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No, I have to be way over here.

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No, exactly.

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Middle is middle is a nice place to be.

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It is.

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I find the most normal people are there, to be honest.

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Well, what about sports and exercise?

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Obviously, you've got into, you know, a profession of health and even with Transcend, you're

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working in the health space, too.

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Were you an athlete when you were younger?

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You know, my that was my dad, my mom, they met my father from a friend at work.

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My mom's from Louisiana, Shreveport, Louisiana, and they met and obviously got married and

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had kids.

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But she was kind of on the opposite in the spectrum in terms of health.

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She was always morbidly obese, smoked two packs a day, just very sedentary.

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So growing up, that's what I was exposed to all her health problems.

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I remember as a child, she made me practice giving insulin shots and, you know, there

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was packets of sugar, little glucose things in case her blood sugar went too low.

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So even as a child, I was in elementary school when she was showing me how to treat her diabetic

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emergencies should they happen.

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You know, but just growing up and seeing, you know, the morbid obesity, you know, a

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couple of pounds overweight with all the health problems that that entails, you know, the

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doctor visits, the hospitalizations.

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You know, I just even as a young child, I was like, boy, you know, I don't want to be

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I don't want you know, you just see how terribly how terrible it is.

236
00:13:29,560 --> 00:13:32,840
And even as a child, I recognize I didn't want to I wanted to make sure my life was

237
00:13:32,840 --> 00:13:33,840
somewhat healthier.

238
00:13:33,840 --> 00:13:37,320
You know, you know what that means as a kid.

239
00:13:37,320 --> 00:13:40,360
But I was always able to maintain a healthy weight and, you know, just like a regular

240
00:13:40,360 --> 00:13:43,160
kid run around, you know, just doing the regular kid stuff.

241
00:13:43,160 --> 00:13:46,560
And then once I got in high school, I did run some track.

242
00:13:46,560 --> 00:13:47,560
You know, I was small.

243
00:13:47,560 --> 00:13:50,920
I played one year of football and got out before I got killed because, you know, even

244
00:13:50,920 --> 00:13:54,640
in ninth grade, some of those guys, man, they're full grown men, you know, and I was a five

245
00:13:54,640 --> 00:13:55,640
foot four twig.

246
00:13:55,640 --> 00:13:57,200
So I was like, I'm going to get killed playing football.

247
00:13:57,200 --> 00:14:02,000
So I did once one season of that and then to move to the non contact sports.

248
00:14:02,000 --> 00:14:06,720
So doing, you know, just running and training and then going into college.

249
00:14:06,720 --> 00:14:07,720
Same thing.

250
00:14:07,720 --> 00:14:13,400
I was I was always very mindful of health and not, you know, get never smoking.

251
00:14:13,400 --> 00:14:17,760
I learned that from early age, just the terrible, you know, what it looked like to be a smoker

252
00:14:17,760 --> 00:14:22,200
and wanted zero part of that again and just maintaining healthy diet weight.

253
00:14:22,200 --> 00:14:24,920
It was always kind of in the back of my mind.

254
00:14:24,920 --> 00:14:29,920
You know, my mom, you know, obviously my mom and lover, she's, you know, probably the reason

255
00:14:29,920 --> 00:14:31,160
I'm a physician today.

256
00:14:31,160 --> 00:14:32,160
Right.

257
00:14:32,160 --> 00:14:36,080
I'm trying to help her, I think, translated into instilling in me that desire to help

258
00:14:36,080 --> 00:14:37,080
people.

259
00:14:37,080 --> 00:14:38,080
Right.

260
00:14:38,080 --> 00:14:39,080
And ultimately, I became a physician.

261
00:14:39,080 --> 00:14:43,240
So so with all that, also, there's the things that, you know, I didn't want.

262
00:14:43,240 --> 00:14:44,800
And I was always very mindful.

263
00:14:44,800 --> 00:14:47,720
I, you know, I didn't know what to make sure I never gained a lot of weight.

264
00:14:47,720 --> 00:14:51,320
You know, try to stay active, you know, just those basic things.

265
00:14:51,320 --> 00:14:56,520
And then I've always tried to maintain that, you know, just again, just to just to be healthy.

266
00:14:56,520 --> 00:15:02,280
And then trying to, you know, as then becoming a physician and then knowing the importance

267
00:15:02,280 --> 00:15:10,360
of, again, just basic lifestyle choices, right, with the with the diet and your exercise routines,

268
00:15:10,360 --> 00:15:18,720
whatever that is, trying to instill the importance of that on my patients as to, you know, how

269
00:15:18,720 --> 00:15:23,720
essential these are to everyday life and, you know, ultimately, ultimately how your

270
00:15:23,720 --> 00:15:26,240
quality of life is going to be.

271
00:15:26,240 --> 00:15:33,080
So what about when you start going on the medical route and now you're in medical school,

272
00:15:33,080 --> 00:15:38,520
something I've heard from a lot of my guests who have physicians was the woeful, inadequate

273
00:15:38,520 --> 00:15:44,340
amount of education on nutrition, on exercise, on sleep, on all the things that we call the

274
00:15:44,340 --> 00:15:46,500
pillars of health now.

275
00:15:46,500 --> 00:15:48,800
And I'm hoping obviously that's moving forward.

276
00:15:48,800 --> 00:15:50,800
But what was your experience when you were in med school specifically?

277
00:15:50,800 --> 00:15:54,480
Well, you know, I don't have any experience because there wasn't any.

278
00:15:54,480 --> 00:15:56,040
Like seriously hit the nail on the head.

279
00:15:56,040 --> 00:16:00,480
I mean, you spend four years in med school learning about diseases.

280
00:16:00,480 --> 00:16:04,240
Hey, here's a list of a thousand diseases you got to know about.

281
00:16:04,240 --> 00:16:06,880
And here's 10,000 medications to treat those diseases.

282
00:16:06,880 --> 00:16:11,560
But you know, how how much preventative medicine did we get in med school?

283
00:16:11,560 --> 00:16:15,200
Boy, I would tell you zero, but maybe there's a week in there somewhere.

284
00:16:15,200 --> 00:16:17,320
But there is there is no preventative medicine.

285
00:16:17,320 --> 00:16:22,960
There is no you know, how do you how do you how do you counsel people on on on diet, exercise,

286
00:16:22,960 --> 00:16:23,960
nutrition, metabolism?

287
00:16:23,960 --> 00:16:28,160
No, it's like, OK, this person has, you know, Graves disease in their thyroid.

288
00:16:28,160 --> 00:16:29,160
How are you going to treat that?

289
00:16:29,160 --> 00:16:30,160
You know, soon to be Dr. Vana.

290
00:16:30,160 --> 00:16:33,760
Well, I'm going to give Synthroid, you know, I mean, it's just that's how it is, you know,

291
00:16:33,760 --> 00:16:36,640
identifying diseases and treating the disease.

292
00:16:36,640 --> 00:16:40,480
Not how do how do we how do we prevent that altogether?

293
00:16:40,480 --> 00:16:41,480
Zero.

294
00:16:41,480 --> 00:16:42,480
It's crazy.

295
00:16:42,480 --> 00:16:46,200
You know, I think that's probably I think that's changed a little bit, but it's a little

296
00:16:46,200 --> 00:16:47,200
bit otherwise.

297
00:16:47,200 --> 00:16:50,040
There's just I think the sense is there's too much to learn about how to be a physician

298
00:16:50,040 --> 00:16:54,480
and how to manage health and how to manage disease, that there's there's no time to

299
00:16:54,480 --> 00:16:58,260
spend on how to how to prevent disease.

300
00:16:58,260 --> 00:17:00,080
You just mentioned something that I've talked about a lot.

301
00:17:00,080 --> 00:17:04,720
And it's funny because my wife is taking thyroid supplements at the moment from Transcend,

302
00:17:04,720 --> 00:17:07,380
but she's about to finish four years of med school.

303
00:17:07,380 --> 00:17:09,720
So you know, she's been stressed to the max.

304
00:17:09,720 --> 00:17:14,040
So I'm sure that once she takes she's taking her final boards in a couple of weeks and

305
00:17:14,040 --> 00:17:15,960
then hopefully everything will settle down.

306
00:17:15,960 --> 00:17:19,760
And I'm hoping it will be at a, you know, kind of wiener off at that point.

307
00:17:19,760 --> 00:17:23,560
As a paramedic, the number of people that I had conversations with that said, well,

308
00:17:23,560 --> 00:17:28,200
the reason I'm like this is I have a hypothyroid, you know, and I'm always thinking, well, was

309
00:17:28,200 --> 00:17:33,160
that the initial thing or have you now got hypothyroid because of the result of, you

310
00:17:33,160 --> 00:17:36,800
know, the old movement, your ex, your nutrition, et cetera, et cetera.

311
00:17:36,800 --> 00:17:41,000
I know nothing is, you know, black and white and there are kind of anomalies there.

312
00:17:41,000 --> 00:17:46,640
But when we hear about thyroid contributing to weight gain, it's kind of a chicken and

313
00:17:46,640 --> 00:17:48,720
egg situation, I'm assuming.

314
00:17:48,720 --> 00:17:54,920
But is that usually the thyroid just given up on its own or are we actually contributing

315
00:17:54,920 --> 00:17:59,760
to this hypothyroidism that we see so rampant in the States because of inactivity and our

316
00:17:59,760 --> 00:18:00,760
nutrition?

317
00:18:00,760 --> 00:18:02,800
Well, I think it could be both ways.

318
00:18:02,800 --> 00:18:06,360
You know, certainly we see even, you know, at Transcend when we're doing routine screening

319
00:18:06,360 --> 00:18:11,120
blood work for people's symptoms, you'd be surprised how many people we find that are

320
00:18:11,120 --> 00:18:16,840
hypothyroid or having like a functional hypothyroidism where, you know, they're having mild symptoms,

321
00:18:16,840 --> 00:18:20,960
but their blood work looks, you know, terrible, you know, but they're only having mild symptoms.

322
00:18:20,960 --> 00:18:21,960
Okay.

323
00:18:21,960 --> 00:18:24,320
So, yeah, it's a very common problem.

324
00:18:24,320 --> 00:18:27,800
You know, we get the autoimmune ones like the, you know, the Hashimoto's thyroiditis

325
00:18:27,800 --> 00:18:31,880
very common, you know, grave disease where the body's forming antibodies to different

326
00:18:31,880 --> 00:18:37,080
parts of the thyroid gland and it subsequently burns out their thyroid gland.

327
00:18:37,080 --> 00:18:38,080
So they become hypothyroid.

328
00:18:38,080 --> 00:18:40,800
They don't have enough thyroid function anymore.

329
00:18:40,800 --> 00:18:45,480
So that's a, it's pretty, you know, we see that, you know, fairly, fairly common.

330
00:18:45,480 --> 00:18:50,320
So we have that aspect of where there's some really some just inherent reasons why people

331
00:18:50,320 --> 00:18:54,040
will get hypothyroid conditions like as a true medical condition.

332
00:18:54,040 --> 00:18:56,880
And along with that, they get the slower metabolism, right?

333
00:18:56,880 --> 00:19:00,640
Your thyroid hormone tightly regulates your metabolism.

334
00:19:00,640 --> 00:19:03,080
So when you're low, you're not going to have as high a metabolism.

335
00:19:03,080 --> 00:19:04,480
Your basal metabolic rate is going to be lower.

336
00:19:04,480 --> 00:19:08,800
You're not going to burn as many calories the way it can slowly creep on.

337
00:19:08,800 --> 00:19:10,900
So that's certainly a factor.

338
00:19:10,900 --> 00:19:17,720
And then you have the concept of kind of like a chronic stress response, right?

339
00:19:17,720 --> 00:19:20,440
Where you have higher cortisol levels, people that don't manage stress, you know, they're

340
00:19:20,440 --> 00:19:24,080
not sleeping, their lives are overly busy, low-restressed, you know, their diets are

341
00:19:24,080 --> 00:19:25,140
poor.

342
00:19:25,140 --> 00:19:31,120
Then you have this constant ongoing on edge stress response where your body will release

343
00:19:31,120 --> 00:19:32,920
more cortisol to help manage that stress.

344
00:19:32,920 --> 00:19:34,200
That's what cortisol does, right?

345
00:19:34,200 --> 00:19:38,440
Helps your body adapt to stressors in your environment.

346
00:19:38,440 --> 00:19:42,440
The problem with that is that, you know, the cortisol does great for helping to manage

347
00:19:42,440 --> 00:19:46,480
that acute response and that acute inflammation that can come around with that.

348
00:19:46,480 --> 00:19:52,480
But it's also a double-edged sword where those high levels of cortisol can really cause immune

349
00:19:52,480 --> 00:19:58,360
dysregulation, so it causes your thymus gland to kind of change what it's doing in terms

350
00:19:58,360 --> 00:20:02,560
of the types of white blood cells, the types of immune cells that it's putting out.

351
00:20:02,560 --> 00:20:07,720
And that imbalance or that dysregulation can predispose people to having different, you

352
00:20:07,720 --> 00:20:10,560
know, autoimmune conditions and can flare those up.

353
00:20:10,560 --> 00:20:15,440
Like, you know, say like psoriasis, say for example, which is, you know, not immune, you

354
00:20:15,440 --> 00:20:19,600
know, you can't turn on the TV nowadays without seeing one of these immune modulating agents

355
00:20:19,600 --> 00:20:20,600
to treat the psoriasis, right?

356
00:20:20,600 --> 00:20:23,840
They're on commercials all the time.

357
00:20:23,840 --> 00:20:27,920
But you know, people that have these high stress response, high cortisol levels, you

358
00:20:27,920 --> 00:20:31,760
know, people are under stress that can bring on those psoriasis plaques, right?

359
00:20:31,760 --> 00:20:36,680
So there really is that intricate interplay between, you know, chronic stress, high cortisol

360
00:20:36,680 --> 00:20:42,360
levels, immune dysfunction that, you know, can lead to some of the hormone imbalances

361
00:20:42,360 --> 00:20:44,200
that we treat very frequently.

362
00:20:44,200 --> 00:20:49,480
Well, speaking of that, when you were in your residency, you know, we hear historically

363
00:20:49,480 --> 00:20:53,360
how insane some of the work weeks are in your profession.

364
00:20:53,360 --> 00:20:55,200
What was your experience specifically?

365
00:20:55,200 --> 00:20:59,920
You know, neurosurgery is, I think, you know, one of the more challenging residencies out

366
00:20:59,920 --> 00:21:01,720
there, right?

367
00:21:01,720 --> 00:21:04,840
You're dealing with, you know, I think overachievers.

368
00:21:04,840 --> 00:21:09,160
Neurosurgery is seven years of residency training after medical school.

369
00:21:09,160 --> 00:21:11,200
And it's a pretty brutal seven years.

370
00:21:11,200 --> 00:21:14,000
It's a lot, you know, it's a lot of brain surgery, it's spine surgery.

371
00:21:14,000 --> 00:21:21,880
It takes a long time to teach people how to be, you know, safe and effective and have

372
00:21:21,880 --> 00:21:29,720
good surgical judgment when you're treating, you know, very tender, gentle, intricate areas

373
00:21:29,720 --> 00:21:30,720
of the brain.

374
00:21:30,720 --> 00:21:32,400
So, again, seven years is a long time.

375
00:21:32,400 --> 00:21:36,200
And back when I did residency back in the 90s, and I feel old when I say that, but back

376
00:21:36,200 --> 00:21:42,360
in the 90s, you know, that was before they had instituted the 80-hour work week.

377
00:21:42,360 --> 00:21:47,740
So we would literally work 100 hours a week, 110 hours a week in the hospital.

378
00:21:47,740 --> 00:21:49,840
Every fourth night we'd be on call.

379
00:21:49,840 --> 00:21:54,800
So we'd be running around the hospital taking care of all the neurosurgery patients, any

380
00:21:54,800 --> 00:21:58,240
new patients that would come through the ER.

381
00:21:58,240 --> 00:22:01,200
So you'd be up all night, you know, as at a busy trauma center.

382
00:22:01,200 --> 00:22:05,200
So literally you come in at 6 a.m., you're there all day, you're awake all night running

383
00:22:05,200 --> 00:22:09,840
around like a monkey doing all these things, you know, trying to manage, you know, neurosurgery

384
00:22:09,840 --> 00:22:14,000
change, which in general can be very sick, critically ill patients, right?

385
00:22:14,000 --> 00:22:17,080
So you're running around all night, and then the next day comes around and it's a full

386
00:22:17,080 --> 00:22:18,320
day for you.

387
00:22:18,320 --> 00:22:23,320
So you're doing, you know, until the following night, which might be 6 or 8 p.m., you know,

388
00:22:23,320 --> 00:22:28,000
and then by the time you're going home, again, you've been up for 36, 38 hours straight with

389
00:22:28,000 --> 00:22:31,480
no rest, and you do that every fourth night.

390
00:22:31,480 --> 00:22:34,240
So it was pretty, it was pretty, it was pretty brutal.

391
00:22:34,240 --> 00:22:38,320
You know, now fortunately things have changed.

392
00:22:38,320 --> 00:22:42,040
You know, where now they have, you can't work more than 80 hours as a resident.

393
00:22:42,040 --> 00:22:45,840
If you work a 24-hour shift, you have to have, I think it's eight hours off or something

394
00:22:45,840 --> 00:22:46,840
like that.

395
00:22:46,840 --> 00:22:49,400
So you can go home and sleep, you know, collect yourself, and then come back.

396
00:22:49,400 --> 00:22:53,320
So there's work hour restrictions now for residents, which I think is a good thing,

397
00:22:53,320 --> 00:22:54,320
you know.

398
00:22:54,320 --> 00:22:58,480
I mean, I certainly fell asleep at the wheel driving home when I was a resident, you know.

399
00:22:58,480 --> 00:23:02,600
There's residents that have accidents, you know, there's the reason that 80-hour work

400
00:23:02,600 --> 00:23:06,400
week came about is because there's a famous case in New York a while back where there's

401
00:23:06,400 --> 00:23:10,680
a resident that was way overworked and made a critical mistake and a patient died.

402
00:23:10,680 --> 00:23:15,240
So then they started making legislation to limit the work hours, which again, I agree

403
00:23:15,240 --> 00:23:20,160
with, you know, in my personal experience, you know, when you're up that many hours,

404
00:23:20,160 --> 00:23:23,600
you feel okay, you know, you think you're okay, and I think that's part of the danger,

405
00:23:23,600 --> 00:23:24,600
right?

406
00:23:24,600 --> 00:23:27,240
It's like having a few drinks at the bar, you've had three or four beers, like, eh,

407
00:23:27,240 --> 00:23:29,240
fine, I just lived on the road, I'm fine.

408
00:23:29,240 --> 00:23:32,120
You know, when you check your blood alcohol level, actually, no, man, you're not fine.

409
00:23:32,120 --> 00:23:35,080
You know, you're.09 or you're.1L, you're drunk, you know.

410
00:23:35,080 --> 00:23:39,600
And I think that's part of the danger of sleep deprivation is that, you know, you still constantly

411
00:23:39,600 --> 00:23:43,320
might think you're okay, but, you know, driving a car at, you know, 80 miles an hour down

412
00:23:43,320 --> 00:23:49,120
the freeway, having been up 38 or 40 hours, you know, it's, you know, in retrospect, you

413
00:23:49,120 --> 00:23:53,880
know, I feel kind of lucky that I never had any real major accidents or anything.

414
00:23:53,880 --> 00:23:58,200
But yeah, it was pretty brutal back then, you know, and that was before we had physician

415
00:23:58,200 --> 00:24:02,600
assistants, you know, or nurse practitioners to help with the load.

416
00:24:02,600 --> 00:24:05,400
It was it was all you, you know, neurosurgery, there's not a lot of us.

417
00:24:05,400 --> 00:24:08,960
So you know, you were the single resident covering, you know, a hospital with hundreds

418
00:24:08,960 --> 00:24:09,960
of patients.

419
00:24:09,960 --> 00:24:13,640
It's not like the like the general surgery teams with internal medicine teams and entire

420
00:24:13,640 --> 00:24:18,160
teams there, you know, like the trauma surgery team, they had, you know, six or eight residents

421
00:24:18,160 --> 00:24:21,520
there, you know, so they're in the car room, they're playing Xbox, you know, they're catering

422
00:24:21,520 --> 00:24:25,640
in Chinese, you know, and then they're hurrying on the lone wolf neurosurgery resident just

423
00:24:25,640 --> 00:24:28,960
fighting for survival for the night, you know, and they would feel pity on you sometimes

424
00:24:28,960 --> 00:24:31,760
like, hey, man, come on in here for me to have some food, you know.

425
00:24:31,760 --> 00:24:35,440
So yeah, so neurosurgery, it's a it's a unique specialty.

426
00:24:35,440 --> 00:24:38,840
It's a it was a lot of pain and suffering to get get where I am.

427
00:24:38,840 --> 00:24:42,840
Well, it's interesting because it parallels the fire service, you know, especially us

428
00:24:42,840 --> 00:24:44,560
to do fire and EMS together.

429
00:24:44,560 --> 00:24:49,120
So many of these men and women, I mean, 24 hours, you know, you are awake or or completely

430
00:24:49,120 --> 00:24:53,080
disrupt asleep, waiting to be awoken and still waking up three or four times a night, even

431
00:24:53,080 --> 00:24:56,340
if you see the bed for, you know, an hour or two.

432
00:24:56,340 --> 00:24:59,720
And then you add in we've got a crisis at the moment, a recruitment crisis.

433
00:24:59,720 --> 00:25:02,080
So now you're adding in mandatory over time.

434
00:25:02,080 --> 00:25:04,960
So just like you said, the morning comes, you're about to go home, you get a phone

435
00:25:04,960 --> 00:25:05,960
call.

436
00:25:05,960 --> 00:25:06,960
Now you're not.

437
00:25:06,960 --> 00:25:09,840
Now it's another 24 hours, 48 hours without sleep.

438
00:25:09,840 --> 00:25:14,000
And you look at neurosurgery and other medical professions that have these residencies, you

439
00:25:14,000 --> 00:25:18,000
look at our police and fire and, you know, especially fire.

440
00:25:18,000 --> 00:25:22,040
And it's like, why are the one the people that are most critical that we need to be

441
00:25:22,040 --> 00:25:27,280
completely on point and be able to think properly, we work them into a ground.

442
00:25:27,280 --> 00:25:30,760
The person that bags your groceries for 40 hours now, you need to go home.

443
00:25:30,760 --> 00:25:32,240
You know, it's it's so backwards.

444
00:25:32,240 --> 00:25:33,240
Yeah.

445
00:25:33,240 --> 00:25:34,240
Yeah.

446
00:25:34,240 --> 00:25:39,280
The neurosurgery, it's there's just not a lot of again, there's not a lot of neurosurgeons

447
00:25:39,280 --> 00:25:40,280
in the world, right?

448
00:25:40,280 --> 00:25:44,040
There's only about 3000 board certified neurosurgeons in the country.

449
00:25:44,040 --> 00:25:49,080
So you know, just, you know, the amount of new training spots for a new neurosurgery

450
00:25:49,080 --> 00:25:53,500
residence every year is I think 160 last I looked.

451
00:25:53,500 --> 00:25:58,040
So every year we can train 160 new neurosurgery residents.

452
00:25:58,040 --> 00:25:59,040
And then you have guys that are retiring.

453
00:25:59,040 --> 00:26:03,000
And, you know, so it's it's barely enough to fill the needs.

454
00:26:03,000 --> 00:26:04,480
There's a lot of hospitals that don't have neurosurgeons.

455
00:26:04,480 --> 00:26:07,520
If someone comes in with a neurosurgery issue, they have to transfer them out.

456
00:26:07,520 --> 00:26:09,280
It's just not enough neurosurgeons to go around.

457
00:26:09,280 --> 00:26:11,600
So we're all all overworked.

458
00:26:11,600 --> 00:26:13,720
You know, all of us are chronically tired.

459
00:26:13,720 --> 00:26:16,200
You know, we're kind of like a band of brothers kind of thing.

460
00:26:16,200 --> 00:26:22,360
Like we all try to help each other out because we know all of us are woefully, you know,

461
00:26:22,360 --> 00:26:24,880
tired and and sleep deprived.

462
00:26:24,880 --> 00:26:25,880
Yeah.

463
00:26:25,880 --> 00:26:27,840
Maybe just lower the bar.

464
00:26:27,840 --> 00:26:28,840
They'll do it.

465
00:26:28,840 --> 00:26:29,840
Yeah, exactly.

466
00:26:29,840 --> 00:26:32,840
That's what they do in the bar service.

467
00:26:32,840 --> 00:26:34,560
So we just need people 18 and a heartbeat.

468
00:26:34,560 --> 00:26:35,560
You'll be fine.

469
00:26:35,560 --> 00:26:36,560
There's the brain.

470
00:26:36,560 --> 00:26:37,560
Yep.

471
00:26:37,560 --> 00:26:38,560
Yep.

472
00:26:38,560 --> 00:26:43,000
Well, what about the folklore I've heard many, many times when it comes to residency?

473
00:26:43,000 --> 00:26:48,040
I think this was so I don't know if it was neuroscience specifically, but I think it

474
00:26:48,040 --> 00:26:49,800
was like the turn of last century.

475
00:26:49,800 --> 00:26:58,200
If I'm not mistaken, there was a famous surgeon slash professor who was doing these these

476
00:26:58,200 --> 00:27:02,140
residencies and staying up for hours and hours and hours and days and days.

477
00:27:02,140 --> 00:27:05,320
But then when that when they actually look back, they realize that he was addicted to

478
00:27:05,320 --> 00:27:09,800
cocaine because obviously it was not really frowned upon back then.

479
00:27:09,800 --> 00:27:11,720
So then you go, OK, well, that wasn't healthy.

480
00:27:11,720 --> 00:27:15,220
And I'm sure he probably died not too long after that.

481
00:27:15,220 --> 00:27:16,400
Have you heard that folklore?

482
00:27:16,400 --> 00:27:20,320
Because I hear that quite a bit and it just kind of smacks of that just because you've

483
00:27:20,320 --> 00:27:23,800
always done it that way doesn't mean it's the right way to do it.

484
00:27:23,800 --> 00:27:25,840
Yeah, I've heard a similar story.

485
00:27:25,840 --> 00:27:28,000
Wasn't it like was it Sigmund Freud?

486
00:27:28,000 --> 00:27:30,440
Was that the famous psychologist that was addicted to cocaine?

487
00:27:30,440 --> 00:27:32,600
Yeah, I think he might have been as well.

488
00:27:32,600 --> 00:27:33,600
Yeah.

489
00:27:33,600 --> 00:27:35,600
I mean, a lot of people were, you know, back then.

490
00:27:35,600 --> 00:27:36,600
OK, back then.

491
00:27:36,600 --> 00:27:38,320
Yeah, it was all cool back then.

492
00:27:38,320 --> 00:27:39,320
Yeah, it's no problem.

493
00:27:39,320 --> 00:27:40,320
All right.

494
00:27:40,320 --> 00:27:44,320
Well, well, then while we're staying on the kind of neuroscience before we progress to

495
00:27:44,320 --> 00:27:49,320
hormones, I know one of your areas of specialty is Parkinson's disease.

496
00:27:49,320 --> 00:27:53,560
And one of my close friends actually just lost his father to it a couple of years ago.

497
00:27:53,560 --> 00:27:57,920
And we just did an interview the other day kind of from a, you know, a carer's perspective

498
00:27:57,920 --> 00:28:02,000
and how heartbreaking it was watching his dad slowly disappear.

499
00:28:02,000 --> 00:28:06,640
So what got you into that field of research and what are some of the, you know, the things

500
00:28:06,640 --> 00:28:10,200
to be excited about, hopefully, as far as addressing that issue?

501
00:28:10,200 --> 00:28:11,200
Oh, yeah, great.

502
00:28:11,200 --> 00:28:16,160
You know, as a brain surgeon, the functional neurosurgery part, which I'll describe a little

503
00:28:16,160 --> 00:28:23,440
more, is some of my most favorite operations to do and patients to take care of.

504
00:28:23,440 --> 00:28:28,760
And because what we're doing, this guy's an overview when you're a functional neurosurgeon,

505
00:28:28,760 --> 00:28:33,600
you're modulating or trying to change the function of certain parts of the brain.

506
00:28:33,600 --> 00:28:36,400
And there's been different ways to do that over the years.

507
00:28:36,400 --> 00:28:42,040
But in regards to Parkinson's, when I was again training back in the 90s, it was still

508
00:28:42,040 --> 00:28:48,160
a relatively new procedure to stimulate different parts of the brain, almost like putting in

509
00:28:48,160 --> 00:28:52,440
a heart pacemaker if someone has an arrhythmia, where you get a heart pacemaker to kind of

510
00:28:52,440 --> 00:28:54,840
pace the heart in a more normal way.

511
00:28:54,840 --> 00:29:00,760
Well back in the 90s, it got FDA approval to put a stimulator wire into different parts

512
00:29:00,760 --> 00:29:06,240
of the brain to try to make those neurons, those nerve cells, fire and communicate in

513
00:29:06,240 --> 00:29:10,200
a more normal way to alleviate some of the symptoms they were having.

514
00:29:10,200 --> 00:29:14,840
And in regards to Parkinson's disease, initially, they were burning parts of the brain, destroying

515
00:29:14,840 --> 00:29:18,200
parts of the brain, which would improve function.

516
00:29:18,200 --> 00:29:21,480
But it had a lot of limitations, a lot of side effects when you're destroying a deep

517
00:29:21,480 --> 00:29:24,040
part of the brain like that, right?

518
00:29:24,040 --> 00:29:26,040
And you could only do one side, couldn't do both, et cetera.

519
00:29:26,040 --> 00:29:27,600
There was different problems with that.

520
00:29:27,600 --> 00:29:33,720
So when the concept of, you know, let's stimulate a part of the brain, the nucleus or the subthalamic

521
00:29:33,720 --> 00:29:40,520
nucleus deep in the brain, that will change the way the motor circuitry is going in Parkinson's

522
00:29:40,520 --> 00:29:41,520
disease.

523
00:29:41,520 --> 00:29:46,280
I found it very fascinating and really took a liking to it, did some extra training time

524
00:29:46,280 --> 00:29:50,160
with one of my mentors at a local hospital here.

525
00:29:50,160 --> 00:29:54,320
And then once I finished my seven years of residency training, made sure that I was going

526
00:29:54,320 --> 00:29:58,880
to have surgeries for things like Parkinson's disease as part of my practice.

527
00:29:58,880 --> 00:30:03,120
And so I got a very busy practice doing that.

528
00:30:03,120 --> 00:30:04,120
And I love it.

529
00:30:04,120 --> 00:30:07,000
It's just very fulfilling because as you've, sounds like you've seen, you've talked to

530
00:30:07,000 --> 00:30:10,200
people that have had Parkinson's disease or have Parkinson's disease, people that have

531
00:30:10,200 --> 00:30:11,200
cared for them.

532
00:30:11,200 --> 00:30:13,440
It's just such a debilitating disease, right?

533
00:30:13,440 --> 00:30:16,120
And it's progressive, gets worse over time.

534
00:30:16,120 --> 00:30:20,280
And their level of being able to function, their motor function just deteriorates year

535
00:30:20,280 --> 00:30:22,360
by year.

536
00:30:22,360 --> 00:30:28,320
And what surgery for Parkinson's does is we implant a pacemaker into that part of the

537
00:30:28,320 --> 00:30:31,520
brain that helps them move in a more normal way.

538
00:30:31,520 --> 00:30:35,240
So instead of having their tremor, it makes their tremor stop.

539
00:30:35,240 --> 00:30:39,120
And instead of having that real rigid muscles you've seen with Parkinson's, they just get

540
00:30:39,120 --> 00:30:40,120
real rigid.

541
00:30:40,120 --> 00:30:41,120
They're stiff, tight.

542
00:30:41,120 --> 00:30:46,280
It can help to make their muscles and joints more loosey goosey so that they're normal.

543
00:30:46,280 --> 00:30:51,400
And that slowness of the movement, the bradykinesia, that's why the classic picture of someone

544
00:30:51,400 --> 00:30:53,600
with Parkinson's is them shuffling down the hallway.

545
00:30:53,600 --> 00:30:56,680
There's no arm swing, they're just slowly shuffling.

546
00:30:56,680 --> 00:31:01,080
It's that slowness of movement or bradykinesia that also is alleviated.

547
00:31:01,080 --> 00:31:06,420
People can walk normally, they can dance with their partners, they can travel.

548
00:31:06,420 --> 00:31:12,120
And it's just extremely rewarding to get people that are markedly debilitated from their Parkinson's

549
00:31:12,120 --> 00:31:15,560
and they're taking so much medication to treat the Parkinson's, kind of like most people

550
00:31:15,560 --> 00:31:19,440
have seen, like Michael J. Fox, where he's got those extra movements called dyskinesias

551
00:31:19,440 --> 00:31:20,440
where they're all over the place.

552
00:31:20,440 --> 00:31:21,440
They can't sit still.

553
00:31:21,440 --> 00:31:22,440
You've seen those videos.

554
00:31:22,440 --> 00:31:23,440
Dr. Justin Marchegiani...

555
00:31:23,440 --> 00:31:24,440
Yeah.

556
00:31:24,440 --> 00:31:25,440
Dr. Justin Marchegiani...

557
00:31:25,440 --> 00:31:26,440
But that's a medication side effect.

558
00:31:26,440 --> 00:31:30,080
They're taking so much dopamine type drugs, it gives them those extra movements just to

559
00:31:30,080 --> 00:31:31,240
be able to move.

560
00:31:31,240 --> 00:31:33,440
So it's either they got all these extra movements or they're frozen.

561
00:31:33,440 --> 00:31:36,520
You know, so obviously if you're frozen, you can't function.

562
00:31:36,520 --> 00:31:38,320
So they take these high doses of medicines.

563
00:31:38,320 --> 00:31:42,040
Anyway, so the deep brain stimulators, we put these electrodes in people's brains, you

564
00:31:42,040 --> 00:31:44,860
can drastically reduce the amount of medicines they need.

565
00:31:44,860 --> 00:31:48,360
You know, you replace a lot of their medicines with electricity.

566
00:31:48,360 --> 00:31:52,360
And so you really take people that are debilitating and have lost a lot of function, a lot, lost

567
00:31:52,360 --> 00:31:57,320
a lot of quality of their life over the course of a few years and you can restore them, you

568
00:31:57,320 --> 00:32:01,360
know, their ability to be independent, their ability to take care of themselves, the ability

569
00:32:01,360 --> 00:32:05,880
to enjoy their life by six or eight hours per day of good time that you've given them

570
00:32:05,880 --> 00:32:07,160
back.

571
00:32:07,160 --> 00:32:10,400
So the most thankful patients in the world, you know, they all send Christmas cards, they

572
00:32:10,400 --> 00:32:13,400
all send pictures like, you know, thank you so much, Dr. Vana, I've got my life back,

573
00:32:13,400 --> 00:32:15,060
I can do this.

574
00:32:15,060 --> 00:32:16,600
So it's highly rewarding surgery.

575
00:32:16,600 --> 00:32:20,640
And there's other reasons why we do deep brain stimulation to this functional neurosurgery

576
00:32:20,640 --> 00:32:23,200
and all are equally rewarding.

577
00:32:23,200 --> 00:32:26,520
So again, as a neurosurgeon, it's one of my favorite things to do.

578
00:32:26,520 --> 00:32:31,360
I think I've seen a video on social media of someone having those and I believe unless

579
00:32:31,360 --> 00:32:35,440
I'm just completely naive and it wasn't what I was seeing, they had the ability to turn

580
00:32:35,440 --> 00:32:36,440
it on.

581
00:32:36,440 --> 00:32:39,680
So you saw them prior and then they turned it on and they were they had the tremors and

582
00:32:39,680 --> 00:32:41,880
all of a sudden the tremors just stopped and I forget what he was doing.

583
00:32:41,880 --> 00:32:45,200
I think he was trying to drink a glass of water and before he, you know, he just couldn't

584
00:32:45,200 --> 00:32:49,000
even get his hand close to it and they turned it on and then he picked it up and drank it.

585
00:32:49,000 --> 00:32:50,600
It was amazing to watch.

586
00:32:50,600 --> 00:32:53,160
Yeah, it's a lot of fun.

587
00:32:53,160 --> 00:32:57,200
And we do that in the operating too because the patients are awake for we're doing these

588
00:32:57,200 --> 00:32:59,640
surgeries, which sounds crazy and barbaric.

589
00:32:59,640 --> 00:33:04,160
But you know, whenever we're doing anything painful, they're sedated.

590
00:33:04,160 --> 00:33:07,500
And then once they're awake, as we're putting these probes in the brain to kind of map out

591
00:33:07,500 --> 00:33:14,160
where these abnormal areas are, and then we put the electrode in and we turn it on.

592
00:33:14,160 --> 00:33:15,200
It's a lot of excitement.

593
00:33:15,200 --> 00:33:18,720
You know, patients sometimes cry because, you know, they've had years where they're going

594
00:33:18,720 --> 00:33:19,720
like this, right?

595
00:33:19,720 --> 00:33:22,920
They can't move and you hit the hit the light switch and then it stops.

596
00:33:22,920 --> 00:33:23,920
Right.

597
00:33:23,920 --> 00:33:26,600
So now they they look at this hand like it's an alien hand, you know, because it's now

598
00:33:26,600 --> 00:33:27,600
it's not moving.

599
00:33:27,600 --> 00:33:31,240
And, you know, beforehand and pre-op area, you've had them.

600
00:33:31,240 --> 00:33:36,160
OK, try to write your name and it's like, you know, or try to drink from a cup of water.

601
00:33:36,160 --> 00:33:37,800
It's all over the place.

602
00:33:37,800 --> 00:33:40,160
And now you have them in surgery with this electrode in place.

603
00:33:40,160 --> 00:33:43,440
You flip it on and now they're able to write clearly.

604
00:33:43,440 --> 00:33:45,400
You know, they can bring a cup up to their mouth.

605
00:33:45,400 --> 00:33:49,600
It's you know, you can see some videos on YouTube where they're, you know, they'll play

606
00:33:49,600 --> 00:33:55,200
a violin or, you know, they'll do things like that that are, you know, fun to watch.

607
00:33:55,200 --> 00:34:00,600
I think somewhat unnecessary and overly dramatized, but I'm still waiting to take a drum set in

608
00:34:00,600 --> 00:34:01,600
there.

609
00:34:01,600 --> 00:34:02,600
That would impress me.

610
00:34:02,600 --> 00:34:04,600
So I mean, it's fun.

611
00:34:04,600 --> 00:34:09,920
But, you know, you can have them do simpler things just to show that there's a sudden

612
00:34:09,920 --> 00:34:12,800
dramatic change in their symptoms.

613
00:34:12,800 --> 00:34:13,800
So it's yeah.

614
00:34:13,800 --> 00:34:14,800
So you've seen the videos.

615
00:34:14,800 --> 00:34:15,800
They're out there online.

616
00:34:15,800 --> 00:34:17,400
You know, that's something we do in the operating room.

617
00:34:17,400 --> 00:34:20,440
You know, it's another day at the office for us.

618
00:34:20,440 --> 00:34:21,840
So it's pretty it's really cool stuff.

619
00:34:21,840 --> 00:34:22,840
I love it.

620
00:34:22,840 --> 00:34:23,840
I enjoy it.

621
00:34:23,840 --> 00:34:24,840
Beautiful.

622
00:34:24,840 --> 00:34:32,480
When it comes to the the elements that contribute to someone being more likely to get Parkinson's,

623
00:34:32,480 --> 00:34:37,080
I just sat and listened to a class a few months ago and I think it was a gentleman from the

624
00:34:37,080 --> 00:34:40,200
U.F. here in Florida.

625
00:34:40,200 --> 00:34:45,240
Because I've heard people on the show many times refer to Alzheimer's as type 3 diabetes.

626
00:34:45,240 --> 00:34:49,640
So clearly, obviously, there's some nutritional elements that we can address and lower our

627
00:34:49,640 --> 00:34:51,120
chances there.

628
00:34:51,120 --> 00:34:56,860
But this gentleman, I forget his name, was talking about the contaminants, the pollutants

629
00:34:56,860 --> 00:35:00,760
in the atmosphere and foods and that kind of thing being one of the main contributors

630
00:35:00,760 --> 00:35:02,880
to the Parkinson's disease.

631
00:35:02,880 --> 00:35:04,680
What are you finding on your end?

632
00:35:04,680 --> 00:35:09,400
Well, I think the neurodegenerative conditions that you're seeing, like you're talking about

633
00:35:09,400 --> 00:35:12,720
Parkinson's disease and also Alzheimer's disease.

634
00:35:12,720 --> 00:35:18,360
Yes, there might be some hereditary, maybe some genetic issues and maybe that can predispose

635
00:35:18,360 --> 00:35:19,840
you.

636
00:35:19,840 --> 00:35:25,520
But I think the environmental things likewise, you know, still working out what those contributions

637
00:35:25,520 --> 00:35:27,080
might be.

638
00:35:27,080 --> 00:35:30,240
But I think part of for me, the most fascinating thing I've heard recently, and maybe you've

639
00:35:30,240 --> 00:35:37,120
heard some in your discussions with the other doctors, is the is the whole idea of mitochondria,

640
00:35:37,120 --> 00:35:41,040
which if people remember back to high school science, little mitochondria, little round

641
00:35:41,040 --> 00:35:46,080
oval thing as the powerhouse of the cell, the thing that powers all the energy for each

642
00:35:46,080 --> 00:35:47,920
cell in your body.

643
00:35:47,920 --> 00:35:50,000
In addition to the neurons, same thing with the brain cells, right?

644
00:35:50,000 --> 00:35:53,960
The mitochondria are essential for every cell's function, right?

645
00:35:53,960 --> 00:35:57,280
It helps it metabolize, helps it to burn glucose.

646
00:35:57,280 --> 00:36:02,640
And in these neurodegenerative conditions like Parkinson's and Alzheimer's, we know

647
00:36:02,640 --> 00:36:09,640
that loss of mitochondria or dysregulation of metabolism inside that mitochondria can

648
00:36:09,640 --> 00:36:15,040
cause mitochondrial cell, the mitochondria can die and subsequently the cell dies.

649
00:36:15,040 --> 00:36:19,360
All right, so there's a lot of fascinating work, you know, looking at, you know, how

650
00:36:19,360 --> 00:36:24,640
do you support mitochondrial function to prevent cell death in those critical areas of the

651
00:36:24,640 --> 00:36:30,640
brain that are involved in Parkinson's and in Alzheimer's, like in the amygdala, hippocampus,

652
00:36:30,640 --> 00:36:37,280
other areas for like memory and function, that how do we support those mitochondria

653
00:36:37,280 --> 00:36:44,280
to, you know, so that you don't get loss of brain cells in something like Alzheimer's.

654
00:36:44,280 --> 00:36:49,200
And in the news, if you've noticed lately, there's so much buzz about the GLP-1s, right,

655
00:36:49,200 --> 00:36:51,880
the ozempics and the menzornos.

656
00:36:51,880 --> 00:36:55,760
And there's been a couple of interesting studies released this last couple of years where looking

657
00:36:55,760 --> 00:36:58,760
at Parkinson's patients, right, let's get the Parkinson's theme going, right?

658
00:36:58,760 --> 00:37:03,280
So we look at Parkinson's patients and we have patients that are diagnosed with Parkinson's

659
00:37:03,280 --> 00:37:10,280
disease and say, oh, well, there's a certain segment of those that also have their overweight

660
00:37:10,280 --> 00:37:14,200
or they have diabetes, so we're going to put them on a GLP-1.

661
00:37:14,200 --> 00:37:18,120
Let's put them on semiglutide or tricepidide, whatever.

662
00:37:18,120 --> 00:37:23,120
And when you follow up on those patients a year later, surprisingly, the ones who are

663
00:37:23,120 --> 00:37:29,520
on the GLP-1, their Parkinson's disease, their motor function did not progress.

664
00:37:29,520 --> 00:37:33,720
You know, Parkinson's disease is a progressive loss of function over many years, right?

665
00:37:33,720 --> 00:37:37,880
But the ones that were getting those GLP-1s showed no change in their motor function.

666
00:37:37,880 --> 00:37:40,360
That's a pretty big deal, right?

667
00:37:40,360 --> 00:37:44,520
And also there's a study looking at the same thing, Alzheimer's patients, where when Alzheimer's

668
00:37:44,520 --> 00:37:49,440
patients were put on GLP-1 medications, you know, and you look at them a year, 18 months

669
00:37:49,440 --> 00:37:56,880
later, their cognitive function, their memory, their ability to function was unchanged compared

670
00:37:56,880 --> 00:38:01,920
to the ones who were not, compared to the Alzheimer's patients that were not on GLP-1

671
00:38:01,920 --> 00:38:02,920
medications.

672
00:38:02,920 --> 00:38:06,960
So again, so I think it just goes to, you know, what those GLP-1 medications are doing,

673
00:38:06,960 --> 00:38:07,960
right?

674
00:38:07,960 --> 00:38:12,560
They're very important for how energy is metabolized in the mitochondria, right?

675
00:38:12,560 --> 00:38:17,440
Help for glucose metabolism and regulation, keeps your blood sugar stable.

676
00:38:17,440 --> 00:38:21,520
And so I think that's fascinating that these things are working on that mitochondrial and

677
00:38:21,520 --> 00:38:26,320
that cellular level to prevent further cells from dying and stopping things like Alzheimer's

678
00:38:26,320 --> 00:38:31,120
or Parkinson's disease from doing their natural progression that they normally do.

679
00:38:31,120 --> 00:38:34,640
That you can stop them with managing their blood sugars or at least helping to regulate

680
00:38:34,640 --> 00:38:37,880
that glucose metabolism, you know, with these medications.

681
00:38:37,880 --> 00:38:40,520
I think it's fascinating.

682
00:38:40,520 --> 00:38:46,280
Would that suggest then that even without the GLP-1, if someone had gone to a very clean

683
00:38:46,280 --> 00:38:51,520
whole food diet that was balanced and got as close to homeostasis, that would have the

684
00:38:51,520 --> 00:38:52,520
similar effect?

685
00:38:52,520 --> 00:38:57,440
Well, we know there's certain things that will predispose you to that, right?

686
00:38:57,440 --> 00:39:02,760
Like diabetes, the high blood pressure, the high cholesterol and hyperglycerides.

687
00:39:02,760 --> 00:39:06,880
We certainly know that there is things that are associated with a higher risk of getting

688
00:39:06,880 --> 00:39:07,880
Alzheimer's disease.

689
00:39:07,880 --> 00:39:11,680
Yeah, so those just underlying, like a lot of the diseases that we deal with and cancers

690
00:39:11,680 --> 00:39:19,320
we deal with, so much is based on healthy diet choices and lifestyle.

691
00:39:19,320 --> 00:39:24,280
Even like exercise, talking about Alzheimer's, we know that people that maintain a moderate

692
00:39:24,280 --> 00:39:29,240
level of exercise can have much less chance of getting Alzheimer's.

693
00:39:29,240 --> 00:39:35,000
And patients who do have early cognitive loss or early Alzheimer's disease who get maintained

694
00:39:35,000 --> 00:39:39,600
in an exercise program, again, they're able to maintain or even regain some of their lost

695
00:39:39,600 --> 00:39:40,600
cognitive function.

696
00:39:40,600 --> 00:39:44,960
But that just tells you how important exercise is and getting the blood flow to the brain,

697
00:39:44,960 --> 00:39:50,520
which increases during exercise and how important that can be for maintaining healthy brain

698
00:39:50,520 --> 00:39:54,840
function and heart function and lung function and circulation and everything else.

699
00:39:54,840 --> 00:39:55,840
Wait, they're all connected?

700
00:39:55,840 --> 00:39:56,840
Wait, imagine that.

701
00:39:56,840 --> 00:39:57,840
That's crazy.

702
00:39:57,840 --> 00:40:00,360
Yeah, but I didn't learn this in med school.

703
00:40:00,360 --> 00:40:01,360
This was not in med school.

704
00:40:01,360 --> 00:40:02,360
Interesting.

705
00:40:02,360 --> 00:40:03,360
Yeah, I mean, I didn't either.

706
00:40:03,360 --> 00:40:04,360
This is the thing.

707
00:40:04,360 --> 00:40:05,360
It's literally talking.

708
00:40:05,360 --> 00:40:08,140
I mean, obviously I've been through a medical route, but it's talking to all these experts

709
00:40:08,140 --> 00:40:10,960
in these fields that have kind of slowly created this.

710
00:40:10,960 --> 00:40:13,240
I tell people the Venn diagram, you know, where everything intersects.

711
00:40:13,240 --> 00:40:18,280
You're like, okay, well, there's obviously a truth, you know, a thousand plus conversations

712
00:40:18,280 --> 00:40:24,360
when it comes to, you know, the things that are detrimental to the brain with this incredibly

713
00:40:24,360 --> 00:40:25,960
important lens that you have.

714
00:40:25,960 --> 00:40:30,600
Talk to me about the connection between sleep deprivation and neurodegeneration.

715
00:40:30,600 --> 00:40:32,600
Oh, boy.

716
00:40:32,600 --> 00:40:37,080
Yeah, you know, I think as a neurosurgeon, I don't get enough sleep.

717
00:40:37,080 --> 00:40:38,920
That's for sure.

718
00:40:38,920 --> 00:40:42,920
You know, I frequently operate late into the evening and sometimes overnight.

719
00:40:42,920 --> 00:40:48,440
So you know, I unfortunately I can speak for firsthand experience, you know, sleep deprivation

720
00:40:48,440 --> 00:40:52,840
and you know, how that affects cognition, not only short term, but you know, can affect

721
00:40:52,840 --> 00:40:56,880
you on a long term basis because sleep is very restorative, right?

722
00:40:56,880 --> 00:41:01,880
It's the time when your brain can, the neurons can kind of clear out the toxins from the

723
00:41:01,880 --> 00:41:05,920
day, can help restore your, you know, and get rid of the oxidative stress that you've

724
00:41:05,920 --> 00:41:07,240
had that day.

725
00:41:07,240 --> 00:41:08,240
Everything can kind of reset.

726
00:41:08,240 --> 00:41:13,640
And again, it's time for your brain to kind of cleanse itself over those hours of sleep

727
00:41:13,640 --> 00:41:17,200
so that it's ready for the next day of brain function.

728
00:41:17,200 --> 00:41:20,080
And there's been, you know, countless studies looking at, you know, people that don't get

729
00:41:20,080 --> 00:41:24,280
adequate amounts of sleep as to how that affects, you know, not just your brain function, but

730
00:41:24,280 --> 00:41:26,280
the rest of your body as well.

731
00:41:26,280 --> 00:41:27,280
Right.

732
00:41:27,280 --> 00:41:30,520
I mean, not, you mean, you know, obviously you're going to, if you're tired and you're

733
00:41:30,520 --> 00:41:32,240
having slept on it, you're going to have that brain fog, right?

734
00:41:32,240 --> 00:41:33,240
You're going to be mentally fatigued.

735
00:41:33,240 --> 00:41:36,560
You're going to be limited to what you can learn or what you can take on.

736
00:41:36,560 --> 00:41:37,560
Right.

737
00:41:37,560 --> 00:41:43,000
But also we know that, you know, sleep deprivation can affect like cortisol levels, right?

738
00:41:43,000 --> 00:41:45,080
It can affect hormone levels.

739
00:41:45,080 --> 00:41:50,720
And when you look at the way it affects cortisol levels, you know, if you have this cortisol,

740
00:41:50,720 --> 00:41:54,800
you know, dysregulation, your sleep cycles are off, you know, cortisol can have, although

741
00:41:54,800 --> 00:41:58,320
there might be some benefits of cortisol in the short term, there's, you know, having

742
00:41:58,320 --> 00:42:03,720
chronically elevated cortisol levels as a, you know, from chronic stress, it could certainly

743
00:42:03,720 --> 00:42:08,360
have some profound impact on the body in negative ways.

744
00:42:08,360 --> 00:42:09,360
Right.

745
00:42:09,360 --> 00:42:15,000
So it's, it can be, you know, it can be adverse to your heart tissue and, you know, your thyroid

746
00:42:15,000 --> 00:42:20,380
gland and, you know, just your immune response, your thymus gland, you know, those high levels

747
00:42:20,380 --> 00:42:25,160
of cortisol, which are associated with sleep deprivation.

748
00:42:25,160 --> 00:42:27,800
And then, you know, like I said, so for terms of cognitive function, you know, you got to

749
00:42:27,800 --> 00:42:28,800
sleep enough sleep.

750
00:42:28,800 --> 00:42:32,560
You know, everybody says, you know, six to eight hours of sleep is what you need.

751
00:42:32,560 --> 00:42:37,960
And I'd say, yeah, eight hours is a good goal to shoot for to make sure that, you know,

752
00:42:37,960 --> 00:42:42,000
during that time, you know, your memories can consolidate, your brain can cleanse itself,

753
00:42:42,000 --> 00:42:46,480
the cells can reset and stay as healthy as possible.

754
00:42:46,480 --> 00:42:47,560
What about strokes?

755
00:42:47,560 --> 00:42:48,760
This is an interesting one.

756
00:42:48,760 --> 00:42:52,560
I mean, tragically interesting, but I'm seeing more and more and more strokes in the fire

757
00:42:52,560 --> 00:42:56,760
service of young, especially men for some reason, it seems to be, you know, more on

758
00:42:56,760 --> 00:42:58,240
the male side.

759
00:42:58,240 --> 00:43:02,720
What impact of chronic stress, sleep deprivation, etc.

760
00:43:02,720 --> 00:43:07,560
How does that create an increased chance of a blood vessel in the brain actually, you

761
00:43:07,560 --> 00:43:08,560
know?

762
00:43:08,560 --> 00:43:11,240
I'm saying the word exploding.

763
00:43:11,240 --> 00:43:12,800
That's not the word I'm looking for here.

764
00:43:12,800 --> 00:43:13,800
Breaching.

765
00:43:13,800 --> 00:43:14,800
Burst, rupture.

766
00:43:14,800 --> 00:43:15,800
Thank you.

767
00:43:15,800 --> 00:43:16,800
Yeah.

768
00:43:16,800 --> 00:43:17,800
Yeah.

769
00:43:17,800 --> 00:43:20,400
And yeah, unfortunately, one of the things I have to deal with as a brain surgeon is

770
00:43:20,400 --> 00:43:24,760
the strokes that happen, you know, the hemorrhagic strokes when something bursts and not necessarily

771
00:43:24,760 --> 00:43:33,520
an aneurysm, but probably the number one cause that I see as a neurosurgeon is uncontrolled

772
00:43:33,520 --> 00:43:38,120
or inadequately controlled even, high blood pressure, or, you know, people can call it

773
00:43:38,120 --> 00:43:39,600
the silent killer, right?

774
00:43:39,600 --> 00:43:46,280
Because people walk around with a blood pressure of 160, 180, 200.

775
00:43:46,280 --> 00:43:50,840
I saw a person in the ER just the other night, 220.

776
00:43:50,840 --> 00:43:53,240
You know, and the blood vessels in the brain just aren't designed to carry that kind of

777
00:43:53,240 --> 00:43:55,880
pressure, that kind of load, and they will burst.

778
00:43:55,880 --> 00:44:00,000
And when you have these bursts in the brain, the blood dissects through the brain tissue

779
00:44:00,000 --> 00:44:01,000
and destroys it.

780
00:44:01,000 --> 00:44:07,320
And you can have significant neurologic deficits or even die from these strokes.

781
00:44:07,320 --> 00:44:12,360
And I think for the younger people that we see, again, it's a lot of things that could

782
00:44:12,360 --> 00:44:14,200
be prevented, just getting routine screenings.

783
00:44:14,200 --> 00:44:16,120
Like, you know, no one wants to go to the doctor.

784
00:44:16,120 --> 00:44:17,120
I feel great.

785
00:44:17,120 --> 00:44:18,120
Why don't I want to go to the doctor?

786
00:44:18,120 --> 00:44:19,120
Right?

787
00:44:19,120 --> 00:44:20,120
I'm not having any problems.

788
00:44:20,120 --> 00:44:23,520
But you stick a stick of the arm in a blood pressure machine, like, oh, did you know your

789
00:44:23,520 --> 00:44:25,840
blood pressure is 160 over 110?

790
00:44:25,840 --> 00:44:27,720
Like, oh, no, I didn't know that.

791
00:44:27,720 --> 00:44:30,720
But my mom and dad both have high blood pressure.

792
00:44:30,720 --> 00:44:33,680
You know, and it's like, okay, well, I'm glad you got checked out.

793
00:44:33,680 --> 00:44:34,880
Let's do, let's lose some weight.

794
00:44:34,880 --> 00:44:35,880
Let's do these things.

795
00:44:35,880 --> 00:44:36,880
Let's recheck it.

796
00:44:36,880 --> 00:44:40,000
And if it's not good, you know, maybe they have to go into a blood pressure medicine.

797
00:44:40,000 --> 00:44:44,280
So that's probably the number one cause that we see is just uncontrolled blood pressure.

798
00:44:44,280 --> 00:44:49,200
And the younger folks who are just blissfully unaware that they have this time bomb just

799
00:44:49,200 --> 00:44:50,200
waiting to go off.

800
00:44:50,200 --> 00:44:52,840
So it's always very sad.

801
00:44:52,840 --> 00:44:56,960
Recently saw even a young person, I think she was 42, that died of a massive hemorrhagic

802
00:44:56,960 --> 00:44:57,960
stroke.

803
00:44:57,960 --> 00:45:00,720
I had no idea that she, her family had no idea she had this high blood pressure.

804
00:45:00,720 --> 00:45:01,720
Neither did she.

805
00:45:01,720 --> 00:45:02,720
So, so yeah, it happens.

806
00:45:02,720 --> 00:45:09,240
And I think, excuse me, people at her high stress jobs, you know, the constant adrenaline

807
00:45:09,240 --> 00:45:14,520
response, you know, that maybe they're getting, you know, these rises in blood pressure during

808
00:45:14,520 --> 00:45:16,640
the day that maybe they already have a baseline problem.

809
00:45:16,640 --> 00:45:21,040
Maybe they're walking around 130, 140, you know, 150.

810
00:45:21,040 --> 00:45:25,280
And then they get these high stress jobs where, you know, they're jacked up on adrenaline

811
00:45:25,280 --> 00:45:30,080
running into scenes of whatever, whether it be the fire, EMS, police, and now suddenly

812
00:45:30,080 --> 00:45:33,480
your blood pressure is 180, 190 because, you know, you got so much adrenaline pumped through

813
00:45:33,480 --> 00:45:34,480
your body.

814
00:45:34,480 --> 00:45:37,600
You know, your heart rate's faster, your blood pressure is higher, and that's enough to send

815
00:45:37,600 --> 00:45:44,200
you over the edge to have a blood vessel burst in your brain.

816
00:45:44,200 --> 00:45:48,080
You talked about prescribing, you know, blood pressure medication.

817
00:45:48,080 --> 00:45:54,800
One of the things that I don't see happening in the regular medical world is you have that

818
00:45:54,800 --> 00:45:57,920
patient, you know, they are 50 pounds overweight.

819
00:45:57,920 --> 00:46:02,400
They're not very active and they've got a BP of, you know, like you said, you know,

820
00:46:02,400 --> 00:46:04,560
160 over 110 walking around.

821
00:46:04,560 --> 00:46:09,320
I don't see that conversation of, so let's give you this medication for now.

822
00:46:09,320 --> 00:46:13,440
We don't want your BP going even higher and being a dangerous point, but we need to have

823
00:46:13,440 --> 00:46:16,400
an exit strategy to ultimately get you off it again.

824
00:46:16,400 --> 00:46:18,560
The same with psych meds, the same with so many.

825
00:46:18,560 --> 00:46:22,200
To me, there seems to be this culture of, well, you're going to be on it forever.

826
00:46:22,200 --> 00:46:26,920
It is what it is, which, you know, economically obviously is great for drug companies if you've

827
00:46:26,920 --> 00:46:31,880
got a, you know, a user for life, but I don't think ethically that's a very good philosophy

828
00:46:31,880 --> 00:46:32,880
to have.

829
00:46:32,880 --> 00:46:37,480
And I understand the kind of broken system as far as the minute amount of time a lot

830
00:46:37,480 --> 00:46:41,160
of these physicians get with their patients, but I feel like there needs to be a change

831
00:46:41,160 --> 00:46:47,120
in those, some of these medications have an application, but not for a lifetime use.

832
00:46:47,120 --> 00:46:49,200
Oh boy.

833
00:46:49,200 --> 00:46:55,200
You know, and I think a lot of that falls into the time that it takes to educate patients

834
00:46:55,200 --> 00:46:58,040
on some of these things, right?

835
00:46:58,040 --> 00:47:01,240
Because doctors and, you know, the primary care docs, you know, like I said, God love

836
00:47:01,240 --> 00:47:02,240
them.

837
00:47:02,240 --> 00:47:06,120
I have a lot of great friends that are family practice docs, internal medicine docs.

838
00:47:06,120 --> 00:47:09,400
And yeah, when they have a patient that comes in their office, they have 15 minutes, maybe

839
00:47:09,400 --> 00:47:13,200
less than that and they got to go through their health history, you know, what medicines

840
00:47:13,200 --> 00:47:19,520
are on, what else is going on and how much of that time is left to say, okay, yeah, your

841
00:47:19,520 --> 00:47:21,120
blood pressure is borderline.

842
00:47:21,120 --> 00:47:22,840
Let's talk about how we're going to address it.

843
00:47:22,840 --> 00:47:27,400
So talking about lifestyle and diet and exercise and programs and what else, what other stress

844
00:47:27,400 --> 00:47:28,400
is going on in their life?

845
00:47:28,400 --> 00:47:29,400
How's your sleep?

846
00:47:29,400 --> 00:47:32,120
You know, how, what are you doing to control stress?

847
00:47:32,120 --> 00:47:34,800
You know, all of these things just take time.

848
00:47:34,800 --> 00:47:38,040
And it's, and it's time that honestly, I don't think that they have or that they're able to

849
00:47:38,040 --> 00:47:42,960
spend with patients to do the whole preventative aspect and make an exit plan.

850
00:47:42,960 --> 00:47:45,720
It's like, okay, well yeah, blood pressure is 160.

851
00:47:45,720 --> 00:47:49,320
Here's a prescription for ABC medicine, whatever it is.

852
00:47:49,320 --> 00:47:51,080
And we'll see back in six weeks to check it.

853
00:47:51,080 --> 00:47:52,280
And they come back for their checkup.

854
00:47:52,280 --> 00:47:53,280
Oh yeah, blood pressure is 130.

855
00:47:53,280 --> 00:47:54,280
Now you're good.

856
00:47:54,280 --> 00:47:57,160
I'll call you in refills every 90 days.

857
00:47:57,160 --> 00:47:58,160
Problem solved.

858
00:47:58,160 --> 00:47:59,960
You know, meanwhile, they're still 50 pounds overweight.

859
00:47:59,960 --> 00:48:02,360
They're still smoking a pack of cigarettes or diet sucks.

860
00:48:02,360 --> 00:48:04,120
And they're, they have an exercise since high school.

861
00:48:04,120 --> 00:48:06,400
You know, I mean, it's just, you're right.

862
00:48:06,400 --> 00:48:07,480
It's broken.

863
00:48:07,480 --> 00:48:10,000
And the emphasis is on the wrong things.

864
00:48:10,000 --> 00:48:13,120
And sometimes medications, you know, are absolutely needed.

865
00:48:13,120 --> 00:48:16,920
You have whatever the kidney issues, heart issues, whatever it is, medications are needed.

866
00:48:16,920 --> 00:48:17,920
Absolutely.

867
00:48:17,920 --> 00:48:23,160
But I think we miss a lot of the opportunity to change things in a natural way, get people

868
00:48:23,160 --> 00:48:25,960
healthier to come off those medications.

869
00:48:25,960 --> 00:48:26,960
They're overall healthier.

870
00:48:26,960 --> 00:48:30,240
They don't have the side effects of the medicines.

871
00:48:30,240 --> 00:48:31,800
And we miss those opportunities all the time.

872
00:48:31,800 --> 00:48:36,520
It's a huge, it's a huge break, I think in the healthcare delivery that all of us give

873
00:48:36,520 --> 00:48:38,600
every day.

874
00:48:38,600 --> 00:48:41,480
There seems to be, and again, correct me if I'm wrong, if it's changed now, but there

875
00:48:41,480 --> 00:48:46,280
seems to be a lot of conversations I had almost to kind of poo pooing at the idea that you

876
00:48:46,280 --> 00:48:51,280
could reverse type two diabetes or hypertension with diet and exercise.

877
00:48:51,280 --> 00:48:56,520
And I think that in itself is in a very, very kind of cancerous way of thinking.

878
00:48:56,520 --> 00:48:57,840
Yeah.

879
00:48:57,840 --> 00:49:03,200
I think, you know, sometimes it's also a much easier route to take, right?

880
00:49:03,200 --> 00:49:04,520
So okay, I'm a hundred pounds overweight.

881
00:49:04,520 --> 00:49:08,000
I'm going to take my, I'm going to take med form in and we start on some of the sardis

882
00:49:08,000 --> 00:49:12,160
mincelin blood pressure, arthritis, rides, whatever, give me medicine.

883
00:49:12,160 --> 00:49:13,440
It's no work needed, right?

884
00:49:13,440 --> 00:49:15,280
Just give me a medicine to fix it, right?

885
00:49:15,280 --> 00:49:18,160
Just doctor make me better.

886
00:49:18,160 --> 00:49:22,480
And you know, I think again, a lot of it comes to the education and trying to partner, you

887
00:49:22,480 --> 00:49:25,400
know, with the patient and saying, okay, here's what you got.

888
00:49:25,400 --> 00:49:28,880
You know, if we can't get this diabetes under control, you know, I mean, I can give you

889
00:49:28,880 --> 00:49:30,400
medicine, but there has to be a team approach.

890
00:49:30,400 --> 00:49:31,400
Like patients have to do that.

891
00:49:31,400 --> 00:49:36,280
We have to, you know, make them understand that there's a part that they play in trying

892
00:49:36,280 --> 00:49:40,280
to reduce their chance of morbidity and mortality.

893
00:49:40,280 --> 00:49:43,720
Years later, you know, that we got to, we got to, we got to figure this out now.

894
00:49:43,720 --> 00:49:46,920
Like we have to be a partnership and here's, you know, I'm going to check on you.

895
00:49:46,920 --> 00:49:47,920
I'm going to do this.

896
00:49:47,920 --> 00:49:51,800
Let's start you on this, but I want you to, let's get you in this at the YMCA or whatever.

897
00:49:51,800 --> 00:49:53,120
Let's get you in a gym.

898
00:49:53,120 --> 00:49:54,600
Let's start doing some treadmill.

899
00:49:54,600 --> 00:50:01,600
Let's, you know, to, to, you know, educate them as to what they can do, that's going

900
00:50:01,600 --> 00:50:02,600
to make a difference with these things.

901
00:50:02,600 --> 00:50:04,400
Cause there, it is the easy way out, right?

902
00:50:04,400 --> 00:50:08,840
So doctors give me a pill to fix it, you know, well, it's not, not that easy as much as you

903
00:50:08,840 --> 00:50:09,840
might want to try.

904
00:50:09,840 --> 00:50:13,040
You're still not solving the underlying issues that created it.

905
00:50:13,040 --> 00:50:14,320
And it's not going to be ideal.

906
00:50:14,320 --> 00:50:15,320
It's not going to be optimal.

907
00:50:15,320 --> 00:50:16,320
Absolutely.

908
00:50:16,320 --> 00:50:17,320
Yeah.

909
00:50:17,320 --> 00:50:20,320
But yeah, well, there's people saying, yeah, you're going to be on it for life.

910
00:50:20,320 --> 00:50:23,720
Well, it doesn't have to be, you know, sometimes it is that sucks.

911
00:50:23,720 --> 00:50:27,400
Uh, but it doesn't have to be, you know, someone sitting there in the office, again, they're

912
00:50:27,400 --> 00:50:30,880
a hundred pounds overweight saying, oh, well, you know, you're going to have diabetes.

913
00:50:30,880 --> 00:50:31,880
Well, not necessarily.

914
00:50:31,880 --> 00:50:36,520
How many, how many patients go on GOP one medications and they lose the extra weight

915
00:50:36,520 --> 00:50:38,200
and their diabetes goes away, right?

916
00:50:38,200 --> 00:50:41,200
They're a, the hemoglobin A1C gets back to normal.

917
00:50:41,200 --> 00:50:44,320
Their blood pressure magically goes down from 160 down to 120.

918
00:50:44,320 --> 00:50:46,000
You know, their cholesterol is no longer 300.

919
00:50:46,000 --> 00:50:48,160
It's down to 170, you know?

920
00:50:48,160 --> 00:50:52,960
So, uh, so yes, there are fixes to these problems if they would just be addressed and not take

921
00:50:52,960 --> 00:50:54,920
the just a knee jerk, easy way out.

922
00:50:54,920 --> 00:50:55,920
Like, oh yeah, here's the medicine.

923
00:50:55,920 --> 00:50:57,560
Here's the medicine.

924
00:50:57,560 --> 00:51:04,200
You know, I had a English author, Johann Hari on the show who just did a book on a Zempik

925
00:51:04,200 --> 00:51:06,240
and then the other drugs.

926
00:51:06,240 --> 00:51:09,880
And you know, he's, he's a great, great author and he's obviously putting the pros and then

927
00:51:09,880 --> 00:51:11,400
some of the cons as well.

928
00:51:11,400 --> 00:51:16,500
But one of the areas that I think has huge application, we're talking about medical intervention.

929
00:51:16,500 --> 00:51:18,680
I've lost two friends or my wife's best friend.

930
00:51:18,680 --> 00:51:24,320
And then a guy I went to school with in fire school to a gastric bypass that ultimately,

931
00:51:24,320 --> 00:51:27,960
you know, went wrong inside and then they passed away.

932
00:51:27,960 --> 00:51:34,080
So to me, even on the more extreme side, you know, the, the Zempik style drugs just seem

933
00:51:34,080 --> 00:51:36,160
to be so much safer even with that.

934
00:51:36,160 --> 00:51:41,020
But you hear this kind of reported that they, it kind of resets the way they look at food

935
00:51:41,020 --> 00:51:45,520
and then you have the ability to, to kind of wean off and hopefully carry on that healthy

936
00:51:45,520 --> 00:51:46,520
lifestyle.

937
00:51:46,520 --> 00:51:50,800
Yeah, and actually have a great friend who's a local obesity surgeon.

938
00:51:50,800 --> 00:51:55,400
He did obesity surgery for 20 years, you know, doing gastric bypasses and then the bands,

939
00:51:55,400 --> 00:52:00,640
you know, different procedures that have come along over the years for, for weight loss.

940
00:52:00,640 --> 00:52:04,080
And as you know, there's such a high failure rate, right?

941
00:52:04,080 --> 00:52:06,680
Of those, those operations.

942
00:52:06,680 --> 00:52:10,040
And in some of the show almost a hundred percent failure rate where, you know, if you don't

943
00:52:10,040 --> 00:52:14,800
make appropriate changes to your lifestyle, your, you know, the modifications to your

944
00:52:14,800 --> 00:52:17,080
diet, people are going to gain the weight back, right?

945
00:52:17,080 --> 00:52:20,360
So there's a really, really high failure rate of gastric bypass surgeries because you haven't

946
00:52:20,360 --> 00:52:24,680
solved the underlying problem with, you know, is the, is the issue with the food, right?

947
00:52:24,680 --> 00:52:27,800
The dietary choices, the amount of food, right?

948
00:52:27,800 --> 00:52:30,440
The cravings, right?

949
00:52:30,440 --> 00:52:32,840
So if you're not solving that eventually, you know, people will eat, they'll stretch

950
00:52:32,840 --> 00:52:34,320
their pouch out, whatever it is.

951
00:52:34,320 --> 00:52:38,680
I told you about my mom, she had gastric bypass surgery, didn't lose an ounce of, an ounce

952
00:52:38,680 --> 00:52:42,200
of weight, you know, and those aren't, you know, when I was talking to my good friend,

953
00:52:42,200 --> 00:52:47,840
like I said, the one who does a weight loss surgery, you know, these, these are not like

954
00:52:47,840 --> 00:52:50,280
you, like you pointed out, they're not benign operations.

955
00:52:50,280 --> 00:52:54,160
You know, they, yes, they're much safer than they were years, years ago, but you're operating

956
00:52:54,160 --> 00:52:57,600
on somebody who's way overweight and their risk of complications from surgery is going

957
00:52:57,600 --> 00:52:58,600
to be higher.

958
00:52:58,600 --> 00:53:01,120
So there's blood clot risk, there's heart attack risks.

959
00:53:01,120 --> 00:53:04,040
And certainly they're, you know, they're always quote, you know, 1% risk of death with those

960
00:53:04,040 --> 00:53:05,040
operations.

961
00:53:05,040 --> 00:53:07,200
And I was like, yeah, that's probably about right.

962
00:53:07,200 --> 00:53:11,720
But when I asked my friend, this obesity surgeon, you know, what do you think about the GLP

963
00:53:11,720 --> 00:53:12,720
ones?

964
00:53:12,720 --> 00:53:16,960
And he was super excited about it, you know, because not only changes the, you know, not

965
00:53:16,960 --> 00:53:20,000
only helps them lose weight, but it changes the reason that they've gained the weight,

966
00:53:20,000 --> 00:53:21,000
right?

967
00:53:21,000 --> 00:53:22,840
It changes those, those cravings, right?

968
00:53:22,840 --> 00:53:26,960
They're overeating, you know, they don't, they, they feel full much faster, right?

969
00:53:26,960 --> 00:53:31,720
Again, they don't, they don't eat as much, you know, so, you know, they just, they eat

970
00:53:31,720 --> 00:53:35,040
one third of the hamburger instead of, you know, two hamburgers, you know, so the amount

971
00:53:35,040 --> 00:53:39,440
of food they're consuming is, is way down and their body can metabolize that glucose

972
00:53:39,440 --> 00:53:42,880
in a more normal way.

973
00:53:42,880 --> 00:53:47,760
So the cravings are gone, they feel fuller faster, they don't overeat.

974
00:53:47,760 --> 00:53:51,720
Like I said, so they, they'll lose weight and that's, so it changes their whole mind

975
00:53:51,720 --> 00:53:56,480
the way they're, they're approaching food and much safer.

976
00:53:56,480 --> 00:54:00,440
Obviously, you're giving yourself an injection, you know, the GLP ones, they're not without

977
00:54:00,440 --> 00:54:05,280
side effects, of course, but you know, it's much better than a 1% risk of death.

978
00:54:05,280 --> 00:54:07,840
You know, you don't have so much, you know, there's a lot of nausea and there can be some

979
00:54:07,840 --> 00:54:13,040
vomiting and things you got to work through over time, but certainly a lot safer to do

980
00:54:13,040 --> 00:54:16,480
an injection rather than having a major gastric surgery.

981
00:54:16,480 --> 00:54:21,360
I think sometimes the, the issue becomes, okay, now they've lost the hundred pounds

982
00:54:21,360 --> 00:54:25,240
or they lost the weight that they needed to lose, now what?

983
00:54:25,240 --> 00:54:29,680
Because there's been concerns that if you just stop your semiglutide, stop your resymthic,

984
00:54:29,680 --> 00:54:31,800
that the weight's going to come back.

985
00:54:31,800 --> 00:54:33,800
And to a degree, that's true.

986
00:54:33,800 --> 00:54:37,520
There is certainly is a failure rate with stopping those medications because the old

987
00:54:37,520 --> 00:54:38,760
habits creep back, right?

988
00:54:38,760 --> 00:54:41,280
Oh, I'm starting to crave this again.

989
00:54:41,280 --> 00:54:45,520
And oh, you know, I'm, I started eating this crap again and I've started, my portions are

990
00:54:45,520 --> 00:54:46,720
getting larger.

991
00:54:46,720 --> 00:54:50,560
So all these bad habits kind of start to creep back up over the course of the ensuing few

992
00:54:50,560 --> 00:54:52,660
weeks or months once you stop it.

993
00:54:52,660 --> 00:54:55,800
And that weight will slowly start to gain gain back.

994
00:54:55,800 --> 00:55:00,880
And that's why there's been this recent chatter, which you've probably heard about microdosing

995
00:55:00,880 --> 00:55:02,240
GLP ones, right?

996
00:55:02,240 --> 00:55:06,800
You lose the lose the weight and then rather than just stopping it, okay, well, let's take

997
00:55:06,800 --> 00:55:07,800
a really teeny tiny dose.

998
00:55:07,800 --> 00:55:11,060
Let's take a little toast, a little taste of a GLP one.

999
00:55:11,060 --> 00:55:13,800
Maybe we do half of the starting dose, something real small.

1000
00:55:13,800 --> 00:55:14,800
Will that be enough?

1001
00:55:14,800 --> 00:55:17,160
Just keep away the cravings, you know, just keep me from overeating.

1002
00:55:17,160 --> 00:55:18,600
I don't want to lose any more weight, right?

1003
00:55:18,600 --> 00:55:19,600
I'm done my weight loss.

1004
00:55:19,600 --> 00:55:21,000
I just don't want to gain it back.

1005
00:55:21,000 --> 00:55:27,040
So if we can do a little bit of a tiny micro dose, maybe that'll help keep me from getting

1006
00:55:27,040 --> 00:55:28,040
the weight back.

1007
00:55:28,040 --> 00:55:29,360
So I know a lot of patients are trying that.

1008
00:55:29,360 --> 00:55:31,160
That's some success with that.

1009
00:55:31,160 --> 00:55:33,880
But still to be determined, okay, what is that dose?

1010
00:55:33,880 --> 00:55:34,880
Is that forever dose?

1011
00:55:34,880 --> 00:55:37,160
You know, how do we how do we manage microdosing?

1012
00:55:37,160 --> 00:55:41,200
So that's I'm sure that's there'll be more to that to come as the years come back.

1013
00:55:41,200 --> 00:55:42,200
Google buy.

1014
00:55:42,200 --> 00:55:43,200
Interesting.

1015
00:55:43,200 --> 00:55:47,960
I want to hit one more topic and then we'll go to transcend and unpack the whole hormonal

1016
00:55:47,960 --> 00:55:49,100
discussion.

1017
00:55:49,100 --> 00:55:54,360
But while we're in the neuroscience side, when I was going, you know, learning science

1018
00:55:54,360 --> 00:55:58,760
when I was kind of young again, the 90s, someone referred to that as the 1900s the other day,

1019
00:55:58,760 --> 00:56:01,520
which really made me sad.

1020
00:56:01,520 --> 00:56:07,200
The science seemed to say that once brain tissue was damaged, you know, with a stroke

1021
00:56:07,200 --> 00:56:10,280
or a spinal cord or whatever it was, that was it.

1022
00:56:10,280 --> 00:56:11,640
Brain doesn't regenerate.

1023
00:56:11,640 --> 00:56:14,880
And then as we've gone through the years, you start hearing about neurogenesis and I

1024
00:56:14,880 --> 00:56:17,320
find that so, so exciting.

1025
00:56:17,320 --> 00:56:21,200
And I've watched some of my friends that have had strokes, you know, not massive, massive

1026
00:56:21,200 --> 00:56:25,120
improvements, but improvements, you know, they are getting better slowly.

1027
00:56:25,120 --> 00:56:27,280
And you know, will they ever get to full function?

1028
00:56:27,280 --> 00:56:31,880
Maybe not, but certainly, you know, X percent better than they were before.

1029
00:56:31,880 --> 00:56:33,760
So talk to me about that side.

1030
00:56:33,760 --> 00:56:37,220
What was the discussion when you were going through med school and what has been this

1031
00:56:37,220 --> 00:56:41,340
revelation that we're seeing of the of the brain, the spine and the brain to actually

1032
00:56:41,340 --> 00:56:44,200
somewhat heal itself?

1033
00:56:44,200 --> 00:56:46,720
You know, that, yeah, same thing we're taught in med school.

1034
00:56:46,720 --> 00:56:52,120
Like you like you've heard those, the nerve cells, the neurons and the pathways, the nerve

1035
00:56:52,120 --> 00:56:58,880
fibers have limited regeneration for healing or repair or reconnection.

1036
00:56:58,880 --> 00:57:00,920
And to a large sense, that's that's true.

1037
00:57:00,920 --> 00:57:07,960
This whole idea of neuroplasticity where a nerve cell can create other connections, you

1038
00:57:07,960 --> 00:57:13,160
know, with other nerve cells, which is important for brain function and memory and learning.

1039
00:57:13,160 --> 00:57:14,160
Right.

1040
00:57:14,160 --> 00:57:16,040
So the more connections, the better.

1041
00:57:16,040 --> 00:57:21,400
And when you have a stroke or a brain injury, those connections, those cells die off, the

1042
00:57:21,400 --> 00:57:24,440
connections die off or a case of a spinal cord injury.

1043
00:57:24,440 --> 00:57:25,720
You know, the spinal cord is cut.

1044
00:57:25,720 --> 00:57:31,280
All those all that fiber optic cable, the nerve fibers, you know, that's that's cut.

1045
00:57:31,280 --> 00:57:36,200
And you know, it's impossible for those optic, you know, cables to get, you know, start,

1046
00:57:36,200 --> 00:57:37,200
you know, functioning again.

1047
00:57:37,200 --> 00:57:40,160
You know, the same thing with the nerve cells.

1048
00:57:40,160 --> 00:57:42,040
Those fibers just don't reconnect.

1049
00:57:42,040 --> 00:57:45,560
So that's why a lot of people who have spinal cord injuries and paralysis frequently don't

1050
00:57:45,560 --> 00:57:46,560
get better.

1051
00:57:46,560 --> 00:57:47,560
Right.

1052
00:57:47,560 --> 00:57:48,560
So it's devastating neurologic injury.

1053
00:57:48,560 --> 00:57:49,880
So that's how we're trained in med school.

1054
00:57:49,880 --> 00:57:53,560
And a lot of and, you know, from a lot a lot of times, that's true.

1055
00:57:53,560 --> 00:58:01,520
But there is has been some work and how how to mitigate the damage, how can restore some

1056
00:58:01,520 --> 00:58:02,960
of that function.

1057
00:58:02,960 --> 00:58:09,760
And with some of the compounds that are being developed, developed, the so-called neurotrophics

1058
00:58:09,760 --> 00:58:15,240
that help the neurons produce more of what's called BDNF or brain derived neurotrophic

1059
00:58:15,240 --> 00:58:19,640
factor that helps to stimulate nerve cells to regenerate or grow.

1060
00:58:19,640 --> 00:58:25,760
And also to create more of those connections, kind of restore those connections between

1061
00:58:25,760 --> 00:58:32,160
other nerve cells and to help modulate the chemicals that are released between neurons,

1062
00:58:32,160 --> 00:58:36,560
you know, the neurotransmitters to again, to help the cells communicate and talk to

1063
00:58:36,560 --> 00:58:37,560
one another.

1064
00:58:37,560 --> 00:58:43,040
And with and with that will be some return of the of the nerve function.

1065
00:58:43,040 --> 00:58:45,200
So there's different compounds that are being developed.

1066
00:58:45,200 --> 00:58:50,120
There's one that's been recently shown to help spinal cord injured animals and hopefully

1067
00:58:50,120 --> 00:58:54,440
humans soon to restore some of those connections.

1068
00:58:54,440 --> 00:58:58,760
There's been electrical stimulation to the brain where they put electrical things on

1069
00:58:58,760 --> 00:59:02,520
this in the scalp to help pass electrical currents across the brain to try and help

1070
00:59:02,520 --> 00:59:05,640
stimulate some of those same thing with the spinal cord injuries.

1071
00:59:05,640 --> 00:59:09,880
There's electrical paddles that we can put in on the area of a spinal cord injury that

1072
00:59:09,880 --> 00:59:14,860
can stimulate those nerve fibers to try to restore some of the muscle function.

1073
00:59:14,860 --> 00:59:19,440
So there are some exciting frontiers, if you will, trying to restore function.

1074
00:59:19,440 --> 00:59:25,080
You know, Elon Musk has the whole, you know, neural link with which I think seems incredibly

1075
00:59:25,080 --> 00:59:31,320
fascinating with the recent one trying to get people that have been blind to see by

1076
00:59:31,320 --> 00:59:36,440
again, put in putting electrical paddles on the occipital lobe, which is the area of the

1077
00:59:36,440 --> 00:59:40,760
brain that controls vision and having that whole interface where people can start to

1078
00:59:40,760 --> 00:59:42,100
see.

1079
00:59:42,100 --> 00:59:45,280
So I think, you know, 10 or 20 years from now, I'm excited to see what's available

1080
00:59:45,280 --> 00:59:49,880
to help people restore function, you know, following, you know, following strokes or,

1081
00:59:49,880 --> 00:59:51,960
you know, spinal cord injuries.

1082
00:59:51,960 --> 00:59:52,960
What about stem cells?

1083
00:59:52,960 --> 00:59:56,960
What are your thoughts on where they will be effective?

1084
00:59:56,960 --> 01:00:00,160
And then maybe some kind of urban legends on where they were.

1085
01:00:00,160 --> 01:00:03,440
Yeah, you know, I think I'll go down again.

1086
01:00:03,440 --> 01:00:08,220
The brain is in the spinal cord or very unique.

1087
01:00:08,220 --> 01:00:10,320
You know, it's all about how the fibers connect.

1088
01:00:10,320 --> 01:00:14,880
And, you know, the stem cells, it's kind of been a bust so far with all the studies that

1089
01:00:14,880 --> 01:00:19,760
have been done, you know, to try to, you know, restore some of the function with stem cells

1090
01:00:19,760 --> 01:00:21,200
in the brain or spinal cord.

1091
01:00:21,200 --> 01:00:26,840
I know there's been experiments, you know, doing intravenous stem cells, different kinds

1092
01:00:26,840 --> 01:00:32,420
of stem cells, you know, umbilical stem cells or bone marrow stem cells, giving them in

1093
01:00:32,420 --> 01:00:34,800
different ways.

1094
01:00:34,800 --> 01:00:39,360
But so far, none that have gained any FDA approval or acceptance because they just so

1095
01:00:39,360 --> 01:00:40,360
far haven't worked.

1096
01:00:40,360 --> 01:00:44,400
Now that might be great for sticking stem cells in a knee or maybe sticking stem cells

1097
01:00:44,400 --> 01:00:45,880
in a degenerated disc.

1098
01:00:45,880 --> 01:00:48,560
You know, maybe there's some utility there.

1099
01:00:48,560 --> 01:00:55,080
But so far, for the spinal cord and brain, haven't seen too many promising results as

1100
01:00:55,080 --> 01:00:56,080
of yet.

1101
01:00:56,080 --> 01:00:57,640
Yeah, I'm hoping it will work for the knee.

1102
01:00:57,640 --> 01:01:00,160
I've got two meniscus that are missing a large part.

1103
01:01:00,160 --> 01:01:03,480
So I'd love for them to figure out how to make that grow back one day.

1104
01:01:03,480 --> 01:01:05,120
Yeah, wouldn't that be nice?

1105
01:01:05,120 --> 01:01:06,120
All right.

1106
01:01:06,120 --> 01:01:08,960
Well, I want to go to Transcend.

1107
01:01:08,960 --> 01:01:13,840
I came across them when I did the 7X round the world project with Ryan Parrott.

1108
01:01:13,840 --> 01:01:15,640
I think was that two years ago now?

1109
01:01:15,640 --> 01:01:17,760
I think it was.

1110
01:01:17,760 --> 01:01:23,080
And met Brendan and some of the other guys and was blown away by the foundation, you

1111
01:01:23,080 --> 01:01:29,000
know, the fact of, you know, the veteran founder Ernie and obviously his story and the why

1112
01:01:29,000 --> 01:01:35,360
behind it and saw such an altruistic organization that was doing this particular area the right

1113
01:01:35,360 --> 01:01:37,720
way, in my opinion, says James.

1114
01:01:37,720 --> 01:01:41,600
What was it, you know, you're this, you know, as you said, you know, one in a very small

1115
01:01:41,600 --> 01:01:46,680
amount of neurosurgeons on the planet, you could probably align with any company you

1116
01:01:46,680 --> 01:01:47,680
wanted to.

1117
01:01:47,680 --> 01:01:49,680
What was it that drew you towards Transcend?

1118
01:01:49,680 --> 01:01:56,560
Oh, you know, Ernie, as you've met, is a very dynamic fellow, highly intelligent.

1119
01:01:56,560 --> 01:02:02,480
You know, when you first meet Ernie, as you know, he's a ex-Marine, very intense guy,

1120
01:02:02,480 --> 01:02:06,120
you know, big muscular guy, you know, tattoos, you know.

1121
01:02:06,120 --> 01:02:09,800
So physically, he's a very impressive man, right?

1122
01:02:09,800 --> 01:02:13,280
But when, you know, you spend five minutes talking to Ernie, you realize this guy, he's,

1123
01:02:13,280 --> 01:02:16,280
you know, coming from the brain surgeon, he's one of the most intelligent guys I think I've

1124
01:02:16,280 --> 01:02:22,320
ever met, just a very dynamic personality, full of creative ideas, and has a roadmap

1125
01:02:22,320 --> 01:02:23,720
of how he wants to get there.

1126
01:02:23,720 --> 01:02:28,240
So I was very impressed from the first meeting I had with Ernie.

1127
01:02:28,240 --> 01:02:32,640
And you know, the vision he has and the reasoning behind it, right?

1128
01:02:32,640 --> 01:02:34,760
He didn't want to, you know, he didn't want to just start a company, right?

1129
01:02:34,760 --> 01:02:36,960
He didn't want to start an HRT business.

1130
01:02:36,960 --> 01:02:41,040
He wanted to start a way that's going to, you know, transforms people's lives and have

1131
01:02:41,040 --> 01:02:46,040
a place where people can come to, to get answers to elements and, you know, that they're not

1132
01:02:46,040 --> 01:02:50,160
getting it from their standard, you know, medical community.

1133
01:02:50,160 --> 01:02:52,600
And it makes people's lives better.

1134
01:02:52,600 --> 01:02:57,040
And he had a special slant, you know, through the Transcend Foundation, of helping, you

1135
01:02:57,040 --> 01:03:03,320
know, his fellow, you know, special forces guys, you know, the armed forces, first responders,

1136
01:03:03,320 --> 01:03:08,000
firemen, policemen, trying to deal with the special needs and the unique circumstances

1137
01:03:08,000 --> 01:03:15,360
that they have, and making sure that part of what we're doing can have a focus and help,

1138
01:03:15,360 --> 01:03:20,640
help these, help that special, special, that particular group of people that had issues

1139
01:03:20,640 --> 01:03:23,320
that were just not being addressed by anyone else.

1140
01:03:23,320 --> 01:03:29,200
So from the very beginning, Ernie had this concept of Transcend and along with that Transcend

1141
01:03:29,200 --> 01:03:34,160
Foundation from the very early stages of him starting Transcend, because that was his passion

1142
01:03:34,160 --> 01:03:37,960
to, to help the first responders.

1143
01:03:37,960 --> 01:03:38,960
So this is my perspective.

1144
01:03:38,960 --> 01:03:39,960
Otto, please jump in.

1145
01:03:39,960 --> 01:03:40,960
Carry on.

1146
01:03:40,960 --> 01:03:41,960
Oh, no.

1147
01:03:41,960 --> 01:03:42,960
Yeah.

1148
01:03:42,960 --> 01:03:45,120
So again, so that was, you know, that's, you know, you always got to be careful who you

1149
01:03:45,120 --> 01:03:46,120
hit your wagon to, right?

1150
01:03:46,120 --> 01:03:50,120
I mean, I had a love for regenerative medicine and passionate about this area of medicine

1151
01:03:50,120 --> 01:03:54,920
outside of, you know, neurosurgery and how it was starting to kind of blend with neurosurgery.

1152
01:03:54,920 --> 01:03:59,880
And Ernie knew was going to allow me to kind of, you know, kind of grow this area and get

1153
01:03:59,880 --> 01:04:00,880
more of this expertise.

1154
01:04:00,880 --> 01:04:04,640
And because this is a pretty unique, unique niche, right?

1155
01:04:04,640 --> 01:04:08,840
In medicine, this is not, I think Transcend does a remarkable job in trying to get in

1156
01:04:08,840 --> 01:04:15,840
the latest and greatest and, you know, kind of not the typical standard medical care you

1157
01:04:15,840 --> 01:04:17,880
get from your dock down the road.

1158
01:04:17,880 --> 01:04:21,400
So it's great to be on this cutting edge of these latest and greatest things that potentially

1159
01:04:21,400 --> 01:04:22,760
can help people.

1160
01:04:22,760 --> 01:04:24,440
So I was very fascinated by it.

1161
01:04:24,440 --> 01:04:25,440
We had that same, same personality.

1162
01:04:25,440 --> 01:04:29,960
It's like, he's just like a man full of creative ideas and things that he wanted to do.

1163
01:04:29,960 --> 01:04:33,560
And we were lockstep with that from the very beginning.

1164
01:04:33,560 --> 01:04:36,200
Well, you mentioned the dock down the road.

1165
01:04:36,200 --> 01:04:42,240
What's interesting in the last eight years of this podcast, I've again been educated

1166
01:04:42,240 --> 01:04:48,100
by all these people and I've realized that the pendulum was one way and it swung completely

1167
01:04:48,100 --> 01:04:49,100
the other way.

1168
01:04:49,100 --> 01:04:53,600
So Kirk Parsley I had on the show was really listening to him on barbell shrug is why I

1169
01:04:53,600 --> 01:04:55,080
started this podcast.

1170
01:04:55,080 --> 01:04:58,720
Navy Seal turned physician really unpacked after about a year.

1171
01:04:58,720 --> 01:05:02,960
He kind of had the penny dropping moment where he realized, oh, this is sleep.

1172
01:05:02,960 --> 01:05:07,600
That's causing my elite war fighters to have, you know, blood results like an 80 year old

1173
01:05:07,600 --> 01:05:09,360
woman.

1174
01:05:09,360 --> 01:05:15,120
And you start hearing about, you know, the range that most of us were subjected to if

1175
01:05:15,120 --> 01:05:17,680
they were even testing our testosterone at all.

1176
01:05:17,680 --> 01:05:21,640
So it was the, I forget, was it one or two 50 all the way to nine 50.

1177
01:05:21,640 --> 01:05:26,600
And he was saying that in the Northeast, one of the Ivy league schools had studied a town

1178
01:05:26,600 --> 01:05:31,040
and the nine 50 was a high school football player and the one or two 50 was the eight

1179
01:05:31,040 --> 01:05:34,320
year old sedentary dude, you know, two days from death.

1180
01:05:34,320 --> 01:05:39,120
And so you've got these 30 year old first responders going into their annual checkup

1181
01:05:39,120 --> 01:05:40,960
and they're like, oh, your T is three.

1182
01:05:40,960 --> 01:05:41,960
You're fine.

1183
01:05:41,960 --> 01:05:42,960
300 you're fine.

1184
01:05:42,960 --> 01:05:46,440
You're within normal limits, but they were not within normal limits.

1185
01:05:46,440 --> 01:05:51,660
Then a few years ago, all of a sudden these recharge and men's clinics started popping

1186
01:05:51,660 --> 01:05:52,660
up everywhere.

1187
01:05:52,660 --> 01:05:58,140
And then I see an absolute epidemic of the same young first responders.

1188
01:05:58,140 --> 01:06:02,540
Now we sometimes even without blood tests being given TRT.

1189
01:06:02,540 --> 01:06:04,160
And so now it's gone all the way the other way.

1190
01:06:04,160 --> 01:06:08,940
No one's talking about sleep or changing the shifts or nutrition or strength training and

1191
01:06:08,940 --> 01:06:11,580
all the holistic things that you want to address first.

1192
01:06:11,580 --> 01:06:13,760
No one's talking about peptides either.

1193
01:06:13,760 --> 01:06:17,800
And so now you've got these young first responders, they haven't been told about losing their

1194
01:06:17,800 --> 01:06:22,600
hair infertility, you know, the the for lack of a better word, the bitch tits.

1195
01:06:22,600 --> 01:06:27,240
I mean, all the things that come along with, you know, if you're not using it properly.

1196
01:06:27,240 --> 01:06:30,520
So I see a complete predatory element to this.

1197
01:06:30,520 --> 01:06:34,480
And my men and women are a lot, you know, more often than not, the ones being preyed

1198
01:06:34,480 --> 01:06:36,820
upon because they don't know better.

1199
01:06:36,820 --> 01:06:38,660
That's James Gearing's perspective.

1200
01:06:38,660 --> 01:06:43,560
What have you seen as far as the the hormone supplementation element through your eyes

1201
01:06:43,560 --> 01:06:45,520
over the last eight, ten years?

1202
01:06:45,520 --> 01:06:49,600
Yeah, you know, it used to be really taboo.

1203
01:06:49,600 --> 01:06:50,600
Right.

1204
01:06:50,600 --> 01:06:56,520
I mean, you look back further than that 15 years ago, you know, TRT clinics weren't a

1205
01:06:56,520 --> 01:06:57,520
thing.

1206
01:06:57,520 --> 01:06:58,520
You know, it was testosterone.

1207
01:06:58,520 --> 01:07:00,000
It always had a bad connotation.

1208
01:07:00,000 --> 01:07:01,560
Oh, you're doing steroids.

1209
01:07:01,560 --> 01:07:02,560
Right.

1210
01:07:02,560 --> 01:07:04,960
So it was just it had a bad connotation.

1211
01:07:04,960 --> 01:07:06,640
Like nobody would talk about TRT.

1212
01:07:06,640 --> 01:07:09,080
You never saw advertisements for TRT.

1213
01:07:09,080 --> 01:07:13,840
And even the doctors like myself was trained in med school that testosterone is bad, you

1214
01:07:13,840 --> 01:07:16,920
know, to give you a heart attack, to give you a stroke, like state, you know, you can't

1215
01:07:16,920 --> 01:07:17,920
do any can't do testosterone.

1216
01:07:17,920 --> 01:07:20,040
That's how I was trained in med school.

1217
01:07:20,040 --> 01:07:22,080
Testosterone is bad.

1218
01:07:22,080 --> 01:07:23,080
Right.

1219
01:07:23,080 --> 01:07:28,400
And, you know, so so if you went to your doc and your your level was 300, you know, oh,

1220
01:07:28,400 --> 01:07:30,200
yeah, the normal is 290.

1221
01:07:30,200 --> 01:07:31,200
You're 300.

1222
01:07:31,200 --> 01:07:32,200
You're good, man.

1223
01:07:32,200 --> 01:07:33,200
You know.

1224
01:07:33,200 --> 01:07:37,000
And maybe it was 300, but you got the whole talk where like, oh, well, you know, you're

1225
01:07:37,000 --> 01:07:38,000
getting old, man.

1226
01:07:38,000 --> 01:07:39,000
Just kind of what happens.

1227
01:07:39,000 --> 01:07:40,840
You know, you're you're not 20 year old.

1228
01:07:40,840 --> 01:07:42,240
Your testosterone 20 anymore.

1229
01:07:42,240 --> 01:07:43,240
Your testosterone is dip dip.

1230
01:07:43,240 --> 01:07:44,240
And that's what happens.

1231
01:07:44,240 --> 01:07:48,440
You know, this whole concept of, you know, andro-paws, you know, like women go through

1232
01:07:48,440 --> 01:07:52,880
menopause when they lose their hormones and men going through andro-paws, you know, just

1233
01:07:52,880 --> 01:07:53,880
a fact of life.

1234
01:07:53,880 --> 01:07:56,320
You just got to got to got to live with it.

1235
01:07:56,320 --> 01:08:02,120
But then, you know, more and more data started coming out showing that not only is quality

1236
01:08:02,120 --> 01:08:08,240
of life can be pretty miserable with low testosterone levels, but also the health disadvantages

1237
01:08:08,240 --> 01:08:12,880
from having low testosterone levels, right, where you're higher risk for having high blood

1238
01:08:12,880 --> 01:08:17,040
pressure, you're higher risk for having diabetes, you're higher risk for having frailty and

1239
01:08:17,040 --> 01:08:19,560
ability from loss of your muscle tissue.

1240
01:08:19,560 --> 01:08:23,040
You know, you're high risk for having high triglycerides and Alzheimer's, you know, with

1241
01:08:23,040 --> 01:08:26,360
low hormone levels for men and women.

1242
01:08:26,360 --> 01:08:30,000
So then, like you said, the pendulum started to swing the other way, where it's like, OK,

1243
01:08:30,000 --> 01:08:35,040
not only are people suffering quality of life with these low testosterone levels, but are

1244
01:08:35,040 --> 01:08:40,160
also setting them up for setting them up for failure later in life over the next 10, 20

1245
01:08:40,160 --> 01:08:43,800
years, 30 years, because we didn't properly balance the hormones because they were, you

1246
01:08:43,800 --> 01:08:46,360
know, quote unquote, normal.

1247
01:08:46,360 --> 01:08:50,680
So you know, there's a way, there's a right way to do it where you check in the blood

1248
01:08:50,680 --> 01:08:54,360
work, you're following up clinically, you're following up with patients, you know, making

1249
01:08:54,360 --> 01:08:59,000
sure that things you want better are getting better and making sure you're avoiding side

1250
01:08:59,000 --> 01:09:00,000
effects.

1251
01:09:00,000 --> 01:09:02,760
You've got to be in a place where the doctors are familiar doing that, the clinics are familiar

1252
01:09:02,760 --> 01:09:04,120
doing that.

1253
01:09:04,120 --> 01:09:09,760
The issue is when people try to, yeah, they go to a clinic, doesn't know, or they're doing

1254
01:09:09,760 --> 01:09:12,880
it, getting it from a friend, MIT is low.

1255
01:09:12,880 --> 01:09:14,720
And you know, people sometimes have no idea what they're doing.

1256
01:09:14,720 --> 01:09:19,840
You know, they get on chat rooms and they'll get all kinds of wild advice on what to do.

1257
01:09:19,840 --> 01:09:24,360
And that's when you start to see the real complications, issues, problems arising from

1258
01:09:24,360 --> 01:09:31,560
TRT, which should be a safe, you know, thing to do that's important for your overall health.

1259
01:09:31,560 --> 01:09:34,400
You know, like at Transcend, we get the, we run through the list.

1260
01:09:34,400 --> 01:09:35,400
Okay, what are you doing?

1261
01:09:35,400 --> 01:09:36,400
What's your lifestyle like?

1262
01:09:36,400 --> 01:09:37,400
What's your exercise program like?

1263
01:09:37,400 --> 01:09:38,400
Tell me about your job.

1264
01:09:38,400 --> 01:09:39,400
How much stress are you on?

1265
01:09:39,400 --> 01:09:40,400
How much alcohol are you drinking?

1266
01:09:40,400 --> 01:09:45,360
You know, are there things we can modify that may naturally boost your testosterone up all

1267
01:09:45,360 --> 01:09:49,480
by itself without having to go on any medication whatsoever?

1268
01:09:49,480 --> 01:09:53,120
So part of what's great about, you know, Transcend, as you've seen, there's wellness specialists,

1269
01:09:53,120 --> 01:09:54,120
right?

1270
01:09:54,120 --> 01:09:58,280
There's wellness coaches, almost like a life coach where you know, they'll do the intake,

1271
01:09:58,280 --> 01:10:03,240
they'll get to know the person and they'll go through all these, all these life factors

1272
01:10:03,240 --> 01:10:06,600
that may be contributing to where, where they're at.

1273
01:10:06,600 --> 01:10:07,680
Yeah.

1274
01:10:07,680 --> 01:10:12,760
But now that there's clinics that are established and able to do this safely, I think doctors

1275
01:10:12,760 --> 01:10:17,480
and people, you know, the community nationwide are starting to realize, okay, you know, it's

1276
01:10:17,480 --> 01:10:19,640
not taboo to talk about my low testosterone.

1277
01:10:19,640 --> 01:10:22,160
You know, I'm not less of a man because my testosterone is 200.

1278
01:10:22,160 --> 01:10:26,680
I can actually get help and it's not taboo and I can do it safely and I'll have a doctor

1279
01:10:26,680 --> 01:10:27,680
that follows me.

1280
01:10:27,680 --> 01:10:32,120
And you know, and then once you get on the TRT and people do so well, you know, people

1281
01:10:32,120 --> 01:10:34,120
talk about it, you know, talking about their buddies.

1282
01:10:34,120 --> 01:10:35,920
Yeah, man, my test was 300.

1283
01:10:35,920 --> 01:10:37,680
The doc said I was fine.

1284
01:10:37,680 --> 01:10:38,680
It wasn't fine.

1285
01:10:38,680 --> 01:10:40,640
I went to a TRT clinic and now I feel amazing.

1286
01:10:40,640 --> 01:10:41,640
I've got my energy back.

1287
01:10:41,640 --> 01:10:44,120
I'm working out again, losing my dad bod.

1288
01:10:44,120 --> 01:10:45,560
You know, I feel so much more energy.

1289
01:10:45,560 --> 01:10:47,800
I'm back in the gym now because I have the energy for it.

1290
01:10:47,800 --> 01:10:49,280
I can really crank out more sets.

1291
01:10:49,280 --> 01:10:50,280
I'm more motivated.

1292
01:10:50,280 --> 01:10:51,280
You know, I'm happier.

1293
01:10:51,280 --> 01:10:54,640
I'm not, you know, having the brain fog.

1294
01:10:54,640 --> 01:10:55,640
My libido is back.

1295
01:10:55,640 --> 01:10:57,520
You know, I'm having sex with my wife again.

1296
01:10:57,520 --> 01:11:00,560
You know, all these things that just have, you know, improved quality of life.

1297
01:11:00,560 --> 01:11:01,560
You know, people talk about it.

1298
01:11:01,560 --> 01:11:06,480
So just like, you know, so many referrals that I get are just like, you know, a friend

1299
01:11:06,480 --> 01:11:07,480
or it's a brother or something.

1300
01:11:07,480 --> 01:11:11,760
You know, it's just like, you know, people know to come to a place that, you know, where

1301
01:11:11,760 --> 01:11:12,760
they can get help.

1302
01:11:12,760 --> 01:11:19,960
What was interesting, I was always very mindful during the fire service and I, you know, kept

1303
01:11:19,960 --> 01:11:22,280
the same body composition through the whole 14 years.

1304
01:11:22,280 --> 01:11:25,960
You know, I've been an athlete, you know, aware of what I eat.

1305
01:11:25,960 --> 01:11:29,520
I went through, you know, plant based for a bit and all kinds of stuff and just, you

1306
01:11:29,520 --> 01:11:33,560
know, really looking at my blood work each year and going, okay, is this good?

1307
01:11:33,560 --> 01:11:34,560
Okay.

1308
01:11:34,560 --> 01:11:35,560
The cholesterol is a little high.

1309
01:11:35,560 --> 01:11:38,040
Let me, let me take some of the fat out, et cetera, et cetera.

1310
01:11:38,040 --> 01:11:41,320
I transition out the fire service.

1311
01:11:41,320 --> 01:11:47,760
And when I get my blood work done, I'm still either 50 years old, either side of 700.

1312
01:11:47,760 --> 01:11:50,280
But like you said, it's a number.

1313
01:11:50,280 --> 01:11:53,520
I still didn't feel like I was, you know, where I needed to be.

1314
01:11:53,520 --> 01:11:55,240
And I'm not talking about, you know, size.

1315
01:11:55,240 --> 01:12:00,640
I have no interest whatsoever being bigger than I am air quotes, but I know, you know,

1316
01:12:00,640 --> 01:12:02,000
the energy levels that I should have.

1317
01:12:02,000 --> 01:12:05,680
And I look back and go, well, I did not sleep for 14 years.

1318
01:12:05,680 --> 01:12:08,100
That would have taken a toll.

1319
01:12:08,100 --> 01:12:11,560
So I already addressed, you know, the lifestyle things.

1320
01:12:11,560 --> 01:12:17,640
And so for me, the next step was the peptides and I take, um, um, a clomiphene.

1321
01:12:17,640 --> 01:12:18,640
Is that right?

1322
01:12:18,640 --> 01:12:19,640
But yeah.

1323
01:12:19,640 --> 01:12:23,680
So, um, I had some other ones and I actually tapered down, um, you know, when we were going

1324
01:12:23,680 --> 01:12:28,680
through it with, with my, um, counselor from you guys, I was talking to initially it was

1325
01:12:28,680 --> 01:12:32,660
too much for me and I tapered down and found the perfect, perfect thing.

1326
01:12:32,660 --> 01:12:36,920
So this is, this is the thing, just because your number in a doctor's office says, you

1327
01:12:36,920 --> 01:12:40,480
know, whatever you can, you know, lifestyle is the first thing.

1328
01:12:40,480 --> 01:12:42,560
Um, I'm obviously an example of that.

1329
01:12:42,560 --> 01:12:45,760
You can absolutely elevate it through lifestyle alone.

1330
01:12:45,760 --> 01:12:49,360
But if you've been on shift for that many years, you know, it's probably taken its

1331
01:12:49,360 --> 01:12:52,200
toll maybe naturally and supposed to be a little bit higher.

1332
01:12:52,200 --> 01:12:56,200
So for me, the peptides were the perfect, you know, middle ground.

1333
01:12:56,200 --> 01:13:00,200
I didn't have to go on TRT, but they were actually just stimulating my body to just

1334
01:13:00,200 --> 01:13:04,240
make a little bit more probably what I would have made had I never been a firefighter.

1335
01:13:04,240 --> 01:13:08,360
So talk to me about the world of peptides.

1336
01:13:08,360 --> 01:13:09,360
Peptides are fascinating.

1337
01:13:09,360 --> 01:13:11,320
The human body, what is a peptide?

1338
01:13:11,320 --> 01:13:15,160
It's a definition of a peptide is it's a string of amino acids.

1339
01:13:15,160 --> 01:13:18,360
You know, people know amino acids that make proteins, but these are short segments of

1340
01:13:18,360 --> 01:13:24,400
amino acids, um, that, uh, have all kinds of ways to, to, um, a different functioning

1341
01:13:24,400 --> 01:13:25,400
in the human body.

1342
01:13:25,400 --> 01:13:29,720
And there's tens of thousands of peptides that have been identified in the human body,

1343
01:13:29,720 --> 01:13:30,880
you know, that have various functions.

1344
01:13:30,880 --> 01:13:32,680
And we've only scratched the surface.

1345
01:13:32,680 --> 01:13:34,720
I mean, people, everybody sort of insulin, right?

1346
01:13:34,720 --> 01:13:39,040
Since the 1950s, um, insulin's a peptide, you know, there's VIP, the ACTH, there's

1347
01:13:39,040 --> 01:13:43,360
all kinds of things that are in clinical, um, use at hospitals every day, uh, that are

1348
01:13:43,360 --> 01:13:44,360
peptides.

1349
01:13:44,360 --> 01:13:45,360
Like we're only scratching the surface.

1350
01:13:45,360 --> 01:13:49,960
I believe there's about 70 or 80 peptides that are in clinical use in the United States

1351
01:13:49,960 --> 01:13:53,000
out of the thousands, tens of thousands that have been identified.

1352
01:13:53,000 --> 01:13:55,400
Um, so there's so many peptides out there.

1353
01:13:55,400 --> 01:14:00,640
Um, and peptides are a great compliment to healthcare.

1354
01:14:00,640 --> 01:14:04,880
And I've, I've just found great utility and success in patients, um, because they can

1355
01:14:04,880 --> 01:14:12,120
do a lot of things on a more natural way to modulate, um, cell function or tissue or tissue

1356
01:14:12,120 --> 01:14:17,560
function, um, not radically change it, but, um, you know, help enhance something that

1357
01:14:17,560 --> 01:14:21,200
a cell is already doing or an organ is already already doing.

1358
01:14:21,200 --> 01:14:27,680
So like you mentioned, uh, like I said, there's, uh, peptides for say, uh, um, say growth hormone.

1359
01:14:27,680 --> 01:14:32,080
Um, there's peptides that, um, cause your body to release more of growth hormone out

1360
01:14:32,080 --> 01:14:33,520
of your, out of your pituitary gland.

1361
01:14:33,520 --> 01:14:35,560
So what is, what does that do?

1362
01:14:35,560 --> 01:14:38,400
Uh, well, um, that creates IGF, right?

1363
01:14:38,400 --> 01:14:43,620
So these peptides do work in a lot of different functions in the body, including in tissue

1364
01:14:43,620 --> 01:14:48,840
repair and regeneration helps you build muscle, helps you burn fat, helps you sleep, have

1365
01:14:48,840 --> 01:14:54,720
sexual function, helps change your lipid profile, your triglycerides, you know, so, so these,

1366
01:14:54,720 --> 01:14:58,280
there's peptides out there that we can use to kind of supplement.

1367
01:14:58,280 --> 01:15:02,520
I almost like to, people have heard of TRT, testosterone replacement therapy.

1368
01:15:02,520 --> 01:15:06,000
Um, I like the word PRT, which is, you know, peptide replacement therapy, because these

1369
01:15:06,000 --> 01:15:08,080
are all peptides that your body makes.

1370
01:15:08,080 --> 01:15:11,840
Um, but like with a lot of the hormones and things that we have in our body, the, the

1371
01:15:11,840 --> 01:15:14,920
levels start to diminish with age, right?

1372
01:15:14,920 --> 01:15:20,120
Like say testosterone, your levels can drop anywhere from one to 3% per year over the

1373
01:15:20,120 --> 01:15:21,120
age of 30.

1374
01:15:21,120 --> 01:15:25,000
Um, so it might not sound like a lot, but you know, you had five, 10, 15, 20 years,

1375
01:15:25,000 --> 01:15:28,080
you know, there's a fair amount of men out there that now kind of start to dip into the

1376
01:15:28,080 --> 01:15:29,680
low testosterone range, right?

1377
01:15:29,680 --> 01:15:33,200
And peptides are the same way, you know, peptides can start to diminish with age.

1378
01:15:33,200 --> 01:15:36,320
Um, so a lot of what we do is again, peptide replacement.

1379
01:15:36,320 --> 01:15:42,040
We're restoring your normal, uh, levels of these peptides that have some very important

1380
01:15:42,040 --> 01:15:44,960
and integral functions, uh, in the human body.

1381
01:15:44,960 --> 01:15:47,520
Um, so, so peptides, they're everywhere now, right?

1382
01:15:47,520 --> 01:15:51,440
I mean, there's peptides, you see them, they're in skincare products, they're in shampoos.

1383
01:15:51,440 --> 01:15:54,160
I mean, they're, there's in vitamin drinks.

1384
01:15:54,160 --> 01:15:56,240
I mean, there's peptide, peptide, peptide.

1385
01:15:56,240 --> 01:16:00,080
Um, but, uh, there, so that's exciting field and certainly we have many that we use every

1386
01:16:00,080 --> 01:16:05,280
day, uh, to help, um, help, you know, people, you know, get better.

1387
01:16:05,280 --> 01:16:06,280
Yeah.

1388
01:16:06,280 --> 01:16:11,040
Well, I can attest, um, one question I have while we're talking about this, I know with

1389
01:16:11,040 --> 01:16:15,040
TRT, you know, certainly if you're using it for a certain amount of time, there's a reliance

1390
01:16:15,040 --> 01:16:16,040
on it.

1391
01:16:16,040 --> 01:16:20,040
The testes are literally atrophying the body's leaning into the exogenous testosterone now.

1392
01:16:20,040 --> 01:16:24,260
So that individual is most likely going to have to take that the rest of their life.

1393
01:16:24,260 --> 01:16:25,680
What about the peptides?

1394
01:16:25,680 --> 01:16:30,560
Is there an ability to come off them or is that something that if you use the body thinks

1395
01:16:30,560 --> 01:16:33,040
it's got enough and is actually making less?

1396
01:16:33,040 --> 01:16:34,040
Yeah.

1397
01:16:34,040 --> 01:16:38,480
So like the, the, the protocol you mentioned within Clomophene, it's been around for decades

1398
01:16:38,480 --> 01:16:44,080
and what it does, um, it's, it stimulates your body or pituitary gland to release, um,

1399
01:16:44,080 --> 01:16:45,080
two things.

1400
01:16:45,080 --> 01:16:49,440
It's a one called FSH, uh, follicle stimulating hormone and LH, a luteinizing hormone.

1401
01:16:49,440 --> 01:16:53,560
And one stimulates testosterone production in the testicles and the other one stimulates

1402
01:16:53,560 --> 01:16:55,640
sperm production in the testicles.

1403
01:16:55,640 --> 01:17:00,200
So when you're taking in Clomophene every day, you're getting a high level of that FSH

1404
01:17:00,200 --> 01:17:01,200
and LH.

1405
01:17:01,200 --> 01:17:03,240
So you're really sending your testicles into overdrive.

1406
01:17:03,240 --> 01:17:07,880
Um, so in the fertility clinic side for guys that have low sperm counts, uh, in Clomophene

1407
01:17:07,880 --> 01:17:11,040
can help boost the sperm counts up quite a bit, you know, for fertility purposes.

1408
01:17:11,040 --> 01:17:15,960
But for what we use it for, um, is to make those testicles make more testosterone and

1409
01:17:15,960 --> 01:17:20,280
you can get some pretty robust changes in testosterone levels from in Clomophene.

1410
01:17:20,280 --> 01:17:22,240
I've seen guys go from 200 to 1500.

1411
01:17:22,240 --> 01:17:27,120
Of course that's overshooting the mark, uh, but that's how profound the testicles can

1412
01:17:27,120 --> 01:17:32,960
respond to in Clomophene to naturally boost, uh, your, uh, your testosterone.

1413
01:17:32,960 --> 01:17:37,320
It's like whipping a race, a race horse around the track and you make the horse run faster.

1414
01:17:37,320 --> 01:17:41,360
Um, and to answer your question, then with the same analogy, if you come off those medications,

1415
01:17:41,360 --> 01:17:44,760
uh, like say you do it for five years, 10 years, whatever, decide you want to come off

1416
01:17:44,760 --> 01:17:46,840
for whatever reason that is, most people don't.

1417
01:17:46,840 --> 01:17:49,240
Um, but if you decide you want to come off, well, it's okay.

1418
01:17:49,240 --> 01:17:52,120
Well, if you stop whipping the horse, it's going to go back down to its trot.

1419
01:17:52,120 --> 01:17:53,720
You know, things are going to slow down.

1420
01:17:53,720 --> 01:17:59,120
Um, and you're going to drift back down to whatever your natural levels of FSH and LH

1421
01:17:59,120 --> 01:18:00,120
were.

1422
01:18:00,120 --> 01:18:01,320
Uh, again, you're no longer whipping the horse.

1423
01:18:01,320 --> 01:18:04,120
Um, and, uh, let's say, but say 10 years passes.

1424
01:18:04,120 --> 01:18:05,120
Okay.

1425
01:18:05,120 --> 01:18:08,520
If you're already testosterone was already low and then now you advanced 10 years, you

1426
01:18:08,520 --> 01:18:11,080
know, what's going to be 10 years from now, probably lower.

1427
01:18:11,080 --> 01:18:13,080
So if you stop, you're in Clomophene and HEG.

1428
01:18:13,080 --> 01:18:14,080
Okay.

1429
01:18:14,080 --> 01:18:16,520
Well now you're sticking that only to your old levels, but also probably even worse than

1430
01:18:16,520 --> 01:18:17,520
your old levels.

1431
01:18:17,520 --> 01:18:20,200
Cause now it's 10 years later and you know, guys start to feel like crap again.

1432
01:18:20,200 --> 01:18:22,240
All the low testosterone symptoms come back.

1433
01:18:22,240 --> 01:18:27,040
Um, so I mean, you can come off of it, but the reality of it is, um, you know, a lot

1434
01:18:27,040 --> 01:18:31,120
of people choose to stay on just because they get all those symptoms come, come back and

1435
01:18:31,120 --> 01:18:35,360
then some, um, because their testosterone levels sink back down.

1436
01:18:35,360 --> 01:18:37,680
I think I responded well because that's all I take now.

1437
01:18:37,680 --> 01:18:39,840
And I take dihex, which I want to ask you about in a second.

1438
01:18:39,840 --> 01:18:44,120
And then BPC one five seven, which I love for the whole joint health thing, but I forget

1439
01:18:44,120 --> 01:18:48,200
the other two I was on, but it got to the point where my nipples hurt and I cried all

1440
01:18:48,200 --> 01:18:53,800
the time and it was either used an estrogen blocker or my, my, again, that, that titrate

1441
01:18:53,800 --> 01:18:54,800
to effect.

1442
01:18:54,800 --> 01:18:56,680
I was like, or not, you know, obviously clearly.

1443
01:18:56,680 --> 01:19:01,840
And so by the time I came down, I think just with the clomophene, um, it was still up like

1444
01:19:01,840 --> 01:19:02,840
nine 50 ish.

1445
01:19:02,840 --> 01:19:04,600
So I'm like, this is perfect.

1446
01:19:04,600 --> 01:19:05,600
This, I feel good.

1447
01:19:05,600 --> 01:19:06,600
I can, I can exercise.

1448
01:19:06,600 --> 01:19:07,600
I can recover.

1449
01:19:07,600 --> 01:19:08,600
I'm not lifting anything crazy.

1450
01:19:08,600 --> 01:19:09,720
I'm not superhuman.

1451
01:19:09,720 --> 01:19:11,720
I haven't put on a bunch of muscle.

1452
01:19:11,720 --> 01:19:13,260
It's right in that sweet spot.

1453
01:19:13,260 --> 01:19:19,200
So it's, it's so great to see that something is, you know, as safe and, and, uh, uh, like

1454
01:19:19,200 --> 01:19:23,880
I said, minimal effective doses of peptide is, is the thing a lot of people don't realize

1455
01:19:23,880 --> 01:19:24,880
is out there as well.

1456
01:19:24,880 --> 01:19:29,200
And if you are that 30 year old first responder that you don't need to go to TRT, because

1457
01:19:29,200 --> 01:19:34,040
as you said, you know, now if your testes are basically not working anymore, you come

1458
01:19:34,040 --> 01:19:36,800
off that you're, I mean, you're, you're tanking, aren't you?

1459
01:19:36,800 --> 01:19:38,800
You're dropping big time.

1460
01:19:38,800 --> 01:19:39,800
Yeah.

1461
01:19:39,800 --> 01:19:40,800
Yeah.

1462
01:19:40,800 --> 01:19:46,320
I mean, TRT is sometimes it's, you know, we have people that go on TRT, you know, if they're

1463
01:19:46,320 --> 01:19:48,320
younger guys, we try the enclomaphen-HTG.

1464
01:19:48,320 --> 01:19:51,440
We do the lifestyle modifications, make sure we've done what we can there.

1465
01:19:51,440 --> 01:19:55,120
Um, that, you know, some, some guys just go into early testicular failure.

1466
01:19:55,120 --> 01:19:58,840
You know, they have for whatever reason, you know, genetically their testicles just, they

1467
01:19:58,840 --> 01:20:01,440
stop producing adequate amounts of testosterone.

1468
01:20:01,440 --> 01:20:03,080
The brain's trying to force them to make more.

1469
01:20:03,080 --> 01:20:05,600
They're not, and testosterone is the right way to go.

1470
01:20:05,600 --> 01:20:10,080
Um, but those are, you know, for the young guys, um, usually it's the enclomaphen that

1471
01:20:10,080 --> 01:20:13,000
makes a much better choice because we're not altering, you know, their testicles.

1472
01:20:13,000 --> 01:20:17,480
We're not, you know, going to shut down their testicles and their fertility, um, on TRT.

1473
01:20:17,480 --> 01:20:19,920
Even though there's a ways to try to preserve that.

1474
01:20:19,920 --> 01:20:24,920
Um, you know, the non testosterone route, um, is always, uh, you know, preferred over

1475
01:20:24,920 --> 01:20:27,200
the, for the younger guys for sure.

1476
01:20:27,200 --> 01:20:31,680
I told my wife that it increases sperm count and we, my oldest is about to graduate and

1477
01:20:31,680 --> 01:20:32,980
go to college in the summer.

1478
01:20:32,980 --> 01:20:38,160
So she's like, okay, you need to stay away from me if I'm even close to being fertile.

1479
01:20:38,160 --> 01:20:40,200
Be careful.

1480
01:20:40,200 --> 01:20:41,200
All right.

1481
01:20:41,200 --> 01:20:42,600
Well, TRT has an application as well.

1482
01:20:42,600 --> 01:20:46,000
And certainly, you know, I've had a lot of people, either they're, they're older or,

1483
01:20:46,000 --> 01:20:49,760
you know, some of our law enforcement, military, you know, some of the TBIs and things that

1484
01:20:49,760 --> 01:20:53,240
they get that can even anatomically stop production.

1485
01:20:53,240 --> 01:20:56,240
So talk to me about who would be the right fit.

1486
01:20:56,240 --> 01:21:02,200
And again, let's kind of take a deep dive into, um, the, the, the cautions, the things

1487
01:21:02,200 --> 01:21:07,120
that, that, you know, might happen as far as fertility and hair loss and that kind of

1488
01:21:07,120 --> 01:21:08,120
thing.

1489
01:21:08,120 --> 01:21:12,680
And also how transcend specifically how you're able to monitor that, the, the blood tests

1490
01:21:12,680 --> 01:21:15,520
that you do to try and try and get these people at the right levels.

1491
01:21:15,520 --> 01:21:16,520
Yeah.

1492
01:21:16,520 --> 01:21:20,240
Like with anything else, you know, before you start treatment with any that you're going

1493
01:21:20,240 --> 01:21:23,960
to go to the doctor before you start any treatment, it's always taken a thorough history, right?

1494
01:21:23,960 --> 01:21:27,840
Finding out what's happened in their life, what current medications they're on, lifestyle,

1495
01:21:27,840 --> 01:21:28,840
what do they do?

1496
01:21:28,840 --> 01:21:30,960
What's their diet, exercise, you know, cover all the bases, right?

1497
01:21:30,960 --> 01:21:34,440
So you get to know the patient so you can meet them where they're at.

1498
01:21:34,440 --> 01:21:35,440
Right.

1499
01:21:35,440 --> 01:21:36,440
So that's first.

1500
01:21:36,440 --> 01:21:39,280
You know, do a lot of blood work, you know, do that thorough evaluation again, see where

1501
01:21:39,280 --> 01:21:45,080
people are at, uh, see what's potentially modifiable just based on a lifestyle modification.

1502
01:21:45,080 --> 01:21:49,960
Um, but let's say all directions, uh, you know, symptoms, blood work, everything's lining

1503
01:21:49,960 --> 01:21:57,720
up, um, that say, okay, this man who's 40, um, has testosterone of a, you know, two 50

1504
01:21:57,720 --> 01:22:01,160
fills all the symptoms of low testosterone feeling terrible, right?

1505
01:22:01,160 --> 01:22:03,400
Uh, the whole list of low testosterone symptoms.

1506
01:22:03,400 --> 01:22:07,760
Uh, then yeah, he'd be a great candidate for some type of testosterone and there's different

1507
01:22:07,760 --> 01:22:09,920
versions of testosterone on the market, right?

1508
01:22:09,920 --> 01:22:14,440
There's pellets, seeing them implanted in your skin, there's creams, there's patches,

1509
01:22:14,440 --> 01:22:16,560
there's the roll on deodorant thing.

1510
01:22:16,560 --> 01:22:21,040
Um, you know, there's, uh, the ones that dissolve under your tongue, you know, there's all kinds

1511
01:22:21,040 --> 01:22:23,360
of formulations of, of testosterone.

1512
01:22:23,360 --> 01:22:29,280
Uh, my, my preference or my opinion has always been that the intramuscular injections, uh,

1513
01:22:29,280 --> 01:22:33,560
work the best, uh, cause we know you're going to get a hundred percent of your, your dosage,

1514
01:22:33,560 --> 01:22:35,240
you know, stuff that you wipe on topically.

1515
01:22:35,240 --> 01:22:39,040
There's a problem with transference, which means it rubs off or rubs off to your spouse

1516
01:22:39,040 --> 01:22:40,040
or children even.

1517
01:22:40,040 --> 01:22:42,560
Um, so you gotta be real careful with the topical stuff.

1518
01:22:42,560 --> 01:22:44,880
You know, the pellets, sometimes they can spit out.

1519
01:22:44,880 --> 01:22:47,920
It's hard to control the dosing with those, you know, it can take some time to get that

1520
01:22:47,920 --> 01:22:48,920
right.

1521
01:22:48,920 --> 01:22:53,520
Um, anyway, so if we decide that whatever formulation of testosterone, with my preference

1522
01:22:53,520 --> 01:22:57,080
being the injections, if we're going to do testosterone therapy, well, then there's got

1523
01:22:57,080 --> 01:22:58,080
to be some follow-up, right?

1524
01:22:58,080 --> 01:23:01,920
We're going to start you on to, on the testosterone to try and get you into that sweet spot of

1525
01:23:01,920 --> 01:23:03,640
physiologic range.

1526
01:23:03,640 --> 01:23:06,200
Shoot for maybe the upper third of the range.

1527
01:23:06,200 --> 01:23:07,920
You want to overshoot cause that creates problems.

1528
01:23:07,920 --> 01:23:10,400
Uh, but get you kind of upper third of the range.

1529
01:23:10,400 --> 01:23:13,000
Uh, it's usually a good range to shoot for.

1530
01:23:13,000 --> 01:23:18,120
Um, let them, you know, we start for three or four months doing the, doing the testosterone

1531
01:23:18,120 --> 01:23:20,120
and then we recheck blood work, follow up with the patient.

1532
01:23:20,120 --> 01:23:21,120
Say, Hey, how you doing?

1533
01:23:21,120 --> 01:23:22,960
How's, how's the program going?

1534
01:23:22,960 --> 01:23:23,960
Are we seeing some differences?

1535
01:23:23,960 --> 01:23:25,640
You know, what differences are you seeing?

1536
01:23:25,640 --> 01:23:26,960
Um, are you happy?

1537
01:23:26,960 --> 01:23:27,960
Are there any side effects?

1538
01:23:27,960 --> 01:23:32,160
So what problems have we, have we caused, if any, um, you know, and then we can, we

1539
01:23:32,160 --> 01:23:33,160
check around to blood work.

1540
01:23:33,160 --> 01:23:34,160
Okay.

1541
01:23:34,160 --> 01:23:35,160
So look, here's where your testosterone was here.

1542
01:23:35,160 --> 01:23:38,800
You know, now it is here, you know, we've got to follow estrogen levels because testosterone

1543
01:23:38,800 --> 01:23:43,560
will be, uh, metabolized, um, or, uh, into estrogen.

1544
01:23:43,560 --> 01:23:47,120
So it's very common that we'll see estrogen levels rise.

1545
01:23:47,120 --> 01:23:50,520
Um, very common and in and of itself, it's not a problem.

1546
01:23:50,520 --> 01:23:55,760
Uh, some guys are very sensitive to, to estrogen levels and if their estrogen level gets to

1547
01:23:55,760 --> 01:23:58,440
50 or 60, they can start to get that nipple sensitivity.

1548
01:23:58,440 --> 01:24:02,520
You know, the areolas get sensitive or, you know, they can get swollen.

1549
01:24:02,520 --> 01:24:07,480
And if that's not addressed or corrected after many, many months, um, with high levels of

1550
01:24:07,480 --> 01:24:11,400
estrogen, uh, then you can get some of the gland in the breast tissue in a man can start

1551
01:24:11,400 --> 01:24:12,400
to hypertrophy.

1552
01:24:12,400 --> 01:24:14,480
They start to get glandular hypertrophy in the breast tissue.

1553
01:24:14,480 --> 01:24:19,960
Um, like what you called earlier, bitch tits, gynecomastia is the, um, is the technical

1554
01:24:19,960 --> 01:24:20,960
term.

1555
01:24:20,960 --> 01:24:23,880
Uh, and that can be a permanent thing if that tissue hypertrophy is enough, you know, so

1556
01:24:23,880 --> 01:24:26,000
then that the only way to get that out is for surgery.

1557
01:24:26,000 --> 01:24:28,640
Um, so again, so that's the, that's what happens in the long run.

1558
01:24:28,640 --> 01:24:33,200
Of course that transcend, you know, it would never happens because we follow patients clinically,

1559
01:24:33,200 --> 01:24:36,160
like they're followed by the physician and our PAs and they're followed by blood work.

1560
01:24:36,160 --> 01:24:37,700
Our wellness specialists are checking up.

1561
01:24:37,700 --> 01:24:41,480
So any of those problems, even at the first suggestion of those kinds of problems, uh,

1562
01:24:41,480 --> 01:24:42,480
we're addressing them.

1563
01:24:42,480 --> 01:24:46,000
Um, so again, so we've got to follow estrogen levels very closely.

1564
01:24:46,000 --> 01:24:47,960
There's ways to, to manage that.

1565
01:24:47,960 --> 01:24:49,720
Usually it's a matter of the dosing issue.

1566
01:24:49,720 --> 01:24:53,400
Like, like you said, with urine, clomothine overshot the mark, too much testosterone, too

1567
01:24:53,400 --> 01:24:54,400
much estrogen.

1568
01:24:54,400 --> 01:24:58,240
You started having problems, you cut down, you're in clomothine and things got better.

1569
01:24:58,240 --> 01:24:59,880
Same thing if you're doing testosterone injections.

1570
01:24:59,880 --> 01:25:00,880
Okay.

1571
01:25:00,880 --> 01:25:01,880
Well, maybe 200 is too much for you.

1572
01:25:01,880 --> 01:25:06,160
Let's drop you down to 180 or under 160 milligrams a week and let's, let's see how you're doing

1573
01:25:06,160 --> 01:25:07,160
in three months.

1574
01:25:07,160 --> 01:25:12,360
Um, you know, sometimes it's guys are just so sensitive that they can have, you know,

1575
01:25:12,360 --> 01:25:16,320
even barely, you know, high range estrogen is still in the normal range and they're getting

1576
01:25:16,320 --> 01:25:17,920
the same high estrogen symptoms.

1577
01:25:17,920 --> 01:25:21,680
And then, you know, we've cut their testosterone dose still doesn't help.

1578
01:25:21,680 --> 01:25:26,120
People put them on an estrogen blocker, very judicious, tiny uses of estrogen blockers

1579
01:25:26,120 --> 01:25:27,120
because those can have side effects.

1580
01:25:27,120 --> 01:25:30,120
So there's ways to manage it, but you got to be on top of that stuff.

1581
01:25:30,120 --> 01:25:33,400
Um, you know, like I said, following up clinically in blood work.

1582
01:25:33,400 --> 01:25:38,640
The other issue that's common is, uh, there's always a physiological response of your bone

1583
01:25:38,640 --> 01:25:43,920
marrow to any type of male hormone, any type of androgen, including testosterone, uh, where

1584
01:25:43,920 --> 01:25:45,760
it stimulates the production of red blood cells.

1585
01:25:45,760 --> 01:25:51,760
So it's a pretty much every patient who gets put on testosterone, um, will have a rise

1586
01:25:51,760 --> 01:25:54,520
in their hermetic rate and hemoglobin, you know, the amount of red blood cells.

1587
01:25:54,520 --> 01:25:55,520
That's a physiologic response.

1588
01:25:55,520 --> 01:25:57,680
Your bone marrow pumps out more red blood cells.

1589
01:25:57,680 --> 01:25:58,680
Uh, that's great.

1590
01:25:58,680 --> 01:26:01,120
You know, so now you have more oxygen carrying capacity.

1591
01:26:01,120 --> 01:26:06,920
Um, you know, it's great in and of itself, having a high red blood cell count, um, is,

1592
01:26:06,920 --> 01:26:07,920
is not dangerous.

1593
01:26:07,920 --> 01:26:12,440
Um, so some, some people think if you're on TRT because your blood counts are going to

1594
01:26:12,440 --> 01:26:16,720
go a little bit higher than I have to donate blood routinely, no, you don't.

1595
01:26:16,720 --> 01:26:24,080
Um, you know, if you look at the Sherpas and Himalayas or you look at, uh, uh, Lance Armstrong,

1596
01:26:24,080 --> 01:26:30,120
you know, the cyclist, um, who was busted for doping, he was using a drug called erythropoietin.

1597
01:26:30,120 --> 01:26:31,120
What does that do?

1598
01:26:31,120 --> 01:26:32,920
It stimulates your bone marrow to make more red blood cells.

1599
01:26:32,920 --> 01:26:34,200
Cause you have those higher blood levels.

1600
01:26:34,200 --> 01:26:38,480
It means you can carry more oxygen, which means, uh, your aerobic capacity is higher,

1601
01:26:38,480 --> 01:26:39,480
right?

1602
01:26:39,480 --> 01:26:40,480
So you can't do that.

1603
01:26:40,480 --> 01:26:41,480
That's cheating.

1604
01:26:41,480 --> 01:26:44,960
I mean, people that live at, live at high altitudes, um, up in the mountains, the Sherpas,

1605
01:26:44,960 --> 01:26:48,360
they have higher hemoglobin and hematocrites cause they need more oxygen carrying capacity.

1606
01:26:48,360 --> 01:26:51,080
The body just naturally produces more red blood cells for them.

1607
01:26:51,080 --> 01:26:54,400
Um, so that they have, uh, they maintain normal oxygen levels.

1608
01:26:54,400 --> 01:26:58,000
Um, anyway, so sometimes people will get alarmed, you know, patients get alarmed.

1609
01:26:58,000 --> 01:27:00,320
We have to educate them that this is a normal response.

1610
01:27:00,320 --> 01:27:01,320
It's no concern.

1611
01:27:01,320 --> 01:27:05,120
Um, sometimes the primary care doctors will see the blood levels and want them to donate

1612
01:27:05,120 --> 01:27:06,120
blood and that's fine.

1613
01:27:06,120 --> 01:27:09,520
If the primary care doctor feels that strongly about it, uh, they can donate blood.

1614
01:27:09,520 --> 01:27:11,920
Typically it's not a recommendation.

1615
01:27:11,920 --> 01:27:15,760
Um, you know, sometimes people will think, Oh, if I have a high blood count, that means

1616
01:27:15,760 --> 01:27:16,760
I'm gonna have a stroke.

1617
01:27:16,760 --> 01:27:22,800
Well, the problem is it's often confused, uh, with other blood disorders like polycythemia

1618
01:27:22,800 --> 01:27:28,680
of era or other blood, uh, uh, marrow, uh, bone marrow problems where not only are the

1619
01:27:28,680 --> 01:27:31,760
red blood cells high, but also the platelet counts are high.

1620
01:27:31,760 --> 01:27:34,320
And it's the platelets that cause the clumping of the blood.

1621
01:27:34,320 --> 01:27:37,880
So if you have these other conditions, uh, that have right blood, high, high red blood

1622
01:27:37,880 --> 01:27:42,640
cells and high platelets, okay, that's the recipe where, you know, uh, we worry about

1623
01:27:42,640 --> 01:27:46,320
blood clotting and strokes and the arteries or veins or the brains or the heart attacks.

1624
01:27:46,320 --> 01:27:49,160
Um, you know, but that's a completely different disorder.

1625
01:27:49,160 --> 01:27:52,000
And unfortunately there's a lot of people just kind of confuse the two.

1626
01:27:52,000 --> 01:27:53,440
So people see, Oh, high red blood cell count.

1627
01:27:53,440 --> 01:27:55,080
Oh my gosh, I'm going to stroke out.

1628
01:27:55,080 --> 01:27:56,560
Uh, it's not the case.

1629
01:27:56,560 --> 01:27:59,880
Like I said, that's an expected response, you know, from TRT.

1630
01:27:59,880 --> 01:28:01,840
We monitor it, you know, we watch it.

1631
01:28:01,840 --> 01:28:05,520
It's extremely rare that someone gets so high that we're like, okay, yeah, maybe she go

1632
01:28:05,520 --> 01:28:06,520
donate it a unit of blood.

1633
01:28:06,520 --> 01:28:10,120
I mean, I, I don't know the tens of thousands of patients that I've treated, you know, I

1634
01:28:10,120 --> 01:28:12,600
can count maybe on one hand, how many times that's been necessary.

1635
01:28:12,600 --> 01:28:17,920
So, um, yeah, so we're checking national levels, checking the hemoglobin levels, um, you know,

1636
01:28:17,920 --> 01:28:22,000
always keeping an eye on the, the lipid levels of, you know, the triglyceride levels.

1637
01:28:22,000 --> 01:28:26,200
Um, yeah, so as long as you're being monitored, you get a physician following you, checking

1638
01:28:26,200 --> 01:28:30,520
blood work intermittently, uh, then you can, then it can be done in a safe and reasonable

1639
01:28:30,520 --> 01:28:31,520
way.

1640
01:28:31,520 --> 01:28:35,120
You know, this isn't, you know, unfortunately people who are uneducated think, Oh, I'm on

1641
01:28:35,120 --> 01:28:37,000
TRT, I'm taking anabolic steroids.

1642
01:28:37,000 --> 01:28:38,320
Well, okay.

1643
01:28:38,320 --> 01:28:39,480
Is testosterone anabolic steroid?

1644
01:28:39,480 --> 01:28:41,520
I guess, you know, technically sure.

1645
01:28:41,520 --> 01:28:44,560
Uh, but we're doing, you know, physiologic ranges.

1646
01:28:44,560 --> 01:28:49,600
We're giving you what you had or what you should have as a normal human male, you know,

1647
01:28:49,600 --> 01:28:51,360
keeping a normal healthy range.

1648
01:28:51,360 --> 01:28:55,960
And we're not giving you super massive doses, super physiologic doses to gain, you know,

1649
01:28:55,960 --> 01:28:56,960
muscle.

1650
01:28:56,960 --> 01:28:59,120
You're not doing a cycle for a bodybuilding competition.

1651
01:28:59,120 --> 01:29:04,440
You know, we're talking about, you know, small reasonable doses to give people feeling good

1652
01:29:04,440 --> 01:29:06,360
and keep them healthy.

1653
01:29:06,360 --> 01:29:09,280
What about our female tactical athletes?

1654
01:29:09,280 --> 01:29:14,240
Um, you know, obviously we all have most of the same hormones, but, um, you know, when

1655
01:29:14,240 --> 01:29:18,680
you look at, for example, HRT, it seems to me, and I might be completely naive, but it

1656
01:29:18,680 --> 01:29:23,120
seems to me it's kind of a one size fits all as well, but every woman is going to be different.

1657
01:29:23,120 --> 01:29:29,820
So with different hormonal profiles, what are some of the common, um, kind of, uh, medication

1658
01:29:29,820 --> 01:29:34,160
prescriptions that you find amongst the females, you know, whether they're military first responders,

1659
01:29:34,160 --> 01:29:39,240
um, that maybe are surpassing what they would get if they went to their GP.

1660
01:29:39,240 --> 01:29:45,120
Yeah, you know, in our world, in the, in the, in the HRT world, uh, in this health and wellness

1661
01:29:45,120 --> 01:29:50,360
realm, uh, women and testosterone is very common.

1662
01:29:50,360 --> 01:29:55,040
I prescribe a lot of testosterone for women, which I think, you know, a lot of people just

1663
01:29:55,040 --> 01:29:57,680
say, what, you know, give testosterone to women.

1664
01:29:57,680 --> 01:30:02,160
Um, and sometimes the primary care doctors, OBGYN doctors, I think some of the newer age

1665
01:30:02,160 --> 01:30:07,520
OBGYN docs and the newer trained doctors, uh, understand that testosterone is vital

1666
01:30:07,520 --> 01:30:12,680
and essential for women just as much as it is for men and that women make small doses

1667
01:30:12,680 --> 01:30:14,240
of testosterone as well.

1668
01:30:14,240 --> 01:30:17,880
And the ovaries, every time they cycle, you know, they make, uh, estrogen, progesterone

1669
01:30:17,880 --> 01:30:22,880
and testosterone and their adrenal glands also produce, you know, small amounts of testosterone.

1670
01:30:22,880 --> 01:30:28,160
Um, so when women have low testosterone, they get the same set of symptoms as men with low

1671
01:30:28,160 --> 01:30:29,160
testosterone, right?

1672
01:30:29,160 --> 01:30:33,280
They get the energy sucks, they get the brain fog, their libido is shot, you know, they're

1673
01:30:33,280 --> 01:30:39,040
by the body composition changes, you know, so for the, so for, um, for females, especially

1674
01:30:39,040 --> 01:30:40,440
the ones that are on birth control pills, right?

1675
01:30:40,440 --> 01:30:44,360
Which is a big percentage, um, because you're shutting down ovulation, you're shutting down

1676
01:30:44,360 --> 01:30:48,680
the maturation, maturation of the follicles every month so they don't ovulate.

1677
01:30:48,680 --> 01:30:52,640
Well, can we not going to get the estrogen progesterone and which is covered by the birth

1678
01:30:52,640 --> 01:30:56,520
control pills, but testosterone is like, uh, just kind of left out in the cold, like, you

1679
01:30:56,520 --> 01:30:57,520
know, that's never addressed.

1680
01:30:57,520 --> 01:31:01,080
Okay, let's stop you from cycling and stopping you from ovulating as birth control.

1681
01:31:01,080 --> 01:31:02,680
What about the poor little testosterone?

1682
01:31:02,680 --> 01:31:05,120
Like you know, it's, it's never, it's never addressed.

1683
01:31:05,120 --> 01:31:06,840
And I would tell you, it's not unusual.

1684
01:31:06,840 --> 01:31:08,480
In fact, we see it all the time.

1685
01:31:08,480 --> 01:31:11,680
If women get their blood work checked and their testosterone levels are close to zero,

1686
01:31:11,680 --> 01:31:17,160
if not zero, you know, and then, so those birth control, um, pills can have significant

1687
01:31:17,160 --> 01:31:20,400
side effects, you know, get leading to again, leading to the low testosterone symptoms because

1688
01:31:20,400 --> 01:31:23,720
it wipes out their testosterone too and is never addressed.

1689
01:31:23,720 --> 01:31:28,180
So for, for, um, the women that are savvy enough and they, they understand this or they,

1690
01:31:28,180 --> 01:31:31,400
they look into it, they come to transcend, get their blood work checked, say, oh yeah,

1691
01:31:31,400 --> 01:31:32,600
you have no testosterone.

1692
01:31:32,600 --> 01:31:36,840
So as part of their treatment protocol, you know, if their symptoms are as such, uh, then

1693
01:31:36,840 --> 01:31:39,920
doing low doses of testosterone for women is, is great.

1694
01:31:39,920 --> 01:31:42,840
They do amazing on low doses of testosterone.

1695
01:31:42,840 --> 01:31:44,400
Uh, they're very thankful.

1696
01:31:44,400 --> 01:31:49,240
Again, libido comes back, they have more energy, they're, they're, they're workouts are more

1697
01:31:49,240 --> 01:31:51,280
intense, you know, they're sleeping better.

1698
01:31:51,280 --> 01:31:53,800
There's all these things that come along just like men.

1699
01:31:53,800 --> 01:31:58,040
Um, but you know, women sometimes are concerned, oh, I'm gonna, you know, I'm going to get

1700
01:31:58,040 --> 01:32:01,080
all jacked, like, you know, I'm gonna get big, you know, no, you're not.

1701
01:32:01,080 --> 01:32:04,320
Now we're using, you know, tiny doses just to restore you into a, you know, something

1702
01:32:04,320 --> 01:32:06,120
that's good physiologic range.

1703
01:32:06,120 --> 01:32:08,400
Um, you know, so we're now you're not there.

1704
01:32:08,400 --> 01:32:09,680
So no one's going to get masculinized, right?

1705
01:32:09,680 --> 01:32:12,080
They're not going to go on Adam's apple, you know?

1706
01:32:12,080 --> 01:32:15,880
Um, sometimes women are worried that they're going to, you know, do those things, but in

1707
01:32:15,880 --> 01:32:20,240
reality, you know, testosterone replacement in women is very common, very successful and

1708
01:32:20,240 --> 01:32:23,840
very safe, uh, uh, as long as they're being monitored.

1709
01:32:23,840 --> 01:32:27,240
So yeah, so the female athletes really appreciate it because again, they, again, they get the

1710
01:32:27,240 --> 01:32:30,480
same benefits as the men, their intent, their workouts are stronger, intensity is better.

1711
01:32:30,480 --> 01:32:34,160
They're able to get better results with their lean tissue or, you know, building strength,

1712
01:32:34,160 --> 01:32:36,520
uh, than when their testosterone's are zero.

1713
01:32:36,520 --> 01:32:41,360
Now the other side of the exercise equation obviously is, is injury and inflammation.

1714
01:32:41,360 --> 01:32:44,880
I have really been blown away by BPC one five seven.

1715
01:32:44,880 --> 01:32:48,400
I mean, my poor body, I was a stunt man, I was a firefighter, I was a martial artist.

1716
01:32:48,400 --> 01:32:52,240
It's, it's, it's been battered the last 50 years, but I've been amazed.

1717
01:32:52,240 --> 01:32:56,880
I mean, it really absolutely has helped along with the corrective exercises that I continue

1718
01:32:56,880 --> 01:32:59,360
to do, you know, parallel to that.

1719
01:32:59,360 --> 01:33:01,680
So talk to me about that particular peptide.

1720
01:33:01,680 --> 01:33:02,680
Yeah.

1721
01:33:02,680 --> 01:33:03,680
BPC one 57.

1722
01:33:03,680 --> 01:33:04,680
It's, uh, I love it.

1723
01:33:04,680 --> 01:33:05,680
It's an amazing peptide.

1724
01:33:05,680 --> 01:33:06,680
I love it.

1725
01:33:06,680 --> 01:33:08,640
Uh, prescribe a lot of it because it works so well.

1726
01:33:08,640 --> 01:33:12,880
Um, and, uh, basically the, uh, it's, uh, something that was initially found in gastric

1727
01:33:12,880 --> 01:33:13,880
juice.

1728
01:33:13,880 --> 01:33:17,560
It's called body protective compound and it helps the stomach lining and the intestinal

1729
01:33:17,560 --> 01:33:21,640
lining, um, pretty, it protects it from getting broken down by the, all the digestive enzymes

1730
01:33:21,640 --> 01:33:25,520
that the acid in your stomach and the digestive, digestive enzymes from your pancreas.

1731
01:33:25,520 --> 01:33:27,320
So it helps to protect the stomach lining.

1732
01:33:27,320 --> 01:33:30,960
Um, and then they also found out as they did research on it that, Hey, this is actually

1733
01:33:30,960 --> 01:33:32,880
very important for inflammation throughout the body.

1734
01:33:32,880 --> 01:33:35,800
And it's, you know, BPC is found in every tissue, every cell in your body.

1735
01:33:35,800 --> 01:33:41,200
Um, so when you, uh, replace BPC, the orally or through injection, it has a very potent

1736
01:33:41,200 --> 01:33:43,000
anti-inflammatory effect.

1737
01:33:43,000 --> 01:33:47,680
Um, and, uh, can, and help, you know, ligaments and tissues heal as well.

1738
01:33:47,680 --> 01:33:53,200
There's a experiment where they actually cut Achilles heel, um, and gave, uh, BPC 157.

1739
01:33:53,200 --> 01:33:55,320
The Achilles heel was able to completely restore itself.

1740
01:33:55,320 --> 01:33:59,880
Um, so I was in the one of the early experiments with BPC, but, uh, but anyway, but it's, uh,

1741
01:33:59,880 --> 01:34:01,960
it's a very effective, uh, I've used it before.

1742
01:34:01,960 --> 01:34:02,960
Same thing.

1743
01:34:02,960 --> 01:34:07,480
I had a really sore shoulder from a lifting injury and a few weeks of BPC, you know, and

1744
01:34:07,480 --> 01:34:11,080
it was gone and never came back, you know, whereas before I had that nagging thing and,

1745
01:34:11,080 --> 01:34:13,080
you know, I would have to take motoring for weeks.

1746
01:34:13,080 --> 01:34:15,880
Uh, but, uh, you know, around a BPC and it's been golden.

1747
01:34:15,880 --> 01:34:20,360
So, um, so speaking from personal experience too, but yeah, it's, uh, it's a great healing,

1748
01:34:20,360 --> 01:34:24,720
you know, anti-inflammatory, uh, compound, you know, people usually run for, do it for

1749
01:34:24,720 --> 01:34:26,680
a few weeks, you know, say six weeks or eight weeks.

1750
01:34:26,680 --> 01:34:31,880
Like you said, like you did, you do the appropriate physical therapy and just, you know, don't

1751
01:34:31,880 --> 01:34:33,480
re-injure it right away.

1752
01:34:33,480 --> 01:34:36,160
Um, so BPC is great for those arthritic injuries.

1753
01:34:36,160 --> 01:34:40,560
We also use it for oral routes too, uh, for some of the inflammatory bowel disease, you

1754
01:34:40,560 --> 01:34:41,840
know, people having digestive issues.

1755
01:34:41,840 --> 01:34:44,520
You can work very well as an oral capsule too.

1756
01:34:44,520 --> 01:34:45,520
Yeah.

1757
01:34:45,520 --> 01:34:46,520
I've been taking the oral ones.

1758
01:34:46,520 --> 01:34:50,320
That's something that I should cycle off at some point or is it something you can continue

1759
01:34:50,320 --> 01:34:51,320
to take?

1760
01:34:51,320 --> 01:34:54,360
You know, you know, it's good for the gut microbiome.

1761
01:34:54,360 --> 01:34:58,520
Like I said, it helps to keep a healthy, uh, bacteria and helps reduce the inflammation

1762
01:34:58,520 --> 01:35:02,120
and you know, kind of promotes, you know, good healthy immunity in your, in your gut.

1763
01:35:02,120 --> 01:35:04,680
Um, but, uh, most people just would cycle it.

1764
01:35:04,680 --> 01:35:09,520
You know, they'll do it for, you know, again, a few weeks for, for an injury, um, and then

1765
01:35:09,520 --> 01:35:10,920
that come off.

1766
01:35:10,920 --> 01:35:12,560
So probably don't need to take a year round.

1767
01:35:12,560 --> 01:35:13,560
Okay.

1768
01:35:13,560 --> 01:35:14,560
Beautiful.

1769
01:35:14,560 --> 01:35:15,560
All right.

1770
01:35:15,560 --> 01:35:18,520
I want to hit one more, um, of the products and then we'll kind of round out.

1771
01:35:18,520 --> 01:35:19,520
Dihexa.

1772
01:35:19,520 --> 01:35:21,640
We're talking obviously about the brain a lot.

1773
01:35:21,640 --> 01:35:24,080
A lot of people listening are chronically sleep deprived.

1774
01:35:24,080 --> 01:35:28,080
I mean, I was a martial artist, like I said, so I've had deep sleep deprivation and head

1775
01:35:28,080 --> 01:35:31,760
trauma, a beautiful, you know, double edged sword there.

1776
01:35:31,760 --> 01:35:35,680
So talk to me about that peptide and the different, uh, areas that you see an improvement with

1777
01:35:35,680 --> 01:35:36,680
it.

1778
01:35:36,680 --> 01:35:42,600
Yeah, you know, the hexa, uh, it's a, a compound kind of falls under the, uh, kind of the heading

1779
01:35:42,600 --> 01:35:46,600
or the category of, uh, neurotropics.

1780
01:35:46,600 --> 01:35:50,200
And there's several that kind of listed into that category, but they're peptides that are,

1781
01:35:50,200 --> 01:35:54,120
um, have most of their usage or most of their function is in, is in brain cells and the

1782
01:35:54,120 --> 01:35:55,600
nerve cells.

1783
01:35:55,600 --> 01:36:00,360
And what dihexa does, it helps to stimulate the production of that BDNF that I mentioned

1784
01:36:00,360 --> 01:36:05,720
earlier, that brain drive neurotrophic factor, uh, which is very important for stimulating

1785
01:36:05,720 --> 01:36:10,160
or for modulating, uh, neurotransmitter release like the serotonins and the dopamines and

1786
01:36:10,160 --> 01:36:13,480
or a penephrine, uh, you know, between cells.

1787
01:36:13,480 --> 01:36:19,240
So it, uh, so it, uh, enhances that enhances that neuroplasticity, which helps development

1788
01:36:19,240 --> 01:36:23,240
or of connections or the way cells, the nerve cells will talk to each other.

1789
01:36:23,240 --> 01:36:28,080
Um, so that's why BDNF is so important and the dihexa is directly involved with that.

1790
01:36:28,080 --> 01:36:32,560
Um, so the, so dihexa and it's, I don't say it's like, it's like an Adderall, it's not

1791
01:36:32,560 --> 01:36:37,480
that, it's not a stimulant, uh, but frequently patients will say it's almost like an Adderall

1792
01:36:37,480 --> 01:36:41,000
like effect where they can have more focus, more concentration.

1793
01:36:41,000 --> 01:36:43,960
Um, personally, when I take it, I feel like I'm funnier.

1794
01:36:43,960 --> 01:36:44,960
I don't know.

1795
01:36:44,960 --> 01:36:49,280
Um, but people just feel, uh, but people just, they can definitely feel like, you know, they're,

1796
01:36:49,280 --> 01:36:50,760
you know, they're learning better.

1797
01:36:50,760 --> 01:36:52,000
They can remember things better.

1798
01:36:52,000 --> 01:36:54,720
Uh, it really just enhances cognition overall.

1799
01:36:54,720 --> 01:36:59,120
Again, kind of like some of the features that Adderall does, uh, but it's not, it's not

1800
01:36:59,120 --> 01:37:00,120
a stimulant like that.

1801
01:37:00,120 --> 01:37:01,120
It's not addicting like that.

1802
01:37:01,120 --> 01:37:04,960
It's just, it's a naturally occurring peptide that stimulates the nerve cells, uh, in that

1803
01:37:04,960 --> 01:37:06,960
way.

1804
01:37:06,960 --> 01:37:08,520
We've covered a host of things.

1805
01:37:08,520 --> 01:37:12,960
Um, you know, some of the, the, the things that the products that, uh, Transcend offers

1806
01:37:12,960 --> 01:37:18,080
and you know, the, the blood tests and all these other areas before we close out, are

1807
01:37:18,080 --> 01:37:22,440
there any other areas or any other elements of Transcend that you want to discuss?

1808
01:37:22,440 --> 01:37:28,320
Uh, you know, I'd like Transcend because it's, you know, we, as the medical, on the medical

1809
01:37:28,320 --> 01:37:33,760
side, uh, we're able to offer things that patients can't find anywhere else.

1810
01:37:33,760 --> 01:37:38,880
You know, I, I just all day we hear, uh, patients saying, you know, I went to my doctor and

1811
01:37:38,880 --> 01:37:39,880
he said, it was fine.

1812
01:37:39,880 --> 01:37:41,280
Did you get any blood work?

1813
01:37:41,280 --> 01:37:42,280
No.

1814
01:37:42,280 --> 01:37:43,280
Any testing done?

1815
01:37:43,280 --> 01:37:44,280
No.

1816
01:37:44,280 --> 01:37:45,280
He just said, oh yeah, this is normal.

1817
01:37:45,280 --> 01:37:46,280
And, but I don't feel normal.

1818
01:37:46,280 --> 01:37:47,280
Something's wrong.

1819
01:37:47,280 --> 01:37:49,200
I hear that all day long.

1820
01:37:49,200 --> 01:37:53,000
And I always say, well, you don't know, you know, you don't know what you don't know.

1821
01:37:53,000 --> 01:37:57,680
So you know, you do a full history, listen to people, you check their blood work and

1822
01:37:57,680 --> 01:38:00,240
like, say, be surprised how many times we find things like, oh, you know what?

1823
01:38:00,240 --> 01:38:02,400
Let's try doing this and see how that helps.

1824
01:38:02,400 --> 01:38:06,480
And you know, how many patients were able to help, you know, we see patients come back

1825
01:38:06,480 --> 01:38:07,880
and back and back and back.

1826
01:38:07,880 --> 01:38:11,520
And I think that's cause we, cause we take good care of them on the medical side.

1827
01:38:11,520 --> 01:38:13,600
Again, they get the followup to get the blood work.

1828
01:38:13,600 --> 01:38:17,880
They're getting these, uh, you know, these treatments that you just can't find everywhere.

1829
01:38:17,880 --> 01:38:20,640
So it's a nice, again, it's a nice kind of niche area of medicine.

1830
01:38:20,640 --> 01:38:24,840
We're able to get patients benefit and help them, you know, make them better.

1831
01:38:24,840 --> 01:38:28,080
Um, you know, so it's, it's, I have a lot of fun with it.

1832
01:38:28,080 --> 01:38:29,080
Patients do great patients.

1833
01:38:29,080 --> 01:38:30,080
Very thankful.

1834
01:38:30,080 --> 01:38:31,560
Um, it's a lot of fun.

1835
01:38:31,560 --> 01:38:38,480
And so, and like I said, I think, um, uh, in terms of your, um, your, um, uh, people

1836
01:38:38,480 --> 01:38:43,280
that tune in to listen to your, to your podcast, especially the first responders and, you know,

1837
01:38:43,280 --> 01:38:47,920
the military crowd, um, you can, we treat a lot of veterans, treat a lot of first responders,

1838
01:38:47,920 --> 01:38:52,440
um, because what we didn't have a chance to talk about, I know we, we covered a lot, but

1839
01:38:52,440 --> 01:38:53,440
we could talk for hours and hours.

1840
01:38:53,440 --> 01:38:58,120
Um, but it's just in that particular, you know, a group of people, um, you know, with

1841
01:38:58,120 --> 01:39:03,560
the brain injuries that we see in the PTSD, uh, they, that we, that we deal with in the

1842
01:39:03,560 --> 01:39:07,880
people that we treat on the transcend foundation side, uh, there's so many things that happen

1843
01:39:07,880 --> 01:39:12,460
in the brain, you know, not only structurally, but, uh, in the chemistry of the brain that's

1844
01:39:12,460 --> 01:39:16,400
associated with the traumatic brain injuries that people get, you know, on the job and

1845
01:39:16,400 --> 01:39:21,880
their training, you know, the, the explosions, the falls, you know, um, this, the PTSD even

1846
01:39:21,880 --> 01:39:26,040
in and of itself, uh, can cause so much, you know, problems in the brain.

1847
01:39:26,040 --> 01:39:29,160
Like I said, not only the structure of the brain, but the function of the brain and the,

1848
01:39:29,160 --> 01:39:33,520
and the hormone imbalances that come from even a single traumatic brain injury, you

1849
01:39:33,520 --> 01:39:37,200
know, all the veterans that we see that, that, uh, that come through the foundation.

1850
01:39:37,200 --> 01:39:41,320
I mean, they've, you know, they've sometimes gone for years, the whole list of problems

1851
01:39:41,320 --> 01:39:43,520
and then no one ever thinks to check the hormones.

1852
01:39:43,520 --> 01:39:44,520
It's crazy.

1853
01:39:44,520 --> 01:39:47,480
You know, whereas if you look at the, on the neurosurgeon side, if you look at my neurosurgeon

1854
01:39:47,480 --> 01:39:52,000
data, data, there's lots of studies looking at brain injuries in my neurosurgery journals,

1855
01:39:52,000 --> 01:39:57,080
um, that show even after just a single severe traumatic brain and brain injury, up to 30%

1856
01:39:57,080 --> 01:40:02,400
of those patients can have growth hormone deficiency later in life, you know, and, uh,

1857
01:40:02,400 --> 01:40:08,160
you know, and up to 30 to 50% in some studies will have, um, sex hormone, uh, deficiencies

1858
01:40:08,160 --> 01:40:09,160
or imbalances.

1859
01:40:09,160 --> 01:40:13,800
Um, so you get people that were spending years in the military and they feel like crap and,

1860
01:40:13,800 --> 01:40:17,040
uh, you know, they, no one checks blood work or they check their blood work.

1861
01:40:17,040 --> 01:40:18,040
Oh yeah, you're fine.

1862
01:40:18,040 --> 01:40:22,800
You're, your testosterone is 300, you know, and this 35 year old man, you know, it's just,

1863
01:40:22,800 --> 01:40:27,560
it's just sometimes it's just, uh, uh, you're just taking back sometimes about how people

1864
01:40:27,560 --> 01:40:31,720
forget about the hormones, people, you know, about how important these are, um, and how

1865
01:40:31,720 --> 01:40:37,360
the brain, um, is intricately, you know, responsible, uh, for, for those hormones.

1866
01:40:37,360 --> 01:40:41,080
And then, you know, with all the concussions and the brain injuries, the encephalopathy,

1867
01:40:41,080 --> 01:40:45,600
you know, the, the PTSD in and of itself, which can cause hormone dysregulations, it

1868
01:40:45,600 --> 01:40:49,560
just goes undiagnosed and unaddressed.

1869
01:40:49,560 --> 01:40:52,200
And like I said, I'm glad that I'm in a place like transcend where there's been so much

1870
01:40:52,200 --> 01:40:56,240
emphasis on the first responders and, and, you know, Ernie's the veterans, you know,

1871
01:40:56,240 --> 01:41:00,560
the Ernie's, Ernie's just such a, such a grand job of making sure that we've, we're taking

1872
01:41:00,560 --> 01:41:03,240
really good care of those folks that seek our help.

1873
01:41:03,240 --> 01:41:07,880
I've seen some of the foundations videos, you know, the testimonials of, of war fighters,

1874
01:41:07,880 --> 01:41:12,160
for example, that were pretty much at the end of their rope and then they actually get

1875
01:41:12,160 --> 01:41:15,960
their hormones regulated and all of a sudden they're, they're better again.

1876
01:41:15,960 --> 01:41:19,120
And not that that's the only thing, of course, as a psychological element too.

1877
01:41:19,120 --> 01:41:24,260
But if physiologically you are not functioning properly, which is sadly so many first responders

1878
01:41:24,260 --> 01:41:28,640
because of sleep deprivation has just crushed their, you know, their adrenal system and

1879
01:41:28,640 --> 01:41:34,700
their endocrine system, um, just getting that to get them on their feet and then have the

1880
01:41:34,700 --> 01:41:39,720
capacity to go seek counseling or do ayahuasca or whatever their magic toolbox is going to

1881
01:41:39,720 --> 01:41:40,720
be.

1882
01:41:40,720 --> 01:41:45,360
So, you know, addressing the simple hormonal balance that can be found out by a simple

1883
01:41:45,360 --> 01:41:48,480
blood test, comprehensive blood tests.

1884
01:41:48,480 --> 01:41:51,760
That's absolutely, you know, it should be one of the first things that we do with anyone

1885
01:41:51,760 --> 01:41:53,840
who's struggling is that, well, let's, let's test you for us.

1886
01:41:53,840 --> 01:41:57,880
Let's see what's going on numerically so we can adjust some of those numbers.

1887
01:41:57,880 --> 01:41:58,880
Yep.

1888
01:41:58,880 --> 01:41:59,880
Yeah.

1889
01:41:59,880 --> 01:42:03,000
It's again, it's amazing how often it's unaddressed and people just don't even think to look at

1890
01:42:03,000 --> 01:42:04,000
it.

1891
01:42:04,000 --> 01:42:06,040
And otherwise you're like a, you know, a fish trying to swim upstream.

1892
01:42:06,040 --> 01:42:07,040
Yeah.

1893
01:42:07,040 --> 01:42:08,040
You might make progress.

1894
01:42:08,040 --> 01:42:12,040
But, you know, with the depression and the anxiety and the symptoms of all the hormones

1895
01:42:12,040 --> 01:42:18,480
that are out of whack, um, and it has to be a critical part of, of treating, uh, those

1896
01:42:18,480 --> 01:42:23,600
types of, uh, situations, you know, with the PTSD or the, you know, um, traumatic brain

1897
01:42:23,600 --> 01:42:24,600
injuries.

1898
01:42:24,600 --> 01:42:26,640
Um, so it's, it's, it's essential.

1899
01:42:26,640 --> 01:42:30,440
Otherwise it's going to be so much harder to, to efficiently treat those things.

1900
01:42:30,440 --> 01:42:31,440
Absolutely.

1901
01:42:31,440 --> 01:42:35,840
Well, for people listening firstly, where can they find Transcend online?

1902
01:42:35,840 --> 01:42:41,240
Oh, they have a big, a good Instagram presence, TranscendCompany.com.

1903
01:42:41,240 --> 01:42:48,200
Um, and Transcend on Instagram, uh, they do a nice job, uh, with, uh, highlighting, uh,

1904
01:42:48,200 --> 01:42:51,720
the services that Transcend has and kind of how we function and what we do, um, on the

1905
01:42:51,720 --> 01:42:53,880
wellness specialist side and then on the medical team side.

1906
01:42:53,880 --> 01:42:57,920
You know, we have a big team of physician assistants, nurse practitioners, you know,

1907
01:42:57,920 --> 01:42:59,520
for Transcend's first point of contact.

1908
01:42:59,520 --> 01:43:03,960
Uh, they do an amazing job and then they get to talk to one of the medical providers, you

1909
01:43:03,960 --> 01:43:06,280
know, we're licensed at all 50 States.

1910
01:43:06,280 --> 01:43:09,920
And then, uh, we get a program going and get people going.

1911
01:43:09,920 --> 01:43:10,920
Brilliant.

1912
01:43:10,920 --> 01:43:12,160
And then what about you personally?

1913
01:43:12,160 --> 01:43:15,080
Were there any places on social media to find you?

1914
01:43:15,080 --> 01:43:20,640
Uh, yeah, I, uh, I am on there and Dr. Vana and I'm also on, uh, on the Transcend site

1915
01:43:20,640 --> 01:43:21,640
as well.

1916
01:43:21,640 --> 01:43:22,640
Brilliant.

1917
01:43:22,640 --> 01:43:24,040
Well, I want to thank you so much.

1918
01:43:24,040 --> 01:43:25,480
It's been such an amazing conversation.

1919
01:43:25,480 --> 01:43:28,360
We could have talked, as you said, we could have talked for hours and hours and hours.

1920
01:43:28,360 --> 01:43:31,960
I've got a thousand other questions I wanted to ask you, but I want to be mindful of your

1921
01:43:31,960 --> 01:43:32,960
time.

1922
01:43:32,960 --> 01:43:36,280
I want to thank you so, so much for being so generous with your time and coming on the

1923
01:43:36,280 --> 01:43:38,040
Behind the Shield podcast today.

1924
01:43:38,040 --> 01:43:40,160
Oh, James, thanks so much for the invitation.

1925
01:43:40,160 --> 01:43:43,240
Like I said, it's, it's, I, you can talk about passion for it and I appreciate the opportunity

1926
01:43:43,240 --> 01:44:03,640
to talk to you today.